And the Band Played On

by Randy Shilts

  “It isn’t going away,” he said. “Even if we find a causative virus or other agent, it will be considerable time, probably years, before we can develop a vaccine or some strategy to eradicate it. We are in for a long haul.”

  Curran scanned the young faces that had suddenly grown so still.

  “It’s likely we’ll be working on this for much of our careers,” he said, “if not most of our lives.”

  Later, many of the doctors confided to each other that Curran was being a bit hysterical.

  Meanwhile, at the fledgling Gay Men’s Health Crisis, fights flared unpredictably between Paul Popham and Larry Kramer, such as on the night the committee received the 10,000 invitations for its upcoming April disco fund-raiser, “Showers.” Paul Popham, the new president, was incensed that the invitation’s return address included “Gay Men’s Health Crisis.”

  “We can’t mail this out,” said Paul.

  Nobody else could figure out why he was so upset.

  “It says gay on it,” he fumed. “You can’t send something to people that has the word ‘gay’ on it. What if they’re not out of the closet?”

  Larry Kramer was not terribly sympathetic. Besides, the invitations already were late. They needed to get them out right away.

  “We can strike it out with a magic marker,” Paul suggested.

  “Ten thousand invitations?” Larry asked.

  “What about my mailman?” Paul finally burst. “He’s going to know I’m gay.”

  Kramer was incredulous.

  “What about your doorman?” he shot back. “You drag tricks up to your apartment every night. Don’t you think your doorman suspects something? Why aren’t you worried about him?”

  The invitations were mailed out, but Kramer wondered about what would happen later, when this community really needed something and the people who were supposed to do the demanding were so ashamed of themselves that they didn’t even want their mailmen to know they were gay.

  CENTERS FOR DISEASE CONTROL, ATLANTA

  During the final weeks of March 1982, the pace quickened in the labyrinthine corridors of the red brick Building 6 of the CDC in Atlanta. The ten people assigned to the task force barely had time to write up a new development before the epidemic took another unexpected turn that had them racing to catch up again. The latest crisis had started with sporadic reports to the CDC’s parasitic disease division of toxoplasmosis in Haitians, first in Miami and then in New York City. At first, parasitologists thought this was some problem unique to the malnourished refugees who had come from the most impoverished nation in the Western Hemisphere. Others remembered reports of strange cases of toxoplasmosis among gay men in the early cases.

  Dr. Harry Haverkos of the KSOI Task Force flew from Atlanta to Miami and reviewed the Haitians’ medical records. The refugees were suffering not only from toxoplasmosis but also Pneumocystis and severe disseminated tuberculosis. There were fewer cases of Kaposi’s than among gay men, but some biopsies had confirmed that diagnosis nevertheless. The patients themselves presented yet a new scene in the unfolding horror show. They tended to die quicker than the gay men Haverkos had seen, and their wasting was far more striking. He came back convinced: The Haitians had GRID.

  This new risk group presented still more mysteries to the task force, which was only beginning to fathom the unknowns behind GRID cases diagnosed a year ago. There was talk of voodoo rituals that might allow blood transmissions. Investigations were made difficult by language barriers and the suspicions Haitians had of anything governmental, a not unlikely tendency after life under one of the most ruthless dictators the U.S. government had ever financed. In their crisp Creole, the patients muttered to interpreters that Haverkos, an Ohioan with a penchant for polychromatic plaid jackets, was a CIA agent. Haverkos found it nearly impossible to track down family members or friends because all the refugees had come to America illegally and few patients were willing to risk their friends’ deportation.

  Were these people really gay, having picked up the disease from vacationing New Yorkers? Had they given it to gay Manhattan men on holiday? Was the disease spreading through ritualistic scarring that might engender blood transmission? Haverkos was already working with Mary Guinan on prisoners and keeping track of possible cases among hemophiliacs. He had taken the Miami trip on what was supposed to be a week off between studies. He quickly mapped out a case-control study that the CDC should conduct on the Haitians. Whatever they held in common with gay men and intravenous drug users might give scientists the key to the epidemic.

