Patient Zero and the Making of the AIDS Epidemic
Page 31
had gathered about the dead fl ight attendant in much the same way.
164. “Bob Tivey,” interview notes, 1986, pp. 6– 7, folder 23, box 34, Shilts Papers.
165. Shilts, Band, 246– 47.
166. Draft, 1986, p. 30, folder: Draft, box 36, Shilts Papers.
167. “Frank,” interview notes, 1986, pp. 3, 10, 11, folder 23, box 34, Shilts Papers.
168. “Simon,” interview notes, 1986, pp. 6, 9, folder 23, box 34, Shilts Papers.
184
chapter 3
* * *
In summary, Randy Shilts was an exceedingly driven reporter, one who
had worked very hard to overcome insecurities relating to his looks,
his talent, and his addictions, and had achieved signifi cant successes
in the process. On balance, he was dedicated and hardworking, with
a natural talent for framing stories to suit the tastes of the heterosex-
ual reading public whose appreciation he valued. At the same time, his
self- professed “old- fashioned” view of the journalist’s role in society—
knowing what makes a good story and simply reporting the facts for the
public— speaks to a distinct lack of awareness of how he, as a reporter,
shaped his stories and how they, in turn, molded the public’s social real-
ity. Shilts was desperate to write an important book, not only to secure
the fame he had long craved but also to help protect the gay community
from the ever- growing threats— both pathological and political— posed
by the AIDS epidemic. While he was constantly at pains to point out
his ethical responsibilities as a journalist serving the public interest, the
pressures that he was facing— death of friends, apparent lack of concern
from authorities, and personal bankruptcy— played a signifi cant role in
coloring his view of anyone he believed was not working to fi ght the epi-
demic. In this state of mind, he learned the identity of the scientifi c liter-
ature’s “Patient 0” and over time decided that this man was a sociopath
and to blame for much of the epidemic, and that it was in the public’s in-
terest to know his name.
Shilts’s view of the reporter’s role centered around the idea that he
was in search of black-
and-
white facts and stories—
which added up
to an objective and morally clear view of the world— to be communi-
cated to his readers. While the more subtle aspects of his own subjec-
tive biases as a writer seem to have escaped him, he did understand the
dangers of having his integrity compromised by appearing to be fi nan-
cially or politically connected to the groups he investigated. His com-
mitment to this more explicit, professional ideal of bias- free reporting
extended to a personal refusal to learn the results of an HIV test his
doctor had ordered while he wrote his book, in case it might color the
way he wrote his history. In March 1987, Shilts fi nished the fi nal draft
of the main text of Band and visited his doctor the same day, apparently
having forgotten this previous test.169 During his appointment he learned
169. Wills, “Rolling Stone Interview,” 122.
“Humanizing This Disease” 185
that he was HIV- positive— carrying the same virus he had written so
much about and whose widespread existence across North America he
blamed on the fl ight attendant. Apart from telling his employer and a
few close friends, Shilts kept this information to himself as he and Mi-
chael Denneny worked to make his book into a best seller.
Chapter Four
Giving a Face to the Epidemic
The book is massively an attack on the Reagan administration. The media was not going to
review an attack on the Reagan administration— they simply were not, in 1986. They were
not going to pick up the failures of the medical research establishment, or the government.
That wasn’t a sexy story to them. But the man who brought AIDS to America, especially
because he’s a fag, and a foreigner? That was a sexy story to them. — Michael Denneny, Randy Shilts’s editor at St. Martin’s Press1
Randy Shilts had begun working on his history of the epidemic at a
time when AIDS seemed far from the news headlines. Matters had
changed by the spring and summer of 1987, however, when the book’s
release was being planned. After years of sporadic coverage that oscil-
lated between disinterest and alarm, the North American news media
was suddenly paying more attention to the epidemic— spurred on es-
pecially by the actor Rock Hudson’s AIDS diagnosis in the summer of
1985. Increasingly, journalists sought to show their readers “the Face of
AIDS,” a phrase commonly employed in the second half of the decade.2
Throughout 1986, the LaRouche Initiative focused the attention of mil-
lions of Americans onto the potential— and misstated— risks posed by
people with AIDS (PWAs). Although the initiative’s Proposition 64 did
not pass at the state ballot box, it received 29 percent of the votes cast,
drawing support from more than two million California voters. Such
1. Denneny, recording C1491/22, tape 1, side B; emphasis on recording. Unless other-
wise indicated, Denneny’s quotations in this chapter are drawn from this April 8, 2008,
inter view, conducted in New York City, with italics denoting emphases on the recording.
2. See especially Newsweek’s cover story on August 10, 1987, entitled “The Face of
AIDS: One Year in the Epidemic.”
