Patient Zero and the Making of the AIDS Epidemic
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told him, ‘Look, we’ve got proof now.’ I didn’t tell him how scientifi cally
accurate the information was. It wasn’t inaccurate, but it wasn’t actually
scientifi cally proven. I said, ‘We’ve got proof that you’ve been infecting
these other people. You’ve got AIDS, you know. We know it’s transmis-
sible now, because you’re transmitting it.’”
Dugas did not believe Dritz, and she recalled that he told her to mind
her own business and that he could do what he wanted with his life. She
continued, recounting their exchange, “‘Yes, but you’re infecting other
people.’ ‘I got it. Let them get it.’ I said, ‘You’ve got to cut it out!’ ‘Screw
you.’ He walked out. I never saw him again.” Dritz conceded that Dugas
was only “presumptive proof” that AIDS was “transmissible from an in-
fected person directly to the uninfected person.”134
It seems likely that Dugas reacted to Dritz’s attempts to overstate the
current evidence for transmission. In addition, he was almost certainly
infl uenced by the strongly defi ant articles emerging from his former
home city of Toronto that month, published in the Body Politic and re-
printed in the Bay Area Reporter. Spencer Macdonell, an acquaintance
of Dugas, explained in an oral history interview the perceived threat to
the fl ight attendant’s identity:
I’m sure Gaétan heard it as probably them telling him to stop being queer,
okay? Because at that time [ speaking slowly] that’s how most fags saw them-
selves. Sucking dick and getting fucked is what made you queer, and if you
stopped doing that you might as well be a straight boy. And I think that was
how he interpreted it and, if he threw it back in their face that was what he
was throwing back in their face, you know, “No, I’m not going back in the
closet for you, not for nothing.”135
Macdonell’s view fi nds support from a June 1983 article by writer Rich-
ard Goldstein, more than half a year after Dritz’s confrontation with Du-
134. Selma E. Dritz, “Charting the Epidemiological Course of AIDS, 1981– 1984,” 35–
36, oral history interview conducted in 1992 by Sally Smith Hughes, in The AIDS Epi-
demic in San Francisco: The Medical Response, 1981– 1984, Volume I, Regional Oral His-
tory Offi ce, Bancroft Library, University of California, Berkeley, 1995, Online Archive
of California, 2009, http:// content .cdlib .org/ ark: / 13030/ kt2m3n98v1/. The author met with Selma Dritz and her daughter in 2007, a year before her death, but the effects of a stroke
prevented a full interview. Her 1992 oral history interview with Hughes remains the best
source.
135. Macdonell, recording C1491/27, tape 2, side A; emphasis on recording.
Locating Gaétan Dugas’s Views 331
gas. The Village Voice reporter described a situation facing gay men that
was every bit as challenging: “No wonder so many gay men feel caught
between hysteria and paralysis. Who can distinguish fact from metaphor
when the clinical data are so scant and suppositional? If one were to de-
vise a course of action based on incontrovertible evidence alone, there
would be no conclusion to be drawn. Should I screen out numbers who
look like they’ve been around? Should I travel to have sex? Should I look
for lesions before I leap? How do I know my partner doesn’t have the ill-
ness in its (apparently protracted) dormant stage?” Though Goldstein’s
remarks were likely intended to describe the diffi culties experienced
by those hoping to avoid falling ill, they would have been just as valid
for articulating the challenges of those who were already sick. Gold-
stein struggled to answer a friend who asked him, “Why can’t you peo-
ple just fuck less?” He ventured that “for many gay men, fucking satis-
fi es a constellation of needs that are dealt with in straight society outside
the arena of sex. For gay men, sex, that most powerful implement of at-
tachment and arousal, is also an agent of communion, replacing an often
hostile family and even shaping politics. It represents an ecstatic break
with years of glances and guises, the furtive past we left behind.”136 As
Goldstein’s words made clear, many gay men— whether already sick or
among the worried well— balked at the prospect of reducing their sexual
connections, let alone abstaining from sex.137
Vancouver
By early 1983, and no doubt in partial response to the hostility he experi-
enced in San Francisco, Dugas had moved to a full- time Vancouver res-
idence. He lived downtown in a tenth- fl oor apartment by the ocean on
Pacifi c Street, in the midst of the city’s growing West End gay district. At
this time, when so little information had been disseminated locally about
the disease, Dugas represented the fi rst person with KS whom many gay
136. Richard Goldstein, “Heartsick: Fear and Loving in the Gay Community,” Village
Voice, June 28, 1983, 12.
137. In a survey of sexually active gay men in San Francisco conducted in November
1983, researchers found that of the respondents who had three or more sexual partners
the previous month, more than two- thirds agreed with the statement, “It is hard to change
my sexual behavior because being gay means doing what I want sexually.” See Leon Mc-
Kusick, William Horstman, and Thomas J. Coates, “AIDS and Sexual Behavior Reported
by Gay Men in San Francisco,” American Journal of Public Health 75 (1985): 495.
