Alfred Ingegno. 291 pages. New York: Birch Brook Impressions; 1992. $22.00.

Literature provides the physician reader with an abstraction of human experience, allowing an examination of character and social dilemma and, at times, a glimpse of what life is all about. In the clinic and on the wards, we strain to discern the diagnostic message in the tale of life, translating persons into patients and their suffering into clues. Somewhere in this process, an essential humanity may be lost, empathy replaced by mere manners, and even the vaunted "Art of Medicine" distilled to a few parlor tricks of give and take. Literature, on the other hand, catches us off duty and off guard and restores to us an appreciation of persons, their experience of illness, and the value of our own work.

The devastation that is the acquired immunodeficiency syndrome (AIDS) epidemic has certainly dominated the internal dialogue of the gay communities but is still too recent to have found a literary voice. U.S. physicians in 1993 generally experience one of two situations regarding AIDS. Most rarely encounter patients with AIDS directly and thus share with most other Americans a few disembodied facts and many unexamined stereotypes and fears. The remaining physicians see far too many persons with AIDS, often in underfunded clinics that magnify the social gulf between physician and patient, or in a terminal condition that defeats the search for fellowship. A thoughtful story that probes some of the dilemmas and feelings of persons infected with HIV could offer to physicians an opportunity for reflection and enhanced understanding of this vast tragedy. Shared Legacy will not fill this need for most physician readers.

This is a tale of yuppie AIDS. Sharyn, Vassar graduate (circa 1980) and promising New York City corporate ladder-climber, donates blood like a good girl and receives a chilling call from her "health advisor" that all is not well. We then learn that Sharyn has not been altogether a good girl and has been living with a not-quite-true love who has known for months that his nightlife has left him HIV positive. He somehow has failed to mention this to Sharyn. After 2 subsequent years of celibate angst, Sharyn succumbs to another charmer, and, loving "not wisely but too well," conceals her virulence with a concocted lie about having an allergy to sperm, thus inducing her paramour to always use condoms. After 2 blissful years of (presumably) suspended contagion, Sharyn catches him with another woman and throws him out, whereupon he returns and rapes her—of course, without a condom. A few months later, he becomes HIV positive and sues her for attempted murder. A trial follows, and thereby hangs the tale.

See what fun we miss by not taking good social histories in the clinic!

Some cogent and interesting issues are argued in the trial. How is a young adult, short of sainthood, to bear the permanent abstinence from sex and mating that is the doom of HIV? Can the careless spread of an infectious disease be prosecuted as assault (or, indeed, as murder)? If so, how exactly do we encode microbes, vectors, and motives into the criminal law? Does the relative efficacy of condoms convey absolute legal protection? What about moral sanction? How can we ever really know who caught what from whom, when, where, and, especially, why? How do clinical presumptions play as legal evidence?

Unfortunately, in this novel, these questions are mere afterthoughts to the melodramatics of rape, both in the event itself and in the trial. Only the first question figures in the jury's deliberations and even this is cast as an "emotional" argument that only holds appeal for the women on the jury. Male jurors are either crude sexists or, in one case, a deeply reflective intellectual who eventually opts for a good-natured resignation against his better judgment. Suffice it to say, Sharyn is acquitted and spends her declining years in surrogate fulfillment as her friends get on with their conventionally romantic lives.

Apart from the simple fact that yuppies are not where it's at with AIDS, this novel suffers from uncompelling characterizations and a pastiche of idealized clinical dialogue and puerile romance. Some of the dialogue must be the author's accommodation to the prohibition against footnotes in a novel. A few minor themes are inserted gratuitously in odd spots, such as a thesis on intermarriage and several naive dismissals of corporate sexism. Above all, this novel does not extend our insight into any corner of human experience, and that is too bad because there are corners that need such illumination. One of these is the large corner called AIDS.