et al., “UCLA Conference: The Acquired Immunodefi ciency Syndrome,” Annals of Inter-
nal Medicine 99 (1983): 208– 20.
336
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does not exist.”148 Brian Willoughby, a family physician and fellow panel-
ist, later recalled gesturing at this point to Geoff Mains, the event’s mod-
erator, to somehow remove Dugas from the microphone. If the man con-
tinued to ask the panel his “valid questions”— “for which,” Willoughby
acknowledged, “there were not answers”— the physician feared it would
“undo any good” that the session had achieved.149
Following Dugas’s very public announcement of his health status,
Ray Redford related that, “despite being harassed by others at the bars
and told that he should stay home,” his friend and former lover contin-
ued to go out publicly, albeit less frequently. Redford admired Dugas’s
determination “to stand up for himself, to be himself. This same, fi ght-
ing spirit was evident when he went to the beach and made no attempt to
disguise or cover up his [KS] lesions, defi antly staring back at those who
stared at him.”150 Another friend, seen walking with Dugas along Van-
couver’s waterfront, was later approached by a stranger and told, “You
shouldn’t be seen with that man. You’re going to ruin your reputation.
He has AIDS.”151 Bob Tivey, who became friends with Dugas through
support activities with AIDS Vancouver, recalled going out for a social
drink at Neighbours, a local bar, and seeing people there treat Dugas
like a “pariah.”152 “People were afraid, they just got out of his way. These
were other gay men moving when they saw him coming.”153
Dugas’s fellow fl ight attendant Richard Bisson remembered hearing
rumors about his friend: “I heard stories around Gaétan that came from
people here in Vancouver . . . [about] his behavior at the baths— you’ve
probably already heard about that, I suspect. I had a hard time believing
that . . . he was actually having sex with people despite the fact that he
had been diagnosed [with] HIV. The idea seemed to be that he didn’t be-
lieve that he could be contagious or that indeed their assessments were
correct, that it was transmissible.” Acknowledging his own uncertainty,
Bisson ventured that, if his friend did continue to have sex, he attributed
his actions to “being human.” And, he continued, “it’s like a girl getting
pregnant, you know what I mean? I think it’s just as much the responsi-
148. Durrell, Larventz, and Spillman, “Gablevision Special.”
149. Willoughby, recording C1491/18, tape 1, side A.
150. Redford, “Reminiscences,” Epilogue.
151. Kevin Brown, interview notes, 1986, p. 7, folder 23, box 34, Shilts Papers.
152. Tivey, interview notes, pp. 4– 5, folder 23, box 34, Shilts Papers.
153. Tivey, September 7, 2008, recording C1491/44, tape 1, side B; emphasis on re-
cording.
Locating Gaétan Dugas’s Views 337
bility of the partner to take measures, so I can’t really out and out blame
Gaétan for that.”154
Ultimately, such expressions of anger and discrimination may have
had less to do with whether Dugas was attending bathhouses locally and
more with his relatively visible presence in the gay community. Noah
Stewart, a typesetter and health activist who was a founding volunteer
for AIDS Vancouver, later described some of the paranoia of the time.
His comments evoke the aftermath of the public forum, where worried
men were encouraged to be alert to their own health and that of their
sexual partners. They may have viewed a man with KS, using makeup
to mask his lesions, or sharing his experiences with other local patients,
as engaging in deceptive behavior aimed at evading their risk- reduction
efforts: “[Was Vancouver] swirling with rumors? Absolutely. That Gaé-
tan was lurking in Stanley Park, infecting people; that Gaétan was dis-
guising himself, . . . that Gaétan was teaching people how to disguise
themselves— ridiculous things. Just idle gay gossip, essentially. And I
don’t . . . think I heard any of these things more than once, from any in-
dividual. . . . It was a bunch of scared people making up stories, and I
think even they realized it.”155
Physician– Patient Confl icts
It is without question that Dugas’s behavior provoked some physicians.
As we have seen, in 1982 his decision to continue attending the baths
clashed with Alvin Friedman- Kien and Marcus Conant, and he shared a
fi ery confrontation with Selma Dritz. In Vancouver, he sought treatment
from at least three physicians whose practices served the city’s gay male
population: Michael Maynard, a founding member of AIDS Vancou-
ver; “Dr. X,” an unnamed gay physician; and fi nally Brian Willoughby,
who, like Maynard, was also closely involved with AIDS Vancouver. Of
these three, the fi rst two doctors certainly found themselves challenged
154. Bisson, recording C1491/38, tape 1, side B.
155. Stewart, recording C1491/19, tape 1, side B; emphasis on recording. Stanley Park is
a large forested urban park adjacent to downtown Vancouver. In 1983, much like today, the
park was a key cruising ground for gay men and had been a site of sexual encounters for at
least two generations; Macdonell, recording C1491/27, tape 1, side A. The reference to dis-
guises is most likely an interpretation of the fact that Dugas continued to use makeup to
mask the KS lesion on his nose.
