And the Band Played On

by Randy Shilts

  Indeed, transmission routes may have seemed mysterious in 1982, but by 1983 the mysteries were solved. All the ways to get AIDS were established by then, and scientists, at least at the CDC, understood precisely how AIDS was spread. Nevertheless, the report of routine household contact lent scientific credibility to ungrounded fears; the social damage would linger for years. The fear inspired by this one story defined the context within which AIDS was discussed for the next crucial months.

  The pictures on the front page of the morning paper a week after the JAMA story marked the first tangible fallout. For weeks, San Francisco police officers had been sending memos through their union, posing fears about what they should do with bloodstained clothes of a crime victim who might be gay. Some union officials advised officers to write a special report every time they had contact with a possible AIDS sufferer. The report could be used at a disability hearing if the policeman got AIDS. The household contact study ignited similar fears among firefighters. Within days of the article, San Francisco officials had to act. By the next Friday, face masks, rubber gloves, and ten-minute education tapes on AIDS were being passed out in every firehouse and police station in the city. The photo of an officer trying on one of the resuscitation masks started cropping up in dailies and newsmagazines across the country in the fearful weeks that followed, a virtual emblem of the AIDS hysteria that enveloped the nation because of the household contact “findings.” The second epidemic had commenced—the epidemic of fear.

  The same day that masks were handed out in San Francisco, prisoners at a New York State prison in Auburn started a hunger strike because the cafeteria’s eating utensils had been used by an inmate who had died of AIDS a week earlier. Days later, California dentists were advised to don gloves, masks, and glasses to protect themselves from AIDS-infected patients. New York City morticians began rumblings about whether they should be forced to embalm AIDS victims, and police departments across the country started agitating for face masks, like those in San Francisco.

  May 16

  LUNDYS LANE, SAN FRANCISCO

  Matt Krieger was in his office at his cottage in Bernal Heights when Gary Walsh called.

  “I’m in the hospital,” Gary said. “Pneumocystis.”

  Matt started to cry.

  “I’m going to beat it,” Gary said. “I’m just tired a little, but I’m going to survive.”

  When Matt hung up, he called his best friend Liz over to his home and explained the situation. He and Gary had been drawing closer in recent weeks, but Matt had been more distant than he would have preferred, trying to respect Gary’s apparent need to be alone. With Gary in the hospital for the first time, Matt now wanted a complete rapprochement. He wanted to be back in Gary’s life full time. It was what he had wanted since moving to San Francisco: a lifelong commitment in which you shared everything, the good and the bad, the joy and the pain.

  “I want to be with him,” Matt said.

  Liz put her hand on Man’s tear-stained face and smiled: “Well, you certainly can’t go looking like this.”

  Matt arrived at Davies Medical Center on Castro Street with a bouquet of helium balloons, all in the bright colors Gary fancied. When Matt walked into Gary’s room, Gary smiled weakly and Matt knew he was exactly where he was supposed to be. The couple picked up almost where they had left off, and from then on, Matt and Gary were closer than ever.

  The next days were tough on both of them. The strong antibiotics the doctors used to purge Gary’s lungs of Pneumocystis kept him sleeping most of the time. When he woke up, Gary chatted with Matt or jotted down notes for his friend Mark Feldman who was in another wing of the hospital, also suffering from the virulent AIDS pneumonia. “Keep fighting,” Gary wrote.

  Struggling for breath was the hardest, most frightening part, Gary confided. “When you’ve got this, you don’t think you’re going to live,” he told Matt, “and sometimes you hope you won’t.”

  Within a few days, his energy started rebounding and he started talking enthusiastically about leaving the hospital. Maybe he’d get back to Sacramento and lobby the legislature more for a governor’s task force on AIDS, and money for AIDS education. He was so angry that people weren’t taking AIDS more seriously. Maybe that anger, Matt thought, was keeping Gary alive.

