by Randy Shilts
“I’m not sure I want to go in that place,” said Jaffe.
“I’ll go in,” offered Rendon matter-of-factly. “What should I ask for?”
“They call it the real thing,” Jaffe said. “Ask for the real thing.”
Rendon returned with an unlabeled amber bottle that Jaffe tucked away for chemical analysis back in Atlanta. Like Mary Guinan, Jaffe was out to explore every possible explanation with a focus on the two leading hypotheses: Either the syndrome came from exposure to some toxic substance, like Ambush poppers, or it was part of the spread of a new infectious agent.
Jaffe didn’t believe he would find the solution in poppers. If the puzzle was that simple, somebody would have solved it by now, he thought. Instead, one of Jaffe’s basic motives was to try to grasp what these new diseases were. Like the growing numbers of doctors involved in the outbreak, he was struck by how sick the sufferers were. They were so emaciated that they looked as though they had been dragged out of some sadistic concentration camp; many were so weak they needed to rest between questions. The thirty-five-year-old CDC epidemiologist had seen people with advanced cancer before, but they were never so young as these.
The severity of the illness as well as the number of cases also convinced Jaffe that this was not some discrete outbreak, like Legionnaire’s, that would strike and then fall quietly back into the woodwork. This epidemic was something novel, something that was only beginning to define itself and take shape. All his interviews gave Jaffe only two substantive leads: Ambush poppers and, of course, numbers of sexual partners. The typical KS or PCP patients had had hundreds of partners, most drawing their contacts from gay bathhouses and sex clubs, the businesses whose profits depended on providing unlimited sexual opportunity. The vials of Ambush poppers might offer an environmental clue to the outbreak, but the highly sexual life-style of the early victims was beginning to persuade Jaffe, as it had Jim Curran and Don Francis, that a sexually transmitted bug might be behind the unexplained cancers and pneumonia.
Mary Guinan had a terrible headache on the flight back to Atlanta. Something stank terribly on the plane and it was splitting her temples wide open. On her arrival, she pulled her purse from under her seat, heard the clatter of small glass bottles, and noticed that the stench followed her through the Eastern Airline terminal. It was those poppers, she realized. She had gone to every porno bookstore she could find to buy every conceivable brand of nitrite inhalants, picking them up herself because none of the men who worked for the New York City Health Department would walk into the places.
When one of Mary Guinan’s gay contacts suggested that the disease might be caused by a mixture of poppers and Crisco, a popular lubricant among the fist-fucking aficionados, Guinan dispatched a gay friend to collect popper-tainted globs of Crisco from various bedrooms throughout Greenwich Village for chemical analysis back at the CDC. Nothing was too farfetched to check out.
Both Jaffe and Guinan returned to the CDC in time to hear the unsettling news of the proliferation of Kaposi’s sarcoma and Pneumocystis carinii pneumonia. In the four weeks after the Morbidity and Mortality Weekly Report on KS, 67 more cases of either the cancer or pneumonia were reported to the CDC. Now there were 108 cases nationwide. Of these 43 were dead.
Of the 82 cases for which a date of diagnosis was known, 20 became sick in 1980, while 55 were stricken just in the first seven months of 1981. Curran was preparing a new MMWR update on the diseases, the last that would appear for the next nine months.
The task force pored over Jaffe and Guinan’s studies. Guinan was convinced it was a new infectious disease. Some of the guys she interviewed didn’t use poppers. Certainly, somebody who gets a rush from heroin isn’t going to toy around with something as lightweight as disco inhalants. Jaffe ran the lab work on Ambush poppers and discovered that their popularity rested on the fact that they were not the isobutyl nitrites usually packaged for gays, but genuine amyl nitrite, the kind you can only get with a prescription, unless, of course, you know the right leather bars in San Francisco. This prescription amyl had been around for a century without killing anybody, Jaffe knew.
