How Did AIDS Spread So Fast?

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Power, Prejudice, and the Almighty Dollar: The Affects of Fundamental Social Problems in "And the Band Played On"

"Why? Why all this happen? You doctor. Why you don't know?"

--A dying youth to Doctor Francis during an outbreak of Ebola in Zaire

"Let me ask you this. When doctors start acting like businessmen, who can the people turn to for doctors?"

--Member of the FDA Executive Committee

When a person gets sick, he goes to the doctor, right? This is a fundamental, underlying norm in our society. A sick person visits the hospital and expects a cure, or at least treatment. In our society, we hold the doctor in high esteem, and expect him to perform his duties--when our bodies begin to fail, he is supposed to fix it. But in the mid-1980's, the scientific world was turned upside-down by an elusive and deadly disease. Doctors were no longer able to do their jobs, because they couldn't help the victims of a rapidly-spreading plague; they could no longer fulfill their role in our society, and this caused a great panic. Around the world, scientists focused their efforts on isolating the virus without the proper tools or cooperation from their peers. Finally, French scientists were able to name and replicate the virus, only to have their work stolen by an American scientist named Bob Gallo. After years of research and 25,000 thousand dead victims, President Reagan finally used the word "AIDS" in public; the epidemic was recognized by the world, and money was finally poured into finding a cure. What caused this scientific fiasco? Why were there so many people infected who could have been spared? Through a sociological analysis of the whole process, we soon discover that the AIDS crisis was impacted and exacerbated both on the macro- and micro- levels. In the film "And the Band Played On," fundamental problems in our society are exposed and their effects are shown during the AIDS crisis of the mid-1980's.

Just like the film, "Karl Marx: Politics of Revolting Bodies," "And the Band Played On" focuses around the issues of power and the body. The great sociologist Michel Foucault, himself a victim of AIDS, stated that our bodies are not our own, and this movie reflects that. AIDS victims are subject to numerous tests, probes, exams, and samples--they are turned from human beings to human guinea pigs. As will be discussed later on, the blood industry, bath houses, and other institutions view the victims not as humans, but as machines through which profits can be manufactured. Because of their sexual preference, gays are isolated and shunned by their society, called "freaks" and "sinners." Throughout the movie, the director portrays these criss-crossing lines of power that intersect around and push the individual in varying directions. The problems arise when these lines begin to collide and conflict as realms of influence overlap.

One region of overlap occurs with the interaction of organizations. These organizations, both political and scientific, played a pivotal role in the discovery of AIDS. The World Health Organization, Food and Drug Administration, Congress, National Cancer Institute, Red Cross, and more all interact over the course of the movie. Structural functionalists would say that these organizations are crucial elements of our society--in their interactions, they help to stabilize and steady it. However, it quickly becomes apparent that the organizations conflict with each other far more than they benefit society. By far, the most important organization is the Centers for Disease Control; ironically, and unfortunately, this is also the most unstable and unfunded organization of them all. Though it is structured hierarchically, it certainly doesn't fit Max Weber's ideal type for a hierarchy. One way to show this discrepancy is through showing two things an ideal hierarchy requires, and why they fail in this case.

Impersonality--In order for a hierarchy to work, there must be an emotional separation between its members. This trait is not possible in the CDC. Throughout the movie, we see friendships between the doctors on the staff and their boss, culminating in numerous insults and confrontations when there is a lack of progress. The close working quarters, combined with the intensity and difficulty of the CDC's task, cause these explosions. One example is this exchange:

Doctor Francis (the main character): "You know, sometimes I wonder how you can wade through so much bureaucratic bullshit and never get any on you." Jim (Director of the CDC): "Insult me all you want, but insult me directly. Don't disguise it in the form of a compliment."

Expertise--Weber believed that, as one's position rises, so should his knowledge and overall grasp of the subject. The fact is, in any government organization, advancement requires political skill, not technical knowledge. Take, for example, the Surgeon General, the nation's chief doctor. How much research does he do? None. Is he considered the foremost authority on, say, cancer? Of course not. He is chosen for the political advantages and his speech-giving ability, not his medical expertise. A better question to ask would be if the person selected to be the Surgeon General has ever been the best candidate for the job. This same effect can be seen in government organizations like the FDA, where often the doctors are really business people with illusions of political grandeur. In "And the Band Played On," these men seem oblivious to the epidemic around them, and instead view money as the deciding factor in all their decisions. Also, an organization like the CDC must contend with the political and social situation it operates under--the environment affects, and sometimes controls, the organization's actions. Though the CDC has incredible amounts of influence and power in the scientific world, it's influence on society--it's authority to take action based on its findings--is insignificant. The medical community is completely isolated from the rest of society, and this separation is seen through the conflicts with the law and political structure. This whole issue of who has the authority to act is witnessed in this scene in the CDC conference room where AIDS is directly linked to sexual contact between gay men:

Francis: "How many of these 'connections' were made in bath houses?" Darrow: "Most of them." Francis: "Well, we know what we have to do. We have to close the bath houses." Jim: "The federal government doesn't have the authority to do that. . . . Something like this has to go upstairs first, and, based on what they recommend, we can act." Francis: "Are you saying that the public might not even be told what we just found out?" [Later in the movie] The Director of Public Health: "I don't have the power to shut down the bath houses. . . . This is San Francisco, where 'bath house' isn't just a word, but a symbol of sexual freedom."