  The nurses enjoyed Gary’s spunk and were amazed when he walked them through an informal therapy session if they seemed down on a particular morning. “This guy’s in the hospital with AIDS and he’s worried about my problems?” they’d whisper to Gary’s doctor.

  Matt was relieved he’d have the next months with Gary. Now that they were reunited, Matt decided he would keep a journal of every day they spent together. This would be a special part of his life, he knew, and he wanted to be able to remember it precisely and not let later years fuzz the images and feelings. As Gary recovered, Matt wrote, “It has been hell, and I thought I would not survive.”

  When it came time to go home, Gary felt he was abandoning his longtime friend Mark Feldman, somehow, even though Mark had a devoted lover and many friends to keep vigil near him. Mark was wasting away to nothing when Gary visited him before checking out. And it was the last time Gary saw him.

  May 17

  LONDON

  In the first official report on the spread of Acquired Immune Deficiency Syndrome to the United Kingdom, London health authorities reported that three Englishmen had died of AIDS as of mid-March and six more cases were being monitored nationwide.

  The report, combined with troubling news from the United States about the epidemic being spread in households, sparked a wave of AIDS panic in the always-hysterical British press. Health authorities began to debate whether to ban the import of American plasma, which made up half of the blood products used in Britain.

  May 19

  METROPOLITAN COMMUNITY CHURCH, CASTRO DISTRICT, SAN FRANCISCO

  The Reverend Jim Sandmire was a tall, sturdy man with unquestioned integrity, a deep booming voice, and a thick shock of white hair. On Sunday afternoons, when he would shake hands with the parishioners of his largely gay congregation, somebody inevitably commented that Jim Sandmire looked the way a minister should. Somebody else would then wink at Sandmire, because he had seen the reverend hunkering down Folsom Street in full black leather regalia the night before. Sandmire believed that the houses of God were to be found on many streets; he felt equally comfortable in all the various milieus to be found in the gay community. That was why Dana Van Gorder had called him for a meeting between gay political leaders, AIDS educators, and the bathhouse owners. Van Gorder wanted Sandmire to be moderator.

  “You’re the only one everybody trusts,” said Dana.

  Jim was in bed, with a severe case of shingles. It was not the first time he had been called upon to moderate some dispute among the always-cantankerous gay factions, but he wanted to beg out of it. Any movement caused him ferocious pain. When he achingly eased himself into the conference room of the Metropolitan Community Church off Castro Street, he wished again he had said no. This discussion, he could see, was going to need some serious moderation.

  The invitations had gone out from Harry Britt’s office a week before, signed by a remarkably broad array of gay leaders such as Cleve Jones, Catherine Cusic, two MCC ministers, and leaders of all the gay Democratic and Republican clubs, as well as the normally timorous Bay Area Physicians for Human Rights (BAPHR). An attorney for the police department, Lawrence Wilson, who served on the Toklas executive committee, also signed the letter.

  “At this meeting we will suggest several steps which we believe are particularly important in light of the large number of gay males who regularly visit San Francisco, particularly during Lesbian/Gay Freedom Week, and who may become infected with AIDS and could spread it to their hometowns upon departure,” the letter read. “We believe that men should be informed of ways to engage in sexual conduct in a fashion that minimizes their risk of becoming infected or spreading infection. Information on this topic is not general
ly available to visitors coming to San Francisco who may patronize your establishment.”

  The letter said the group would discuss ways to make sure bathhouses were clean, that each patron was provided AIDS information, and that notices were prominently posted warning of AIDS. The BAPHR safe-sex guidelines were enclosed as suggested brochure material.

  Before the meeting started, Toklas Club president Randy Stallings had spread word among the bathhouse owners that Bill Kraus and his Milk Club allies wanted to shut the places down. It was the next logical step in their rhetoric about changing life-styles. The incitement proved unnecessary. A number of bathhouse owners were incensed that such a meeting would even be called. The owners of one South-of-Market sleazy leather den, Animals, handed out a flier stating, “We do not intend to be singled out, subjected to an inquisition-like atmosphere. We find no evidence either from the medical community or health department which indicates that bathhouses are either the source of or a primary contributing factor to the AIDS threat.”

