And the Band Played On

by Randy Shilts

  Gottlieb understood, of course, that much of his colleagues’ antipathy dated back to 1983, when he and Dr. Marcus Conant had gone over the heads of University of California administrators to secure an emergency legislative appropriation for AIDS research. Conant had suffered a similar academic exile at UCSF and had largely limited his recent AIDS activities to his private practice. By early 1987, Gottlieb realized the breach of academic politics had destroyed his university career as well. In just six months, Gottlieb, who remained a mere assistant professor, was turned down for tenure three times. There was also talk that the envious academicians thwarting his tenure would also effectively blackball any move he might try to make to any other university research center. Gottlieb couldn’t help but recall a conversation he had had with Marc Conant in April 1982, after they had appeared at the first congressional hearing on AIDS to plead for more funding and more concern. At that time, the pair thought that once people realized how serious the threat was, they would be cast as villains for not being more strident in their warnings. Now, both Gottlieb and Conant found themselves undone, not because people believed they hadn’t cared enough, but because they cared too much. A few weeks before the conference, Gottlieb left his position at UCLA and opened a private practice of immunology in Santa Monica.

  The night’s main event was scheduled before dinner, outside, in a huge tent that had been properly secured by Secret Service agents for President Reagan’s speech. As people filtered from the restaurant to the tent, their master of ceremonies was on hand to greet them. Easily recognizable by his shock of silver hair, Dr. Mervyn Silverman, former director of the San Francisco Department of Public Health, was now the president of AmFAR. Of all the early AIDS figures who had left an ambiguous legacy, it was Silverman who had taken the most redeeming course in recent years.

  After his resignation as health director, he had quickly been tapped by a number of national medical groups to articulate the public health perspective on AIDS issues. During the LaRouche AIDS initiative in California, which called for mandatory AIDS testing, his mediagenic demeanor provided anti-hysteric forces with their most reasoned spokesman. As antibody testing emerged as a potent and divisive issue around the nation in 1987, it was Silverman who patiently explained the public health point of view. In the previous days, he had worked with Reagan speech writers on early drafts of that night’s presidential address. It was a long way from painful meetings with sexual liberationists who worried that the city’s safe-sex warnings sounded too “anti-sexual.” Silverman had been a man of good intentions when AIDS policy was determined by the people of good intentions. Though he had sometimes bumbled, he was also a visible reminder in these less hospitable times that the people of good intentions would ultimately do far less harm to the cause of public health than the people of bad intentions.

  While Dr. Silverman greeted colleagues and chatted with movie stars at the front of the tent, Dr. Paul Volberding took a seat near the back, away from the crowd. The first heat of the summer reminded him of the epidemic’s first appearance. For Volberding, that day had been July 1, 1981, his first day on the job at San Francisco General Hospital, when the man whom he was replacing had pointed into an examining room and said, “There’s the next great disease waiting for you.” It had been an uncannily prescient introduction to Volberding’s first Kaposi’s sarcoma patient; his subsequent six years of AIDS research had made him one of the world’s leading AIDS clinicians. Today, he had suffered a typically hectic schedule, awaking early for an appearance on “Meet the Press.” He also had been chosen as one of nine members on a committee organizing an International AIDS Society. A week of speeches, meetings, and interviews lay ahead. In a few days, he would announce that San Francisco had been chosen as site of the 1990 international AIDS conference.

  The band struck the fanfare from “Hail to the Chief,” and everybody rose as the president and Mrs. Reagan walked into the tent.

  As Silverman gave his opening remarks, Volberding marveled at how far the epidemic had come—to the forefront of American life. Where would it go in another six years? Volberding couldn’t comprehend what it would be like. He certainly understood the projections of cases, and he had some grasp of what it would mean for his hospital and his clinic. But he truly couldn’t comprehend what it meant in a larger sense—what it meant for the nation, for the world, for history. He was too involved to allow himself to get frightened; yet, he knew that if he weren’t so involved, he would be very frightened.

