And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition (5 page)

Another problem was enteric diseases, like amebiasis and giardiasis, caused by organisms that lodged themselves in the intestinal tracts of gay men with alarming frequency. At the New York Gay Men’s Health Project, where Dan William was medical director, 30 percent of the patients suffered from gastrointestinal parasites. In San Francisco, incidence of the “Gay Bowel Syndrome,” as it was called in medical journals, had increased by 8,000 percent after 1973. Infection with these parasites was a likely effect of anal intercourse, which was apt to put a man in contact with his partner’s fecal matter, and was virtually a certainty through the then-popular practice of rimming, which medical journals politely called oral-anal intercourse.

What was so troubling was that nobody in the gay community seemed to care about these waves of infection. Ever since he had worked at the New York City Department of Public Health, Dan William had delivered his lecture about the dangers of undiagnosed venereal diseases and, in particular, such practices as rimming. But he had his “regulars” who came in with infection after infection, waiting for the magic bullet that could put them back in the sack again. William began to feel like a parent as he admonished the boys: “I have to tell you that you’re being very unhealthy.”

Promiscuity, however, was central to the raucous gay movement of the 1970s, and his advice was, as the Texans so charmingly put it, like pissing in the wind. At best, he tried to counsel the Elizabeth Taylor approach to sexuality and suggest serial monogamy, a series of affairs that may not last forever but that at least left you with a vague awareness of which bed you slept in most evenings.

The crowd cheered the parade again when the Bulldog Baths float came rolling into Civic Center. The young musclemen, in black leather harnesses, the best and the most beautiful, jumped from the cages in which they had discoed down Market Street. That night they would be at the huge Cellblock Party at the bathhouse, one of a panoply of celebrations sponsored that day by San Francisco’s thriving sex industry.

This commercialization of gay sex was all part of the scene, an aspect of the homosexual life-style in which the epidemics of venereal disease, hepatitis, and enteric disorders thrived. The gay liberation movement of the 1970s had spawned a business of bathhouses and sex clubs. The hundreds of such institutions were a $100-million industry across America and Canada, and bathhouse owners were frequently gay political leaders as well, helping support the usually financially starved gay groups. The businesses serviced men who had long been repressed, gay activists told themselves, and were perhaps now going to the extreme in exploring their new freedom. It would all balance out later, so for now, sex was part and parcel of political liberation. The popular bestseller
The Joy of Gay Sex,
for example, called rimming the “prime taste treat in sex,” while a leftist Toronto newspaper published a story on “rimming as a revolutionary act.”

It was interesting politics, David Ostrow thought. From a purely medical standpoint, however, the bathhouses were a horrible breeding ground for disease. People who went to bathhouses simply were more likely to be infected with a disease—and infect others—than a typical homosexual on the street. A Seattle study of gay men suffering from shigellosis, for example, discovered that 69 percent culled their sexual partners from bathhouses. A Denver study found that an average bathhouse patron having his typical 2.7 sexual contacts a night risked a 33 percent chance of walking out of the tubs with syphilis or gonorrhea, because about one in eight of those wandering the hallways had asymptomatic cases of these diseases.

Doctors like David Ostrow and Dan William did not consider themselves prudish, even if they were cut from a more staid mold than the people whose pictures were in the newspaper coverage of the Gay Freedom Day Parade. But they were uneasy about the health implication of the commercialization of sex. In a 1980 interview with a New York City gay magazine,
Christopher Street,
William noted, “One effect of gay liberation is that sex has been institutionalized and franchised. Twenty years ago, there may have been a thousand men on any one night having sex in New York baths or parks. Now there are ten or twenty thousand—at the baths, the back-room bars, bookstores, porno theaters, the Rambles, and a wide range of other places as well. The plethora of opportunities poses a public health problem that’s growing with every new bath in town.”

Such comments were politically incorrect in the extreme, and William suffered criticism as a “monogamist.” Self-criticism was not the strong point of a community that was only beginning to define itself affirmatively after centuries of repression.

Altogether, this generation of gay men was blessed by good health. Being a gay doctor was fun, William often told himself. Physical fitness was a community ritual with tens of thousands of gay men crowding Nautilus centers and weight rooms. He rarely had to go to a hospital because none of his patients ever got very sick.

David Ostrow too was haunted by forebodings as he left the parade. Between the bathhouses and the high levels of sexual activity, there would be no stopping a new disease that got into this population. The likelihood was remote, of course. Modern science had congratulated itself on the eradication of infectious disease as a threat to humankind. But the specter sometimes haunted Ostrow because he wondered where all the sexually transmitted disease would end. It couldn’t continue indefinitely. He had already noticed that some Chicago gay men were having immune problems. Dan William was seeing strange inflammation of the lymph nodes among his most promiscuous patients. The swelling was curious because it did not seem to be in response to any particular infection but was generalized, all over; maybe it was the effect of overloading the immune system with a variety of venereal diseases.

