Patient Zero and the Making of the AIDS Epidemic
Page 28
ates Camus,” College Literature 24, no. 1 (1997): 202– 12.
86. Shilts, “Book Proposal,” 8.
“Humanizing This Disease” 165
ideas.” 87 In this way, we can see how in 1985 Shilts was keen to fi nd peo-
ple with interesting stories that fi t the aims of his book and that, conse-
quently, he would have been particularly attuned to learning the identity
of the medical literature’s “Patient 0.”
In the fi nal proposal, Bill Kraus was to be the “central homosexual
character of the book,” Cleve Jones “the personifi cation of the Gay Ev-
eryman,” while Gary Walsh “refl ect[ed] the best aspects of how many
gay people heroically responded to an AIDS diagnosis in the fi rst years
of the epidemic.”88 Some characters, including Marcus Conant, Selma
Dritz, and— most important— Gaétan Dugas, are not mentioned. These
fi gures evidently overtook and replaced other characters who were
planned but never appeared in the fi nal manuscript. This latter group in-
cluded Dr. Thomas Ainsworth, the “typical gay community doctor”; the
Bauer Family, a working- class family in the suburbs who must deal with
transfusion- associated AIDS and the heterosexual transmission of HIV;
and Clarence Ridle, a Haitian immigrant living “in the squalor and pov-
erty of Belle Glade, Florida.” Shilts noted that “through Ridle, who con-
tracts AIDS in 1981 and dies in 1983, we examine the curious role of
Haitians and impoverished drug users in the AIDS story.”89 There is
no mention of “Patient Zero” or of Dugas, the identity of whom Shilts
would not discover until at least six months later. Signifi cantly, though,
at this stage the writer included “the epidemic” in his outline’s cast of
characters. “To a large extent,” he wrote, “the disease itself is the major
character. In the beginning of the book, the spreading infection lurks in-
sidiously and mysteriously, appearing in manifestations which few un-
derstand. Quietly, the infection proliferates— to a large extent, before it
is even detected. As the book progresses, the masks that have hidden the
face of this enemy fall away as more becomes known about AIDS.”90
As Shilts’s work on the book progressed and he learned more about
Dugas, it seems that the journalist began to equate the fl ight attendant
with the character of “the epidemic” and, to a lesser extent, “the cu-
rious role of Haitians.”91 The medical historian Charles Rosenberg has
87. Ibid., 10. See also “Proof of Story ‘21880,’” May 21, 1985, folder 2: “2nd book pro-
posal,” box 41, Shilts Papers.
88. Shilts, “Book Proposal,” 10– 13.
89. Ibid., 14– 18.
90. Ibid., 19.
91. Compare this description with “the unique role the handsome young steward per-
formed” in Shilts, Band, 23.
166
chapter 3
suggested that Dugas’s narrative function in the book resembles that of
the rat in Camus’s The Plague, though he points out that the moral im-
plications are signifi cantly different when an author does so using a hu-
man vector.92 It is possible to go further: to Shilts, Dugas came to rep-
resent the plague itself.93 This view supports the suggestion of other
observers that, through his characterization of Dugas, Shilts invested the
virus with agency.94
The proposal also shows that Shilts intended to begin the book in
1980 with the San Francisco Gay Freedom Day parade, noting that “the
major San Francisco characters of the book are all assembled at the pa-
rade that day.”95 The opening section of the book would offer “ominous
vignettes of women and men falling ill of strange cancers and pneumo-
nia in San Francisco, New York, Haiti, Zaire and in European cities with
close contacts to Africa.” He wrote that doctors would “later recall 1980
as a year of grim foreshadowing and the section documents how the vi-
rus spread rapidly across America even while amusement parks whirled
and gays celebrated their new liberation.”96 As Shilts would discover,
the last few years of Dugas’s life would fi t uncannily well into the book
that the journalist had already decided to write.
“I Got So Obsessed with Him”
Shilts later claimed that Dugas “was the one person in the book I wasn’t
looking for. He just appeared. Everywhere I turned in doing the re-
search, his fi gure arose.” Some might view this statement as a late at-
tempt to downplay the importance that many readers would eventually
place on Dugas. These readers might be interested in learning at what
point Shilts, in his own words, “got so obsessed with him.”97 On the
one hand, Shilts’s original book proposal did indeed start with the San
92. Rosenberg, Explaining Epidemics, 287.
93. The Halloween party scene in Band, where Jack Nau picks up a masked blond who
turns out to be Dugas, bears a striking resemblance to the aforementioned description of
“The Epidemic.” See Shilts, Band, 41.
94. Wald, Contagious, 215– 17. See also Hans Zinsser, Rats, Lice, and History (London: George Routledge, 1935), where the author undertakes a biography of the disease typhus.
