The literature of the acquired immunodeficiency syndrome (AIDS) runs the gamut, from scholarly review to underground newsletter, from textbook to pamphlet. Few medical publications attempt to provide a view of the human side of the epidemic, particularly when the faces of AIDS are those of the poor.

Building on pieces published in Discover and The New York Times Magazine, the author uses a series of case vignettes to comprehensively examine the effect of AIDS on individual persons, their families, and their health care teams. The cases are presented as narrative medical records for each person and include chronological entries documenting conversations, impressions, and reflections. Periodically, explanations of terminology or treatment philosophy are inserted into the record. Patients are followed for as long as 4 years in the course of the narrative, which gives an accurate sense of the longitudinal nature of caring for patients with AIDS.

Those who work with human immunodeficiency virus (HIV)-infected persons will immediately recognize the faces portrayed in this text; they are surprisingly universal. The vignettes are well written, the descriptions vivid. Somehow, against overwhelming odds, the patients often remain optimistic, proud, and even heroic. Physicians are patient and responsive. Because this is a nonfiction work, however, the denial, self-destructiveness, and deceit of patients and the frustrations and insecurities of their physicians are also presented in a matter-of-fact style. The format of the book illustrates the focus on primary care that is characteristic of physicians who work with HIV-infected persons; in this setting, pragmatism and the creative use of resources are vital. Many patients have problems that are worse than AIDS.

If this book has a weak point, it is a failure to appeal to a particular audience. Persons who work in the AIDS field may find that the procedural explanations distract from the stories, and others may misinterpret some instances of medical cynicism and humor. Those who are interested in a comprehensive review of HIV treatment options or in-depth discussions of the psychosocial aspects of AIDS should look elsewhere.

The public's interest in HIV infection and patient–physician communication are well served by the author, and the appeal of the case description is powerful. The book may find a niche in the corner bookstore. Medical students could use it to stimulate discussion of bioethical and medical issues. Most readers, however, are likely to be physicians who care for HIV-infected persons. They will find in this work a skilled description of the intricacies of caring for this needy population.