Hazel McHaffie

HIV/AIDS

Future possibilities

There will never be a shortage of subjects for me to write about! I lose tracks of scientific breakthroughs and medical marvels. And today, given the breadth and range of material available, I’m not going to even attempt to link everything I mention to scientific papers – Google the key words and you’ll get the information if you’re interested.

When HIV/AIDS first came to our attention in the 80s there were doomsday predictions of biblical plague proportions and real-life devastating statistics. I was a researcher at the time and saw it, wrote about it, first hand. Then came huge public awareness campaigns … followed by the development of anti-retroviral wonder drugs … then combination therapies, that could hold the disease at bay. Now here we are, with stories of stem cell donations from people with ‘natural immunity’ rendering patients free from the virus. You could weave a pretty complex plot with that one! And in 2019 my file marked HIV/AIDS looks completely different from the slim wallet of 30 years ago.

Inside of Me coverThen there’s the transgender issue. Wow! So many dimensions. About young children wanting to transition. About people wanting to reverse the process; the irreversibility of some therapies. About misleading statistics. Eebie jeebie – how crazily tortuous a plot could you construct in that area. The imagination goes into overdrive. Makes my little sally into that world in Inside of Me, pale into banality.

It’s 41 years since the first test-tube baby, Louise Brown, was created, and infertility was very much top of my pile when it came to choosing subjects for my set of novels. Now despite widespread opposition, criticism, vilification, stigma, as many as 8 million babies have been born by IVF. And the endless thirst for knowledge and understanding, coupled with a bottomless pit of compassion, drives researchers and clinicians in this area to seek more and more solutions to the problems couples have in conceiving, or avoiding perpetuating deadly genetic diseases. There’s mileage for several more books to follow on from Paternity, Double Trouble and Saving Sebastian. Did you know, for example, that the success rate for assisted fertility is way way higher (50%) than for natural conception (25%) … plenty of scope to work up a story-line there, huh? Imagine a gang of 35-year-old career girls going to the freezer to select artificially-created sperm … or genetically screened/modified embryos … ticking selection boxes along the way for green eyes, athletic ability, fiery temperament …? Endless possibilities!

The statistics on abortion reflect changes in society’s mores and values; programmes like Call the Midwife have increased public awareness of how things have developed in a generation. Add in dating apps, modern career paths, cohabitation, social expectation, fertility statistics … I feel an historical reflective story coming on! I well remember, in the 70s/80s soon after the 1967 Abortion Act was introduced, women coming in for a second, perhaps even third, abortion were looked upon askance. Recent Government figures have highlighted that of almost 68000 abortions carried out in 2017, 1049 were undergoing their fifth abortion and 72 their ninth! And there’s a story behind every one.

Then there’s the horrific topic of female genital mutation … don’t get me started! The recent story of the first person to be convicted in Britain briefly reported in the national press was shocking enough – the little girl was three years old; the mother cut the child herself in her London home; indecent images and animal pornography were involved. I absolutely couldn’t go there with fiction. But … should our collective conscience be prodded?

Resources, caps on the cost of medical and social care … I’m somewhat allergic to numbers, but reading about the human consequences of budgetary restrictions brings out the indignant in me. And might just compel me to write about it if I’m around long enough to get to that file.

Even the topic of assisted dying – a recurring hot potato – has subtly changed since I published my novel on the subject, Right to Die, eleven years ago. The issue’s been described by lawyers for the Royal College of Physicians as ‘one of the most controversial and morally contentious issues in medicine’, but ongoing polls of both medical and public opinion show a definite move towards accepting the need for some change. This might be simply taking a neutral professional stand as against opposing it; or a swing towards legalising some form of assisted suicide in the UK. A novel today could look very different.

Yep, I’m endlessly adding to the possibilities in my files as medicine and science reveal more and more, and society’s tolerances and expectations change. This is just a superficial skim. Anyone out there keen to pick up the gauntlet?

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More thrills from Harlan Coben

Well, as predicted, the extreme weather (commonly dubbed the Beast from the East) meant no one in our area was going anywhere any time soon. So, with all my appointments cancelled for six days, I did indeed have a lot more reading time than anticipated. And I made a rather interesting discovery.

