While painstakingly factual, Dominique Lapierre's new history of the AIDS epidemic is actually fictional in its approach--a gripping adventure story that succeeds by virtue of its skillful manipulation of plot, suspense and character.
Far from being a straightforward chronology of red-letter dates in the spread of the disease, it is an eminently readable pastiche of literary genres: of the detective story, in its engaging portrayal of scientific sleuths stalking the biological culprit, hot on the trail of new clues; of the spy story, in its riveting account of international espionage, with medical pioneers such as Robert Gallo and his French counterpart, Luc Montagnier, swept up in a James Bond thriller as they snipe at each other across the Atlantic, each claiming to have discovered the virus; of the Harlequin romance, in its purplish descriptions of love blossoming in laboratories, of eyes locking over Bunsen burners and Petri dishes; and even of hagiography, in its moving profiles of Mother Teresa and the armies of courageous health-care providers who have withstood the harrowing challenges of AIDS.
As he takes us from "the enigma in room 516" (the macabre epithet for one of the first victims of the disease, treated in the UCLA hospital) all the way up to the controversial placebo-blind studies of AZT, Lapierre lays it on thick with a variety of fictional techniques: internal monologues, lush evocations of the mise en scene, even short, alternating chapters that break off with heart-stopping cliffhangers like installments in a 19th-Century soap opera.
The merits of this novelistic approach are that they make Lapierre's humane overview of the epidemic accessible to the popular audience. His use of storytelling devices captures the interest of even uninformed readers with lively information about everything from the first articles in Morbidity and Mortality Weekly Reports in 1981 describing the early casualties in the two cradles of the disease, Los Angeles and New York, to the infected tissue samples from the autopsy of a gay man that a doctor from the Centers for Disease Control was forced to store in her home freezer between two tubs of strawberry ice cream intended for her children.
Full of humorous accounts of things such as the 100 pounds of herring sperm that went into the first batch of AZT, "Beyond Love" contains useful summaries of scientific advances, along with sympathetic portraits of shadowy players in medical politics at the FDA and the CDC, as well as at the major pharmaceutical companies (officials too often characterized as dastardly profiteers and cutthroat careerists hell-bent on mopping up fortunes by exploiting the tragedies of others).
And yet the disadvantages of Lapierre's attempts to usher us into the presence of the epidemic by conjuring it up for us, pitching us into the thick of its harsh realities, ultimately outweigh the advantages of this narrative approach. When a catastrophe as sensational and politically charged as this one is presented to us more or less in the guise of pulp fiction, with a cast of glamorous, self-sacrificing heroes in the title roles who dodge in and out of interweaving plot lines, we respond to AIDS not as an enormous medical crisis but as if it were a novel, a lively spectacle, almost a titillating form of theater.
The very techniques that Lapierre intended to bring us closer to the epidemic in fact keep us safely outside of the proscenium arch in an audience that obediently reads the cue cards, claps for the good guys, boos the bad, weeps at the sad parts, and laughs at the happy. Nothing makes this epidemic more an affliction of the "other," of exotic, depraved strangers well beyond one's own range of experience, than the distancing effect of many writers' efforts to novelize the disease by inadvertently turning their readers into gaping tourists in a fictitious, reassuringly make-believe world where, nestled in literary conventions, they are allowed to witness a tragedy in which they are always the spectators, never the participants.
Even more disturbing than the way this tidy melodrama is padded with noble sentiments that cushion our responses to AIDS is the fact that, with one or two exceptions, the story is told almost exclusively from the vantage point of the unaffected heroes rather than the victims. Lapierre gives detailed biographies of dedicated immunologists such as Michael Gottlieb, who was farsighted enough to grasp the full implications of the earliest clusters of AIDS victims; of general practitioners like Joel Weisman, who treated AIDS patients virtually from the beginning; even of Ananda Chowdhury, a character straight out of "Oliver Twist," an Indian teen-ager booted out of her house by her family only to be abducted by a nefarious child-prostitution ring and then finally, after wandering as a leper through a proverbial vale of tears, recruited by Mother Teresa as a nurse for an AIDS hospice in Manhattan.