Bill Darrow was alarmed by the preliminary data Jaffe and Guinan had collected. A twenty-year veteran of VD work, Darrow was generally deferred to as both the most eminent sociologist at the CDC and an expert in the gay community. At forty-two, he was pretty much the old man among the CDC staffers, who tended to be in their early thirties, and he had a calm, professorial way of analyzing a crisis. That was why people were shaken with his analysis of the thirty-one patients interviewed in New York and California.
“It looks more like a sexually transmitted disease than syphilis,” he concluded bluntly.
Hepatitis and amebiasis could be contracted in other ways than by sexual contact, like infection through food, or, as with hepatitis, through shared needles or by blood transfusions. The epidemiology was much more cut and dried with the new victims, Darrow said. The only thing that seemed to matter in these cases was number of sexual partners, which, not coincidentally, was about the only thing that mattered in charting the risk of someone with any sexually transmitted disease in a low-prevalence situation.
In early August 1981, Bill Darrow and perhaps six or seven people in Atlanta were worried; across the country, there were, maybe, a dozen or so other clinicians and gay physicians who also saw the implications of what was beginning to unfold. The trouble, Darrow thought, was trying to convince the other 240 million Americans that they had something to be concerned about too.
The next weeks were spent acculturating the CDC field staff to the complicated gay sexual scene. Local epidemiologists like Selma Dritz of the San Francisco Department of Public Health were flown to Atlanta and given instruction on how to administer the twenty-two-page questionnaire for the case-control study. Invariably, as task force members explained that some victims would have as many as 2,000 lifetime sexual contacts, somebody’s jaw would drop and he or she would ask, “How on earth do they manage that?”
August 1981
CASTRO STREET, SAN FRANCISCO
Gary Walsh ushered Joe Brewer, the gay psychologist with whom he shared an office, through the swinging doors of the Badlands saloon a few doors off Castro Street.
“I’m going to teach you to cruise,” Gary explained with his characteristic decisiveness. “Anybody can do it.”
Joe had spent the spring moping about the breakup of his seven-year relationship, and the ever-ebullient Gary had had enough of his friend’s depression.
“See that gorgeous guy over there,” Gary said, pointing toward a blond in jeans that fit so snugly one couldn’t help but notice he was wearing no underwear. “First, somebody else will walk up to him and try to strike up a conversation. He won’t talk much to him, though. Remember, never be the first guy to go up to someone.”
Gary gave Joe a significant look to make sure he understood.
“People won’t go home with the first person to talk to them—it makes them look too hard up,” continued the thirty-six-year-old psychotherapist. “It’s the second person who gets the shot.”
Joe leaned back toward the wall as he watched Gary’s prediction unfold perfectly. Gary pulled Joe away from the wall.
“No, no, no,” Gary prodded, like a nun lecturing an errant altar boy. “Never stand by the wall. Always stand out a little, and keep yourself sort of turned, so people notice you.”
Although he had been a psychotherapist in gay San Francisco for seven years, Joe was still amazed at the intricacies involved in gay cruising. Joe had always tended toward long relationships, while Gary was the horniest person Joe had ever met. Joe and Gary were so different in so many ways; that probably was why they had been best friends almost from the day they met in 1977.
Gary Walsh saw the Georgia-bred Joe Brewer as a southern gentleman who understood life’s finer qualities; for his part, Joe liked Gary’s straightforward midwestern informality, the legacy of a working-class Catholic childhood in Iowa so vastly
different from Joe’s southern Methodist roots. Gary seemed to envy Joe’s ability to maintain long, sizzling relationships; Joe couldn’t fathom how Gary kept up his active sexual pursuits even after he was settled down with a wonderful boyfriend. Professionally, Joe and Gary made a good pair. They were among the pioneers of gay psychotherapy in San Francisco, and they had virtually invented gay couples’ therapy.
Gary barely held back a wicked smile as he slipped into sample poses guaranteed to increase Joe’s cruising yield. Brewer mused on the irony that he and Gary were guiding couples through the difficulties of maintaining relationships in the biggest sexual candy store God ever invented, even while they were having problems in their own love lives. Joe was single now, and he hated being single. Gary, meanwhile, was struggling with his lover Matt Krieger over all the typical issues of monogamy and individualization. Matt wanted to be married but Gary wanted to fuck around, so Matt would fuck around just to show Gary. To his psychologist’s eye, Joe thought it was typical male competition. But then, so much of the gay community’s sexuality, right down to the whole cruising ritual, seemed more defined by gender than sexual orientation, Joe noticed.
