Patient Zero and the Making of the AIDS Epidemic

by Richard A. McKay

  11. Bayer and Oppenheimer, AIDS Doctors, 63– 64.

  12. Epstein, Impure Science, 45– 78; Brier, Infectious Ideas, 26– 44.

  Locating Gaétan Dugas’s Views 293

  plied. In her sensitive examination of the Irish American cook’s life in

  the late nineteenth and early twentieth centuries, the historian Judith

  Walzer Leavitt explored the coping diffi culties experienced by an indi-

  vidual when the terrain of scientifi c and medical knowledge dramatically

  shifted around her vantage point. Mallon faced repeated and lengthy in-

  carcerations when the scientifi c and medical authorities of her day mod-

  ifi ed their way of imagining disease transmission in response to novel

  observations. Their new paradigm allowed for the existence of healthy

  carriers, capable of transmitting infections while displaying no signs of

  disease. This shift did not translate into Mallon’s worldview, and her re-

  luctance to concede to new public health demands left her vulnerable

  to demonization in subsequent historical accounts. Not surprisingly,

  Leavitt specifi cally compared the experiences of Mallon and Dugas,

  both being vulnerable to public health scrutiny following their identifi ca-

  tion as disease “carriers” by experts.13 This chapter extends this compar-

  ison as it investigates a key diffi culty presented by such paradigm shifts:

  the challenges faced by individuals whose behavior comes to be judged

  by a new paradigm’s standards.

  In this chapter I oppose the assertion that Dugas ignored incontro-

  vertible information about AIDS and was intent on spreading his infec-

  tion. The information available to him and to others between April 1982

  and June 1983— the period during which his actions have faced the most

  scrutiny— and on which they based their decisions and actions, was far

  less stable, coherent, and self- evident than it was often later portrayed

  to be. The chapter combines interview and documentary evidence to in-

  terpret how members of several North American gay communities made

  sense of the threat of the condition that would become known as AIDS.

  Throughout, readers might ask themselves: To which sources would a

  gay man turn to obtain what he perceived to be reliable information

  about a growing risk to his health? How would he have perceived the ad-

  vice of doctors and public health offi cials? At what stage did the threat

  of AIDS move from the realm of distant to present danger? And, cru-

  cially, in what theories of causation and cure might he have believed?

  Keeping these questions in mind is essential if we are to position Gaé-

  tan Dugas’s responses to AIDS in a historically sensitive manner. A re-

  vised view emerges of Dugas’s experience as a KS patient, and later as

  a person with AIDS, based in part on reading Shilts’s research mate-

  13. Leavitt, Typhoid Mary, 14– 38, 162– 201, 234– 38.

  294

  chapter 6

  rials against the grain.14 Drawing from these notes, Shilts would sug-

  gest in his book that from March 1983 onward, Dugas’s “sexual prowl-

  ing had reached near- legendary proportions.” He believed that the man

  attempted to infect others on the basis of internalized homophobia. The

  journalist also wrote, dismissively, “At one time, Gaetan had been what

  every man wanted from gay life; by the time he died, he had become

  what every man feared.”15 Challenging Shilts’s perspective, this chap-

  ter demonstrates that, while Dugas did indeed struggle with his diag-

  nosis and with some physicians’ interventions, he also made attempts to

  change his behavior, was able to offer assistance to others, and main-

  tained close contact with friends and family whom he loved. In the pro-

  cess, he shared much in common with other early KS patients and would,

  shortly after his death, be eulogized for symbolizing strength and deter-

  mination in the face of adversity.

