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The online version of this article can be found at:

DOI: 10.1177/001789698804700227
1988 47: 104 Health Education Journal
Icebergs ahead: And the Band Played On. Randy Shilts. 8.95. Penguin

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104
allocation decisions must
only
be
made under conditions of
perfect
knowledge
about the various mar-
ginal
costs and
products
involved -
only
that more attention must be
given
to relative
productivities
in
deciding
between different course
of action.
Inevitably,
neither of the vol-
umes is immune to criticism The
IEA Health Units
essayists might
have addressed the issues
implicit
in the volumes subtitle - the
pur-
suit of
equality
in health care -
more
directly
And the introduction
to the combined Black/Health Div-
ide volume
might
have
given
more
space
to the
problems
of
darifying
those factois within material
deprivation
that are most relevant
to different forms of ill health
Nevertheless, both books
provide
stimulating reading
and will
help
ensure that this
particular
debate remams
high
on the health
agenda
NICHOLAS WELLS
Icebergs
ahead
And the Band
Played
On.
Randy
Shilts. £8.95.
Penguin.
TOO
long,
too fictional, too
per-
sonalised - these are the three
major
criticisms levelled at
Randy
Shiltss
passionate
account of the
USAs first five
years
of Aids Are
they just? Well, the book runs to
630
pages, mcludmg
an
index, but
the
style, though
sometimes awk-
ward in an American
way,
makes
for
readabihty.
As for
being
fictional
Shilts
certainly
attributes
thoughts
to
people,
and describes con-
versations at which he was not
present.
Too
personalised?
Shilts has
been
heavily
attacked for
tellmg
his
story
around one
recurring person,
a Canadian airlme steward whose
promiscuity,
and sexual
practices,
he
suggests,
contributed to the
spread
of Aids
through
the homo-
sexual half-world of bars and bath
houses.
But the
technique
is
permissible
in the context of
urgency,
and Aids
is an
urgent problem
Randy
Shilts has two aims - to
demonstrate how disinterested
officials and
111-fig11t1I7g
within the
homosexual and scientific worlds
delayed
action
against Aids,
and to
ensure that the momentum
towards humane treatment of suf-
ferers and
experiments
for a cure
continue.
It
is, indeed,
a
sorry
tale
Because of the association
between Aids and
homosexuals,
politicians
avoided it hl<e the
plague
it was soon to become The
homosexual world, with its own
politics
and
politicians,
and its
jus-
tified fears, either refused to con-
front
reality,
or
argued
that
attempts
to close down the notori-
ous bath
houses, or even to advo-
cate different sexual
practices,
were
attempts
to force them back
into the closet
Scientists, meanwhile, battled
for research funds
and,
in some
instances, battled each other for
kudos,
vulth
publication
in learned
journals
more
important
than
help
for
people
Anger
It is
impossible
to read this book
without
feehng anger,
sadness.
and admiration for the few who
stuck out their necks and risked
careers, fnendships,
and
hostility
One such was
Larry Kramer,
founder of
Gay
Mens Health Crisis
in New York, whose
bloody-mmd-
edness first
brought
the
group
mto
being,
then led to him
being
chucked out.
Kramer is the hero of And the
Band
Played
On -
prickly, opmon-
ated, outspoken, passionate
The
story
of what
happened
to Kramer
has wider
implications.
As
Shilts observes, with committees,
bureaucracy, jargon
and
euphem-
ism
blunting urgency, promoting
inactivity through
the search for
consensus,
and
leading
to a state
where
talking
to hke-mmded
people
in
mutually acceptable
language
becomes more
important
than
talking
to the world at
large
I
defy anyone
to read this book
and remain unmoved.
MICHEAL JACOB
A sweet
nothing?
Pure, White,
and
Deadly,
John
Yudkin.
Penguin.
&pound;3.95.
THIS is a revised and
expanded
edition of the book of the same title
written
by
Professor
Yudkin,
and
first
published
m 1972 In the book
Professor Yudkm descnbes the dif-
ferent
types
and sources of
sugar
in
the diet, estimates of the amount of
sugar consumed, sugar
as a
pro-
vider of
&dquo;empty calories&dquo;, and
possible
connections between
sugar
and
coronary thrombosis,
diabetes, gastro-enteroligical
problems, caries, and a number of
other disorders. He is
sceptical
about claims for a lmk between
sugar
intake and
hyperactivity
and
delinquency
He concludes
by
a
fascinating
account of
allegations
of
sugar industry suppression
of his
views on the role of
sugar
in health.
Professor Yudkins views on
sugar
have
always
been contro-
versial, but an essential
part
of the
development
of ideas is
challeng-
ing
orthodox ideas He does make
it clear in the book which are his
opinions
and
interpretations,
and
what is more
generally accepted
scientific research.
Unfortunately,
it is sometimes difficult to be
critical of statements in the book
(both
of
interpretations
and sum-
maries of
research),
because all of
the information which would be
necessary
for critical comment is
not
presented.
For the
missing
information it would be
necessary
to look
up
the scientific references
hsted at the back of the
publication
-
something
which few
people
are
likely
to do Professor Yudkin is also
quick
to
point
out some of the fal-
lacies in convential scientific
interpretation
of data,
but then
seems in a number of
places
to use
the same
approach
himself to
sup-
port
his
hypotheses
The current view
amongst
sci-
entists is that
frequency
of
sugar
intake is related to the
develop-
ment of dental
problems,
that it
may play a
role in the
development
of
obesity,
and
that,
because it
pro-
vides
many
calories and few other
nutrients,
it
may displace
other
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