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July 10, 1996

Strong Shadows: Scenes From an Inner City AIDS Clinic

Author Affiliations

University of California San Francisco


by Abigail Zuger, 243 pp, $22.95, ISBN 0-7167-2916-4, New York, NY, WH Freeman & Co, 1995.

JAMA. 1996;276(2):163. doi:10.1001/jama.1996.03540020085036

This book is a little gem. In it, Abigail Zuger, an infectious disease specialist at Albert Einstein Medical Center in the Bronx, describes the lives of eight of her patients as seen in a succession of clinic visits.

Caring for these patients in an environment of woefully limited resources takes a unique kind of resourcefulness. A good day in clinic is when you've snagged an exam room with a sink. Getting your patient a lymph node biopsy in less than two months might involve sending him to the breast clinic (where the biopsy queues are shorter). All the players in this drama—patients, families, doctors, nurses—are running as fast as they can.

In the preface, we are told that for many of the urban poor, having AIDS is simply the final coda to a life of hardship. For the author's patients, medical crises are juggled with dozens of others: court dates