And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition (28 page)

Other research-oriented scientists told CDC Task Force members that they found the cluster stories intriguing, although somewhat anecdotal, and that a case-control cluster study would be necessary to prove the hypothesis of sexual transmissibility. Of course, such a study would take a few years to construct, but nobody said science worked fast.

In any event, the cluster study failed to resolve the transmissibility question as Bill Darrow and the CDC researchers originally had hoped it would. A handful of scientists and public health officials clearly saw the implications, but nobody rushed into action because the science wasn’t then set in concrete. Although the study attracted a brief flurry of national media attention, it faded fast.

V
ANCOUVER
, B
RITISH
C
OLUMBIA

Gaetan Dugas confided to only a few friends that he was the “Orange County connection,” as the study became known because of Gaetan’s role in linking the New York, Los Angeles, and Orange County cases. Though on leave from Air Canada, the thirty-year-old flight attendant still had the passes that allowed him to fly all over the world for virtually nothing. He loved the travel, but he had decided to settle in San Francisco. They had an interferon program at their GRID clinic, and besides, he’d always wanted to live there.

It was around this time that rumors began on Castro Street about a strange guy at the Eighth and Howard bathhouse, a blond with a French accent. He would have sex with you, turn up the lights in the cubicle, and point out his Kaposi’s sarcoma lesions.

“I’ve got gay cancer,” he’d say. “I’m going to die and so are you.”

July 2

A
TLANTA

Bruce Evatt heard of still another case of immune suppression in a hemophiliac in Canton, Ohio, and now he saw clearly what was ahead. GRID was an infectious disease caused by a virus that could be spread through the blood. The nation’s blood supply was already contaminated with the virus. A meeting of blood-industry officials would be needed soon; emergency measures would be needed to save lives.

July 6

C
ASTRO
S
TREET
, S
AN
F
RANCISCO

Cleve Jones had spent all afternoon passing out leaflets on Castro Street for the Kaposi’s Sarcoma Foundation’s first public forum the next night. When he arrived at the home of his old boyfriend, attorney Felix Velarde-Munoz, he was still buzzing with talk of GRID and the new organization he was forming. Cleve couldn’t believe how apathetic other gay leaders were about it. He had begged Pat Norman for a list of doctors to whom he could refer the scores of worried callers; she said she’d have to check about the right process for releasing such information.

People were dying and gay bureaucrats were worried about process. There wasn’t time for process, Cleve said. Gay doctors still hadn’t decided whether they’d bother to put together risk-reduction guidelines, and Cleve had spent half the day on the phone pleading with gay lawyers to sit on the board and give the organization some credibility. None of them seemed particularly interested either. They had their own political agenda, and there didn’t seem anything to be gained by associating their names with some downer that was probably a lot of media hype.

Cleve took a long sip on his second vodka tonic, puffed heavily on a Marlboro, and noticed that Felix wasn’t talking much. Cleve kicked himself for running off at the mouth and asked what the civil rights lawyer had been up to lately. Usually, there was some injustice that Felix was fighting in his new job at the State Bar of California. But the handsome Chicano lawyer offered little comment, complaining that he’d been tired a lot lately, just coming home after work and going straight to bed. Cleve thought it odd. They had spent the romantic summer of 1980 together, dancing hours away in the hot afternoon Tea Dances. Energy had never seemed to be Felix’s problem.

The memories ended there. Cleve’s peripatetic mind went back to the next day’s KS forum, the new words he was learning, expressions like intubate and interferon, and the intricacies of probate with which he was becoming familiar. Suddenly, Felix excused himself from the table, dashed to the backyard, and threw up. With this, Cleve politely excused himself and headed for a bar.

Felix admitted it to no one, certainly not to old flames like Cleve Jones and not even to his best friends. Like hundreds of others in San Francisco, however, his doctor had sat him down for a serious talk. The yeast infections in his mouth, the fatigue, and those nightsweats, the doctor warned, might all be part of this new GRID syndrome. They needed to monitor his health carefully because he might come down with something worse. Somewhere, in some compartment separated from the rest of his being, Felix secreted this knowledge. There it stayed, never emerging in words to another person, haunting his sweaty sleep like a nightmare waiting to happen.

N
EW
Y
ORK
C
ITY

Rodger McFarlane and other Gay Men’s Health Crisis members were training scores of hotline counselors, random volunteers collected from the board of directors’ little black books. There was so much for the volunteers to learn, from the intricacies of the immune system to holding hands of healthy men who lay awake at night because a lymph node seemed just a little bigger than normal. One corps of volunteers was needed to finagle their way through the legendary red tape of getting disability and Social Security benefits. Each agency would have one or another social worker who would lend a sympathetic ear to the gay man or drug addict ailing with
Pneumocystis,
and these people needed to be discerned from among the many more who wouldn’t.

Just when McFarlane would think he was going to work on long-term care plans, somebody would call and he’d have to change some man’s sheets so he wouldn’t be lying in shit all night. Then he’d have to talk to the guy for a couple of hours because it turned out that the family was coming the next day and they didn’t even know the guy was gay, much less sick with gay cancer.