  When a reporter for a gay newspaper walked in, Rick Crane, the director of the KS Foundation, ordered him out. It wouldn’t do to have public discussions of bathhouses. No, this needed to be decided in an…appropriate way.

  Some of the entrepreneurs were open to suggestions. The owner of one private sex club, The Caldron, conceded that the sex business was soft lately. He already had published his own “health hints” guide and had oriented his business toward jack-off nights, promoted as rollicks during which gay men could give each other a “helping hand.” The city’s only bisexual bathhouse, Sutro Baths, also had put out its own safe-sex guides, though this did little to calm the heterosexual clients’ fears; they were staying away in droves.

  Other bath owners were querulous that anyone should think they owed it to their clients to post warnings. The owner of the Jaguar Bookstore, for whose license Bill Kraus had worked so hard, was on record as telling the Bay Area Reporter, “I don’t want that [passing out brochures] going on. People come here to forget what’s going on.” The owner of the Liberty Baths best summed up the sex business’s sentiments on AIDS: “I wish the whole problem will go away.”

  The problem was not going away, Bill Kraus knew; it was gay men who were going away, dying, while the bathhouse owners did nothing. As soon as Bill walked in with Catherine Cusic, he could see there were problems. Stallings’s allies quickly took up the call against “sexual fascists” who would “stifle sexuality.” And what for? Nobody really knew how AIDS was spread, they argued. Nobody could prove it really was a virus. You were as likely to get this from somebody you pick up in a bar as at the baths.

  Nobody lies facedown in a bar with a can of Crisco and takes on all comers, thought Catherine Cusic as she watched the tide of denial wash over the meeting. These politicos are acting as though they don’t know what goes on in a bathhouse, she thought. Cusic was surprised at how quickly the rhetoric turned harsh. She figured that the bathhouses would be smart enough to cut a deal. Nobody would come out for closure if they took these steps in time for the parade.

  As the talk got more belligerent, a San Jose bathhouse owner announced that he was forming the Northern California Bathhouse Owners Association. In the end, the group reached no consensus, although they put out a press release saying they had met.

  “They should be shut down,” Bill Kraus said calmly to Catherine Cusic on the way out. “They don’t care that they might be killing people, they are so greedy. Every one of them should be shut down.”

  Shortly after the meeting, the owner of Sutro Baths appeared in Selma Dritz’s office. He had heard that the communicable disease specialist had made no secret of her view that bathhouses were a cesspool of AIDS contagion.

  “If you try to shut them down, I’ll have you in court a day later with a temporary restraining order,” he shouted.

  Dritz feared he would stick to his word. She already had asked for an opinion on the legality of closure from the city attorney’s office. It had not come through, but she knew that a closure order might be difficult to get because doctors had not yet isolated an AIDS virus. Epidemiology was at best inferential data. Would it stand up in court?

  Still, Selma Dritz had no doubts about the role that bathhouses played in the epidemic. Going to a bathhouse was not like picking someone up in a gay bar or even a park. Picking up in a bar only gave somebody one shot at the virus. It was haphazard. Parks were more iffy; the weather did not always cooperate and shrubs did not provide a good ambience for anal intercourse, the riskiest sexual behavior. On the other hand, bathhouses were havens for anal intercourse. The only limit to promiscuity was stamina. The institutions were designed to expedite many partners, thus ensuring that everyone there had a higher chance of being infected because they were exposed to many others.

  For this reason, Don Francis had called “commercialized gay sex” an “amplification system” for the disease. Virtually every study on sexually transmitted diseases had shown for years that gay men who went to bathhouses were far more likely than others to be infected with whatever venereal disease was going around, whether it was gonorrhea or syphilis, hepatitis B or AIDS. Bathhouses guaranteed the rapid spread of AIDS among gay men. To be sure, the disease would have crept through the United States without bathhouses, but these foci of sexual activity fueled the brushfire propagation of the infection more than any other single element of American society.

