All The Young Men: Medical neglect and homophobia in 1980s Arkansas

All The Young Men

Author: Ruth Coker Burks and Kevin Carr O’Leary

ISBN-13: 978-1409189107

Publisher: Trapeze

Guideline Price: £16.99

It’s 1986 in Hot Springs, Arkansas, and Ruth Coker Burks is visiting a friend with throat cancer at the local hospital when something unusual occurs. The nurses on call are drawing straws to decide who will enter a room marked on the outside by a “blood red tarpe”. Inside, a man is crying for his mother. The writer, incensed by the thought of anyone suffering alone, walks right by the biohazard sign and her life changes forever.

Jimmy, an emaciated, dehydrated gay man, is dying of Aids. He is calling for his mother but his mother, the medical staff and the wider world refuse to help him. Coker Burks phones his mother herself but the line goes dead.

“You hang up on me again, and I swear to Almighty God I will ask your Jimmy where he’s from and put his obituary in your town paper with his cause of death,” Coker Burks tells her. The threat of a public outing keeps Jimmy’s mother on the line but her homophobia means she refuses to witness the death of her son. When asked what to do with his body she tells the writer to “burn it”.

Winter Nights

Some people inherit jewellery but, because of her own mother’s impulsive reaction to a challenge, Coker Burks inherits a 262-plot cemetery. She figures out how to get the state to cremate Jimmy’s body and buries the ashes in a cookie jar alongside her own father. When standing at the graveside she tells him: “I’m sorry we only had a short time together. But you’re safe now, okay?” The dialogue is thoughtful and shattering. It charges the story with a compelling compassion as more men die.

Medical neglect

The divorced white single mother becomes the person that nuns, doctors and administrators phone when they don’t want to deal with the bodies of gay men who have died of Aids. Only 26 at the time, Coker Burks seems fully grown, with more humanity in her little finger than those in power could muster in a lifetime. This book tells the remarkable story of how she used that energy – and a paycheck from her job selling timeshares – to support a community crushed by medical neglect, homophobia and hate in 1980s Arkansas.

The origin story of the protagonist, dramatic on its own, is mentioned as an aside to the vignettes about the lives of the men she helps. It provides a powerful backstory. Her mother, a former nurse, was placed in a TB sanatorium when she was a child. She didn’t have TB but a rare lung disease. Medical misdiagnosis and mistreatment are part of the family history, and so too is caretaking.

The first-person narrative offers the reader moments of shared epiphany. The tools of survival include dumpster diving to feed the community of men with Aids she is supporting, stockpiling medication from those who have died and learning how to draw blood so that people can get tested. What follows are threatening calls from the KKK, a daughter bullied at school, and a church that ostracises her.

Antiretroviral medication

In 1987, when another man, Marc, returns to Arkansas from New York City, he brings hope in the form of antiretroviral medication. Ever resourceful and determined, Coker Burks shames pharmacists into providing supplies: “I had one pharmacist grab a big gold can of Lysol and spray it at me as I walked... I refused to run. I pulled over where no one could see me, and I cried,” she writes. “Then I got back on the road to try another pharmacy.”

The unflappable nature of her resilience against the shifting historical context is stunning to witness. Her co-writer, Kevin Carr O’Leary, helps shape this hero narrative well.

Any drag queen worth her words will admire Coker Burks’s southern sass as an art form. The dialogue is cutting and exact. Take the occasion in 1988, two years into her work, when a friend calls her to the hospital because the homophobic charge nurse, “one of those you did this to yourself whispers”, is on duty. She thinks quick, pinning a condom to her lapel before entering the ward without the recommended personal protective equipment. She addresses the nurse:

“Does a condom prevent infection?”, I asked, still facing Tim. We smiled at each other.

“That’s what they say,” she said.

I turned to show her my brooch: “well, I’m wearing one.”

Humour is a powerful medicine when expertly applied.

Socially produced trauma

In the early 1990s the Aids activist and historian Douglas Crimp said that "apart from the corporeal reality of the disease, we could say if there's trauma associated with it, it's a socially produced trauma". Coker Burks, like the community she cares for, is a survivor. It is when she finally enters the local gay bar that her physical body moves from observing death to a more realised LGBTQI+ joy. Paul, the manager, questions her work: "Why are you serious about this?"

Self-reflection is a relief for the reader and a gift to the caregiver. It arrives from a member of the resistance, someone who is both a gay man and a drag queen who is not dying. The community creating social, physical and psychological life support for one another unifies beneath a wider lens and the story benefits.

All the Young Men could be categorised in many ways: it’s one woman’s relentless mission to help a community survive when those in power abandoned them. It’s the tale of people with Aids who returned to Arkansas during the first years of the epidemic. It’s also the story of a Christian woman who would go on to advise the Clinton administration on Aids education.

The desire to witness the dying runs parallel with the writer’s human need to be witnessed herself and, unsurprisingly, there’s now a movie being made. When there was no internet or social media there were gay bars, live drag shows and community spaces where we held one another. This book tells the story of how Coker Burks facilitated connection and education and refused to look away. Clearly, the category is love.