  Gaétan Dugas’s Early Life

  Dugas was born on February 19, 1952, and adopted into a large Que-

  becois family living in the small town of Ancienne- Lorette, a parish

  roughly thirteen kilometers (about eight miles) west of Quebec City

  which could trace its roots to the seventeenth century. His adoptive par-

  ents hailed from farming families in the more remote Gaspé Peninsula

  and had moved to their new community by the mid- twentieth century.16

  14. Porter suggested several works as exemplars to guide efforts at patient- centered

  histories of medicine, including Carlo Ginzburg, The Cheese and the Worms, trans. John

  Tedeschi and Anne Tedeschi (Baltimore: Johns Hopkins University Press, 1980). This

  “microhistory” provides an excellent example of reading evidence— in this case the inquis-

  itorial trial records of a sixteenth- century miller accused of heresy— “against the grain” to

  reconstruct the worldviews of a man who would typically have been left out of the histori-

  cal record. This tactic has been widely employed by postcolonial scholars as well, following

  a provocative and widely discussed lecture by Gayatri Chakravorty Spivak in the 1980s;

  see Rosalind C. Morris, ed., Can the Subaltern Speak? Refl ections on the History of an

  Idea (New York: Columbia University Press, 2010), 1– 7.

  15. Shilts, Band, 251– 52, 439.

  16. Dugas’s adoptive parents were married in 1935 in Ste- Anne- des- Monts, Quebec,

  and worked at the time as a day laborer (“journalier”) and a domestic worker (“travaux do-

  mestiques”); Bulletin statistique de mariage no. 104443, formulaire de mariages, 1935, Bi-

  bliothèque et Archives nationales du Québec, Montreal. The 1911 Census of Canada lists

  several families with their surnames in the surrounding area.

  Locating Gaétan Dugas’s Views 295

  In the 1950s, like today, two landmarks dominated Ancienne- Lorette: at

  its heart, the towering twin spires of the Notre- Dame de l’Annonciation

  church, and, to the southwest, an expansive airfi eld. Farming land and

  a small glove factory offered ready employment for its residents, while

  improving transportation links to Quebec City and gradual expansions

  to the airfi eld strengthened the town’s connections to the wider world

  and held the prospect of growth. Following its use as an air force base

  and air observer school during the Second World War, the community’s

  airfi eld was inaugurated as a commercial airport in late 1957.17 The air-

  port’s increasing size helped drive the small town’s development, and it

  seems likely that Dugas’s dreams of fl ying, and of the wider world be-

  yond Ancienne- Lorette, would have been stirred at a young age. By

  training as a hairdresser he initially followed in the footsteps of sev-

  eral female family members who worked in the hair and beauty profes-

  sion, though the young Dugas may also have been infl uenced by an older

  brother- in- law who worked as an airman.18 A friend later recalled him

  praising his family members for their steadfast acceptance of his non-

  conforming expressions of gender and sexuality.19 Given his nurturing

  upbringing, it seems likely that Dugas would feel confi dent in eventually

  choosing a profession that married the glamour of hair an
d makeup with

  the horizon- breaking excitement of air travel.

  These youthful stirrings were quite possibly further encouraged by

  the 1967 world’s fair in Montreal, an event of international signifi cance

  marking Canada’s centennial year and the host city’s 325th anniversary.

  Held between April and October, and with participation from more

  than sixty countries, Expo ’67 set attendance records and drew more

  than fi fty million visitors, a number more than double the host country’s

  17. Lionel Allard, L’Ancienne- Lorette (Ottawa: Éditions Leméac, 1979), 361– 62. It

  seems that the townspeople enjoyed good relations with the international airmen who

  trained at the base during the war and who were remembered as “congenial and courteous

  young men.” A record kept at the airport, possibly written by the local chaplain, pointed

  out the “providential” fact that the town’s namesake, Notre- Dame de Lorette, was also the

  recognized patron saint of fl iers; see “Village Founded in 1667,” clipping, ca. 1945, institu-

  tional records, l’Aéroport international Jean- Lesage de Québec. The author is indebted to

  Claude Savard, the airport’s director of safety and security, for taking the time to locate

  this material during a visit in December 2007.

  18. I have derived this employment information from a review of marriage records

  compiled by Institut généalogique Drouin and accessible with a paid subscription to Gene-

  alogy Quebec, https:// www .genealogiequebec .com/ en/.

