At Risk by Alice Hoffman

at risk

Polly and Ivan are concerned about their daughter, Amanda.  She’s a gymnast and has an unusual diarrheal illness for the past couple of weeks.  Their pediatrician, who knows them well, can deduce that this is not a good sign and from her low white blood cell count he is extremely worried about the possibility of cancer.  But not in a million years is he expecting that she’d be positive for AIDS, having contracted it from a blood transfusion after a complicated surgery for appendicitis 5 years prior, before blood was screened for the virus.  The paranoia and alienation that the whole family experiences is unexpected and devastating, possibly even worse than the actual diagnosis.

This book, published in 1988, reminds us of the experience that so many went through when HIV first appeared in the 1980’s.  With ads on TV for HIV medications so commonplace and ordinary today, it’s hard to remember that not so long ago, there was mass victimization of those who were infected with the virus.  Children infected via intrauterine transmission or from blood transfusions were sometimes not allowed in school because of fears of casual contact transmitting the virus to others, even when there was early evidence that this was not possible.  Millions of infected adults suffered not only from the disease but from the indignities of being ostracized from a society who rejected them because of their disease.  And we have still not cured it.  [The reason for this has probably more to do with financial incentive than the science – it is more beneficial for pharmaceutical companies to produce medications that sustain patients with the disease than to cure it.  Just as with cancer. But I digress…]

As for the book, I found the story compelling, but the writing a bit awkward.  It is told in the present tense, which I often dislike.  More importantly, though, the narration also shifts from one character to another almost as if they are passing a hot potato from one to another, to another.   This shift occurs so frequently and over so many characters that it dilutes and distracts from the actual plot and it is harder to become attached to the truly important players.   We just can’t feel that sorry for everyone.  So while the story is tragic, it does not cut quite as deeply as it might.

Nevertheless, At Risk is a timepiece and tells a part of the story of our bitter history of the HIV epidemic that is important to remember.  We think of HIV as a disease of adults only, but there were thousands of children affected by the disease as well.  And still are today.