338
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by their patient, while the third was able to adopt a more sympathetic
perspective.
Noah Stewart recalled that Maynard, his own physician and a man
whom he considered to act with consummate professionalism, surprised
him one day with a remark about Dugas. He and Maynard were discuss-
ing AIDS in Vancouver when Stewart mentioned that he had recently
run into Dugas on the street. The two men recognized each other from
attending the same parties in Manhattan several years previously, a pe-
riod when Stewart divided his time between Toronto and New York.
They stopped to talk, and it was during this conversation that Dugas had
mentioned that Maynard was his doctor. As Stewart recalled, “I remem-
ber this quite well because it was the only time that [Michael] ever said
an unprofessional thing in my presence. He said, ‘Honest to God, I don’t
know what to do for the guy, but a sterile revolver is at the top of the list.’
And I said ‘What? What are you talking about?’ And he said, ‘As near
as I know, this guy is the one that’s spreading that disease locally.’”156
Evidently, Maynard believed that Dugas posed a sexual risk to other
Vancouver men in Vancouver’s gay community. In retrospect, this would
seem to disregard the close travel links that many gay Vancouverites en-
joyed with San Francisco and Los Angeles, other cities with more es-
tablished epidemics.157 At the time, however, the short hypothesized
incubation period fi t with Maynard’s fears that his patient was largely re-
sponsible for Vancouver’s emerging epidemic. Maynard
’s suspicions were
not supported by Stewart, who recalled that “I knew every single person
that had AIDS in Vancouver at that point in time, and for the most part
I knew where they got it. And they didn’t get it from Gaétan.”158 While
on one level Stewart’s statement still presupposed a short incubation pe-
riod for the disease, the point remained that many gay men in Vancouver
shared practices that put them at risk of becoming infected with the etio-
logical agent for AIDS.
Evidence about the interactions between Dugas and his second Van-
couver physician, “Dr. X,” come from an unusual source: court deci-
sions from 1990 and 1991 where the unnamed doctor was found guilty
156. Stewart, recording C1491/19, tape 1, side A.
157. Martin T. Schechter et al., “The Vancouver Lymphadenopathy-
AIDS Study:
1. Per sistent Generalized Lymphadenopathy,” Canadian Medical Association Journal 132
(1985): 1273– 79.
158. Stewart, recording C1491/19, tape 1, side A.
Locating Gaétan Dugas’s Views 339
of professional misconduct for having sex in 1985 with a male patient,
one whom he had that day diagnosed as having antibodies to AIDS.159
According to the 1990 case record, the physician did not deny having
sex with his patient but invoked an unusual historical justifi cation for
his behavior: “In 1983 Dr. X was made aware of the seriousness of the
spread of AIDS when he became the Vancouver physician for Gaetan
Dugas. Dr. X had tried to convince Mr. Dugas not to engage in unsafe
sex, but had failed.” The case record noted parenthetically that “Gaetan
Dugas was the French Canadian fl ight attendant who is believed to have
spread the AIDS virus into many cities in North America in 1983.” The
decision reported that “this experience had weighed heavily on Dr. X,”
and it worried him when in 1985 another patient tested positive and “an-
nounced that he would not practice safe sex.” Apparently fearing “he
might be dealing with another Mr. Dugas,” the doctor argued that,
through his unconventional actions, he was trying to show his patient
that he would not be rejected sexually if he disclosed his status and used
protection. “Further,” the case record explained, Dr. X “believed that
if he did not engage in sex with the complainant that evening, that the
complainant would leave with the intention of concealing the fact that he
was infected and infl ict the virus on numerous innocent victims.”160
At fi rst glance, this example might read as straightforward evidence
that Dugas had refused to practice safe sex in 1983. Yet one wonders
how the physician could have been certain that his efforts with this man
had failed. Also, the imbalance between the naming of Dugas, a dead
patient and for several years an infamous public fi gure, and the anonym-
ity afforded to the accused physician, is striking. In this precarious le-
gal situation, the medical professional had every reason to emphasize
the outlandishness of Dugas’s historical behavior. For him to justify an
extreme breach of his own professional ethics, the stakes for the extenu-
ating circumstances needed to be exceptionally high.
Dr. X was punished for his error in judgment by being suspended
from practice for a year. Maynard, too, would later stand accused of pro-
fessional misconduct for having sex with his patients. Though he denied
the charges, in 2003 he resigned from the British Columbia College of
Physicians and Surgeons and agreed never to resume practicing medi-
159. X. v. College of Physicians and Surgeons of British Columbia [1990] B.C.J.
no. 1316, and [1991] B.C.J. no. 2410.
