- Hardcover: 640 pages
- Publisher: Knopf; 1 edition (November 29, 2016)
- Language: English
- ISBN-10: 0307700631
- ISBN-13: 978-0307700636
- Product Dimensions: 6.5 x 1.6 x 9.5 inches
- Shipping Weight: 2.2 pounds (View shipping rates and policies)
- Average Customer Review: 54 customer reviews
- Amazon Best Sellers Rank: #97,897 in Books (See Top 100 in Books)
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How to Survive a Plague: The Inside Story of How Citizens and Science Tamed AIDS Hardcover – Deckle Edge, November 29, 2016
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“Remarkable… I doubt any book on this subject will be able to match its access to the men and women who lived and died through the trauma and the personal testimony that, at times, feels so real to someone who witnessed it that I had to put this volume down and catch my breath… This is the first and best history of [activists’] courage.” —Andrew Sullivan, The New York Times Book Review
“My favorite book of the year is easily David France’s How to Survive a Plague, a powerful history of the HIV/AIDS crisis… This book is heartbreaking, but it is also inspiring. We owe so much to those brave activists and to Mr. France for writing this vital book.” —Anderson Cooper, The Wall Street Journal
"Masterful... Despite its grim subject, this is an inspiring book... How to Survive a Plague offers a salient reminder of what can be achieved by citizens who remain unbowed and unbroken." —The Economist
“France delivers a monumental punch in the gut; his book is as moving and involving as a Russian novel, with the added gravitas of shared memory from the not-distant past. It is both an intimate, searing memoir and a vivid, detailed history of ACT UP.” —Rick Whitaker, The Washington Post
“Riveting, galvanizing.” —Alexandra Schwartz, The New Yorker
“A truly American story… [France] turns the AIDS epidemic into a thriller, one whose heroes are mostly tragic. A powerful reminder of what happens when ideology is put before humanity.” —Newsweek, Our Favorite Books of 2016
"Riveting and comprehensive... Simultaneously intimate and sweeping... How to Survive a Plague stands as a remarkably written and highly relevant record of what angry, invested citizens can come together to achieve, and a moving and instructive testament to one community's refusal—in the face of ignorance, hatred and death—to be silenced or to give up." —Chicago Tribune
“An authoritative account of a bleak time in human history, the book spans both abject horror and radiant hope—regularly moving you to tears… When science and society come together, France’s history transforms from gutting tragedy to human triumph. And with each false breakthrough, life shattered, and new day, How to Survive a Plague lives up to its name, providing a blueprint for our continued existence.” —Paste
“Extraordinary… A sweeping social history, a bracing act of in-depth journalism, and a searingly honest memoir all at once… A chronicle of the recent past that sheds light on the fights to come… The chaotic, contentious, painful form of hope offered in this book is vital even as the fight it chronicles remains unfinished.” —Slate
“David France managed to simultaneously break my heart and rekindle my anger in just the first few pages of his breathtakingly important new book… Riveting.” —Steven Petrow, The Washington Post
“Nuanced… Substantial and elegantly written, [How to Survive a Plague] is at once a deeply reported (if New York-centric) AIDS history and an intimate memoir that makes clear the author’s stake in the story.” —Boston Globe
“Remarkable… the definitive book on AIDS activism, a long-overdue update on Randy Shilts’ 1987 And the Band Played On… It’s not easy to balance solid journalism with intimate understanding of a subject, and even harder to write eloquently about a disease that’s killing your friends and loved ones. France pulls it off.” —SF Chronicle
“Flawless. Masterfully written, impeccably researched, and full of feeling for the living and dead heroes of the AIDS movement… There can be no clearer picture of the uphill battle against ignorance and bigotry… No better person to write this book, which had to be written, creating a complete and correct record of this terrible story and its heroes.” —Newsday
“France uses the techniques of the epic 19th-century novel so well that the line between fiction and nonfiction blurs… Full of vivid, intimate detail.” —The Gay & Lesbian Review
"A moving and an enraging read." —Bookforum
"Expansive, intimate, dramatic and elegantly-penned... a gripping, engrossing read — the most essential text of its kind to date." —Dallas Voice
"Painfully vivid history... Through it all, France captures the immense fortitude of those who continued to fight AIDS when it seemed unbeatable and while they were mourning the many lives lost around them." —The National Book Review
"Masterful... [France] knows how to tell a story." —EDGE Boston
"Powerful... This superbly written chronicle will stand as a towering work in its field, the best book on the pre-treatment years of the epidemic since Randy Shilts’s And The Band Played On… Most of the people to whom it bears witness are not around to read it, but millions are alive today thanks to their efforts, and this moving record will ensure their legacy does not die with them." —Sunday Times
