Patient Zero and the Making of the AIDS Epidemic

by Richard A. McKay

  And the Band Played On were sold, the result would be a continued na-

  tional “silence” on AIDS policy. His deployment of the “Patient Zero”

  story to hook the media’s interest and generate discussion was power-

  fully effective. In these aforementioned examples, we can see how si-

  lence was used in a variety of ways: to deal privately with familial grief

  and anger, in the case of the Dugas family, and to reclaim a space of dig-

  nity. Employees of the Centers for Disease Control employed silence in

  an attempt to guard a dead man’s identity and the agency’s own repu-

  tation, as part of a wider necessity of safeguarding a long tradition of

  protecting confi dential health information. Meanwhile, workers for the

  Canadian Broadcasting Corporation sought to employ silence for pro-

  tection. One exploited the cloak of secrecy afforded by linguistic incom-

  mensurability to help guard a family’s little remaining privacy in one

  case, while another withheld a story to shield lesbian and gay commu-

  nities and AIDS organizations from potentially damaging rumors in

  another. The decision to stay silent may, in some cases, have been suc-

  cessful, while in others it may have deprived the wider public of useful,

  corrective information to counter the “Patient Zero” story. Ultimately,

  there may be too little evidence to suggest that these acts of silence—

  enacted by members of the media and the public in opposition to the

  widespread naming of Gaétan Dugas and dissemination of the “Patient

  Zero” story— made a signifi cant difference to the narrative’s impact, in

  view of the sustained efforts by St. Martin’s Press to promote the book.

  They do, however, point to moments of individual agency and alterna-

  tives to the compulsion to disseminate information that appears to have

  underpinned the approach of Shilts and other reporters like him.

  Giving a Face to the Epidemic 217

  Reactions

  As California Magazine’s exclusive rights to the “Patient Zero” story ex-

  pired near the end of October 1987, St. Martin’s Press licensed the ex-

  cerpts from the book dealing with Dugas to be serialized and featured

  in newspapers across North America. In artwork accompanying one of

  these featured segments, a uniformed fl ight attendant’s face was replaced

  with a fi ngerprint, in an allusion to Dugas’s own personal stamp on the

  virus within him (see fi g. 4.4). His gloved fi ngers are separated and tightly

  constricted in a clawlike, predatory manner suggestive of a vampire or

  other demon in search of a victim. The article’s subtitle— “Wherever

  Gaetan Dugas paused, gay men began to sicken and die”— strongly rein-

  forced this message.78 Response in the form of letters to mainstream and

  gay newspapers reveals fears that the reported behavior of Gaétan Du-

  gas— as a conscienceless monster— would tar the entire gay community.

  Many readers certainly did take away that impression. A Florida man

  writing to his local newspaper, the St. Petersburg Times, used Shilts’s

  work to buttress his claim that homosexuality was synonymous with pro-

  miscuity. With a muddled sense of the facts gleaned undoubtedly from

  a combination of the media’s misleading reports and the serialized ex-

  cerpts, the man explained that “Dugas picked up the disease in Europe

  through sexual contacts with Africans. He was diagnosed in 1980 as

  communicating a possibly fatal sexual disease and labeled ‘Patient Zero’

  by medical researchers. Even then he refused to restrict his homosexual

  activity, which averaged some 250 partners per year and was spread from

  coast to coast through his airline travels.” The letter writer signaled his

  disdain for the claims by gay AIDS organizations that they were being

  unfairly criticized: “If, as one letter writer claims, homosexuals ‘have

  done more than any other group to combat the AIDS crisis,’ then it is

  also an inescapable fact that these same homosexuals brought on the cri-

  sis in the fi rst place and for the most part refuse to curtail the activity

  that is spreading it exponentially.”79

  Another reader wrote to Time magazine, nominating the fl ight atten-

  dant for the publication’s annual “man of the year” award. “ Unfortunately,”

  78. Chicago Tribune, November 1, 1987, sec. Tempo, 1, Shilts Papers.

  79. James V. Christy, letter to the editor, St. Petersburg [FL] Times, November 8, 1987, 3D, Factiva (stpt000020011118djb802326).

  Figure 4.4 Artwork accompanying the serialized “Patient Zero” story, Chicago Tribune,

  November 1, 1987, sec. Tempo, 1, Randy Shilts Papers (GLC 43), LGBTQIA Center, San

  Francisco Public Library. Framed image of fl ight attendant measures 7.5 × 10.4 cm. © Tom

  Herzberg. Reproduced with permission from the artist. This image, by Chicago- based ed-

  itorial illustrator Tom Herzberg, introduced the Tribune’s serialization of the “Patient

  Zero” excerpts from Shilts’s book. At the bottom of this page, below the fl oating image of

  the uniformed air steward, a reader of the Tribune would have seen a pixelated, black- and-

  white photograph of a crowd of about twenty people walking toward the camera. Four of

  them had a fi ngerprint stamped on their faces, suggestive of the spread of one individual’s

  virus. A photograph of Dugas from his 1984 obituary in Le Soleil lay buried in the section’s

  fi fth page, perhaps indicating the decreasing signifi cance of Dugas’s actual likeness to the

  development of the mythological fi gure of “Patient Zero.” In a September 2016 e- mail to

  the author, Herzberg recalled being intrigued by the idea that AIDS could be traced to one

  person, and given the feature’s emphasis on identifying Dugas, he developed the idea of

  featuring a fi nger print. Since the job was a rushed one and the technical process involved

  in rendering an artistic fi ngerprint was too time- consuming, he simply used his own. This

  image and the accompanying story were distributed to more than 1.2 million readers of the

  Tribune’s Sunday edition.