  The crowd cheered loudly, even pointedly, and stood when Elizabeth Taylor presented a special award to the surgeon general. After Koop delivered his brief remarks, glancing toward the president when he endorsed “voluntary” testing with guarantees of confidentiality and nondiscrimination, Dr. Silverman introduced Dr. Gottlieb, who was about to hand out the first of two scientific awards for AIDS research.

  A restrained but courteous applause greeted Dr. Robert Gallo when he walked to the podium to accept his award from Gottlieb. Gallo, of course, gave a nod to the French for their contributions to AIDS research and talked about how international cooperation was necessary among scientists to overcome the epidemic. In the tent, however, significant glances darted quickly among the gathered scientists. The events of the past two years of bitter feuding between French and American scientists was hardly a tribute to international cooperation.

  The Pasteur Institute’s lawsuit against the National Cancer Institute, filed in late 1985, had threatened to bring their ugly dispute to trial in federal court. Though the suit asked only for a share of the royalties that the NCI had accrued from its AIDS blood test patent, the scientific community understood that the French were really suing for the full recognition that had been denied them. To be sure, the Rock Hudson affair had brought worldwide attention to the Pasteur Institute’s work in AIDS treatments. And the Pasteur continued to produce world-class AIDS research, most notably with the discovery of a second AIDS-like virus in late 1986. But they still felt they had been robbed of recognition for their most important achievement, the discovery of the elusive AIDS virus.

  The United States government, which had so brazenly transformed Gallo’s work into political capital for the Reagan administration, tenaciously held on to the myth that Gallo had discovered the AIDS virus. This meant adhering to Gallo’s notion that the virus was a relative of the HTLV family that Gallo also had discovered, and that he had the right to name the virus, as viral discoverers always do. Ultimately, it had, taken an international committee to rule that, no, this was not a leukemia virus and, no, Dr. Gallo did not have the right to name it. To smooth ruffled feathers, however, the committee arrived at a compromise name: Human Immunodeficiency Virus, or HIV.

  Throughout 1986, however, the Pasteur pursued its depositions and Freedom of Information Act requests against the National Cancer Institute. It slowly became obvious to even the most obdurate government lawyers that the lawsuit could prove very embarrassing for the United States government. A pithy memorandum from Dr. Don Francis on the potentials of such a suit warned the administration, “If this litigation gets into open court, all of the less-than-admirable aspects will become public and, I think, hurt science and the Public Health Service. The French clearly found the cause of AIDS first and Dr. Gallo clearly tried to upstage them one year later.” On the most central issue of whether HTLV-III was the product of viral pilfering, Francis posed the hypothetical question: Could the prototype isolates of HTLV-III and LAV be identical merely by coincidence? And he answered, “Probably not.” However, two years later, at the request of Dr. Gallo, Francis wrote to Gallo, “I do not now, nor ever have, supported the claim that you or anyone in your laboratory ‘stole’ LAV.”

  For his part, Gallo dismissed the notion with a wave of his hand. He already was a star in the field of human retrovirology without the discovery of HTLV-III, he said. Of course, he wanted a Nobel Prize and he believed he deserved one, but he would not commit a scientific felony to achieve it.

&n
bsp; Facing the possibility of open court hearings, the U.S. government began to reconsider fighting the French. In the early months of 1987, Dr. Jonas Salk shuttled between the warring scientists like an ambassador at large, forging a compromise. Ultimately, the settlement was signed by President Reagan and French President Jacques Chirac in a White House ceremony. It was one of the first times in the history of science that heads of state were called upon to resolve a dispute over a viral discovery.

  The settlement accorded each researcher partial credit for various discoveries on the way to isolating HIV. It was from this settlement, and because none of the mainstream press had pursued the controversy in any depth, that the pleasant fiction had arisen that Drs. Robert Gallo and Luc Montagnier were “co-discoverers” of the AIDS virus. To this extent, Gallo had won. Now, moments before the president was to deliver his first speech on the epidemic, Gallo accepted his award for being a “co-discoverer” of HIV.

