Patient Zero and the Making of the AIDS Epidemic
Page 55
“the truth is, Paul freely admits, ‘We don’t know.’”110
Meanwhile, in the absence of reliable information, readers expressed
concerns about the sexual activities of KS patients, some of whom they
could identify by their visible lesions. A letter published in mid- September
1982 related a disclosure at an August 24 forum on AIDS hosted by the
city’s public health department. The writer explained that Jim Geary
from the Shanti Project, a support organization serving gays and lesbians
with life- threatening conditions, announced “that it has been brought to
his attention that KS clients are being seen at the various baths and back-
rooms.” The letter writer urged for the newspaper to “acknowledge this
information so that we attending such places can at least make an aware
choice as to our possible exposure.”111 The same author published a letter
the following week, criticizing as “vague” the editor’s September 9 discus-
sion of the syndrome and asked again, “If the public health department
lectures can expose the fact that men with KS are being seen at the 8th &
Howard baths then why don’t you honor any letters with this information?
The public, e.g. gay brothers, should be aware and make choices as to
their exposures to baths and glory holes.” The author also suggested that
“an open letter to KS men addressing their sexuality would be helpful.”112
Jim Geary penned a lengthy response for the following week’s paper.
He started by stressing the tenuous nature of the sightings, stating, “The
reports that a man with Kaposi’s sarcoma was seen at the baths was ru-
mored by several sources. I know of no KS client currently served by
the Shanti Project who attends the baths.” He went on to point out the
diffi culties these men faced upon diagnosis: many doctors were advis-
ing them not to engage in any sexual interactions— even kissing— except
with an ongoing partner. This strategy might protect them from further
infections, yet it also “radically and painfully alters their sexual expres-
sion.” He continued, “There is also speculation that acquired immuno-
defi ciency syndrome (not Kaposi’s sarcoma) may be caused from a
transmissible agent. The clusters of men who have this syndrome lends
support to this speculation.” Here, the rapid repetition of the word spec-
110. Konstantin Berlandt, “KS Therapist Contracts KS: Denies Any Connection,”
BAR, August 19, 1982, 1.
111. J. Claremont, “They Shoot Horses, Don’t They?” letter to the editor, BAR, Sep-
tember 16, 1982, 8.
112. J. Clar[e]mont, “Vague,” letter to the editor, BAR, September 23, 1982, 7.
Locating Gaétan Dugas’s Views 325
ulation suggests Geary’s lukewarm assessment of this claim and lays the
groundwork for his letter’s shift toward a conclusion that was more in
keeping with the immune overload theory. The issue, for Geary, was not
what risks the men with KS might present to him but rather “what am I
doing in my own life that puts my health at risk.” Whereas he had previ-
ously rationalized episodes of VD with the prospect of swift treatment,
he now saw the risks of this view: “I have come to understand that re-
peated exposure to such infections is detrimental. For me it’s not as sim-
ple as getting known carriers of possibly infectious diseases out of baths
but in examining my own sexual patterns and in realizing the full im-
plications of the risks I take.” Geary stated that he respected and ad-
mired the men he knew with KS, whom he counted “among the most
strong, caring and socially conscious persons I know.” Rather than “an
open letter to persons with KS addressing their sexuality,” as Claremont
had suggested, Geary believed that it was “far more necessary to address
such a letter to ourselves and to await our own answers.”113
Bobbi Campbell, a local nurse who had received a KS diagnosis in
October 1981 and had since been writing articles about his experience
for a rival gay newspaper, applauded Geary’s letter with his own a week
later. He emphasized that “doctors and scientists have clues, not hard
facts about AIDS,” and that “if anything is transmissible, it is likely to be
immune defi ciency, not KS.” He conveyed the most recent information
that if a virus was the root cause, it was likely to be the sexually transmit-
ted CMV, which was already common in the community. “Immune de-
fi cient persons shouldn’t be socially shunned as pariahs,” Campbell ar-
gued. “We have more to fear from contacts with you than you do: your
minor illnesses could be serious to our weakened conditions.”114 Hank
Wilson, one of the nurse’s friends, would later recall that Campbell him-
self continued to attend the baths during this period, “all the way up un-
til he got sick.” Wilson pointed out that he did not know whether his
friend “was doing X, Y, or Z in the baths”; nonetheless, the “physical
presence [of people with KS] alone could get some people upset.”115
113. Jim Geary, “Who Should Look at Whom,” letter to the editor, BAR, Septem-
ber 30, 1982, 7.
114. Bobbi Campbell, “KS Exposure,” letter to the editor, BAR, October 7, 1982, 10.
See also J. Wright, “‘Only Your Calamity,’” 1788– 98.
115. Hank Wilson, interview with author, San Francisco, July 22, 2007, recording
C1491/08, tape 2, side A, BLSA. Wilson died in 2008.