Joe Brewer’s early memories of the Castro were of romantic bubble baths after lovemaking. He was not long from the closet when he came to the Bay Area in 1970, and not far from the times when he had pleaded with a psychiatrist to make him straight. Shedding his guilt in the frolicsome first days of the Castro boom was liberating, and the sex was so brotherly. Slowly, the relational aspects of the sexual interaction dropped away. Intimacy disappeared and, before long, people were wearing outward signs of sexual tasks, hankies and keys, to make their cruising more efficient, and the bathhouses became virtual convenience stores for quick cavorting, 7-Elevens for butt-fucking.
About 3,000 gay men a week streamed to the gargantuan bathhouse at Eighth and Howard streets, the Club Baths, which could serve up to 800 customers at any given time. Joe figured that the attraction to promiscuity and depersonalization of sex rested on issues surrounding a fear of intimacy. Joe knew these were not gay issues but male issues. The trouble was that, by definition, you had a gay male subculture in which there was nothing to moderate the utterly male values that were being adulated more religiously than any macho heterosexual could imagine, right down to the cold, hard stares of the bathhouse attendants. Promiscuity was rampant because in an all-male subculture there was nobody to say “no”—no moderating role like that a woman plays in the heterosexual milieu. Some heterosexual males privately confided that they were enthralled with the idea of the immediate, available, even anonymous, sex a bathhouse offered, if they could only find women who would agree. Gay men, of course, agreed, quite frequently.
Too frequently, Joe sometimes thought. Stripped of humanity, sex sought ever-rising levels of physical stimulation in increasingly esoteric practices. Joe preferred the bubble baths and wished he were in love again.
Gary Walsh had a far less complicated view of gay sexuality. A passionate devotee of sexual liberation, Gary believed that promiscuity was a means to exorcise the guilt and self-alienation ingrained in all gay men by a heterosexual society clinging to the obsolete values of monogamy. Privately, Gary thought people who didn’t like a lot of sex were just plain boring. Life was for learning, he lectured Joe, and sex was as legitimate a learning tool as anything else.
Over lunch, the pair planned a weekend trip to the gay resort area on the Russian River, an hour’s drive north of San Francisco. Joe wasn’t surprised when Gary later canceled, complaining of a yeast infection in his mouth. Gary always seemed to be getting something.
August 7
SAN FRANCISCO
By early August, there were eighteen cases of gay men suffering from the baffling immune deficiency in the San Francisco Bay Area; two had died.
“No one yet knows the extent of this potential danger, but playing it on the safe side for a few weeks cannot hurt,” The Sentinel, a local gay paper, editorialized. “Just a few short years ago, the government dropped millions of dollars into research to determine the cause of Legionnaire’s disease, which affected relatively few people. No such outpouring of funds has yet been forthcoming to research the how’s and why’s of KS, a rapidly fatal form of cancer that has claimed far more victims in a very short time than did Legionnaire’s disease.”
August 11
2 FIFTH AVENUE, NEW YORK CITY
Twilight brought no respite from the humidity as eighty men streamed into Larry Kramer’s apartment on the edge of Washington Square. Paul Popham was there with his Fire Island housemate Enno Poersch; KS victim Donald Krintzman came with his lover. The men milled around the apartment, sharing the latest rumors about who was sick and who didn’t look well. Larry scanned the crowd and noted, with some relief, that none of the political crazies were there. Present, instead, were la crème de la crème of New York’s A-list gay nightlife, the hottest guys you’d see on the island or at the trendiest discos. The conversation abruptly ended when Larry introduced a short balding man who mounted a platform in the center of the comfortable living room.
“We’re seeing only the tip of the iceberg,” said Dr. Alvin Friedman-Kien in what would become the all-encompassing metaphor for the AIDS epidemic for years to come.