Giving a Face to the Epidemic 187
fears circulated widely: a national survey conducted the following year
showed that 41 percent of respondents believed that it was “‘very or
somewhat likely” that a person with AIDS could transmit the causative
virus through coughing or sneezing.3 Issues of criminal law were debated
as well, following the publicity, in June 1987, of a court martial of a mili-
tary man accused of knowingly transmitting the virus.4 That month, un-
der increasing pressure to appear decisive, the two houses of Congress
agreed to policy changes that imposed mandatory testing for immigrants
and prison inmates and excluded HIV- positive immigrants from enter-
ing the United States. While the developing consensus that the origins
of AIDS lay in Africa formed part of the rationale for this shift— despite
widespread views in many African countries that the United States was
the source of the disease— long- lasting concerns about the role of homo-
sexual travelers also continued to play a role (see fi g. 4.1).5 Intense social
anxiety about deadly germs combined with heightened unease about an
increasingly interconnected global community, leading at least one his-
torian to conclude that the last fi fteen years of the twentieth century saw
the rise of a sustained “germ panic” in the United States.6 Meanwhile,
across North America most people did not personally know anyone with
the disease. Thus, they relied on the news media for much of their infor-
mation about the epidemic.7
By 1988, recently formed treatment activist groups had begun chal-
lenging the service- focused approach of many community- based AIDS
3. Thomas G. Rundall and Kathryn A. Phillips, “Inf
orming and Educating the Elector-
ate about AIDS,” Medical Care Review 47, no. 1 (1990): 5.
4. Robert O. Boorstin, “Criminal and Civil Litigation on Spread of AIDS Appears,”
New York Times, June 19, 1987, A1, A16.
5. See Brier, Infectious Ideas, 104– 10; Crimp, Melancholia and Moralism, 118. In fi g-
ure 4.1, the planned fl ight path of a “foreign visitor” traveling between North American gay
tourist meccas is rendered with imagery suggestive of Cold War paranoia. “Although atypi-
cal,” the authors note, “this case clearly illustrates how an infectious agent might have been
seeded in various urban populations in a relatively short period of time” (Darrow, Gorman,
and Glick, “Social Origins of AIDS,” 99). It seems that this itinerary was never completed—
the man was admitted to a Florida hospital several weeks into his travels and died ten days
later. Yet the vivid depiction of this potential threat is suggestive of the anxiety that was de-
veloping in the United States in the mid- 1980s when this image was created and published, a
trend which would soon result in the exclusion of immigrants and some travelers with HIV.
6. Nancy Tomes, “The Making of a Germ Panic, Then and Now,” American Journal of
Public Health 90, no. 2 (2000): 191– 98.
7. Emke, “Speaking of AIDS in Canada,” 259.
188
chapter 4
Figure 4.1 Map depicting a “Travel Itinerary (Forty- seven Days and Twelve Cities) for
a Man with AIDS (PCP) from March 1983 to May 1983”; 16.3 cm × 7.6 cm (from Ca-
nadian border to southern tip of Texas). William W. Darrow, E. Michael Gorman, and
Brad P. Glick, “The Social Origins of AIDS: Social Change, Sexual Behavior, and Disease
Trends,” in The Social Dimensions of AIDS: Method and Theory, ed. Douglas A. Feldman
and Thomas M. Johnson (New York: Praeger, 1986), 102. The artist was an unnamed mem-
ber of the CDC’s graphics department. In contrast with the much slower spread of syphilis
in the 1950s represented in fi gure 2.2, here the United States, again depicted in isolation,
appears to be under attack by a rapid, almost missile- like force; the diagram’s frenzied ar-
rows reinforce its message of a swiftly moving “foreign” disease threat.
organizations. Groups such as the AIDS Coalition to Unleash Power
(ACT UP) in the United States and smaller organizations including
AIDS Action Now! and Vancouver PWA Coalition in Canada all de-
manded access to AIDS drugs and staged media- savvy protests that gen-
erated further news coverage.8 Commemorative efforts—
initially the
NAMES Project AIDS Quilt and later more permanent physical struc-
tures such as the AIDS memorials in Toronto and Vancouver— served
dually to remember the thousands of North Americans who had died
in the epidemic and to draw attention in a dramatic fashion to the con-
tinued silence of the American and Canadian federal governments.9 In
8. Larry Kramer, Reports from the Holocaust: The Making of an AIDS Activist (New
York: St. Martin’s Press, 1989), 127– 39; Gould, Moving Politics; Kahn, AIDS, The Win-
ter War, 77– 79.
9. Marita Sturken, Tangled Memories: The Vietnam War, the AIDS Epidemic, and the
Politics of Remembering (Berkeley: University of California Press, 1997), 183– 219.
Giving a Face to the Epidemic 189
May 1987, US President Ronald Reagan delivered his fi rst speech focus-
ing on AIDS since he arrived in offi ce more than seven years previously.