326
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The autumn weeks saw further confusion and concern. One man
with KS, writing on behalf of others with the disease, requested that
the newspaper’s writers “report the best information you can obtain,
checking all facts and labeling any speculation or hearsay as such. Ru-
mor and falsehood are nearly as dangerous to the health of our commu-
nity as the diseases themselves.”116 One front- page article reported that
the death rate from AIDS was much higher than previously thought,
and a reader’s letter advised against kissing friends “until we can rule
out this as a means of transmitting the virus involved with the AIDS
epidemic.”117 An October gathering of researchers at UC Medical Cen-
ter received extended coverage, a journalist noting at one point that
“one Gay man with Kaposi’s sarcoma [was] reported to have had sexual
contact with eight men who later came down with AIDS diseases”— an
anonymized reference to Dugas and the LA cluster study, which also
carried an implied direction of source and spread. Still, the root causes
for AIDS remained undetermined; though poppers were considered less
likely to be the single cause of immunosuppression, an agent transmit-
ted through anal intercourse might also be at work, as might the anti-
bodies produced in reaction to “sperm deposited time after time in the
rectum.”118 Parasites, too, were raised by researchers and column writ-
ers as a promising lead in this rapid succession of explanations.119 In the
same November edition that carried news of the UC Medical Center
conference, BAR editor Paul Lorch invoked ideas from Toronto’s Body
Politic, cauti
oning against “allowing the medical profession to defi ne,
[restrict], pathologize us.”120
A very unusual letter from “The Fungus Queen” appeared in mid-
November 1982. In a gloss, Lorch acknowledged that it was diffi cult
to judge “where fact leaves off and fantasy takes over.” The writer de-
scribed a recent visit to a public sex facility where, “in the dimly lit shad-
116. Jerry Badurski, “Covering KS,” letter to the editor, BAR, September 16, 1982, 7.
117. Wayne April, “AIDS Mortality Higher Than First Thought,” BAR, October 14,
1982, 1; Keith Stanton, “Hugs Instead of Kisses,” letter to the editor, BAR, October 14,
1982, 6.
118. Richard B. Pearce, “‘AIDS’ Topic of Local Conference: Causes, Spread, and Pos-
sible Cures Discussed,” BAR, November 4, 1982, 2.
119. Karl Stewart, “A Full Knight,” BAR, December 23, 1982, 29; Richard B. Pearce,
“Parasites and Immune Suppression: An AIDS Connection?” BAR, December 30, 1982, 4.
120. Paul Lorch, “The Cast [ sic] against Fear,” BAR, November 4, 1982, 6; restrict spelled “restruct” in original.
Locating Gaétan Dugas’s Views 327
ows,” “a very pretty blond, about 30 and not much more, maybe less,
reached out and held my arm for a long time it seemed, must have been
three minutes or more.” Suddenly, the writer realized with horror that
the blond’s “hands were half eaten away by athlete’s foot. I broke con-
tact and ran away to the sink, and soaped away.” The Fungus Queen ex-
plained that using fungal cream on one’s hands for long periods of time
could lead to the body absorbing its elements, “wip[ing] out your im-
mune system. . . . No defense, and on comes all disease and maybe lots of
death too for many gay souls, and nobody knows how it happens; it’s the
‘Gay Disease’ they say.” The Fungus Queen fi nished sardonically: “If
you’re lucky, you only give the doctors lots of money and live to repeat
it all again, never knowing how the vicious circle in all ignorance works,
between the ‘Immune Defi ciency’ and the ‘New Gay Disease’ and the
masochistic pain lovers who enjoy the hot burning pain of half- eaten
hands, touching hundreds each month, working for the doctors and the
undertaker.”121
This fascinating submission articulates and parodies the fear and ru-
mors that had descended on San Francisco’s gay community, by appar-
ently acknowledging the tale of a disease- carrying blond. By invoking
athlete’s foot, a relatively benign condition which one might easily con-
tract by attending bathhouses, the author may have been commenting
on the extreme paranoia of the times. That being said, medical research-
ers at the October UC Medical Center conference had listed fungal in-
fections as one of several types of opportunistic infections, two of which
would allow a physician to diagnose AIDS.122 The infections were also
diffi cult for those with compromised immune systems to fi ght off; in-
deed, according to one of Dugas’s friends, fungal infections were one of
the reasons that Dugas would later substantially reduce his casual sexual
contacts when he moved to Vancouver.123 By suggesting that the under-
lying cause of this disease may have been due to the overapplication of
a prescribed drug, the Fungus Queen’s letter cast a net of suspicion over
the medical community as well.
This climate could prove unsurprisingly hostile to people with AIDS;
men with KS, whose lesions threatened to render them visible, may have
121. The Fungus Queen, “Fungus,” letter to the editor, BAR, November 18, 1982, 8.
122. Pearce, “Local Conference,” 13.
123. Noah Stewart, interview with author, Vancouver, September 3, 2007, recording
C1491/19, tape 1, side B, BLSA.