  19. Conn, recording C1491/34, tape 1, side B, BLSA.

  296

  chapter 6

  population.20 Whether Dugas attended remains in the realm of specula-

  tion. However, it would seem strange if the fi fteen- year- old had not vis-

  ited the fair— one of the most signifi cant events to take place in North

  America that year— which took place less than a three- hour car journey

  from his quiet hometown. Air Canada’s pavilion— a distinctive structure

  topped by a helix of cantilevered triangular blades rising into the sky—

  was a crowd favorite, drawing regular queues and an average of nine

  thousand visitors each day.21 Visitors were guided along an artfully de-

  signed journey of darkness and light, projected slides and sixteen milli-

  meter fi lm, through a history of fl ight culminating in “the airplane’s con-

  quest of time and geography.” The fi nale was a projected fi lm sequence,

  depicting Montreal as a gateway to the world and climaxing in a mosaic

  of exciting travel destinations— “a colourful spectrum of simultaneous

  worlds, not just to be talked or read about, but experienced. ” At a bud-

  geted cost of $1.5 million, the pavilion’s interior was carefully planned

  to avoid any explicit advertising message for Air Canada. Yet the pro-

  motional benefi ts to the company were clear and even extended beyond

  the aim of inspiring among visitors the desire to travel by air at a cost

  within their reach.22 As the draft for a company speech noted optimisti-

  cally, “Such personal contact with compressed knowledge on air trans-

  portation may even invite visitors in seeking a career in aviation.”23 If, in

  1967, the teenaged Dugas was one of the several hundred thousand vis-

  itors to pass through this celebration of the glamour, opportunity, and

  adventure of mid- twentieth- century aviation, the experience could in-

  deed have been a formative one.

  Certainly, Dugas decided in his teenage years that he would become

  a fl ight attendant, and in 1972, he took advantage of a recent federal gov-

  20. Bureau International des Expositions, “1967 Montreal,” accessed February 2, 2017,

  http:// www .bie - paris .org/ site/ en/ component/ k2/ item/ 102– 1967- montreal.

  21. J. M. Jackson to P. S. Turner, 12 July 1967, folder 9000– 4- 1c, vol. 264, RG70– 10- b,

  Air Canada Expo 67 Pavilion, Air Canada fonds, Library and Archives Canada, Ottawa

  (hereafter cited as Air Canada fonds).

  22. Meeting minutes and attached summary of design objectives and comments of the

  Air Canada Expo Committee, September 6 and 7, 1966, folder 500– 3, vol. 260, RG- 70–

  10- b, emphasis in original document, “Comments on Pod 3”; budget outlook fi gures from

  Expo 67 Operating Plan, folder 9000– 4- 1c, vol. 264, RG- 70– 10- b, Air Canada fonds.

  23. Lillian Lancaster to Chris de Lavison, 17 February 1966; Chris de Lavison, “Notes

  on Air Canada’s Participation to Expo 67,” p. 4, 25 February 1966; both in folder 500– 8,

  vol. 260, RG- 70– 10- b, Air Canada fonds.

  Locating Gaétan Dugas’s Views 297

  ernment initiative to encourage bilingualism. This program subsidized

  the cost of immersion language training for Canadians wishing to learn

  either French or English as a second language in areas where this was

  the primary language spoken.24 Because Air Canada required fl ight at-

  tendants working in Quebec to be able to speak both languages, Dugas

  traveled with a friend to Vancouver to learn English in the spring of 1972

  (see fi g. 6.1). Staying in dormitory residences at the University of Brit-

  ish Columbia, he met Ray Redford, and by the end of that summer the

  two young men had begun an intense love affair. Redford recalled a visit

  to stay with Dugas’s family in December of that year, which demon-

  strated to him how well integrated his lover was within his adopted fam-

  ily. Dugas tried to fi nd work in British Columbia as a hairdresser; their

  relationship lasted for a couple of years until the strains of Dugas’s fre-

  quent traveling and parallel romances overwhelmed it.