The tensions between Larry Kramer and Paul Popham were growing over the nature of what GMHC was supposed to be. Paul realized that a whole network of social services needed to be created for gay men during this epidemic. By now, it was clear that the city wasn’t going to do much for a minority that wielded so little real political power in such a vast metropolis. Larry Kramer, meanwhile, wanted the group to veer into political activism and simply demand these services from the city as its just due.

Another point of conflict was over what to tell gay men. Larry was adamant that GMHC should tell homosexuals exactly what the doctors were telling board members in private meetings—to stop having sex. Or, if not to stop having sex altogether, at least to stop having the kind of sex that involves putting semen in another person’s body. Most of the board members were themselves fresh from the hot summers in Fire Island bushes and long nights at spacious Manhattan bathhouses, and they had a hard time putting down the activities they had spent most of the past decade pursuing. It seemed prudish to make judgments. In the GMHC newsletter issued in July, the first nonscientific publication issued by any organization in the world on the year-old epidemic, various views of risk reduction were presented.

“A number of physicians, many of them gay as well, have advised their gay patients to moderate their sexual activity, to have fewer partners, and to have partners who are in good health,” went the toughest advice. “It is the
number
of sexual partners, not sex itself, that increases risk.”

Another story, by sociologist Marty Levine, however, sneered at such suggestions as “fallacious reasoning” and such advice as “panic…still washing over us.” Levine wrote that “278 cases out of a possible 11 million (gay men in America) hardly constitutes an epidemic.”

For its part, GMHC as a group decided that its job would be to give gay men the most up-to-date information about the epidemic and let them make their own decisions. This policy engendered another fierce debate between Larry Kramer and the other board members. “We don’t want to get into the business of telling people what to do in bed,” came the chorus against Larry. During an epidemic of a sexually transmitted disease, Larry thought, this was
exactly
what you did to save lives. He lost the arguments but remained convinced that the board ultimately would shift its position. The only question in his mind was how many people would die first.

July 13

M
T
. S
INAI
H
OSPITAL,
N
EW
Y
ORK
C
ITY

Even before Dr. Jim Curran from the Centers for Disease Control started to speak, the symposium was buzzing about the
MMWR
that had just been issued a few days before from Atlanta. The report finally confirmed what doctors in New York City and Miami had known since last year—that this so-called gay cancer was all over the Haitian refugee communities in their cities. The
MMWR
documented thirty-four Haitian cases of opportunistic infections, like those striking gay men and intravenous drug users. Most Haitians suffered from either
Pneumocystis
or toxoplasmosis, although some contracted the deadly cryptococcus brain infection or disseminated tuberculosis. Unlike the stricken gay men, few of the Haitians seemed to be getting Kaposi’s sarcoma. However, their blood showed the same deficiencies in T-helper lymphocytes that marked all the various risk groups.

“The occurrence of opportunistic infections among adult Haitians with no history of underlying immunosuppressive therapy or disease has not been reported, previously,” the report stated dryly. In plain talk, the CDC was saying that this had never happened before and they’d be damned if they could figure out why it was happening now. The Haitians presented a new enigma in which to wrap the mystery of the growing epidemic. The worst news of the day, however, was yet to come.

When Curran started talking, a discernible chill crept through the room. There was still another new risk group, Curran said. That week, the CDC would release the case histories of three hemophiliacs who apparently contracted the immune suppression from their Factor VIII. The three cases, Curran knew, were the hemophiliacs in Canton and Denver whom Dale Lawrence had just researched, as well as the elderly Florida man who had been reported to the CDC back in January. A stunned silence greeted Curran’s report.

After the lecture, somebody whispered something in the corridor to Curran about a rumored transfusion-related GRID case in Montreal. Curran’s normally cool face looked plainly disturbed at the news.

Meanwhile, the doctors fell into little groups, seizing on the implications of GRID in hemophiliacs. First gays, then intravenous drug users, and now hemophiliacs. Those were the major risk groups for hepatitis B. They also knew that there was another risk group for hepatitis B: doctors, nurses, and health care workers. Hospitals were now vaccinating their entire staffs with the new hepatitis B vaccine in the first move toward eliminating that dreaded disease from the profession. Would GRID be the encore? Many doctors wondered aloud that afternoon whether the next risk group to be described in the
MMWR
would include themselves.

As of July 15, 471 cases of GRID had been reported to the Centers for Disease Control, of whom 184 had died. The victims now spanned twenty-four states; the pace of their diagnoses was quickening. One-third of the cases had been reported in the past twelve weeks alone. New diagnoses, which had been coming in at a rate of 1.5 a day in February, were being reported at a rate of 2.5 a day in July. Finally, the CDC was publicly calling the outbreak of immune suppression an epidemic.

“The pressure is on” to find the cause, said Jim Curran in a
Washington Post
interview published on July 18. “There may be additional groups that get it, and, in the other groups, people are going to keep on dying…. Somebody’s got to find this thing.”