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Looking Back on 'The Normal Heart,' and Patients' Activisim

A few weeks ago I saw The Normal Heart, a play about the early, unfolding AIDS epi­demic in NYC and founding of the Gay Men’s Health Crisis. The semi-​​autobiographical and now essen­tially his­torical work by Larry Kramer first opened at the Public Theater in 1985.

Cover of the paperback, pub­lished by “Plume,” from Wikipedia

The story takes on the per­spective of a young man who’s seeing the death of too many of his friends and neighbors from a strange and previously-​​unknown disease. As much as the sit­u­ation is dis­turbing, and fright­ening, and shat­tering of the gay men’s barely decade-​​old freedom to behave as they choose, most of the protagonist’s asso­ciates just can’t deal with it. Nor can other, poten­tially sym­pa­thetic offi­cials like Mayor Koch, health offi­cials at the CDC and NIH.

Among the men who form GMHC, in this drama, there’s a mixed crew. Some say they’re  embar­rassed by the attention the illness drew to some gay men’s behavior. Many stay fully or half-​​closeted, under­standably insecure in their jobs. They worry about dis­crim­i­nation and rejection by fam­ilies, land­lords and even doctors, some who were reluctant to take on patients with this disease. Some of the affected men and their friends, straight­for­wardly, fear death; others are in plain denial about what’s going on in their community.

The scenes unfold between 1981 and 1984, more or less the time when I moved to Man­hattan, lived downtown, applied and matric­u­lated at NYU’s medical school. Many of the first clinical cases, i.e. patients, I saw, were young men with HIV and Kaposi’s sarcoma, one of the first con­di­tions asso­ciated with the out­break and that’s fea­tured in the play – the appearance of maroon or violet-​​colored, usually but not always flat, often elongate, spots on the skin. The AIDS patients tended to have anemia, either from immune blood dis­orders or, more often, infection in the bone marrow. As a hematologist-​​to-​​be, I was intrigued.

Then and now, looking back, it’s hard not to respect those men’s activism, espe­cially those who, with Kramer, created the AIDS Coalition to Unleash Power (ACT UP). They were impa­tient with the pace of research and physi­cians’ pro­tocols, and spoke out so emphat­i­cally about their needs: for more research; for pre­vention and treatment; for easier access to new drugs; and, simply, for good medical care.

The play closes soon in New York;  its pro­ducers are said to be planning a tour and a London pro­duction of the work. Patients and their advo­cates, of all back­grounds and par­ticular con­cerns, might take notes.

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