  Following some help from Redford in the application process, Dugas

  was hired as a fl ight attendant with Air Canada in 1974. The airline had

  recently opened up the former “stewardess” position to male applicants,

  and Dugas began to travel widely. Although this appears to have doomed

  their relationship as lovers, Redford and Dugas would remain in touch

  as friends. Dugas moved frequently between bases in Canada and spent

  periods living in Toronto (1976– 1979), Halifax (1977, 1980), Ancienne-

  Lorette (1980), Montreal (1981–

  1983), and Vancouver (1983–

  1984).25

  Work with Air Canada permitted him to fl y to Europe, the Caribbean,

  and extensively across the United States. He even married a California

  woman in 1977, a friendly and convenient exchange which, he explained

  to a friend and coworker, allowed him and his wife to move with greater

  ease between each other’s countries.26 As another fl ight attendant friend

  24. Matthew Hayday, “Confusing and Confl icting Agendas: Federalism, Offi cial Lan-

  guages and the Development of the Bilingualism in Education Program in Ontario, 1970–

  1983,” Journal of Canadian Studies 36, no. 1 (2001): 50– 79.

  25. In addition to details Shilts provides in Band, this reconstruction is based on a re-

  view of telephone directories for these Canadian cities for the years spanning 1972– 1984;

  Library and Archives Canada, Ottawa. No record of the fl ight attendant was found in the

  directories covering the city of Halifax and the neighboring town of Dartmouth, Nova Sco-

  tia. Nonetheless, Shilts’s notes indicate that Dugas
was based in Halifax in 1977 (interview

  with “Simon,” p. 1, folder 23, box 34, Shilts Papers), and his colleague Desiree Conn re-

  called his presence there in 1980; Conn, recording C1491/34, tape 1, side A, BLSA.

  26. Jacques Menard, interview with author, Vancouver, August 19, 2008, recording

  C1491/37, tape 1, side A, BLSA; marriage registry certifi cate, June 27, 1977, County of Los

  Angeles, California.

  298

  chapter 6

  Figure 6.1 Gaétan Dugas in Vancouver, summer 1972; 7.7 × 7.7 cm. Scan of a photograph,

  which was printed from a slide original. Reproduced with permission from Ray Redford

  and from Richard A. McKay, who holds rights to the digital image. This candid photo-

  graph of a relaxed and confi dent- looking Dugas, at the age of twenty, was taken by Ray

  Redford at his downtown Vancouver apartment, near the beginning of their relationship.

  recalled in 1986 when he was interviewed by Randy Shilts, it was “hard

  to keep track” of Dugas’s movements, a diffi culty which remains as true

  for later historians as it was for Shilts, and for William Darrow tracing

  Patient 57’s travels in 1982.27 The fl ight attendant thrived amid the social

  networking afforded by his position, and he was also able to treat family

  members, particularly his adoptive mother with whom he was very close,

  to travels beyond their regular means. Furthermore, Dugas was able to

  27. “Simon,” interview notes, p. 3, Shilts Papers.

  Locating Gaétan Dugas’s Views 299

  take part in a gradually more visible gay culture in cities across North

  America. Canada’s urban gay communities began to be more open and

  active following the 1969 decriminalization of consensual sexual acts be-

  tween two adults of the same sex in private. This cultural enlivening par-

  alleled developments south of the border, as the gay liberation move-

  ment gathered momentum.28

  Dugas’s coworkers at Air Canada fondly recalled that he had unfail-

  ing optimism, was an exceptionally hard worker, and had a delightful

  and mischievous sense of humor, which made him popular with passen-

  gers, to whom he delivered outstanding service. They recalled the care

  and attention he took to looking his best— he would joke that he was

  “the queen of the queens”— with perfectly applied makeup, carefully