NetNews Usenet Archive 1992 #31/NN_1992_31.iso/spool/sci/med/aids/2180

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From: Billi Goldberg <[e-mail]>
Subject: As Real As It Gets:Review
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Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
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The following article was printed in the San Francisco Sentinel on
Thursday, December 31, 1992. It is being posted with the permission of
the author, Charles R. Caulfield.
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Book Review: "As Real As It Gets"
Carol Pogash. Birch Lane Press. 1992
249 pages.  $18.95

Reviewed by Charles R. Caulfield

    If the ravages of the AIDS epidemic could be viewed as concentric
circles, "As Real As It Gets" would be like looking at the epicenter with
a magnifying glass. The book, which is subtitled, The Life of a Hospital
at the Center of the AIDS Epidemic, is a penetrating look into the
effects of the epidemic on the operations of San Francisco General
Hospital.

    With its foreword written by Randy Shilts, the author of "And The
Band Played On," the book takes a much more humanistic and perhaps less
histrionic view of the effects of this disease on the lives of those
infected by it and otherwise affected by it than did the historic work
of her mentor.

    The book, which reads like a thriller, would make great copy even if
the story were a work of fiction. Unfortunately, it is not.  It is an
inside view of the institutional turbulence generated by the onset of
this new disease on the hospital, showing the bureaucratic struggles
inevitable in coping with such a challenging course of events. But it
also highlighted the courage, the innovation and the humanness of the
health care professionals who devoted themselves to caring for those
afflicted with the strange new disease.

    So many years after the beginning of the epidemic, it seems easy to
forget that there was a time where health care professionals had no way
of knowing if they were at risk of infection by simply breathing the
same air as patients with AIDS. She documents the dedication of the
professional caregivers who put themselves at potential risk, setting
aside their fears in order to tend to their charges.

    Central to the story is the controversy surrounding Dr. Lorraine
Day, an orthopedic surgeon who advocated the right of physicians to know
the HIV status of prospective surgical patients, and to retain the
option of refusal of care. Day made the talk show circuit fanning flames
of fear as to the transmissibility of the AIDS virus.

    Another central theme is that of Jane Doe, a staff nurse who, while
infected by a needle stick with infected blood, fought with the
assistance of her peers to retain her anonymity while receiving the
disability benefits she was entitled to.

    Pogash deftly explores the quandary of physician researchers, who
having in hand potentially promising therapies, must move through the
sluggish channels of bureaucratic red tape, while watching potential
beneficiaries of their research die agonizing deaths. This was
epitomized by the dilemma of Dr. Mike McGrath with Compound Q.

    While the book explores the development of what was to become the
model of clinical care for AIDS patients, the most compelling facet of
this work is its frank look at the humanity involved in an intractably
bad situation, and how the human spirit in many unacknowledged ways rose
to surmount it. Few, if any other works have captured a slice of the
AIDS epidemic as this work has.