  Dr. Mathilde Krim stepped forward to give a comparable award to Montagnier. Perhaps it was all the memories that jarred the normally unflappable Krim that night. Until that point the ceremony certainly had been polite enough. Krim, however, had spent so many of the past four years fighting for people to care, whether in the New York City Department of Health or in the federal government, that she would not be silent and courteous, not when there was still so much to do.

  There were AIDS treatments on the shelf that needed to be tested, for instance, but the drug testing process had been stalled. There was talk that no treatment or vaccine would get quick FDA approval for experimentation unless it was developed by the federal government; among AIDS organizers, NIH had become the acronym for the agency disinterested in treatments that were Not Invented Here. There was no stop the government did not pull out for AZT, a drug the NCI had originally developed. However, there seemed no bit of red tape too minor to delay the release of other treatments. Throughout the country, vast networks of gay men now distributed their own AIDS treatments, some obtained in Mexico, others put together in kitchen laboratories.

  The delays and disorder, Krim knew, was due less to malevolence than to incompetence, bureaucratic bumbling, and, most importantly, the lack of any leadership on AIDS within the administration.

  Krim told the crowd that she had heard optimistic talk about a vaccine that might come for AIDS, someday, and she had heard of possible treatments, someday.

  “But when?” Krim pleaded, as her audience suddenly fell silent.

  Outside the tent, where the echo of protesters could be faintly heard, was a candlelight vigil, she noted.

  “Thousands of candles, carried by people with AIDS, are flickering in the night, asking the question of us. ‘When?’ The answer to that question depends on the national will.”

  Tim Westmoreland sat near the back of the tent, a few rows behind Paul Volberding, waiting for the applause for Dr. Montagnier to die down. President Reagan would speak next.

  As counsel to the House Subcommittee on Health and the Environment, Westmoreland had worked on AIDS for longer than just about anyone on Capitol Hill, back in the days when he and Bill Kraus counted themselves lucky if their struggles could get an extra $2 million for AIDS research tacked on to a supplemental appropriations bill. The days of such nickel and diming were past. Only a week earlier Senator Kennedy had introduced legislation calling for nearly $1 billion in AIDS spending for the next year, and it appeared that a figure close to this amount would ultimately be enacted. Money was no longer the key issue, Westmoreland understood. It was leadership.

  Westmoreland hoped the president’s speech would not focus on testing, but on research and education, the only real ways the epidemic could be fought. Westmoreland and Senate aides had been carefully formulating bipartisan AIDS legislation for this session of Congress. Democrats and moderate Republicans both seemed eager for some compromise, because most leaders understood that AIDS had a dangerous potential if it were overly politicized. It touched too many nerves and engendered too many fears; it was better left to the offices of public health departments. As the old saying went, when war is contemplated, turn to your politicians; when war is declared, turn to your generals. By declaring a national war on AIDS, Westmoreland thought, Reagan could at last give his moral support to the generals of public health and pull the battle away from the politicians and all their calls for mandatory AIDS testing.

  “Ladies and gentleman,” Dr. Silverman said, “the President of the United States.”

  Ronald Reagan grinned boyishly and started his first address on AIDS with the words, “Many years ago, when I worked for General Electric Theater…”

  After a brief reminiscence about GE Theater, the president decided to tell a little joke. It was a story he told often at fund-raising dinners, about a charity committee that goes to the wealthiest man in town to seek a contribution.

  “Our book shows that you haven’t contributed any money this year,” the committee tells the man.

  The prosperous businessman asks if the charity committee’s book shows that he has an infirm mother and a disabled brother.

  “Why no,” the committee says. “We didn’t know that.”

  “Well,” the man retorts. “I don’t give them any money. Why should I give any to you?”