  Giving a Face to the Epidemic 219

  the woman noted dryly, “it appears he was man of the year for a number

  of years.”80 It would seem that People magazine took such a suggestion se-

  riously: the publication featured Dugas as one of the year’s “25 most in-

  triguing people” in an issue released two weeks later, alongside Princess

  Diana and other luminaries of the period. The entry, which reused the

  60 Minutes photograph of Dugas, suggested that the fl ight attendant was a

  “human explosive” who “never fully understood or accepted his role as a

  major transmitter of the virus” and was “sexually active to the end.”81

  In Halifax, this magazine article infuriated those fl ight attendants

  who had been close with Dugas. As his friend and former colleague De-

  siree Conn recalled, it was an affront not only to Dugas’s memory but

  also to their profession:

  I remember reading that and being so angry, and I mean I’m not gay, but I

  was so angry about what they were accusing him of. And I thought to myself,

  “Okay, how many people before Gaétan— Gaétan, when I knew him, thought

  he had cancer— so how ma
ny people before him who thought maybe they

  had cancer didn’t really have cancer at all but had AIDS?” So how dare they

  [ speaking slowly] say that, and how dare they say that when he knew he had

  AIDS that he didn’t care about other people and actually tried to spread it

  on purpose. . . . But when that particular issue of People came out, everybody

  was so up in arms, we were buying them to throw them out, [ pausing] because

  we were just so, I don’t know, ticked, I guess, with the article and the fact that

  it wasn’t just a slight against Gaétan, it was a slight against all of us. And they

  were saying in the articles that basically we were a bunch of promiscuous fl y

  people and that that’s what we basically did for a living.82

  Conn recalled many copies of the popular issue being left on planes af-

  ter passengers disembarked: “We kept picking them up so that if people

  were reading them, we were taking those magazines and throwing them

  in the garbage, so that they didn’t stay circulating.”83

  Some friends and colleagues, like Conn, were later adamant that the

  80. Jeanne Padron, “Man of the Year?” letter to the editor, Time, December 14, 1987;

  this letter was also quoted in “Did You Hear . . . ?,” NYN, December 21, 1987, 4.

  81. “Patient Zero,” People, December 28, 1987, 47.

  82. Desiree Conn, interview with author, Halifax, NS, July 31, 2008, recording C1491/

  34, tape 1, side B; emphasis on recording.

  83. Ibid.

  220

  chapter 4

  man they knew had not “a mean bone in his body” and would never de-

  liberately hurt another person in the manner suggested by Shilts and

  by media reports like the People magazine article.84 Others held more

  complicated views. One queer-

  identifi ed and HIV- positive male ac-

  quaintance recalled “a very popular saying back then, ‘Stiff dick has no

  conscience.’” Though this man completely rejected the notion of ap-

  portioning any blame to Dugas, he believed it was likely that the fl ight

  attendant had engaged in “unprotected sex when he probably knew

  he shouldn’t have.”85 Another colleague, while carefully stressing that

  she did not know Dugas well enough to interpret his specifi c experi-

  ence, acknowledged what for her was an abstract plausibility to Shilts’s

  characterization— that someone facing such trying circumstances and

  so many unknowns might engage in careless behavior which put others

  at risk:

  I think it’s entirely possible for a person, not necessarily for Gaétan but for a

  person, who receives a diagnosis that is in essence a death sentence, and who

  gets really angry because nobody can really tell them exactly where it came

  from but they say to them, “Because of who you are, because you are a gay

  man, because you enjoy sex, because you’ve been with lots of men, that’s why

  you’ve got this disease,” combine it with a Catholic upbringing which says ev-

  erything is your fault anyway or God’s visiting upon you because of some-

  thing you did, I think it’s entirely possible for him to be in a state of denial,

  anger, whatever emotional turmoil he was in, to go out and have sex with peo-

  ple unprotected, knowing that there was a chance that he was doing some-

  thing that might put them at risk. Not, not maybe deliberately loading the gun

  and fi ring it and saying, “I know I’m gonna kill you,” but, “I’ve got it. I didn’t

  do anything to bring this on myself other than be who I am. Why should I be

  worried about whether or not I’m giving it to you? I’m just bloody pissed off.”

  So I guess in an abstract sense I could understand it if that’s what happened,

  but I . . . didn’t know him well enough to understand if that was where he was

  coming from.86

  84. Conn, recording C1491/34, tape 1, side A (“a mean bone in his body”); Barbara

  Dunn, Elaine Watson, and Janice Miller, interview with author, Vancouver, June 10, 2008,

  recording C1491/26, BLSA (Dunn’s defense of Dugas at tape 1, side B).

