20 Books of Summer, #3 and #4: How To Survive A Plague and Exit West

9781509839414how to survive a plague_15

David France’s monumental history of the activist campaigns to gain public attention, funding, and appropriate healthcare interventions for the fight against HIV/AIDS in the USA in the 1980s and early 1990s, How To Survive A Plague, is an incredible achievement. France was a young gay journalist in New York during this period, and so this is literally front-line reporting; as France says near the end of the book, by the age of thirty-five, he had lived his entire adult life in the shadow of death. He highlights the criminal neglect of HIV/AIDS by the Reagan and Bush administrations, and by the mainstream media, noting that, in the early years of the epidemic, there was virtually no coverage of the hundreds of deaths, in comparison to the huge headlines that had accompanied an outbreak of legionnaires’ disease in Philadelphia in 1976, which had only claimed 34 lives. The lack of knowledge about the gay community confirmed old stereotypes and created new ones, hindering medical research. At first, it was believed even by sympathetic doctors that gay sex itself might be the cause of the disease, triggering an immune reaction – a theory that was swiftly disproven as female and/or heterosexual cases emerged.

What How To Survive A Plague really brought home to me that, for some reason, other fiction and non-fiction about HIV/AIDS had not was the heart-wrenching irony of a disease that targeted sexually active people spreading through a community that had so recently fought for the right to live and love as they wanted. In the very early days of HIV/AIDS – before it became clear that condoms prevented the spread of the disease – it might be hard to understand why some gay men continued to have sex with each other despite knowing that they were risking their lives, but at the same time, having experienced the pain of living closeted half-lives before gay liberation in the 1970s, returning to those restraints was also unbearable. France highlights how it was the efforts of organisations led by gay men and lesbians, such as ACT UP, People With AIDS and TAG that secured funding for AIDS research and fought against some particularly cruel practices in medical trials of new drugs, such as forcing patients to discontinue all other medication, and excluding groups such as women, African-Americans and IV drug users because they were not seen as ‘typical’ sufferers.

How To Survive A Plague, at more than 500 pages, is a dense read, and I found myself getting lost in the numerous names at times; a quick guide to the key figures at the start of the book would have been a very helpful tool. It’s also primarily a history of activism, not a exploration of the science behind the development of effective treatment for HIV/AIDS; although some popular science features, I would happily have read more of this and a little less of the complicated network of alliances and rivalries that developed between particular activist figures and groups. Only a few key figures – such as Peter Staley, who went from straight-passing Wall Street bonds trader to a gay radical breaking onto the trading floor to protest the prohibitively high price at which Burroughs Wellcome were selling HIV/AIDS drug AZT – stood out to me in France’s writing. Nevertheless, this is a book that had to be written, and France seems like the right person to have written it. (He also produced a 2012 documentary of the same name).


Mohsin Hamid’s Booker-shortlisted novel, Exit West, is a hauntingly simple story, told in the language of modern fairytale, but with the brutality of the refugee crisis at its core. Saeed and Nadia meet in a war-torn city. As conditions get worse, they hear that doors – closet doors, bedroom doors, garage doors – are becoming gateways to other countries, allowing people to escape their present situation, but at risk of repression and death elsewhere. Throwing in their lot together, Saeed and Nadia take a trip through one of those doors. Hamid’s writing reminded me strongly – and strangely – of Robin McKinley’s, a writer I’ve grown up loving, and who has spent her career either retelling familiar fairytales or making up new ones of her own (Beauty; Rose Daughter; The Hero and the Crown; Sunshine). Both writers have the gift of putting together sentences that are utterly simple but totally rooted; there’s a sense that they know exactly what they are doing, and that the lack of detail – nameless cities, places that have few distinguishing features – is always deliberate. Exit West is so thematically different from any of McKinley’s work that I kept on trying to reject this comparison while I was reading the novel, and then kept on returning to it. But anyway, it’s a beautiful and short book that I definitely read too fast; I’d like to return to it some time and take it more slowly.

Next up for 20 Books of Summer: I’m reading Negroland, and have Built waiting on my shelf.

5 thoughts on “20 Books of Summer, #3 and #4: How To Survive A Plague and Exit West

  1. I got bogged down in all the detail of How to Survive a Plague and ended up just skimming it for the Wellcome shadow panel that year. But I agree it’s a powerful story.

    I have been so conflicted about whether to give Hamid another try — I abandoned The Reluctant Fundamentalist early on and have heard such divergent opinions on Exit West. I guess all I can do is try it for myself (from the library) one of these days.


    • How To Survive A Plague did feel more like work than fun at times (I taught the HIV/Aids crisis in the UK as part of one of my modules this year). The good thing about Exit West is that it’s VERY short, so you won’t waste too much time on it if you don’t like it!


  2. Pingback: 20 Books of Summer: A Retrospective | Laura Tisdall

  3. Great review! I enjoyed the documentary of How to Survive a Plague, and I might check out the book as well now. It sounds like it covers a lot of ground that the doc couldn’t.

    Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s