Miracle Cure is one of Coben’s earlier works. He wrote it in his ‘naive’ early twenties and in my version (re-published twenty years later), after re-reading it himself, he makes something of an apology: it’s a bit ‘preachy’ and somewhat ‘dated’.¬† But those very criticisms made me feel a whole lot better. Why? Because I’ve said the same of my own early writings. So, being already a fan of his work, I was keen to see for myself just how he’d fallen into the same trap.

It’s a book set in a particular time in history, a time when HIV/AIDS was first coming to public attention. I remember it well. Fear of the unknown and sensational headlines fuelled a real sense of foreboding and doom. But I was unexpectedly thrown into this whole scenario at the deep end. I applied for a research post in the Institute of Medical Ethics which was exactly where I wanted to be, and got it. My first investigation there was to explore attitudes, fears and education around this whole topic – across the UK. In order to thoroughly understand what was happening I immersed myself in the culture and context. I spent a lot of time with homosexual men, intravenous drug users, and the folk who tried to help and care for them. I visited centres set apart for people infected with the virus, many of whom were in the terminal phases of the illness. I watched gay marches for justice. I sat in a prostitutes’ clinic on one memorable day. I cried in response to a young man who had lovingly nursed several friends through agonising deaths. I listened to terribly bigoted and judgemental people who believed this was God’s plague sent on the immoral world.

Coben’s story is set in the USA where opinion was much more polarised and vocal. It includes
– a dedicated team of doctors researching a cure for AIDS in the Sydney Pavilion
– the lead scientist, Dr Harvey Riker, whose own brother died of the disease, and who has dedicated his life to this cause
– his colleague, Dr Bruce Grey, who’s convinced he’s being followed and in danger
– a televangelist, Reverend Ernest Sanders, a rampant homophobe, who’s leading a crusade to condemn all those who contract the virus and shut down the centre
– Sara Lowell, a beautiful but crippled tele-presenter and reporter who wants to expose hypocrisy and reveal the truth
– Dr John Lowell, her father, formerly Surgeon General, whose loyalties are seriously conflicted
– Sara’s handsome star basketball player husband, Michael Silverman, whose own symptoms suggest something sinister
– Cassandra Lowell, her promiscuous and jealous sister
– Lieutenant Max Berstein, a policeman whose brilliance is hidden behind a facade of nervous tics, and whose own personal history is kept under wraps
– George Camron, a brutal hired killer whose techniques are not for the fainthearted …
– a whole cabal of powerful men who all seem to have secret and highly suspect agendas …
oh, and so many more besides,. You need all your wits about you to hold this mighty cast of characters firmly in your head and sort out the Saras from the Susans, and the Matleys from the Markeys, and the Willies from the Winstons.

But it’s well worth the effort. As I’ve said before, Coben is a master plotter, and he keeps you guessing till the end. I ended up suspicious of almost everyone! But knowing some of the tricks of the trade I had a head start once I got the hang of the points of view we were given. And it was there I think, that it became apparent that this was an early work. Here and there the POV was smudgy.

But it’s in relation to the subject matter that I most identified with Coben’s ‘naivety’. He describes his style as ‘preachy’. It packs a stack of information into the speeches made by the characters as they lecture and educate and inform. As an author with something of an agenda myself, I worried a lot about getting the balance right between spinning a gripping yarn, informing the reader, and putting across intellectual challenges. My early publishers told me it was the fictional approach to serious issues that constituted the main appeal of my books, their unique selling point. And that was the point. But I am less inclined to pack in as much information nowadays.

Coben also calls his book ‘dated’. And indeed it is – as medical works can so easily become. But it properly captures the public hysteria and professional angst that prevailed at the time. Back then we had no idea what kind of Armageddon lay just over the horizon. But we were terribly fearful, and fear and passion to avert catastrophe can drive people to extraordinary lengths. Coben has merely traced a possible scenario; and done so brilliantly.

It’s now back to my own cliff-hangers with a sense of having just had a wonderfully instructive masterclass!

(NB. The conflation of HIV positivity and full-blown AIDS is medically inaccurate in places but that too was a common error in the early years of this disease.)

 

 

 

 

 

 

 

 

And yet he recognises¬† that there’s an energy and risk-taking about it that he hopes he still has.

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