  As with so much in this year of lost opportunity, however, Haverkos’s proposal languished among the many other projects left undone because the CDC didn’t have enough money. By the time the study was begun two years later, everybody already knew what was causing the disease and the research became art academic exercise that provided interesting, but not essential, information.

  “Give us something else,” the reporters begged Haverkos.

  It was their standard line. Haverkos translated it to mean, “Give us something about the epidemic that doesn’t involve gays.” The science writers insisted their editors wouldn’t hear of writing stories about gay diseases and gay sex. They needed an angle that was, well, legitimate. Haverkos had noted that the story didn’t make the Wall Street Journal until it had a heterosexual angle. He wondered how reporters could honestly try to get around the fact that for all the new risk groups emerging, gay men still composed the greatest proportion of GRID cases. He also knew, of course, that lack of coverage was the most obvious single reason studies like his Haitian protocol would be left undone. Without the media to watch the federal government, the budget people would be left to finance GRID research as they saw fit. In an administration committed to cutting domestic spending, that meant virtually no funding at all.

  NEW YORK UNIVERSITY MEDICAL CENTER, NEW YORK CITY

  Gaetan Dugas seemed quite pleased with himself as he rattled off his sexual exploits to Bill Darrow. Darrow had tracked down Gaetan through Alvin Friedman-Kien. All my beautiful lovers, the airline steward seemed to be saying, rather proudly. He paused for a moment before asking a question in what Darrow thought was too naive a tone.

  “Why are you interested in all these people?”

  “Some of them have been diagnosed with this immune deficiency and some haven’t. We want to find out why some get the disease and others don’t.”

  Gaetan’s face dropped. He looked stunned, as if a new and horrible idea had only now taken residence in his mind.

  “You mean I may have been passing this around?” he asked.

  “Yeah,” Darrow said, surprised that Gaetan hadn’t thought of it before. “You may be passing it around or you might have gotten it from someone else.”

  The last part of Darrow’s comment, it turned out, would probably have been best left unsaid given Gaetan’s subsequent activities.

  March 25

  SAN FRANCISCO

  After the last heart attack, Simon P. Guzman’s body struggled three painful minutes before surrendering to the inevitable shortly after 11 A.M. He was the eleventh man to die in the GRID epidemic in San Francisco. His death certificate marked the first time that cryptosporidiosis, a disease of sheep, was listed as a cause of death for a human being.

  March 30

  ATLANTA

  The NCAA basketball play-offs were starting on the tube, but Harold Jaffe had more than sports on his mind when he invited Paul Weisner over to the watch the game. As chief of the CDC’s venereal disease division, Weisner was boss not only to Jaffe but to the greatest share of the Kaposi’s Sarcoma and Opportunistic Infections Task Force. Jaffe figured the basketball game would give them a chance to talk, away from the constantly ringing phones at headquarters on Clifton Road. Jaffe methodically gave the growing evidence that GRID was a sexually transmitted disease. Weisner quickly saw the implications of the epidemiology.

  “We’re going to have to make a long-term commitment,” Jaffe ventured.
“We can’t just keep borrowing resources. This isn’t going away. It’s going to get bigger and bigger.”

  Weisner weighed Jaffe’s comments and agreed. “You’ve got my commitment,” he answered.

  Jaffe was ecstatic as he settled back to watch the game. For the first time, a person in authority was on record as favoring a permanent commitment of resources to the epidemic. In terms of the organizational chart, of course, Weisner was at best a mid-level administrator, but he was somebody who had more clout than anybody on the task force. The top CDC brass were more likely to listen to him, Jaffe figured. At this point, any sign of help was welcome.

  April 1

  UNIVERSITY OF CALIFORNIA, SAN FRANCISCO

  Speaking smoothly in his charming French accent, the young man seemed the personification of all things debonair. Marcus Conant was amazed that the airline steward had been diagnosed with Kaposi’s sarcoma for almost two years already. He still looked healthy. He still exuded a vibrant sensuality.