95. Shilts, “Book Proposal,” 25.
96. Ibid., 30.
97. Bluestein, “Cries and Whispers,” 65.
“Humanizing This Disease” 167
Francisco Pride Parade in 1980, and his discovery of Dugas’s life fi t per-
fectly into an already established framework. On the other hand, the au-
thor believed that AIDS could have been prevented. He combined his
search for heroes and villains with a tendency to glorify epidemiology,
confi dent that this discipline— like the journalistic profession— could ob-
serve, report on, and establish an objective reality. Signifi cantly, he did
not question the initially suggested incubation rate of several months,
even though he had himself written an article in 1985 about the length-
ening incubation period for “HTLV- III, the suspected AIDS virus”— up
to fourteen years.98 All of these factors contributed to the generation of
the mythical and negative portrayal of Dugas.
In an undated fi rst interview with Selma Dritz, Shilts was told about
a “Montreal case” with “8 contacts— all had AIDS.” This man moved
from “SF → LA → Montreal,” and apparently Dritz and her colleagues
“were hoping he had died,” since he had been “going to baths.” She
noted that he had a diary with “176 names,” including “many famous
NYC names,” and that “3 [were] already SF patients.” Though it was
a time when a variety of causes were being considered, “8 confi rmed
he was contact”; therefore, it “had to be infection.”99 Shilts would re-
call that he had written a story about AIDS patients who continued to
go to the baths. As he told an interviewer in 1993, “I had known there
was a guy [with AIDS] knowingly having sex in the bathhouses, and I
did a Chronicle story on that in November of ’82, and I also knew that
there was this study that had linked a lot of the early cases, but I didn’t
know that the person in that study was also the
person who was hav-
ing sex in the bathhouses. And it was only through people dropping
comments that I was able to piece that all together.”100 Shilts would
have been aware of the cluster study in 1982, and in 1983 have heard lo-
cal AIDS researchers talking about a Canadian man who traveled fre-
quently between coastal cities of the United States, and who was diag-
nosed with AIDS, as were some of his sexual partners.101 He may also
98. Randy Shilts, “Longer Incubation Period Reported: New Fears about Spread of
AIDS,” San Francisco Chronicle, April 18, 1985, 4.
99. “Dr. Selma Dritz [I],” interview notes, n.d., pp. 9– 10, folder 19: Dritz, Selma K.,
box 33, Shilts Papers.
100. Wills, “Rolling Stone Interview,” 48. Shilts made an error regarding the year in
which he wrote this story; see Shilts, “Some AIDS Patients Still Going to the Baths,” San
Francisco Chronicle, November 15, 1983, 4.
101. April, “Doctors Brief,” 3.
168
chapter 3
have been aware of a rumored version of this tale that was circulating in
New York in 1983, in which another member of the fl ight crew was pos-
ited to be one of the fi rst affected cases and whose example supported
the notion of an asymptomatic period of infectiousness. “An airline pi-
lot who shuttled between New York and Los Angeles apparently passed
the illness on to four lovers in each city,” a magazine explained. “In a
three-
month period, all eight lovers died.”102 In her interview, Dritz
may have been hinting that the two separately told stories were linked
through this Canadian man. Later in the interview, she recounted her
inter action with the “Montreal case.” “It’s none of your goddamn busi-
ness. It’s my right to do what I want to do with my own body,” Shilts’s
scribbled notes read. “It’s their duty to protect themselves,” declared
“Montreal.” When Dritz replied “not at baths,” the man from Montreal
retorted, “They all know what’s going on there.” According to Dritz,
he then declared, “I’ve got it. They can get it too.” Shilts recorded that
Dritz had not been able to “prove anything” and had contacted the at-
torney general for guidance.103
It seems that Marcus Conant gave Shilts a similarly tantalizing ver-
sion of the story on January 8, 1986. The notes from this interview speak
of “the Canadian case” hailing “from Toronto.” Shilts wrote:
big dick, handsome
blond
slim
wounded puppy faces
brought tremendous empathy
seductive in movements, spe[e]ch
affect
could get anyone he wanted
take home, after sex,
turn on lights
102. Michael Daly, “AIDS Anxiety,” New York [Magazine], June 20, 1983, 25.
103. “Dr. Selma Dritz [I],” 12. Shilts’s handwritten notes of this section of the inter-
view read as follows: “Montreal ‘Ts none f yr gddm [/] busns. Ts my rt t do [/] wht I wnt to
do w/my [/] own bdy.’ [/] SD→ Your right [/] Mon: Ts tr duty to prtct tmslvs [/] SD→ not at
baths [/] Mon: Ty o knw wt gg on [/] there [/] Ive got it. [/] Ty cn get it true.”
“Humanizing This Disease” 169
“See t[he]s[e] bumps. [I’]V[e] g[o]t gay
cancer.”
Conant noted that people were “calling [the KS] hotline” to report that
this man “would screw (anal intercourse).” Conant recalled that he had
phoned Dritz, and he noted that the man had apparently “already threat-
ened to sue Friedman- Kien.” The dermatologist fi nished by pointing out
that the man had had 250 partners in 1979 before he was symptomatic
(fi ve of whom had been confi rmed as AIDS cases), and another 250 in
1980 when he had lymphadenopathy, which had produced another fi ve
AIDS cases. In 1981, he had displayed KS lesions, and of his estimated
250 partners from that year, two AIDS cases had been discovered.104
Shilts pestered Dritz and Conant for the name of this Canadian,
which they both refused to give him. Conant recalled that
when Randy Shilts found out that there was such a patient, Randy went nuts
trying to get the name out of me as to who the patient was. Randy and I by
that time had become close friends, and of course, I was trying to give him as
much information as I could. But I wouldn’t give him Gaetan Dugas’s name.