"[A] subtle and searing history of this late-20th century plague and those who survived it… [The] great advantage France has is that… he was an eyewitness to many of the key moments during the spread of the disease and… shared in activists’ pain and suffering." —The Observer
"How an impossibly brave and unlikely coalition of gay activists, doctors, scientists and public health officials finally succeeded in putting the brakes on this global catastrophe is the subject of [this] important and powerfully written new book... How to Survive a Plague stands on its own as a… richly nuanced telling of a chain of events that forever changed medicine... Inspiring, uplifting and necessary reading." —Financial Times
"As important as Randy Shilts's And the Band Played On was in 1987, France's work is a must-read for a new generation of empowered patients, informed medical practitioners, and challenged caregivers—lest history repeat itself." —Publishers Weekly, starred review
“Prepare to have your heart buoyed and broken in this riveting account… In unflinching, brutally honest detail, France traces the lives of the people behind the constellations of aid and advocacy movements and presents their struggles in a way that will have readers stirred by each diagnosis, cheering the efforts to find a cure, and growing frustrated at the political establishments that ignored the terrible tragedy as it unfolded… This highly engaging account is a must-read for anyone interested in epidemiology, civil rights, gay rights, public health, and American history.” —Library Journal, starred review
“David France brilliantly chronicles AIDS in America during the 1980s and 1990s… Powerful… American history, memoir, public health, and a call-to-action are perfectly and passionately blended here. Spectacular and soulful.” —Booklist, starred review
“A lucid, urgent updating of Randy Shilts’ And the Band Played On (1987) and a fine work of social history.” —Kirkus
“Heroic and heartbreaking and magnificent history throughout, How to Survive a Plague is one of the great tales of our time: the story of incredibly brave and determined men and women who defied government, the pharmaceutical industry, vicious homophobia, and the death sentence of AIDS to overwhelm an awful scourge. These gay activists—refusing to die without a fight—were vital in staunching the epidemic. Their resistance and cunning will remain as seminal to medical history and humanity as the efforts of Pasteur and Salk.” —Carl Bernstein
“As one generation grows up with the misconception that AIDS is nothing more than a manageable illness, another grows old with the fear that the epidemic’s early days will disappear into the fog of history. How to Survive a Plague is the book for both generations. France invokes the terror and confusion of those dark times while simultaneously providing a clear-eyed timeline of the epidemic’s emergence and the disparate, often dissonant forces that emerged to fight it.” —Dale Peck
“David France is uniquely positioned to bear witness to the science and politics of the AIDS epidemic, its deeply personal impact, and the activists who refused to be silenced by it: courageous and brilliant, often selfless, willing to fight even as they struggle with death, but always fully human. From the story’s beginning, France was on the ground doing hard-hitting reporting on the plague while living its toll in the most intimate of ways. How to Survive a Plague is a definitive, long-awaited and essential account of the plague years—haunting and hopeful, devastating and uplifting. Incredibly important.” —Rebecca Skloot
“How to Survive a Plague is both a great and an important book, and we owe David France an enormous debt of gratitude for writing it. At once global and achingly intimate, his story provokes righteous rage, despair, the blackest of humor, heartbreak and, finally, blessedly, hard-won hope... for all of us. You will not soon forget these smart, courageous, dying young men. In fact, let’s call them heroes, since they were.” —Richard Russo
“How to Survive a Plague is epoch-making: the whole social and scientific history of AIDS, brilliantly told. Informative and entertaining, suspenseful, moving, and personal.” —Edmund White, author of Our Young Man
“This is a masterpiece of intimate storytelling with moral purpose, a contemplation not so only of an epidemic of illness but also of an epidemic of resilience. It’s a book about courage and kindness and anger and joy, written with fierce, passionate intensity and utter conviction.” —Andrew Solomon, author of Far From the Tree: Parents, Children and the Search for Identity
About the Author
DAVID FRANCE is the author of Our Fathers, a book about the Catholic sexual abuse scandal, which Showtime adapted into a film. He coauthored The Confession with former New Jersey governor Jim McGreevey. He is a contributing editor for New York and has written as well for The New York Times. His documentary film How to Survive a Plague was an Oscar finalist, won a Directors Guild Award and a Peabody Award, and was nominated for two Emmys, among other accolades.
