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All the Young Men by Ruth Coker Burks review – an uplifting memoir

<span>Photograph: Santiago Felipe/Getty Images</span>
Photograph: Santiago Felipe/Getty Images

In the spring of 1986, Ruth Coker Burks was in the medical centre in Little Rock, Arkansas, visiting a friend with cancer, when she noticed three nurses drawing straws to see which one would have to enter a patient’s room. Curious, she snuck down the corridor to take a look. The door was hung with a scarlet tarp and a biohazard sign. Food trays were piled on the floor outside, along with a cart of isolation suits and masks. Inside, she found an emaciated young man calling for his mother.

When Coker Burks challenged the nurses, one of them told her she was crazy to go in. “He’s got that gay disease,” she said. “They all die.” They refused to contact the patient’s mother, and so Coker Burks made the call from a payphone herself. “My son is already dead,” the woman told her. “My son died when he went gay.” Appalled, she went back to the room and sat with the young man, holding his hand until he died a few hours later. But when she told the nurses he was dead, they insisted that she was now responsible for the body. It took hours of phone calls before she found a funeral home willing to perform the cremation. As for the ashes, she buried them herself in a cookie jar at Files Cemetery in Hot Springs, where her family owned some land.

This was Coker Burks’s introduction to Aids, the disease that would come to shape her life. In 1986, Aids was a death sentence. Five years after the New York Times had reported the first cases under the famous headline “Rare Cancer Seen in 41 Homosexuals”, there was still no reliable treatment, let alone a cure. The fear, ignorance and stigma were so great that hospitals regularly refused to treat patients. Informal networks of care were predominantly urban, centred in the gay capitals of New York City and San Francisco. The pressure group Act Up would not be founded for another year. In the south, people were coming home sick and terrified, hoping for refuge with their families, only to be rejected and die alone.

Coker Burks was 26 that year, a bottle-blonde Methodist and divorced single mother in a hyper-conservative town where divorce meant “social death”. In Arkansas, consensual sex between two men was punishable by up to a year in prison. She knew that helping people with Aids put her at risk of losing custody of her four-year-old daughter, never mind being shunned by other parents, co-workers or members of her church. But, as she explains, there was literally no one else. Within weeks of her first deathbed encounter, she was rung up by a nun who told her a patient had been dumped on the doors of the Catholic hospital and they were “not equipped” to treat him and anyway didn’t “want the reputation”. Once again, she sat by his bed, holding his hand until he died.

Jared Leto and Matthew McConaughey in the 2013 film Dallas Buyers Club.
Hollywoodising the crisis … Jared Leto and Matthew McConaughey in the 2013 film Dallas Buyers Club. Photograph: Allstar/Focus features/Sportsphoto Ltd

The calls kept coming, first from hospitals, and then from the men themselves. With no treatment, people were dying with terrifying rapidity, a life expectancy counted in weeks, not months. She educated herself about the virus by sneaking into the library at the local teaching hospital. She helped people get on disability benefit and found them places to live. In between her job at a sawmill, she cooked nutritious meals for her patients, begging for vegetables from neighbours and bone marrow from local deer-hunters. When the antiretroviral drug AZT was approved in 1987, she set up an ad hoc home pharmacy in her pantry, filled with stockpiled pills left behind when people died. Realising early diagnosis meant a longer lifespan, she got a friend to teach her to take blood, stole needles from nurses’ stations and took the samples in a minnow box to the state health department, getting them tested anonymously under names like Ronald Reagan and Minnie Mouse.

I admit I was sceptical of a narrative about an angelic straight woman saving helpless gay victims, the Hollywoodisation of the Aids crisis that runs all the way from 1993’s Philadelphia to 2013’s Dallas Buyers Club. But it’s hard not to be disarmed by Coker Burks (ably ventriloquised by her ghostwriter Kevin Carr O’Leary). She dresses prettily in floral frocks to charm doctors, whom she then browbeats with statistics about cytomegalovirus and pneumocystis – anything to improve the treatment of her “guys”. If she needs to feed them, she has no compunction about climbing into the dumpster at the Piggly Wiggly and helping herself.

Although her pastor did not agree, she believed she was doing God’s work and she refused to stop, even though she and her daughter Alison were systematically isolated by their community. A sample incident: after Alison’s father was killed in a car crash, the pastor refused to let them participate in the family advent service, explaining to Ruth: “You’re not a family. You don’t have a husband.” Later, after she started appearing on TV, people burned crosses on their lawn.

They found a new community at Our House, a gay bar two doors down from the police station. Here Ruth met Billy, AKA Miss Marilyn Morrell, a ravishing drag queen who became her closest friend. For the first time, she and her daughter had a family who loved them, who’d babysit and do the school pickup. Her own mother had been abusive, and it’s evident that her sense of solidarity with the sick came from an intimate knowledge of what it meant to be hated and excluded. Drag balls also provided her with a vital infusion of fun. Later, visiting a strip club, she can’t help but be shady about the girls’ lacklustre dancing compared to the manifest glories of Mother Superior and Cherry Fontaine.

Over the years Coker Burks buried more than 40 people at Files Cemetery in secret, and sat at the bedside of hundreds more. But as Aids care became increasingly professionalised in the 90s, she was left behind. It isn’t clear why this competent woman was repeatedly turned down for jobs, but maybe she functioned best as a renegade, doling out condoms at the cruising ground, a sex-positive Florence Nightingale.

It is not to diminish her story to say that heterosexual angels weren’t the dominant narrative of the Aids crisis, but a vanishingly rare exception to a rule of homophobia, cruelty and prejudice. That said, there’s something immensely uplifting about her decision to involve herself in the travails of a community not her own, simply because she could see that there was a need. It’s a brighter story of human nature, an analogue to this winter’s tale of good Samaritan Sikhs bringing curry to stranded Bulgarian lorry drivers in Kent. There are other stories of the Aids crisis that foreground activism and community (look out for Sarah Schulman’s forthcoming history of Act Up, Let the Record Show), but this is a paean to making friendships across boundaries, to being kind even when the cost is nearly unbearable.

• Olivia Laing’s Funny Weather: Art in an Emergency is published by Picador. All the Young Men: A Memoir of Love, Aids and Chosen Family in the American South is published by Trapeze (£16.99). To order a copy go to guardianbookshop.com. Delivery charges may apply.