I can remember calling Randy one day and he said, “You don’t have to tell
me. I’ve got it.” So I don’t know where he fi nally got the name from, but he
got the name.105
Shilts found out the name within a week of his interview with Conant,
while he was interviewing a longtime person with AIDS (PWA) and ac-
tivist, Dan Turner, on January 13, 1986. After asking Turner what it was
like to have AIDS in 1982 and inquiring about his experiences as a PWA
at the Fifth National Lesbian/Gay Health Conference in Denver in 1983,
Shilts may have asked Turner about an early Canadian case.106 On the
last page of the interview notes, Shilts recorded:
104. “Dr. Conant [II], Jan 8 ’86,” pp. 11– 12, folder 14: Conant, Marcus, box 33, Shilts
Papers. This was an approximate recounting of the cluster study’s data.
105. Marcus A. Conant, “Founding the KS Clinic, and Continued AIDS Activism,”
oral history interview conducted in 1992 and 1995 by Sally Smith Hughes, in The AIDS
Epidemic in San Francisco: The Medical Response, 1981– 1984, Volume II, Regional Oral
History Offi ce, Bancroft Library, University of California– Berkeley, 1996, Online Archive
of California, 2009, http:// ark .cdlib .org/ ark: / 13030/ kt7b69n8jn.
106. The Denver conference would later become viewed as the birthplace of the PWA
170
chapter 3
Canadian steward— treated
chemo
since
1980—
(Gayton)–
2
friends
died
airline
steward
sandy
colored
hair—
cute
treated at SFGH
has KS
Laubenstein
treats
Gayton107
From here, Shilts was led, following the clue of Dr. Linda Laubenstein,
to New York City, a destination to which he had recently booked travel
for a research trip in late January and early February. Following this in-
terview with Turner, in his notes from his second interview with Dritz on
January 15, 1986, Shilts uses the name “Gayton.”108
Shilts’s realization that he was on the trail of “Patient Zero” appears
to have struck him in early February 1986, when he was conducting in-
terviews in New York City. While he was there, he found out from a New
York City public health offi cial that the fi rst two patients in that city had
sexual links to a French Canadian fl ight attendant.109 This offi cial, judg-
ing from Shilts’s list of interviewees during this trip, was most likely Mel
Rosen, a former executive director of Gay Men’s Health Crisis (GMHC),
by then the director of the AIDS Institute within the New York State
Dep
artment of Health.110 Shilts later explained dramatically, “The worst
day . . . which I’ll never forget, was the day I discovered that Gaetan
Dugas was Patient Zero and was conceivably the person who brought
the disease to the United States.” Shilts related that on the night that he
movement. These activists decried the use of the term “AIDS victims,” or “patients,” pre-
ferring instead to be called “people with AIDS.” See Grover, “AIDS: Keywords,” 26– 27;
Silversides, AIDS Activist, 43.
107. “Dan Turner 1– 13– 86,” interview notes, January 13, 1986, p. 12, folder 32: Turner,
Dan, box 34, Shilts Papers.
108. “Dr. Dritz II,” interview notes, January 15, 1986, p. 8, folder 19, box 33, Shilts
Papers.
109. See Sipchen, “AIDS Chronicles,” V9. Shilts seems to have interpreted this descrip-
tion of the fi rst two patients in absolute terms, rather than as fi rst among the early reported
cases in New York’s gay community.
110. Shilts’s New York to- do list laid out his intended interviewees, including Mel
Rosen, Michael Callen, and Paul Popham, in that order: “New York, 1986,” handwritten
list, folder 11: New York, Trip, box 35, Shilts Papers.
“Humanizing This Disease” 171
discovered “Dugas’s role as Patient Zero,” he interviewed a dying Paul
Popham, the former president of GMHC. “I’d decided to ask everybody
I was interviewing if they knew Patient Zero, and Popham said very ca-
sually that sure, he knew him, and he told me that his former lover, who
had died of AIDS, once went out with Gaetan.”111
Shilts’s interview notes from his meeting with Popham are headed
with a boxed inscription: “Gayton [/] is [/] Patient Zero.”112 Popham told
him how, as Shilts noted, on “Halloween, 1980,” “Gayton met Jack at
Flamingo” and that Popham had “met Gayton at Trilogy [and] suggested
he see Laubenstein.”113 Shilts appears to have been reminding himself
to ask more questions about Dugas while he listened to Popham talk
about his experiences with GMHC and being diagnosed with AIDS, as
the word Gayton appears twice more in the margins of his notes, until he
arises with more detail once again on page 15. The fl ight attendant is de-
scribed as “blond curly” and having a “trace of a Fr[ench]- Canadian ac-
cent.” Apparently Dugas had promised Popham that he would visit Jack
Nau in hospital. Popham later “told Linda [Laubenstein] to get in touch