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I bought a copy of the documentary of the same name last year and was deeply moved. There is a visceral difference between reading about Peter Staley scaling the entrance to buildings at the FDA and the NIH and seeing a video taken of the event. I watched the dvd again after finishing the book and felt devastated all over again. Reading the book had deepened my understanding of what happened and my love for the people involved, and seeing them on film, so many of whom died, broke my heart. It's worth having your heart broken to read this book.
The book was mostly focused on what happened in NYC and Act-up (Vs. SF based.) What ACT UP! did was truly astounding. They changed the way drug trials were done, the speed of them, how people were found for them, got companies to do parallel studies without placebos for those who didn't meet the stiff criteria of official studies, and most importantly, broke down the secretive doors of pharmaceutical companies and got them to involve People with AIDS in all sort of ways, to the benefit of the companies and the people who needed the drugs.
It's hard to believe what it was like back then PWA's when it was basically a death sentence for everyone.... Hard to fathom what they went through-the utter despair when dozens and dozens of friends and lovers would die a year. And the way gay people were treated and discriminated against-it is so unbelievable. And the horrible way Reagan and the Republicans (and to a large extent, Democrats too) in congress ignore AIDS for 9 years because they disliked gayness and thought that AIDS was god's retribution.
It was an enthralling and horrifying book. Very well researched, a little slow in the beginning but it really gets interesting about 1/3 of the way through.
For me, that documentary remains, even since this book, uniquely incredible and a hard act to follow. It is a brilliantly compelling and moving account, with a lot of archival footage, of the ACT UP (AIDS Coalition to Unleash Power) movement composed of mostly AIDS sufferers from its March 1987 founding. By that point, tens of thousands of mostly homosexual men in the U.S. had already died horrible deaths, everyone infected was doomed to the same fate, and there was no effective cure or treatment in sight.
But ACT UP’s highly publicized civil disobedience actions at the White House gates, the National Institutes of Health and elsewhere and its success in gaining inclusion on official boards evaluating experimental treatment options, is widely credited, including by the nation’s foremost public health official Dr. Anthony Fauci, with playing a critical and indispensable role the discovery of an effective treatment by 1996.
In late 1996 when, having been an early post-Stonewall gay activist myself, I learned that Time magazine had named Dr. David Ho, a long-time AIDS researcher, its ‘Person of the Year,’ I breathed a deeper sigh of relief than for any time in the previous 15 years. It was an affirmation that, indeed, a life-saving treatment for the hideous AIDS had been found. Dr. Ho is not even mentioned in France’s documentary or book because to France’s mind, and undoubtedly in reality, it was the ACT UP activists and the researchers willing to work with and learn from them who finally came up with the right combination of protease inhibitor treatments that produced an immediately efficacious and enduring life-saving treatment.
From France’s work it is shown how without the input of a faction of ACT UP that formed itself as the Treatment Action Group (TAG) to work on technical research issues the existing efforts whether by the National Institutes of Health or private pharmaceutical companies were fragmented and out of touch with one another.
Despite annual world conferences on AIDS research, “there was no global strategy,” so TAG members had to devise a “National AIDS Treatment Agenda” to put the disparate research efforts into one comprehensive strategy.
It was in 1995, after the first discovery of the “protease inhibitor” that an “activist- proposed drug design” combining therapies was introduced, and almost immediately began to work wonders. Within 30 days, very ill patients became symptom free, Fauci said, calling it “a Lazarus effect.”
