In objective terms, the acquired immunodeficiency syndrome (AIDS) epidemic is only too familiar to all of us. The spread of AIDS in the United States and throughout the world has been chronicled relentlessly. The effects of the controversies stirred within our society are common knowledge. However, objective knowledge of human immunodeficiency virus (HIV) infection does not stimulate the reflections that result from the loss of a twin brother to this disease.

The analogy of gardening in clay is apt, because AIDS has revealed aspects of our society that represent clay and that have been seen as unsuitable for nurturing life. Each chapter, or reflection, begins with a quotation that sets the stage for reflections on the illness of the author's twin brother. Both brothers are physicians: The author is a pathologist, and his brother is a psychiatrist. A medical background, with its focus on the complexities and pathogenesis of the virus, can become an impediment to understanding AIDS in human terms. Gardening in Clay helps to overcome this.

The reader will find reflections on the epidemiology of anger and a comparison between the AIDS epidemic and the sinking of the Titanic, with several cogent analogies, including the lack of societal lifeboats. The reflections are spiced with thought-provoking sentences. For example: "The individual simply cannot control all of the circumstances required to achieve good health." Also, "The epidemic ... has taught me the inadequacy of looking toward the future as a means of rescue from the present." And again, "Icebergs are easier to avoid than they are to vanquish."

Valdiserri has been professionally involved in the care of patients with AIDS and in AIDS prevention since the beginning of the epidemic. He points out effectively that AIDS is "our" disease rather than "their" disease.