328
chapter 6
felt particularly vulnerable. Paul Lorch, the editor of the Bay Area Re-
porter, wrote a lurid article in December 1982 about a twenty- nine- year-
old man who hanged himself in Golden Gate Park after being diagnosed
with a KS lesion in his mouth. According to Lorch’s unpleasant account,
for the previous year and a half the dead man “had been spending four
to fi ve nights a week at the 8th and Howard baths [where] he took on
all comers and was regarded as hot sex.”124 Meanwhile, the man’s sui-
cide note, printed alongside the article in a macabre editorial decision,
speaks of unbearable pain, pressure, and loneliness. “I am weak,” the
man wrote, “and no one to touch, to hold, to cry on.” Lorch would later
controversially endorse suicide as a reasonable response to an AIDS di-
agnosis and dismiss gay people with AIDS as offering little to their com-
munity apart from their “calamity.”125 Randy Shilts would later write of
a “stranger” approaching Dugas on the streets of the Castro in the fall
of 1982 and threatening him with violence if he did not choose to leave
town. The man declared, “I know who you are and what you’re doing.”126
By this it was implied that Gaétan was the rumored individual deliber-
ately infecting others with his “gay cancer” in the bathhouses. But how
could a stranger be certain of this, unless he felt emboldened by stories
in circulation?127
Within this powder keg of tension, it is diffi cult to determine how
much, if any, Dugas’s actions contributed to these rumors, or whether
the rumors simply stuck to Dugas because of his visible KS. It is con-
ceivable that the rumors in San Francisco were also linked in part to
the scale- up of public education in that city. In July 1982, the Kaposi’s
Sarcoma Research and Education Foundation set up a telephone hotline
and began printing informational brochures; by November, it had distrib-
uted nearly twenty- fi ve thousand copies of the brochure, and the offi ce
continued to be “barraged by phone calls and information requests.”128
Conant congratulated the foundation’s director for his team’s “excellent
job” in establishing the hotline and putting on community forums, not-
ing that these had “met with excellent success and have been responsible
124. Paul Lorch, “KS Diagnosis, Takes Life,” BAR, December 23, 1982, 1, 15.
125. J. Wright, “Only Your Calamity,” 1792.
126. Shilts, Band, 208.
127. It is logical to assume that if this man was a stranger, he was acting based on— at
best— secondhand information.
128. “Foundation Program Activities,” Rick Crane to Board of Directors, 15 Novem-
ber 1982, folder 10, carton 2, SFAF Records.
Locating Gaétan Dugas’s Views 329
for identifying patients with Kaposi’s sarcoma.” Conant may have been
mistaken, however, when he added that the foundation’s efforts had suc-
ceeded in “allaying the fears and hysteria that is occurring in New York
and which could so easily have occurred in San Francisco.”129
Conant recalled being told by Frank Jacobsen, who oversaw the KS
Foundation’s hotline, that the phones would “literally light up” with call-
ers relaying stories of a man with a French accent having sex in the city’s
bathhouses. According to
these callers, the man would tell his partners
after sex that he had gay cancer.130 The aggregation of the hotline’s call
statistics into monthly totals and a complete absence of references to
problematic patients with KS in the organization’s records from that pe-
riod prevent the interrogation of this claim. It seems possible that Dugas,
not believing his KS to be contagious, might have remained quite calm
if asked by a sexual partner during postcoital bathhouse conversation
about one of his skin lesions. Furthermore, the erotics of bathhouse in-
teractions often discouraged conversation before sexual contact.131 How-
ever, to someone in Dritz’s or Conant’s position at that time— physicians
who had been working for many months with the hypothesis of a sexu-
ally transmissible agent— such calmness could easily have been misinter-
preted as an act of malice.132
According to Shilts, who drew a great deal of information for his book
from Dritz, whom he held in high esteem, “it was one of the most repul-
sive things Dritz had heard in her nearly forty years in public health.”133
In a 1992 oral history interview, Dritz recalled her single encounter with
the fl ight attendant, which Shilts dates to November 1982: “I knew that
Gaetan Dugas was still in town. I couldn’t get to him, but I put word out,
‘If you see Gaetan Dugas, let him know I want to see him.’ He came up. I
129. Marcus Conant to Rick Crane, 11 November 1982, folder 32, carton 2, SFAF
Records.
130. Conant and Robinson, recording C1491/10 (Conant recollection at tape 1, side A),
emphasis on recording; Conant, “Founding the KS Clinic,” 165– 67.
131. For descriptions of sexual interactions at bathhouses in New York and San Fran-
cisco in 1984, some without a verbal exchange until after physical contact, see Lucio Ca-
stigliano, “My Night at the Baths,” NYN, January 30, 1984, 1, 21, 23; Michael Helquist and
Rick Osmon, “Sex and the Baths: A Not- So- Secret Report,” Journal of Homosexuality 44,
no. 3/4 (2003): 153– 75.
132. Cochrane, When AIDS Began, 85– 86.
133. Shilts, Band, 200. The author’s handwritten dedication in Dritz’s personal copy
of Band clearly articulates his view: “To Selma Dritz— a hero in this story”; Dritz Papers.