  Gaetan Dugas was proud that his cancer had not progressed. He was going to beat this thing, he insisted. He just wanted Conant to check him out and make sure everything was under control.

  After the examination, as Gaetan was pulling on his stylish shirt, Conant mentioned that Gaetan should stop having sex.

  “It’s probably some virus,” said Conant. “If you do have sex, make sure to avoid anything where you come inside somebody or exchange body fluids.”

  Gaetan looked wounded, but his voice betrayed a fierce edge of bitterness.

  “Of course, I’m going to have sex,” he told Conant. “Nobody’s proven to me that you can spread cancer.”

  Gaetan cut Conant’s rebuttal short. “Somebody gave this thing to me,” he said. “I’m not going to give up sex.”

  April 2

  ATLANTA

  By now, a dizzying array of acronyms was being bandied about as possible monikers for an epidemic that, though ten months old, remained unnamed. Besides GRID, some doctors liked ACIDS, for Acquired Community Immune Deficiency Syndrome, and then others favored CAIDS, for Community Acquired Immune Deficiency Syndrome. The CDC hated GRID and preferred calling it “the epidemic of immune deficiency.” The “community” in other versions, of course, was a polite way of saying gay; the doctors couldn’t let go of the notion that one identified this disease by whom it hit rather than what it did.

  Whether CAIDS, ACIDS, or GRID, the epidemic had by April 2, 1982, struck 300 Americans and killed 119. In the past two weeks, cases had been detected in two more states and two more European nations, indicating that the epidemic had now spread across nineteen states and seven countries. Of the 300 cases in the United States, 242 were gay or bisexual men, 30 were heterosexual men, 10 were heterosexual women, and 18 were men of unknown sexual orientation. Since transmission through unclean needles had yet to be proven scientifically, the cautious CDC statisticians had not yet roped off addicts as a separate risk group. By now, somebody was dying almost every day in America from an epidemic that still did not have a name.

  April 8

  PARADISE GARAGE, MANHATTAN

  Few nights could have been more poorly chosen for the first benefit any organization had ever undertaken to raise private funds for the epidemic. It was the second day of Passover, the night before Good Friday. Gay Men’s Health Crisis had distributed tickets in stores all over town, in the bathhouses and gay card shops. But so far, they had sold only 500 tickets. Larry Kramer, Paul Popham, Enno Poersch, and the other organizers from the Gay Men’s Health Crisis nervously waited to see whether anyone would show up; so many of their friends had told them the whole subject of this gay cancer was such a downer.

  Tensions had begun to surface in the committee. Larry Kramer insisted on being the public spokesman for the press. That was fine with Paul Popham since he didn’t want any public role that might have repercussions for his job. Some board members, however, were worried that Kramer’s rhetoric was too harsh. He was always chastising Mayor Ed Koch for refusing to meet with the group and ridiculing Health Commissioner David Sencer for not providing any educational material on the epidemic. After any fight, however, the board always got back together. There weren’t that many other people who believed the epidemic was a worthwhile effort to work on.

  In the past few weeks, the committee had realized that it was going to be a permanent organization, not a temporary fund-raising structure. With the city government ignoring the epidemic, somebody needed to get out educational information and coordinate volunteer efforts directed at the GRID victims, who were often left immobilized and isolated. Kramer was agitating that the committee could be a powerful pressure group to force the city into providing services, but most members were eager to avoid the kind of politics that marked the petty gay leadership scene. Besides, the medical needs seemed to be growing so fast. Dr. Michael Lange had recently appeared before the board and outlined the disaster he was convinced lay ahead. There was a lot of work to be done, he insisted, and the gay community would have to shoulder a lot of it themselves.

  The lines started queuing up an hour before Paradise Garage even opened. Everybody was there, many toting checks with substantial contributions. Within a few hours, the committee raised $52,000. Enno Poersch was amazed at the turnout. These weren’t political people—they were the party crowd he had danced with on Fire Island; finally, they were caring about something other than the “four D’s” of drugs, dick, disco, and dish. By now, Enno had been told that Nick’s toxoplasmosis was part of the GRID epidemic. Enno thought often of Nick, dead now for fifteen months. As he saw the hundreds of men swaying to disco music under the shimmering disco ball, Enno wished Nick were there to share the night and the happiness with him.