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Vancouverites would meet. He endured a great deal of fear and resent-
ment in his new community, particularly after publicly identifying him-
self as a KS patient at the fi rst public forum of AIDS Vancouver, the re-
cently formed community- based organization, on March 12, 1983.138
As the evidence will show, it is diffi cult to determine whether Du-
gas attracted stories due to his particular actions, public knowledge of
his illness, or his refusal to disappear from public life. Nonetheless, it
seems clear that his evolving fashion preferences reinforced his out-
sider status. Gone were the carefully styled Marilyn Monroe locks from
years past. By donning leather gear and riding a motorcycle around Van-
couver, Dugas presented a more hard- edged masculinity and invoked a
strong linkage to S/M culture. As the anthropologist Gayle Rubin has
demonstrated, leather functioned as a cultural marker that could be read
in many ways, whether to “signal merely a passion for motorcycles . . . [,]
indicate an interest in sexual and social interactions among men with
masculine personal styles, or announce a preference for some variety
of ‘kinky sex.’”139 Since, from 1982 onward, men who wore leather were
more readily associated with risky sex and AIDS, Dugas’s stylistic self-
presentation would have amplifi ed any perceived risk that he posed to
his communities. The recollections of one man, who sang in the Van-
couver Men’s Chorus, support this explicit linkage: “A friend was visit-
ing from Toronto and Gaetan pulled up on his motorcycle. My friend,
knowing my type, said to me, ‘Stay aw
ay from him, there are stories in
Toronto that he has some strange sickness.’ Only later did I learn that he
had been pegged as Patient Zero.”140
The local gay press did not record Dugas’s arguably overstated out-
burst at the AIDS Vancouver public meeting in March as signifi cant at
the time. Instead, the pages of the Vancouver Gay Community Centre
News presented two articles that described the forum from opposing
viewpoints.141 The fi rst, Fred Gilbertson’s “Forum Fans Fears,” argued
138. A description of this meeting can be found in Shilts, Band, 246– 47.
139. Rubin, “Elegy for the Valley of Kings,” 101– 44, quotation on pp. 103– 04.
140. Bill Monroe, e- mail to author, January 4, 2008. Another acquaintance who met
Dugas in New York City circa 1980 linked him to men he thought “were into S and M and
stuff like that”; Stewart, recording C1491/19, tape 1, side A.
141. Based on a decision taken at the February 11, 1983, AIDS Vancouver meeting,
the “regular media” was not contacted in advance of the forum; see “AIDS Vancouver—
February 11, 1983,” in AIDS Vancouver: Exhibits of the British Columbia Hearings,
March 1994— Commission of Inquiry on the Blood System in Canada (Ottawa: The Com-
Locating Gaétan Dugas’s Views 333
that it had failed to answer basic questions about AIDS, and “may have
done us harm . . . by exhorting us to make life style adjustments on an
unproved supposition.” Gilbertson made no reference to Dugas, while
specifi cally mentioning another man by name. Greg Cutts was a gay ac-
tivist and producer for Gayblevision, the local lesbian and gay television
program, who enjoyed close connections to San Francisco and to Los
Angeles, where his spouse, Troy Perry, was the spiritual leader of the
Metropolitan Community Church. Cutts, Gilbertson wrote, “relentlessly
pressed the panel on the number of sex partners question.” The panel,
observed the author, appeared to have diffi culty replying with a defi nite
answer to Cutts’s questions, acknowledging that the “‘infection agent’
[was] an assumption. ‘Last year AIDS was caused by poppers,’ [Cutts re-
portedly said,] ‘this year it is caused by promiscuity.’”142 Clearly, Dugas
was not the only one to question the motives or wisdom of the medical
“experts,” a fact that Shilts acknowledged but downplayed in his book.
Gilbertson’s skeptical report was accompanied by a rebuttal from Da-
vid Myers, who noted that “the analysis presented in the preceding ar-
ticle differs from most of the opinion presented by the guest speakers at
the AIDS symposium.” Myers included quotes from Dr. Stephen Sacks,
who had outlined the apparent similarities between hepatitis B and
AIDS; from Paul Popham, describing AIDS in New York City; and from
Dr. Michael Maynard, who listed the following risk- reduction strategies:
1. Decrease the number of different sexual partners cutting out anonymous
one- time sex.
2. Reduce the number of contacts of anal or oral- anal sex.
3. Don’t get involved with someone whose health you’re not sure of.
4. Do not use intravenous drugs or get involved sexually with people who do.
5. Get a lot of rest, make sure you have adequate nutrition, decrease stress, get
exercise and cut down on your use of drugs, recreational or prescription.
mission, 1994), vol. 49, tab B21; copy consulted at the Sir James Dunn Law Library, Dal-
housie University.
142. Fred Gilbertson, “Forum Fans Fears,” Vancouver Gay Community Centre News
(VGCCN), April 1983, 41– 43; copies of this periodical are held at the British Columbia Gay
and Lesbian Archives in Vancouver. After Cutts died suddenly and unexpectedly less than
three months after the AIDS Vancouver forum, a report in the Body Politic raised questions
of suicide. See Kevin C. Griffi n, “A Community Mourns BC Activist’s Death,” Body Politic,
July/August 1983, 10; Nancy Wilson and Jeri Ann Harvey, “Profi le: In Memorium,” Journey,
June/July 1983, 6– 7, 31, https:// issuu .com/ mccchurches/ docs/ 1983 - june - july - journey.
