And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition (26 page)

As they would throughout the early stages of the epidemic, most doctors preferred to shove aside fears that such worst-case scenarios might materialize. Dr. Fred Siegal, the Mt. Sinai Hospital researcher who did much of the early immunology work on GRID, offered such optimism in the
New York Native’s
article on the
MMWR
lymphadenopathy report. “My hunch is that most of these patients will not go on to develop the full immunodeficiency syndrome,” Siegal said. “If we’re wrong, on the other hand, it would be a catastrophe.”

B
UREAU OF
C
OMMUNICABLE
D
ISEASE
C
ONTROL
,
S
AN
F
RANCISCO

Amid the arrows and circles on her beat-up blackboard, Dr. Selma Dritz could now trace connections between forty-four cases of GRID in New York, San Francisco, southern California, and Canada. She had done the detective work that showed six couples in San Francisco alone were ailing from the disease. Her thoughts frequently drifted toward the bathhouses when she looked at the blackboard. She had never been overly fond of the institutions. It wasn’t that she had any moral qualms; she didn’t really care what people did with their lives, and she harbored a genuine curiosity about people who were preoccupied with regulating other humans’ destinies. But bathhouses were biological cesspools for infection.

“Of course, from an old-fashioned textbook public health standpoint, you might go in and close the places down,” Dritz mentioned to a
Chronicle
reporter one day.

“Of course, some people might argue that there were civil liberties issues involved,” Dritz said, her voice trailing off in a way that suggested she did not think for one minute that civil liberties were the central issue involved here.

Such comments just fell, unharvested by the reporters and gay community leaders with whom Dritz talked. The notion that businesses might be closed was so unthinkable that it was put aside. A few dozen cases of some mystery illness did not justify such an extreme measure.

Dritz didn’t push; that wouldn’t be professional. Instead, she tried to engage the health and medical communities with the seriousness of what was unfolding. The future revealed itself so clearly, Dritz thought, as she looked at the charts and graphs that were the crystal balls of her career.

There was a terrible beauty in how obvious the flow of this disease was. For example, Dritz had charted a graph of the first two years of GRID cases in New York City, from 1980 through 1982, and then compared it with the San Francisco Bay Area cases. With a nearly perfect synchronicity, the curve and numbers in San Francisco followed those of Manhattan by exactly one year. The 150-plus cases New York City showed now were the 150-plus cases San Francisco would have in one year, she figured, and there undoubtedly would be hundreds, if not thousands, to follow those.

At night, in her comfortable home near the dunes of San Francisco’s Pacific beaches, Selma Dritz lay awake wondering where this all would lead. She kept a small tape recorder on her neatly arranged nightstand in case she had that one insight on some sleepless night, the thought that might stop these young men from dying so horribly.

C
ASTRO
D
ISTRICT
, S
AN
F
RANCISCO

Marc Conant woke up with a start, his forehead dripping in a hot sweat. Again, the incredible feeling of loss and the fear, the gnawing fear, overwhelmed him. Conant’s restless Doberman paced nervously on the back porch while the dermatologist walked around his comfortable home, its lights still off, trying to clear his mind of the dream. It was recurring often now. He would be somewhere, very alone, and he would look at his skin and see the massive purple lesions of Kaposi’s sarcoma spreading over his body. He was beginning to look like them, the patients he was seeing every day now in his practice, the young men so horribly disfigured by the splotches of bluish purple.

Then he would wake up in his hot sweat, seized by the impulse to run. Only a fool would stay here when you know that everybody is going to die, he thought.

Like most of the doctors working with GRID around the country, Conant had his blood tested regularly to ensure it held the proper ratios of T-helper and T-suppressor lymphocytes. It was the closest thing to a GRID test around. His lymphocytes were just fine, he knew. He didn’t have gay cancer, but there were so many other things to worry about.

All day, people had been calling him about the cluster study, and every terror Conant had conceived on that April morning a year before when he first heard about Ken Home now seemed realized. He immediately recognized Patient Zero as the suave Quebecois airline steward who had come into his office the month before. He was the type of man everyone wanted. What everyone had wanted was bringing them death. Quite literally, Conant thought. Conant had heard that the young airline attendant was one of the more popular catches you could make at the Club Baths on Eighth and Howard these days. He might even be there now, Conant thought. People could be out there catching this now.

There were other worries. The sum total of all Conant’s funding pleas was a $50,000 grant from the American Cancer Society. That was just enough to afford one harried secretary to coordinate the increasing numbers of patients using the KS clinic. The secretary ended up doing social service referrals, grief counseling, and lots of hand-holding, as well. There was nobody else.

Nine months had passed since the National Cancer Institute conference in Bethesda, and still there had not been a single gesture to intimate that the NCI was prepared to release funds. Refusing to wait for the official request for proposals, Conant had outlined his own research project on KS treatments and submitted it to the NCI. He then dashed off a letter to Assistant Secretary for Health Dr. Ed Brandt, begging him to intercede for accelerated NCI money. He received a polite reply that the United States government was deeply concerned with the problem and that both the CDC and the National Institutes of Health were doing everything possible to stop the epidemic, and thank you for writing.