He didn’t know what was causing the epidemic, but he knew that the people who got sick had lots of sex partners and a long history of VD. (Larry noticed a lot of the men shift uncomfortably in their Topsiders.) The word needed to get out, Friedman-Kien warned; people needed to take it seriously. The doctor added that he needed money for research—now.
For most of the people in that apartment, the brief stunned silence that followed Friedman-Kien’s talk represented the moment between their Before and After. The days of their lives would be counted from this time when they realized that something brutally unexpected had interrupted their plans. For Enno Poersch, this was the moment it dawned on him that the horrible death Nick had suffered seven months ago might be related to Jack Nau’s and Rick Wellikoff’s illnesses.
When Larry asked for volunteers to work on some larger fund-raisers, Enno stayed behind and so did Paul Popham. Paul had rather prided himself on never getting involved in gay politics, but this was different. Two friends were dead and another was dying. About thirty-five other people stayed behind to organize fund-raising tables at Fire Island for Labor Day weekend. Larry passed the hat for Friedman-Kien’s NYU research and collected $6,635. That was just about all the private money that was to be raised to fight the new epidemic for the rest of the year.
Some people left Larry Kramer’s apartment angry at Friedman-Kien. When one man asked him how to avoid getting this gay cancer, Friedman-Kien had repeated that he would stop having sex. The gay community didn’t need some Moral Majority doctor telling them what to do with their sex lives, somebody fumed. Others suspected that the meeting was simply a furtherance of Larry’s well-known distaste for promiscuity.
Still, Larry considered his new cause to be off to a grand start. He spent the next few days writing letters to alert key people to the epidemic. He dropped a note to Calvin Klein, asking for contributions to research, and he dashed off a plea to a closeted gay reporter at The New York Times for more coverage. Cases had more than doubled in the month since that first piece in The Times, and Larry hadn’t seen another word since.
September 7, Labor Day
FIRE ISLAND, NEW YORK
“Are you crazy?”
Paul Popham couldn’t comprehend what the guy was driving at.
“You’re just making a big deal out of nothing,” the acquaintance continued, giving Paul another strange look before striding purposefully toward the Donna Summer music pulsating from the Ice Palace.
How could you not be concerned, Paul wondered. More than 100 gay men were sick with something, many of them dead, and everybody was acting as though Paul were some major-league party-pooper out to wreck everybody’s good time. Paul was downright aggravated. Lord knows, he like
d to party too, but this was a time to be serious. He was asking people to put a buck or two in a can, and he was not only ignored but was often treated with unabashed hostility. Guys told him that he was hysterical, or participating in a heterosexual plot to undermine the gay community. At best, the men were apathetic.
The weekend was a disaster from the start. Larry Kramer, Enno Poersch, Paul Popham, and a handful of others had stretched a banner above a card table near the dock where everybody came into The Pines. “Give to Gay Cancer,” it read. With some of the money raised at Larry’s apartment, they had printed up thousands of copies of a New York Native article written by Dr. Larry Mass, another volunteer that weekend, and put them at every doorstep in the island’s two gay communities, The Pines and Cherry Grove. To each reprint, they attached slips explaining how people could support Friedman-Kien’s research. The small band of organizers figured they’d be able to raise thousands from the 15,000 gay men who had congregated for the last blowout of the ’81 season.
They were wrong.
“Leave me alone,” was one typical reaction.
“This is a downer,” was another.
“What are you talking about?” was about the nicest response they got.
Enno was amazed at all the smart-ass remarks. Larry was dispirited. How do you help a community that doesn’t want help? he wondered. For his part, Paul felt a wholly unfamiliar sense of alienation. These are my kind of people, he thought. He knew these faces, had seen them for years dancing at The Saint, strolling around the St. Mark’s Baths, sunning on the beach. They were paying $10 to get into the Ice Palace and another $50 or so for the drugs that would keep them up until dawn, not to mention the $4,000 it took to buy this summer’s share in a Fire Island house rental. What was a few dollars for scientific research?