The treatment was provided to hundreds of thousands of AIDS patients in the U.S. and then overseas, especially in Africa, and began saving literally millions of lives.
As with his film documentary, France does an excellent job of telling the story in his book, including with some key information the documentary didn’t include, such as exactly how ACT UP came to be formed in 1987. Earlier activist split offs from existing gay organizations, like the Lavender Hill Mob and the Swift and Terrible Retribution Committee, had begun “zaps,” spontaneous street theater and office takeover demonstrations, following a solemn but massive, 200,000-strong June 1986 Gay Pride parade that was greeted with newspaper headlines reporting that a Supreme Court decision had ruled 5-4 to uphold a Georgia gay sex ban.
That December, an anonymous effort pasted lower Manhattan with three thousand black posters with an inverted pink triangle and the words “Silence = Death.”
Larry Kramer, having been on a hiatus after the highly-successful production of his hard-hitting AIDS-themed play, “The Normal Heart,” decided it was time to spark something new.
Ah yes, Larry Kramer! This man had enraged the official gay community in 1978 with the publication of his best selling novel, Faggots, because it exposed the depths of sexual promiscuity and depravity that much of the New York and other urban gay scenes had descended to by then. He was subjected to a massive display of denial and angry insistence on keeping such “secrets” away from the outside world. The leadership, such as it was, of the so-called gay movement then was composed mostly of gay sex club, bathhouse and bar owners, many with ties to the Mob, in an alliance with the sex-addicted often-nightly patrons of their establishments insisting that gay liberation was synonymous with massive amounts of anonymous sex.
Kramer was like an Old Testament prophet sounding an alarm. Many never forgave him from that time forward, but the evidence is clear from the wider corpus of his work that he was motivated not out of hate, anger or personal repression, but out of a deep love and compassion for gay people. (It is relevant that science learned just this year that the HIV virus that causes AIDS was present in the blood of many gay men collected in the early 1970s, at the time the “sexual revolution” first broke out. The HIV did not enter the picture in the mid-1970s, as previously thought, by introduction to the U.S. probably from Africa. It had been here much earlier, and sexually-active gay men were playing Russian roulette since 1970 not only with all the other STDs of the day, but unbeknownst to them, also a virus that would wind up killing at least 600,000 of them.)
This was shown when the first public reports of a gay “cancer” was first reported in July 1981. It was Kramer to leaped into action to organize a grass roots political response, the formation of the Gay Men’s Health Crisis. But in a subculture swimming with petty jealousies and fear, Kramer’s insistence on strident action was too much, and he became marginalized.
Still, that only led to his authorship and production of a quasi-autobiographical “The Normal Heart,” the powerful play that exposed the plight of sick and dying gay men, and a pathetic lack of government response, to a much wider audience.
Then, in 1987, when the effort against AIDS was going absolutely nowhere, it was Kramer, again, who provided the spark for the formation of ACT UP that ultimately got the gay community activated to get the results it needed.
Due to a last-minute cancellation, Kramer got to fill the program for the March 1987 meeting of a monthly speaker series at the Gay and Lesbian Community Center. This was the opportunity he needed, and he didn’t miss it. He organized an array of activists to show up. “I’m going to try to organize a civil disobedience group,” Kramer said to a friend, as France quoted him. “I’m putting friends in the audience as plants. When I call for people to help me organize a demonstration, I need you to stand up and join in and rabble rouse.”
Some 250 gay men showed up. As France wrote, “Kramer’s savage oratory power, honed over his years of screed writing, swelled as he read his prepared remarks. ‘If my speech tonight doesn’t scare the s*** out of you, we’re in trouble,’ he told them. ‘I sometimes think we have a death wish. I think we must want to die. I have never been able to understand why we have sat back and let ourselves literally be knocked off man by man without fighting back. I have heard of denial, but this is more than denial – it is a death wish!”
France wrote that the presentation morphed the group into a “Capraesque town hall meeting” full of energy and animated talk. He wrote, “The fuse caught fire…Kramer’s strategy had worked. Something brand new was afoot.”
