This book is written in the reportage style (appropriate, as Shilts was a reporter) that results in, what I believe, is the type of non-fiction book that most people find the most entertaining and readable. In other words, real-life characters are developed, situations and dialogue are recreated, and tension is built up, despite the fact that the majority of readers know, in general, how things play out in the tragic saga of the AIDS epidemic. Shilts made no attempt to be objective. He editorializes heavily, or as some like to call it, offers up the "muckraking" style of reportage. His blunt assessments and judgmental asides are quite enjoyable most of the time. And the method gains credibility by the fact that he lambastes everyone with (almost) equal vigour.
Shilts was a gay man and lived and worked in San Francisco as a reporter for the San Francisco Chronicle. But, in And the Band Played On, he does not hesitate to go after many in the gay community for their stubborn refusal to alter their behaviour as details of how AIDS was spread came to light. As Shilts states a number of times, many gay men literally "fucked themselves to death." He also heaps hammer-blows of well-deserved criticism on owners of gay bath houses, which Shilts refers to as "biological cesspools," and provides the kind of stomach-churning details that may be too much for some readers (think Crisco and limbs disappearing up...well, you get the picture).
As a result, Shilts was vilified by many in various gay communities throughout the US. Still, I can't help but feel that in some ways, he didn't go far enough in his criticism. For example, as the book moves into the early 1980s and the first instances of blood transfusion AIDS cases surface, Shilts rightly rips the arrogant executives of the blood industry for failing to take action to properly screen donors.
Yet, Shilts indicates that, for whatever reason, gay men donate disproportionately more blood than most other demographics in the US. They apparently continued to donate heavily as questions about blood safety were raised, and Shilts even mentions a phenomenon that he claims to have existed among some gay men: that they continued to donate blood as if the very act was a way of convincing themselves that they couldn't possibly contract AIDS.
So surely the question will rise up in the minds of many readers: does the gay community, or at the very least those infected men who donated blood, not bear some culpability in the horrible deaths of the many innocent people who died as a result of tainted blood transfusions? But Shilts never really goes near this angle and instead reserves the majority of his wrath regarding tainted blood for the money-grubbing scumbags in the blood industry who were apparently more concerned about the costs of implementing new screening procedures than the possibility of heading off the impending disaster.
Similarly, while Shilts despises the rationalizations and self-serving excuse-making of many in the gay community and other politically correct enablers in society (he calls their mealy-mouthed bullshit "AIDS-speak"), at times he seems to veer into that same territory himself.
Also, Shilts cannot resist the urge felt by so many non-fiction writers and engages in some myth-making. This is with regards to an early AIDS patient named Gaetan Dugas who was labelled "patient zero" for the apparent fact that he infected so many other men through his reckless sexual activity. This notion of a patient who caused the disease to spread faster than it otherwise would have has largely been debunked.
The storyline of Dugas features quite significantly in the early part of the book, replete with apocryphal anecdotes of Dugas happily informing other gay men that he has just infected them with AIDS. Also, Shilts builds Dugas up as being attractive in some kind of otherworldly way. But a Google image search turns up photos of a relatively average-looking dolt. I believe that Shilts knew how such a narrative would appeal to so many people's sense of the sinister and so he ran with it. However, to be fair, some researchers at the time also floated this idea of "patient zero" and gave some credence to it.
Shilts and the characters in the book rail against and righteously bash various levels of government, with the federal government under Ronald Reagan coming in for the most well-deserved and complete pasting. It's hard to believe how short-sighted and petty the Republicans were and how many lives were lost (e.g., limited funds for research and nation-wide information campaigns) due to foot-dragging and sometimes outright hostility. Reagan did not utter the word “AIDS” publicly until about 1986 or 87.
The book is prescient in many ways, especially in debunking the early propaganda that heterosexuals in North America should fear AIDS in the same that homosexual men eventually did. And the Band Played On was first published way back in 1987 but Shilts already saw that kind of talk (i.e., that non-drug-using heterosexuals were at risk to the same degree as intravenous drug users and gay men) as fear-mongering and an attempt to get more people concerned about the disease and thus increase government funding. This was a number of years before the one-man North American heterosexual male epidemic hit in the form of Magic Johnson and before such shrill proclamations by the likes of Oprah Winfrey that heterosexuals in the US would be devastated by the disease in the same way that gay men had been. Of course, that has never happened.
Finally, I don't believe what Shilts says regarding those who died of AIDS; that they were heroic in the way they died. People beset by tragedy cope in any way they can because there is no other choice. Just as the word "hero" is tossed around casually in war, the reality is that, just as with millions who have already perished from AIDS, a much better description is “tragic waste.” However, I agree that people who had AIDS and spent their remaining days risking arrest during protests and did everything in their power to increase awareness and funding deserve a great deal of praise.
Despite some of the criticisms mentioned above, And the Band Played On is an informative and epic chronicling of the early years of the AIDS epidemic in the US and other parts of the world. While many people may have a general idea of how things transpired, they will undoubtedly learn a great deal about the disease and the numerous obstacles faced by scientists, activists and the people who were infected. Sadly, Shilts was diagnosed with AIDS and died in 1994. He leaves an impressive legacy with And the Band Played On.