Furthermore, upon the first report of AIDS in gay men, Jim strikes out the word "Homosexual" from the title. After Mary protests this change, Jim says sadly, "Mary, do you want to see this published so people can read it, or do you want to see it killed?" The problems continue, even when the virus is nearly identified. The FDA refuses to take action, saying that there isn't enough evidence to force the blood industry to test its blood. Doctor Francis, in a fit of rage, shouts,

"How many people have to die before you take action? A hundred? A thousand? Tell us so we don't bother you with our insignificant body count . . . When a house is on fire, you don't stop and wait for 'scientific proof,' you grab the first hose and start putting out the the fire!"

Finally, the re-election of President Ronald Reagan is a devastating blow to the CDC's efforts. Money is re-directed from public health to the Defense Department and the Star Wars program. Bill, the leader of the gay community, comments:

"This report says that 26 million dollars is being spent on AIDS research. Fifteen of that is spent finding a cure for the common cold. Since both involve the breaking down of the immune system, this is considered 'AIDS research.' In truth, only 750,000 dollars are really being spent on AIDS research."

Without money, no research can be done--in fact, for most of the movie, the CDC lacks an electron microscope, a tool that is vital to any form of sub-cellular inquiry. Thus, the political and social influences hampered the CDC during its research into AIDS, causing a lack of public information and numerous unnecessary deaths.

Foucault focused on the use of power in society. Due to societal influences, the CDC lacked any power or control over other agencies, despite the rising number of AIDS-related deaths. When Doctor Jaffey goes to inspect the bath houses, the following scene occurs:

Jaffey: "There may be some kind of epidemic spreading among the gay community. I'd just like to come in and have a look around." Eddie (owner): "I'm sorry, that's impossible. We have to protect the confidentiality of our clients." Marsha: "Cut the bullshit, Eddie. There's practically nobody here." Eddie: "Ok. But only for you, Marsha."

Even when the CDC believes it has found a link between AIDS and the blood stream, Doctor Darrow is prevented from testing any of the hospital's stored blood samples. In the following scene, the issue of confidentiality is once again raised:

Darrow: "Are you saying that the New York Blood Center won't give me a list of the donors? The CDC is convinced that this patient could not have gotten the disease from any other source except a blood transfusion." Director: "The legal protection of donor confidentiality prevents us--" Bob: "One of those donors has disease that's gonna kill the man who got blood from you to save his life. And if we don't find the donor before he donates more blood and kills more people--" Director: "Unless there is irrefutable scientific evidence that the alleged disease does in fact exist, that it can be blood borne, and is proven to be transfusion transmissible, there is nothing I can do."

In these situations--Foucault called them "micropowers"--the CDC loses the fight to continue its research to powerful organizations--the bath houses, blood banks, etc. The underlying motivation of these organizations, as will be discussed later, is money, and, as a result, the public is put at risk.

As much as this society prides itself on its acceptance of minorities, we see that prejudice is alive and well in this movie. Numerous times, AIDS is referred to as the "gay plague," producing a stigma that separates gays from "normal" people. Ministers are shown on television preaching that gays are now suffering for their sins. But this prejudice is exhibited in more subtle fashion. The lack of funding for AIDS research by the Reagan administration is one way, but there are countless others. The "gay cancer" is ignored by the straight community and down-played by the gay community. The media doesn't publish anything about the issue until Haitians and newborns become infected, and gays recognize this:

Bill (speaking to an empty press conference room): "Our proposed amendment doesn't even ask for the basic rights most Americans are given. All we want is recognition that we are human." Bill (later): "The only ones interested in gay men dying are gay men and the ones who wish they'd all die."

As the story continues, nurses quit instead of helping AIDS victims. When a gay man is involved in a car crash, police call the hazardous materials team. For a year, AIDS is referred to as GRID, or "Gay Related Immuno-Deficiency." As a result, not only do gay men die at an alarming rate from an unknown disease, but those who live are forced into a stigmatized, subservient role by their society.

Moreover, the "experts," both here and in France, have tremendous difficulty in their search as a result of the stigma around sex and AIDS victims. One of these difficulties is ignorance, as shown in the following scene:

Darrow: "I'm sorry, we have to ask personal questions about [the patient's] sexual history. Has he ever had sexual contact with another man?" Woman: "I don't understand the question. I mean, he's a man. How can a man have sex with another man?"

