Picks and Pans Review: As Real as It Gets: the Life of a Hospital at the Center of the Aids Epidemic
Like the 1987 landmark And the Band Played On (whose author, Randy Shilts, wrote the foreword here), this riveting account of the decade-long AIDS crisis gives the disease a human face.
While former San Francisco Examiner writer Pogash focuses her narrative on one hospital—San Francisco General—she writes only occasionally about the patients on the AIDS ward there. Instead, she profiles the doctors, nurses, volunteers and politicos embroiled in the medical, social and emotional issues that accompany the epidemic.
"The General," as the hospital is known, turns out to be the perfect backdrop for a drama about AIDS. Consistently at the medical forefront (the controversial drug Compound Q—a component of which is now in FDA tests—was developed there), the General and its staff were also instrumental in policy-making. Thanks to the perseverance of a young nurse accidentally stuck with an HIV-infected needle, national health care worker safety issues were investigated.
Pogash makes it clear that there are few pure heroes and no sure villains here; like the disease itself, the surrounding issues are too complicated. How can Dr. Michael McGrath, the developer of Compound Q, be anything less than an obvious good guy? Some AIDS activists say he kept his promising findings secret for too long. (He says he was just following established research protocol.) Is surgeon Dr. Lorraine Day—who lobbied hard, on 60 Minutes and elsewhere, for mandatory HIV testing—a crackpot worry-wart, or is she simply protecting herself and her fellow doctors from AIDS contamination?
Pogash also manages to inject some levity: Her profile of a 70-year-old, pot-smoking AIDS volunteer who delivered marijuana brownies to AIDS patients, for example, is a welcome relief. Occasionally, though, the narrative becomes confusing: Some characters get far more attention than others and you can't always keep them and their positions straight. Still, the book's title (the motto on T-shirts worn by emergency-room workers) aptly describes its contents: as real—not to mention as complicated, tenacious and disturbing—as it gets. (Birch Lane, $18.95)