  Everybody cheered enthusiastically when Paul Popham addressed the crowd in his broad, plainspoken Oregon accent.

  “It may be that an equal measure of fear and hope has brought us together, but the great thing is, we are together,” said Paul. “Most of you know someone, or someone who knows someone, who has been touched by the outbreak. I have lost two friends myself…. We’ve got to fight back. We’ve got to be tough. We’ve got to show each other and the unfriendly world that we’ve got more than looks, brains, talent, and money. We’ve got guts too, plus an awful lot of heart.”

  FIRE ISLAND

  Paul Popham had waited all weekend in the house on Ocean Walk for the overcast skies to clear, but they kept their steely cast. Finally, on Sunday, it was nearing the time when he would have to return to Manhattan, and he couldn’t wait any longer. A year ago, he had come here with the ashes of his friend Rick Wellikoff. It had been a sunny, melancholy day, warmed by the sharing of grief with Rick’s surviving lover and friends. Now, Rick’s lover was ailing too, the fourth person from the house on Ocean Walk to be stricken by this new plague, and Paul was alone with the ashes of Jack Nau.

  Paul knew, in some corner of his awareness, that he was devoting himself so thoroughly to the Gay Men’s Health Crisis in large part because he had to bury the grief he still felt so keenly both for Rick, the Brooklyn schoolteacher, and for Jack, the designer who once did the windows at the Long Island Sale’s Fifth Avenue. As a harsh rain beat down, Paul again pondered the familiar imponderables. Why is this happening to me, to all my friends? Hadn’t they put up with enough shit for one lifetime? Why doesn’t anybody seem to care?

  What a fucking nightmare.

  The cold white fingers of the sea stroked the indifferent sand, littered by a winter’s worth of misshapen flotsam. Paul opened the box and shook. The sea fingers reached to grab Jack’s ashes and pull them into the brine. Paul gazed out to where the leaden sky met the gray Atlantic and wondered when it would all end. This can’t be happening, he thought, it’s simply too unbelievable.

  Yet, as he shook the last of the bone dust that was once Jack Nau into the sea, Paul knew that it was happening and it was all too believable.

  14

  BICENTENNIAL MEMORIES

  April 1
982

  DAVIES MEDICAL CENTER, SAN FRANCISCO

  Michael Maletta was bitter, angry, and hostile when Bill Darrow phoned him at his hospital bed. For two years he had been suffering from bizarre health problems and none of the doctors had been able to help him; for the longest time they hadn’t even told him what he had. Now, some nosy doctor from the Centers for Disease Control was on the phone to ask him all kinds of personal questions about some Air Canada flight attendant he had fucked with only God knows when. And all those questions about his life in Greenwich Village. Christ, that must have been five, six years ago. He couldn’t remember.

  Darrow maintained his best professional demeanor. He had spent years chasing syphilis in New York City back in the 1960s after he had answered President Kennedy’s call to do something for his country. Then he had been in his twenties, when he could hold on to the naive notion that just one person could make a difference. Now, Darrow was forty-two years old, with shards of gray at his temples and the sophist’s cynicism that creeps into the voices of those who tend toward the academic. Once again, however, he had that old feeling that he could make a difference.

  He had scented the trail distinctly after his talk with Gaetan Dugas in New York City. Gaetan had apologized about just updating his fabric-covered address book. Many names had been lost, he sighed, but one just couldn’t keep them all. There’d be far too many. Nonetheless, he had seventy-three names and phone numbers of his most promising recent assignations. That led Darrow to the stories about Jack Nau and Paul Popham and the house on Ocean Walk, where so many of New York City’s first GRID victims seemed to have lived. There was a second house on Fire Island with a similar concentration of dead and dying, Darrow also learned; it was the home of Paul Popham’s former lover, the place where Paul had lived the summer before he moved in with Nick, Enno Poersch, and Rick Wellikoff.