160. Ibid.
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cine.161 Marcus Conant, the San Francisco dermatologist, refl ected on
the intense pressures faced by gay physicians within North America’s
gay communities during the early years of the epidemic. He recalled that
“the number of young men who had AIDS who would try to seduce their
doctor was legion. I mean you would have these beautiful young men who
literally were saying, ‘I’ll do anything if you’ll keep me alive.’ And . . . it
was a challenge for young physicians, I’m sure, to realise that this was
not affection, this was not sexual interest, this was desperation.”162 Other
physicians would acknowledge the blurring of professional and personal
boundaries during these years, as well as the moral distancing they oc-
casionally established between themselves and their patients to protect
against their own feelings of vulnerability as gay men.163 Though a small
minority subsequently found themselves accused of abusing their posi-
tions of power, it is worth emphasizing that the period was an exception-
ally diffi cult one for gay patients and physicians alike.
Brian Willoughby, the third Vancouver physician to take Dugas as a
patient, recalled a conversation with the fl ight attendant near the end of
summer 1983, when he realized that the man might be experiencing con-
fl ict with his current physician. Shortly thereafter, Dugas became Wil-
loughby’s patient. Refl ecting on Dugas’s sexual activity, whether he took
precautions, and whether he advised others about the possible risks,
he acknowledged that he couldn’t be certain. “But I do know this, that
came from a different patient, a patient who had sex with him, with Gaé-
tan, and who was also my patient by then, who had been negative, and
became positive in a manner that is compatible with [acquiring] it from
Gaétan, although certainly he could have acquired it from someone else.
As we became aware of this I refl ected on some of what [I’d] heard, and
thought, ‘Well, gee, maybe it’s true.’” And yet Willoughby recalled that
both Dugas and this individual independently said that it was the lat-
ter man, not Dugas, who chose to forgo using condoms: “I’m not sure,
I mean one can always fault Gaétan in that circumstance, saying, “Well
you shouldn’t . . .” you know? But I’m not sure how strongly I would
choose to fault him, under such a situation. Because it would still have
been in the timeframe when there was no absolute proof that this was
161. Pamela Fayerman, “AIDS Doctor Faces Permanent Ban: Michael Maynard Is Ac-
cused of Sexual Misconduct,” Vancouver Sun, March 6, 2003, A1.
162. Conant and Robinson, recording C1491/10 (Conant quotation at tape 1, side A).
163. Bayer and Oppenheimer, AIDS Doctors, 113– 18.
Locating Gaétan Dugas’s Views 341
a virus and that this was the mode of transmission.”164 As one of Wil-
loughby’s other patients, Kevin Brown, explained to Shilts in an inter-
view in 1986, “When you’re that pretty and p[eo]pl[e] push it hard on
you[,] you put some resistance but they push and push!”165
Willoughby remembered Dugas to have been a “bright” and “thought-
ful” patient, and “very co- operative.”166 He recalled that they attempted
a course of low- dose radiation therapy that succeeded in treating the KS
lesion on Dugas’s nose, though it left another on his arm unaffe
cted.167
Willoughby could not associate the patient he knew with the accounts
of deliberate transmission described in Shilts’s book, and he took issue
with the description offered by physicians including Friedman- Kien and
Conant of the fl ight attendant being a sociopath. Willoughby preferred
instead to view Dugas’s challenge as one of a patient demanding strong
evidence for medical hypotheses:
I think there would be some people who work within public health who would
take his aggressive questioning of what we knew versus what we thought, and
the suggestion that we should act on what we know, not what we think, to
verge on being sociopathic, that I could accept. But I’m not sure that fulfi lls
the criteria for sociopathy, and I’m not a shrink but I would bet a lot of the
people who made the statement weren’t psychiatrists either. And that’s just
their view, that this man should have been more cautious, and a failure to do
so was sociopathic.168
Shifts in medical authority and a rise in patient activism in the late twen-
tieth century would lead to physicians being challenged more than ever.
In this regard, perhaps sociopathic is an extreme articulation of non-
164. Willoughby, recording C1491/18, tape 1, side A, BLSA; emphasis on recording.
165. Kevin Brown, interview notes, 1986, p. 5, folder 23, box 34, Shilts Papers.
166. Willoughby, recording C1491/18, tape 1, sides A and B.
167. Willoughby, recording C1491/18, tape 1, side A.
168. Willoughby, recording C1491/18, tape 1, side B. Willoughby’s comments were
echoed by a Toronto psychologist, Rosemary Barnes, who had been involved as a coun-
selor with the AIDS Committee of Toronto (ACT) in the early 1980s. She noted that the
casual application of the term sociopath “completely disregards” the framework in which
such a diagnosis was meant to function and in some cases “it’s just a way of saying some-
thing nasty about someone because you’re mad about what they’ve done.” She believed it
also disregarded “other ways of understanding what might have been happening for him.”
Rosemary Barnes, interview with author, Toronto, September 5, 2008, recording C1491/43,
tape 1, side B, BLSA.
342
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compliant, the term most frequently used to refer to such patients. Al-
though the term sociopathic is now obsolete in professional parlance,
Patient Zero and the Making of the AIDS Epidemic Page 57