The United States, Conant thought, had the know-how and resources to conquer this disease. The greatest scientific technology waited in the world’s best-funded laboratories. People could be warned through a mass media network that could reach into virtually every citizen’s home within a matter of minutes. This wasn’t some Third World country, for Christ’s sake. We could win this fight, but nobody is willing to make the effort or even acknowledge that there is a battle out there to be won.

Conant settled back into his bed, hoping the nightmare would not return, at least that night. When he was young, Conant had sometimes wondered what it might have been like to be a bright, resourceful Jewish man on the day after
Krystalnacht,
to see clearly the wholesale death that lay so soon ahead, even if the rest of the world didn’t seem to care. Why didn’t they run away?

Now, for the first time, Conant understood.

At the end of May, Marc Conant and Paul Volberding went to Tokyo to present their data on Kaposi’s sarcoma to the World Dermatological Conference. Their Japanese hosts were polite and intrigued by the new phenomenon.

“Isn’t it a shame you have the problem in San Francisco,” said one prominent Japanese scientist. “It’s because you have homosexuals.” He paused a moment and confided, “Of course, we don’t have homosexuals here.”

N
ATIONAL
C
ANCER
I
NSTITUTE
,
B
ETHESDA

Robert Biggar’s paper, hypothesizing an infectious agent as the cause of GRID, had now been rejected by every major scientific journal in the country. It simply went too much against the grain of prevailing theories. Other doctors were shooting up mice with semen to show that sperm actually was causing the immune suppression. Lab assistants scurried to pornographic bookstores to buy bottles of “Rush” and “Bolt” so rats could be overdosed on butyl inhalants in other experiments. Herpes experts seemed positively elated at the renewed attention to cytomegalovirus, or CMV. Other doctors posited that the collapse of GRID patients’ immune systems occurred because they were overloaded with other infections. Many reviews of scientific theories on GRID etiology completely dismissed the single-agent theory as too unlikely.

Biggar’s colleague, Jim Goedert, leaned toward the popper theory when the pair started putting together a large cohort of gay men in New York City and Washington, D.C., for a long-range study. Biggar was frustrated that his hypothesis was being ignored, but he also knew work must proceed. He had seen plagues in Africa, and he knew that the American infatuation for quick and easy theories, like semen or poppers, came only from naivete. No matter how affluent and civilized, humans were humans and susceptible to viruses that could come from nowhere. In fact, it was easier for a virus to come from nowhere these days.

Once, epidemics needed great movements of people to inspire their spread. The Spanish flu pandemic of 1918, which struck 20 million people, killing 200,000 Americans, directly followed the massive movements of people during World War I. Mixing Americans from diverse regions during the mobilization for World War II created a big viral mixing bowl that blended the poliomyelitis virus into people from every corner of America. The widespread outbreak of polio in the late 1940s and early 1950s was the direct result.

The popularity of air travel had eliminated the need for such dramatic world events to cast the seeds of apocalypse. It took just one person here or there to carry the right virus to the right population, and disease would strike again. Others might not see it now, but it would become obvious in time. Bob Biggar only hoped that it would not be too late.

C
ENTERS FOR
D
ISEASE
C
ONTROL
,
A
TLANTA

Dr. Harry Haverkos of the KSOI Task Force had come up with the idea of bringing Gaetan Dugas to Atlanta. If nothing else, the flight attendant was certain to be harboring lots of virus in his blood, the CDC figured, and Haverkos had him hooked on to a plasmapharesis machine so the agency could collect a half liter of his plasma for lab research.

Everybody in Building 6 was talking about Patient Zero and the cluster study, due for publication next month. Bill Darrow and Harold Jaffe wanted to get pictures of as many GRID victims as they could and start showing them to new patients. They were convinced even more connections could be established. Higher CDC officials, sensitive to gay concerns about confidentiality, vetoed the idea.

Jim Curran passed up the opportunity to meet Gaetan, the Quebecois version of Typhoid Mary. Curran had heard about the flamboyant attendant and frankly found every story about his sexual braggadocio to be offensive. Stereotypical gays irritated Curran in much the same way that he was uncomfortable watching Amos n’ Andy movies.

Gaetan Dugas later complained to friends that the CDC had treated him like a laboratory rat during his stay in Atlanta, with little groups of doctors going in and out of his hospital room. He’d had this skin cancer for two years now, he said, and he was sick of being a guinea pig for doctors who didn’t have the slightest idea of what they were doing.

M
EMORIAL
S
LOAN
-K
ETTERING
C
ANCER
C
ENTER
, N
EW
Y
ORK
C
ITY

Brandy Alexander kept a Rubik’s Cube by his bed in Room 428A at the sprawling cancer center. Sometimes he would take the cube, with all its colors, and turn and twist it every which way with his bony, aching fingers to find the solution. But it never worked; there were no solutions.

Before the first spot had appeared, Brandy had been a brassy female impersonator who could knock ’em dead with “Over the Rainbow,” “Maybe This Time,” and “New York, New York.” As the lesions spread, though, his brown curls turned gray and he lost twenty pounds, leaving his bones to jut out of his loose, purple-spotted flesh. Brandy’s once-handsome face was covered with thick scabs wrought by an uncontrolled herpes virus. None of the standard medications stopped the herpes, so his face oozed all over with pussy discharges. Besides the KS and herpes, the thirty-eight-year-old had an array of the usual opportunistic infections, including severe hepatitis and tuberculosis of the bone marrow.