Members of the audience responded with boos when he argued for the
need for widespread HIV testing— including prenuptial HIV tests and
mandatory screening for immigrants— since many public health experts
believed that his proposed measures would do little to address the cri-
sis.10 In another attempt to signal his leadership, Reagan approved the
formation of a presidential commission to investigate the impact of HIV
on the United States and to formulate a national strategy, a move which
guaranteed that the epidemic would stay on the media’s radar.11
As early as 1983, health authorities had recognized that the Canadian
epidemic appeared to be lagging behind that of the United States, by as
much as two years. Nonetheless, Canada still had a high per capita num-
ber of cases and the world’s third- highest reported incidence in the early
1980s.12 Its federal government had also been hesitant to get involved in
the response to AIDS, delegating the research and decision- making to
an underfunded and often dysfunctional National Advisory Committee
on AIDS (NAC- AIDS). The committee’s chair would eventually resign
in 1989 in protest of the continued inadequacy of the federal govern-
ment’s response.13 With a hesitancy that resembled that of the Ameri-
can president, the Canadian prime minister Brian Mulroney waited un-
til 1989— after nearly fi ve years in offi ce— before publicly mentioning
AIDS, in front of booing protesters at the International AIDS Confer-
ence in Montreal. These activists— Canadians and Americans protesting
together— were a testament to the strong networks of information and
strategy distribution that fl owed across the shared border and to other
continents in the 1980s. These alliances benefi ted from previous connec-
tions established through gay liberation efforts in the preceding decades,
ease of travel between the countries in question, and similarities in their
gay cultures.14
10. Philip M. Boffey, “Reagan Urges Wide AIDS Testing But Does Not Call for Com-
pulsion,” New York Times, June 1, 1987, A1, A15.
11. Brier, Infectious Ideas, 91– 101; Kahn, AIDS, The Winter War, 101– 215; Kramer,
Reports from the Holocaust, 149– 61, 182– 85.
12. Horace Krever, Commission of Inquiry on the Blood System in Canada, Final Re-
port, 3 vols. (Ottawa: The Commission, 1997), 1:283.
13. Norbert Gilmore, interview with author, Montreal, July 10, 2008, recording
C1491/32, tape 2, side A, BLSA.
14. Silversides, AIDS Activist, 190–
98. As Silversides demonstrates in her book,
190
chapter 4
It was into this mélange of political developments and media coverage
that Shilts’s popular history made its fi rst appearance, offering a com-
pellingly readable— and at times dangerously simplistic— explanation of
how the epidemic had begun. This chapter explores how North Ameri-
can audiences responded to And the Band Played On and, in particu-
lar, to the “Patient Zero” story that was used to sell it. The chapter fo-
cuses fi rst on the yearlong period from the spring of 1987 to the spring
of 1988, from the time that Shilts fi nished his manuscript to the peak
of the book’s success. It considers the marketing approach adopted by
Michael Denneny, Shilts’s editor at St. Martin’s Press, and draws on
newspaper interviews with Shilts over the fall and winter to evaluate
Denneny’s claim that he adopted the promotional strategy against the
journalist’s wishes.15 The chapter turns next to how the story was imag-
ined, adopted, ignored, and protested by various individuals and groups
across North America and deployed for di
fferent aims. In particular,
it shows how the idea of “Patient Zero” became embedded, with long-
lasting consequences, in emerging discussions about the criminalization
of HIV transmission in the United States. Throughout, the chapter em-
phasizes how the story displayed a widespread utility as it was recycled
and reformulated for particular audiences. Here, with its recombination
and recirculation of tales of disease origin and deliberate transmission,
the North American AIDS epidemic bore a remarkable similarity to ep-
idemics from centuries past.
Producing and Releasing And the Band Played On
By the time that Denneny commissioned Shilts’s history in the spring of
1985, Denneny had been working in the publishing industry for fi fteen
years. The editor had developed a name as one of the few openly gay ed-
itors in a robustly closeted industry. Since 1981, he had also been closely
linked to members of the New York lesbian and gay community who
were leading the fi ght to respond to the emerging epidemic. Denneny
Michael Lynch was the quintessential border- crossing activist, forging and bridging re-
sponses in both countries.
15. In research that took place independently and in parallel to my own, Phil Tiemeyer
covers similar ground in his book Plane Queer: Labor, Sexuality, and AIDS in the History
of Male Flight Attendants (Berkeley: University of California Press, 2013), 168– 93.
Giving a Face to the Epidemic 191
had begun as a part- time editor at the University of Chicago Press in the
late 1960s, working there for two years while conducting research for his
PhD in Social Thought under political theorist Hannah Arendt. Coming
to New York City in 1971, he sought work in the publishing industry and
secured a job as an editor at Macmillan, where he enjoyed a successful
fi ve years. With Charles Ortleb, Denneny founded the glossy gay maga-
zine Christopher Street in 1976, an act that promptly resulted in his be-
ing fi red from Macmillan following the fi rst issue’s release. Once again
searching for a job, the editor impressed the CEO of St. Martin’s Press
and convinced him of the viability of an emerging gay market for which
he wanted to develop books. Denneny soon brought forward a proposal
for Shilts’s fi rst book, The Mayor of Castro Street. While working for