  Common sense dictated that bathhouses be closed down. Common sense, however, rarely carried much weight in regard to AIDS policy. Indeed, the debates that simmered around the country over bathhouses in the next two years emerged as paradigms of how politics and public health could conspire to foster catastrophe.

  In other parts of the United States, the bathhouse issue was becoming troublesome as well. A week after the San Francisco meeting, a Washington, D.C., gay bathhouse canceled an AIDS fund-raiser because a local organization issued a brochure advising gay men to “eliminate or decrease sexual activity in places where multiple sexual contact is frequent, such as the baths, the bookstores, the bushes, and backrooms of bars.”

  The bathhouse owner complained that the advice linked bathhouses to AIDS. The city’s gay leaders came rushing to his defense with the chorus that gay businesses should not be singled out for harassment during this crisis.

  In Miami, Jack Campbell, owner of the Club Baths chain of forty-two bathhouses, brushed off questions about the baths’ role in the epidemic by insisting that most of Florida’s AIDS cases were Haitians, and it wasn’t a problem for gays. This was not accurate. Campbell’s role in the gay community, however, illuminated one reason the gay political leadership would be reluctant to get stern with bathhouses. Campbell, for example, served on the boards of five major national gay organizations. Without dispute, he was the most powerful gay leader in Florida. No Miami gay leader and no liberal politician out to curry favor with Florida’s sizable gay community would drop a word about bathhouse closure.

  A similar scenario shaped up in Los Angeles, where the godfather of local gay politics was Sheldon Andelson, the owner of the property where that city’s most popular bathhouse, the 8709 Club, was housed. He had been listed as an owner of the bathhouse, but another person’s name suddenly appeared on city permits once Governor Brown appointed Andelson to the prestigious University of California Board of Regents. In Chicago, bathhouse owner Chuck Renslow published the local gay paper and carried substantial weight in gay Democratic politics. The owner of the St. Mark’s Baths in New York City had made himself invaluable by providing his popular disco, The Saint, as a site for gay community fund-raisers.

  Moreover, most of the nation’s gay newspapers received substantial advertising revenues from the bathhouses and sex businesses. This business and political clout assured that not only would few gay leaders support moving against the baths, but that the gay newspapers would unanimously support their advertisers. Potential bathhouse closure was not even to be discussed as an alternative.

&n
bsp; In the aftermath of the San Francisco meeting, local bathhouse owners launched a counterattack. “If AIDS is indeed sexually transmitted, why have there been so FEW cases?” asked an advertisement from Liberty Baths. “Yes, I say few because if an estimated 20,000,000 gays have an estimated 200 contacts per year this means that in 4’/2 years we have seen 1,279 cases of AIDS in 4,000,000,000 contacts, or odds of 3,127,443 to 1 against getting AIDS during a given contact. With all this gay play going on, why aren’t we all getting AIDS instead of only 1,279 of us?”

  STANFORD UNIVERSITY BLOOD BANK

  One-in-a-million chance.

  It had become the cliché for blood bankers to talk about how a transfusion recipient’s chances of getting AIDS from blood products were one in a million.

  In his office at the Stanford campus, Dr. Edgar Engleman viewed the estimates as a cruel hoax on the American people. The tall, lanky Engleman—who bore a striking resemblance to comedian Chevy Chase—had served for five years as medical director of the blood bank for Stanford University Hospital, the biggest hospital blood user in the country. As an immunologist, he had closely followed the epidemic. Not long after the first cases of AIDS were reported among hemophiliacs in mid-1982, he added two and two, and figured the disease could be spread in blood transfusions as well. By early 1983, three AIDS cases were lying in Stanford University Hospital wards; for all three, their only “risk behavior” was having a blood transfusion in San Francisco.