Dan Sandman

27: Strong Shadows by Abigail Zuger

In Books, Non-Fiction on 04/07/2014 at 12:00 pm

Strong Shadows by Abigail ZugerAbigail Zuger, M.D. works in a New York AIDS clinic during the early 1990’s and treats the terminally ill. She writes about eight of her patients, each patient is unable to afford private healthcare. Unlike, for example, the United Kingdom, the United States is a wealthy nation resistant to public health care. Whereas the National Health Service was founded in 1948 to offer free healthcare for all UK citizens, at the time this book was written, American people on low incomes were reliant on a bureaucratic system called Medicaid. This is the context for Dr. Zuger’s book, which gives voice to those on low incomes, living with the HIV virus during an epidemic.

There is Deborah Sweet, shouting at her doctor and demanding more drugs. Shannon Gallagher, fraudulently seeking help from the medical care system to fill an emotional void. The stoic Eddie Rios, looking after his wife whilst keeping his kids out of foster homes. A whole family by the name of Wilson, all dying from HIV related illnesses. And another four tragically upsetting cases of people being attacked by the virus. All the action takes place over a three year period, in an underfunded infectious disease clinic, on Wednesday afternoons.

These eight Scenes from an Inner City AIDS Clinic – as the book is subtitled – are elegantly crafted case studies written from a doctor’s point of view. They show that many heterosexual people from poor communities were dying of AIDS related illnesses in the early 1990’s. Today there has been a steep decline of such cases in New York, but the HIV virus remains prevalent throughout the world. At the end of 2012, 35.3 million people were living with HIV, this figure is significantly higher than in 1991 when an estimated 9 to 11 million people were infected. Although important medical advances have helped, clearly we still have a long way to go.

Often, Dr. Zuger treats her patients with a drug called AZT which became available in 1987. From 1992, combination drug therapies for HIV were introduced, which lead – when combined with early diagnosis and later a drug called saquinavir (1995) – to a steep decline in AIDS, at least in the developed world. These positive developments have improved our ability to treat HIV patients. During the epidemic, the treatments were still in the experimental stage. This book is as much a testament to these early trials as it is to the bravery of those who first suffered from the virus. It is written with the eye of a good short story writer and the medical insight of a doctor.

An interesting book, listed under non-fiction / health.

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  1. Ooo, And the Band Played On is next on my to-read list. Somehow I suspect this book would be a good companion read. Thank you for the review!

    • Great, and thanks for pointing me in the direction of another book on the topic. It certainly is an important subject, and one that is worth researching. You’re welcome!

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