Secondly, just as the CDC had to conform to its society in order to receive funding and cooperation, so do the hospitals in France. Doctor Rozenbaum, perhaps the scientist most responsible for the discovering of AIDS, encounters this problem in the following scene:

Director of the Hospital: "This is very embarrassing. We're both humane, yes? But people refer to us as, 'That place where those people go.'" Dr. Rozenbaum: "I don't advertise. Doctors send them because I reported it first." Director: "Some of our 'normal' patients are afraid to come here. That puts us in a very difficult position, do you understand? Can I assume this is the end of the matter?" Dr. Rozenbaum: "No, it's the end of the discussion. The end of the matter is that I'll find another hospital."

Third, the researchers have to deal with their own biases. Bob Gallo, the scientist who discovered the first human retro-virus, is devoted to proving that the AIDS virus falls under his family of viruses. His desire to classify AIDS as a human retro-virus blinds him to the increasing evidence against that prospect. Another victim of this self-serving bias is Doctor Francis, as evidenced by the following scene:

Francis: "Isn't it likely, Max, that what we're looking for is some kind of new virus, like the retro-virus that causes feline leukemia and Hepatitis B?" Max: "Possible. It's also possible that since your two fields of expertise are feline leukemia and Hepatitis B, what seems like a scientific 'Eureka' might only be a case of wishful thinking?"

Further, because of the sexual nature of AIDS, it is difficult to ask questions of the patients. One of the key conflicts of the story is over a prominent man who died of AIDS--though he was probably gay, his family is resolute in maintaining his reputation and integrity. Finally, after an exhaustive search, the CDC investigators find the doctor who treated him for AIDS. Obviously, in a situation where suspected AIDS victims must reveal all of their personal information; must give urine, blood, and semen samples; and in a culture that repulses and reviles its sick, one can understand why victims are so wary of seeking medical treatment.

Perhaps the most depressing of the developments in "And the Band Played On" is the controversy and conflict over the discovery of AIDS. Bob Gallo, head of the National Cancer Institute, is portrayed as a true villain--his quest for the Nobel Prize is unrelenting, and, once again, the public suffers as a result. He starts with positive motives--he supplies the CDC with crucial medical supplies so that they can continue their research. But when the French discover the virus first, Gallo goes ballistic. First, he demands to know what happened:

Gallo: "Don Francis from the CDC sent the French samples? The French?" Scientist: "Are you upset?" Gallo: "Upset? No. What I don't understand is how someone from my own side--someone from the US . . . " (Slams down phone.)

Next, he cuts off the flow of medical supplies to the CDC, and refuses them any other aid. A glimpse of his motives can be seen in the following phone call:

Gallo: "You sent blind samples to the French." Doctor Francis: "What makes you think they didn't discover the virus?" Gallo: "What makes you think I care?" Doctor Francis: "I don't understand the purpose of this call." Gallo: "That's the purpose of this call."

Gallo publishes the findings under his own name, and, as a result of this plagiarism, the case nearly goes to court. If this had happened, the whole process would have been tied up for years in the legal system. Thankfully, the crisis is averted when the two sides sit down and compromise. But several critical weeks have been lost, and the damage to the reputation of the scientific community as a result of this controversy is irreparable.

Behind many of these tragedies is the capitalistic desire for accumulating more money. This is the main reason for the horrible tragedy of the blood banks refusing to test the blood supply for AIDS. The prospect of spending around $100 million for a blood test for a disease whose existence is uncertain horrifies the blood industry, and the FDA backs them up. The CDC, in the meantime, proves that the AIDS virus is blood borne, and finds that 89 percent of severe hemophiliacs have become infected with the virus. In light of this evidence, the FDA attempts to mandate blood testing for all donors, but the motion fails as "too expensive." One doctor is forced to ask, "When doctors start acting like businessmen, who can the people turn to for doctors?" In a dramatic scene, a hemophiliac is told that she has AIDS:

Doctor Jaffey: "Every blood bank in the country has known for some time that some of the blood that they've been using is contaminated, but we've been unable to get them to use any testing or take any precautions whatsoever." Victim: "Are you telling me that they knew they were giving AIDS to people, and continued to do it?"

To the same extent, the bath houses fight the CDC to maintain their profits. One bath house owner states that, if the bath houses are closed, "What's next? Separate drinking fountains, one for gays and one for humans?" Later he says, "We're all in this for the money. We make it when the men come in, doctors make it when they come out." As one can see, both the bath houses and the blood industry fight the CDC in order to continue doing business and maintain their profits.

In conclusion, the search for AIDS, as depicted in the movie "And the Band Played On," changed from a medical endeavor to a scientific fiasco as a result of the conservative political climate, prejudiced society, the obstructions--legal, monetary, etc.--put in the CDC's way, some scientists' desire for fame, and the business' unrelenting pursuit of profits. Clearly, the Symbolic Interactionist view of sociology is demonstrated in this movie--the director depicts both the macro-level conflicts of science versus industry, the rights of society versus the right of the individual, and the micro-level interactions between scientists, lawyers, the gay community, politicians, and others. At the same time, it depicts the extraordinary, even heroic, efforts of men like Don Francis, Harold Jaffey, and Bill Daryl. In all, "And the Band Played On" gives a startlingly real and hard-hitting look at the problems of our society, but at the same time, gives us hope that they may one day be resolved.

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