  85. Spencer Macdonell (pseud.), interview with author, Vancouver, June 11, 2008, re-

  cording C1491/27, tape 2, side A.

  86. Dunn, Watson, and Miller, recording C1491/26 (Watson quoted at tape 1, side B).

  Giving a Face to the Epidemic 221

  The photographic portrait of Dugas in People magazine would receive

  the widest circulation and deployment of any photograph depicting him,

  appearing as it did in the magazine and weeks earlier on 60 Minutes. As

  such, it is illuminating to examine the picture and its wide travels. The

  image viewers see most clearly shows the fl ight attendant in a moment of

  apparently good physical health— tanned, muscled, and lean. Given the

  emphasis in Shilts’s popular history and the surrounding publicity that

  Dugas had lured hundreds of men into sexual liaisons, it should not be

  surprising that this photo would be used the most frequently to depict

  his physical appeal. As it appears in 60 Minutes, the image has a slightly

  awkward composition, with the lower edge of frame clipping Dugas’s

  right arm at the elbow, left forearm at the wrist, and most of his lower

  body at the waist. By contrast, a distant view of the image, held later by

  the host Harry Reasoner in a medium over- the- shoulder shot as he inter-

  viewed one of Dugas’s former lovers, one is able to see that this was not

  its original composition but rather a cropped view, a reduction possibly

  imposed by producers wary of broadcasting standards and not wanting

  to engage with complaints about the depiction of Dugas’s groin, clad in

  what appears to be a bodybuilder’s posing pouch. It seems likely that the

  original image was a 5- by- 7- inch photograph, probably belonging to one

  of Dugas’s former lovers, a memento sent by the fl ight attendant while

  he was out of town. In this sense, Dugas was like many other gay men of

  the period who sent letters and postcards with enclosed photographs of

  themselves to distant friends and lovers.87

  The image was wrenched from this originally private realm, one

  which acknowledged the physical, sexual relationship connecting two

  men, and thrust into an overwhelmingly public and disembodied set-

  ting—broadcast to millions of North American viewers in their homes.

  This dislocation is amplifi ed by the cropping the photograph underwent,

  fi rst by the producers of 60 Minutes and then in its subsequent incarna-

  tions. An even smaller version was printed in People magazine. Its ap-

  pearance now approached that of a standard head- and- shoulders shot,

  although due to differences of shading and the original angle of the pho-

  tograph, Dugas’s neckless head rather looks as if it has been removed

  from another body and glued onto a new set of shoulders. The photog-

  87. Where they have survived, the correspondence and enclosed photographs in nu-

  merous LGBT archives attest to this fact.

  222

  chapter 4

  rapher’s identity was permanently erased, with the caption for the image

  reattributing the credit: “Photograph by CBS News, 60 Minutes.”

  People magazine’s international circulation facilitated the wide dif-
<
br />   fusion of this photograph— literally presenting Dugas as “the Face of

  AIDS,” a popular theme in news feature reporting throughout 1987. The

  owner of one particular copy apparently thought that Dugas personifi ed

  the group that was responsible for the epidemic. Such was the force of his

  or her conviction that this person photocopied the magazine page, anno-

  tated it, and mailed this palimpsest to the San Francisco AIDS Foun-

  dation, in whose archived records it now rests (see fi g. 4.5).88 One can

  scarcely think of a more different motive for this mailing than the one

  that may have brought the picture from Dugas to a lover. The original

  article presents Dugas as a “missing link” to researchers, when in 1987 it

  was clear that the “links” he represented in the early cluster study were

  deeply problematic, given the current knowledge of HIV incubation pe-

  riods. The article likely suggested other “links” to the person mailing

  the photo, too, given the immediate historical context. In the past year,

  Lyndon LaRouche had spearheaded a restrictive initiative in California

  to test and track down PWAs; just weeks before, on October 14, Sena-

  tor Jesse Helms was fi ghting in Congress to remove funding from gay-

  run AIDS prevention services and declared, “Every AIDS case can be

  traced back to a homosexual act.” 89 In this context, the reader who an-

  notated and mailed the image was able to view Dugas/“Patient Zero” as

  the ultimate embodiment of guilt and the cause of the epidemic. In some

  instances, then, by delivering to conservatives an exaggerated model of

  gay male sexuality, And the Band Played On and the publicity surround-

  ing it managed to fan the fl ames of a movement Shilts and Denneny were

  hoping to counter.

  Of the image’s many subsequent apparitions, some more public than

  others, three in particular are worth mentioning. The fi rst, retitled

  “Proud Lives,” appeared in a gay magazine in Vancouver, in an article

  showing solidarity for fallen community members (fi g. 4.6). In contrast

  88. San Francisco AIDS Foundation (SFAF) Records, MSS 94– 60, carton 2, folder:

  “Assorted Bizarrities” [mail received] (2 of 2 folders) 1985– 91, Archives and Special Col-

  lections, UCSF Library and Center for Knowledge Management, University of California–