  The crowd laughed uncertainly. Tim Westmoreland marveled at how much the joke summed up Reagan’s handling of AIDS: He hadn’t ascribed much importance or funding priority to any other non-armaments program during his presidency, why should he have given any to AIDS?

  “That wasn’t a joke,” said Westmoreland to the friend sitting next to him. “That was a fable.”

  In the next twenty minutes, the president laid out his views on AIDS. There was little talk of education and a lot of talk about testing. There was no mention, however, of confidentiality guarantees or civil rights protection for those who tested positive. Reagan’s program, of course, would do very little to actually stop the spread of AIDS. Though testing heterosexuals at marriage license bureaus created the illusion of action, very few of these people were infected with the virus and very few lives would be saved. But then saving lives had never been a priority of the Reagan administration. Reagan’s speech was not meant to serve the public health; it was a political solution to a political problem. The words created a stance that was politically comfortable for the president and his adherents; it was also a stance that killed people. Already, some said that Ronald Reagan would be remembered in history books for one thing beyond all else: He was the man who had let AIDS rage through America, the leader of the government that when challenged to action had placed politics above the health of the American people.

  All afternoon, Larry Kramer had asked himself how he would respond this night to President Reagan’s speech. Though Larry remained one of the most outspoken gay activists in the country, he was no longer alone in his rage against the Reagan administration. Even Kramer’s sharpest critics could no longer maintain he was wrong, even if his personal style had been off-putting; he had only been ahead of his time. With the success of The Normal Heart, Kramer had found his measure of vindication, and another play was beginning to form itself in his imagination. He had even made his peace with Paul Popham, the staid GMHC president with whom he had had so many struggles in the early years. When they talked for the last time, only days before Paul died, Larry apologized for their fights, and Paul just said, “Keep fighting.”

  Though mellower, Kramer still felt compelled to make some protest when Reagan spoke. Other gay advocates present that night agreed, but no protest had been organized. Dr. Krim had passed word that she and other AIDS researchers would walk out if Reagan endorsed mandatory testing, but his speech had artfully dodged such a call. In fact, the speech seemed crafted to touch on all the right themes. There were calls for compassion and understanding, and tributes for the volunteer efforts helping people with AIDS. Reagan even singled out San Francisco’s Shanti Project for praise.

  As Larry listened, he became aware th
e president’s speech made no mention of the word “gay.” There was talk about hemophiliacs who got AIDS, transfusion recipients, and the spouses of intravenous drug abusers, but the G-word was never spoken. And then Reagan turned to the nitty-gritty of testing.

  Larry’s temper began to rise. There was something so utterly dishonest about discussing almost every aspect of the AIDS epidemic in this address and not mentioning the fact that it was homosexuals who had been killed and homosexuals who had, in fact, done so much of the work in fighting the epidemic for all those years that Reagan had ignored it.

  On the night President Reagan finally spoke, Paul Popham was three weeks dead, having gone to his grave profoundly disillusioned with the United States, the country in which he had always believed, the country for which he had fought in Vietnam. This country had turned its back on Popham and his friends and let them die. And now Reagan refused to talk about Paul Popham or any of the gay men who had shown such courage for so many years, as if Popham had played an embarrassing role in the epidemic and not Reagan himself. And when Reagan started talking about testing, as if he were really proposing policies that might at last do something to stop the epidemic, the anger of six years welled up inside Larry Kramer, and he began to jeer.

  By the time President Reagan had delivered his first speech on the epidemic of Acquired Immune Deficiency Syndrome, 36,058 Americans had been diagnosed with the disease; 20,849 had died.

  THE NEXT MORNING WASHINGTON HILTON

  When Dr. Dan William remembered the San Francisco Gay Freedom Day Parade on a sunny day in June 1980, he was struck by how naive he had been. That must have been what it was like in Europe in the 1920s, before the Depression and war, when everyone was so rambunctiously and hedonistically joyous and so oblivious to the future and their own vulnerability.