Still, people accused Kramer of wanting to become famous for this effort. It is a sad thing, but a reality that people who can only think in terms of such things, or in terms of hate or vengefulness, can only assign similar motives to others.
To an observer like me, it is clear that everything Kramer did, including his stridency, was done more out of love than anything else. The world still won’t acknowledge that, in the context of how bad the AIDS plague was, he was right from the start and almost all the others were wrong.
France is ambiguous about Kramer in his book. On the one hand, he wrote in his introduction, “No individual was more responsible for galvanizing the AIDS movement than Kramer. His plays, books and essays over the years pushed the gay community to demand that the world take notice.”
But in another place he claimed that Kramer did almost more harm than good, although not with the viciousness of gay blogger Andrew Sullivan in his review of France’s book in the New York Times Book Review of Nov. 27. Sullivan wrote, “There was the despised Larry Kramer, fresh off excoriating gay men’s sex lives in his novel, Faggots, who bravely confronted the core problem of transmission, but who also displayed a personal viciousness that derailed the movement as much as galvanized it.”
In his book, France underscored his ambiguity about Kramer by quoting a gay leader who wrote a highly critical letter to Kramer, saying, “You should beg the forgiveness of every gay man who you have caused pain,” but then credited Kramer “with raising the visibility of the epidemic like no one else by working to become, ‘like Goethe, the personification of an era much linked with sadness and death.’”
The most serious shortcoming of France’s work is in his effort at applying pop psychology to Kramer and others in the struggle, saying Kramer owed his stridency to a “stern father,” and his tendency “to see the world as a battle between aloof parent figures and rejected children.”
How about the fact that an entire generation of gay men were being wiped out by the most heinous of incurable diseases being his motivator? The pop psychology is just so much BS and really a terrible take-down of Kramer’s motives.
There is a valid point to the charge of “tone policing” that feminists are increasingly talk about. It is a silencing tactic that protects privilege and silences people who are hurting, often targeting women. (In Keith Bybee’s book, How Civility Works, he notes that feminists, Black Lives Matter protesters, and anti-war protesters have been told to “calm down and try to be more polite.” He argues that tone policing is a means to deflect attention from injustice and relocate the problem in the style of the complaint, rather than to address the complaint.”) Kramer continues to be a huge target of this kind of “tone policing.”
Surely, the heroic role of many in the ACT UP struggle cannot be ignored, the work of Peter Staley, Bob Rafsky, Mike Harrington, Greg Consalves, Spencer Cox, Jim Eigo, Ann Northrup, Iris Long, David Barr, Derek Link, Gregg Bordowitz, Bill Bahlman, and of course, their predecessors like Joe Sonnabend, Michael Callen, Richard Berkowitz, Mathilda Krim and many others.
Something that France’s book does not include is the added level of pain above the medical and physical pain of AIDS victims, worst of all being the brutal and complete rejection of young AIDS victims by their own parents and families throughout that period.
France tells the stories of a couple AIDS victims who were being cared for by their parents as they expired. But there were many, many more cases of total rejection of AIDS victims by their own parents, and left to die with an emptiness in their hearts even more painful than their physical illness.
Even today, the rejection of young gay men and women by their families is heartbreaking, with an estimated full 25 percent of homeless persons being young gays.
The story of ACT UP is not so much about glorified heroism as about a resolve to live. Staley said when he and others were about to toss the ashes of loved ones over the White House fence in 1992 that, “Some are making something beautiful out of the epidemic, but there’s nothing beautiful about a box of ashes and bone chips. There’s no beauty in that.”
When France wrote of the real breakthrough being found in 1996, he confessed, “It had been many years since I had cried – maybe I hadn’t shed a tear since Doug’s memorial service – but now tears rolled down my cheeks. When I caught my breath again, it came in sobs. Was it over? Was the long nightmare passed?”
“Tears filled Spencer Cox’s eyes,” he wrote. “’We did it,’ he whispered to the person sitting beside him. ‘We did it. We’re going to live.’” I knew the feeling, as every gay man in the nation must have that day.
Final point, I suggest that France’s work be examined from the standpoint of what he doesn’t say about how a new plague might be avoided.