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Maynard was also quoted by Myers in an attempt to convince the audi-
ence of the possibility that the AIDS- causing agent— if it existed— might
spread in Vancouver. The physician noted that there was thought to be
a latency period of at least eighteen months before people would dis-
play symptoms. As quoted by Myers, Maynard stated, “We already have,
we believe, at least six people in Vancouver with AIDS. During that 18
months a person is probably contagious.”143
Paul Popham and Bob Tivey, both of whom Shilts interviewed with
regard to this event, seem to have viewed Gaétan Dugas’s conduct at the
forum as characterized by strong anger and denial. Another witness’s
recollection presents a substantially different possibility, one of defi ant
public disclosure to his fellow community members. Alan Herbert, who
would go on to join AIDS Vancouver and eventually served as its chair,
recalled:
He stood up, wearing a cape, pushed forward a moveable seat in front of him
so he could put one foot up on it, then stared at the “Five AIDS Docs” as
they were called, and bitterly posed the question: “So I’ve got this disease
you’re talking about . . . what are you going to do about it.” The audience of
the West End Community Centre went silent, everyone turned to look at this
man, “a person with AIDS”— many still called it GRID [gay related immune
defi ciency]. Of course the answer, which followed an uncomfortable silence,
was that “there is nothing we can do for you.”144
Readers are invited to compare these men’s descriptions with video re-
corded that evening, segments of which were recently made available on-
line as part of AIDS Vancouver’s thirtieth anniversary activities.145 In
the only known surviving audiovisual footage to capture Dugas, the man
speaks during the question- and- answer session with a measured, serious,
143. Quotations from Myers, Sacks, and Maynard in David Myers, “Doctors Warn
Gays,” VGCCN, April 1983, 43– 44.
144. Alan Herbert, e- mail message to author, June 5, 2008. Refer also to Alan Her-
bert, interview with author, Vancouver, June 11, 2008, recording C1491/28, tape 1, sides A
and B, BLSA.
145. Don Durrell, Don Larventz, and Barry Spillman, A Gablevision Special on
A.I.D.S. , television program fi rst broadcast April 2, 1983 (Vancouver: Video Out Distribu-
tion, 2013), DVD. See also an edited compilation video of Dugas’s questions from the Gay-
ble vision broadcast, along with some of the doctors’ responses: AIDS Vancouver, “30 30
AIDS Vancouver: 1983– The Forum,” 2013, http:// 3030 .aidsvancouver .org/ 1983/.
Locating Gaétan Dugas’s Views 335
and sometimes pleading tone.146 His comments repeatedly expressed his
concerns about fears directed toward people with AIDS or displaying
related symptoms, and, with a strong parallel to the experiences of Mary
Mallon, he pressed the doctors for information on how they could con-
fi rm that someone was a “carrier.”
D
ugas suggested that “you shouldn’t fear someone who has AIDS
or has symptoms of AIDS, because there is no specifi c reason why you
should get in contact with AIDS, with an infectious agent.” Regarding
people with AIDS having lovers, he asked the panel, “What is the warn-
ing you are giving to people?” He observed of the risk- reduction guide-
lines, “It seems like there is a kind of a fear towards those people here,
that, who could have the symptom or did have the symptom, or did have
the disease, you should fear those people. But,” he fi nished tentatively,
“you should, you know, not necessarily fear those people?” He asked
whether, since the new hepatitis B vaccine was developed from samples
donated by gay men, individuals receiving the vaccine were at risk of ex-
posure to AIDS.147 And he pushed for more certainty about diagnosis,
asking, “If you think you may have or you could be a concerned person
with AIDS, if you present yourself to doctor, what kind of test could you
ask him to be undertaken in a manner to confi rm if you are possibly a
carrier or not?”
Popham replied that, although nothing could be proved, an infectious
agent was likely involved and that if he was an AIDS patient, he would
disclose his health status to any sexual partners. Sacks responded that
there was “not one shred of evidence” that the vaccine might cause the
syndrome. Maynard, while describing the types of tests doctors could
run to test for immune function, acknowledged that there was no way to
“check whether or not you’ve been exposed to AIDS. That test simply
146. Though this raises the possibility that some of those present later confl ated Cutts’s
anger with Dugas’s presence in their memories, one must also bear in mind that the origi-
nal video may have been substantially edited before it aired on Vancouver’s Gayblevision
television show.
147. Durrell, Larventz, and Spillman, “Gablevision Special.” One might interpret the
question Dugas raised regarding the hepatitis vaccine as suggestive of a growing paranoia.
At the same time, however, it may simply be an indication of his close attention to cur-
rent debates, since from late 1982 through the middle of 1983 a number of observers had
ventured the possibility of infection via this route. See, for example, Michael S. Gottlieb