Years later, Dan William would recall that it was during the days of early 1980 that he saw a man in his mid-forties recovering from a bad bout with hepatitis B. He had strange purplish lesions on his arms and chest. William referred him to Memorial Sloan-Kettering Cancer Center. The man, it turned out, was suffering from a rare skin cancer, Kaposi’s sarcoma. William had to look up Kaposi’s sarcoma in a medical textbook because he had never heard of the ailment. Fortunately, the book said, the man had a good prognosis. Elderly Jewish or Italian men got Kaposi’s sarcoma; twenty years later they usually died of old age. The cancer itself, however, appeared benign.

Mervyn Silverman watched the bare-breasted women in leather straps, with rings through their nipples, walk by him, and he definitely had the feeling that he was not in Kansas anymore. In his twenty years in public health, he had traveled around the world and had lived in Bangkok and South America. As he watched the passing parade of humanity at the Gay Freedom Day Parade, he knew he had never lived in a more exciting place than San Francisco, and he sensed that he would not want to live anywhere else.

With his full head of prematurely gray hair, Silverman was easily recognizable to many of the bystanders, who shook his hand and introduced their lovers. Few City Hall officials were more popular than Silverman, the director of the Department of Public Health, and few had gone out of their way to show greater sensitivity to the gay community. Within weeks of his appointment as health director by Mayor George Moscone in 1977, Mervyn Silverman had understood that being public health director in San Francisco was like nowhere else. Every community and interest group had their own advisory board to the health department—there were thirty-four of them in all—and it seemed that no decision went over his desk that was not rife with political overtones. Already, a decision over the closing of a neighborhood health center had prompted a picketing of Silverman’s spacious Victorian home on Frederick Street in the Upper Ashbury neighborhood.

Something about the political tension, however, excited Silverman. He enjoyed the challenge, maintained cordial relations with the press, and carved a singularly good reputation in every corner of the city. Silverman was a popular official, and that was the way he liked it. He had avoided hard feelings by making all decisions on the basis of consensus. He had listened to all sides and forged the middle path. All public health policy was basically political, he felt; as someone who relished public approbation, he was a good politician. It was his strength as a public official.

“I am the prettiest one.”

It had been the standing joke. Gaetan Dugas would walk into a gay bar, scan the crowd, and announce to his friends, “I am the prettiest one.” Usually, his friends had to agree, he was right.

Gaetan was the man everyone wanted, the ideal for this community, at this time and in this place. His sandy hair fell boyishly over his forehead. His mouth easily curled into an inviting smile, and his laugh could flood color into a room of black and white. He bought his clothes in the trendiest shops of Paris and London. He vacationed in Mexico and on the Caribbean beaches. Americans tumbled for his soft Quebeçois accent and his sensual magnetism. There was no place that the twenty-eight-year-old airline steward would rather have the boys fall for him than in San Francisco.

Fog streamed over the hills into the Castro, toward the 1980 Civic Center rally. The first cool breezes of evening were thinning the throng downtown, but throughout the city thousands of gay men crowded into giant disco parties that had become a staple of the weekend-long celebration. There was the Heatwave disco party for $25 a head in the Japantown Center, the Muscle Beach party and the trendy Dreamland disco, and Alive, a funkier dance fest a few blocks away.

The hottest and hunkiest, Gaetan knew, would be among the 4,000 streaming to the chic Galleria design center, where the party was just starting when the steward and his friend arrived. Every corner of the lobby and the five-story atrium was crammed with men pulsing to the synthesized rhythms of disco music. Any redundance in the musical patterns was quickly obviated by the cocaine and Quaaludes that were a staple of such parties.

Gaetan easily made his way through the profusion of sweaty bodies with his closest friend, another airline steward from Toronto. They had met in 1977, when they were based in Halifax, Nova Scotia. Together, they had ventured to San Francisco for the 1978 gay parade, and every year they returned for the carnival. They decided that San Francisco would always be their ultimate refuge. The last weekend of every June was now set aside for nonstop partying at bars and baths.

Here, Gaetan could satisfy his voracious sexual appetite with the beautiful California men he liked so much. He returned from every stroll down Castro Street with a pocketful of matchbook covers and napkins that were crowded with addresses and phone numbers. He recorded names of his most passionate admirers in his fabric-covered address book. But lovers were like suntans to him: They would be so wonderful, so sexy for a few days, and then fade. At times, Gaetan would study his address book with genuine curiosity, trying to recall who this or that person was.

As Gaetan neared the crowded dance floor at the Galleria, various men shouted greetings, and he hugged them ebulliently like long-lost brothers. “Who was that?” his friend would ask. “I don’t know,” Gaetan laughed offhandedly. “Somebody.”

Here, swaying and stomping to the music, Gaetan was completely in his element. San Francisco was the hometown he never had. It helped him forget the other, distant life, long ago, when he was the major sissy of his working class neighborhood in Quebec City. Being gay then meant constantly fighting taunts hurled by the other kids and being gripped by guilt, by his own conscience. But that was then and this was San Francisco. On June 29, 1980, Gaetan was the ugly duckling who had become the swan.

At the first opportunity on the dance floor, Gaetan stripped off his T-shirt and fished out a bottle of poppers, nitrite inhalants, from his jeans pocket in one swift, practiced move. Fine blond hair outlined the trim natural proportions of his chest.

He felt strong and vital.

He didn’t feel like he had cancer at all.