Patient Zero and the Making of the AIDS Epidemic
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believe that the devil obliges and helps to further this notion so that it actu-
ally comes to pass. I am also told that some individuals are so desperately
wicked that they carry the pestilence among the people and into houses for
no other reason than that they regret that the disease has not struck there,
and so they spread the pestilence as if this were a great joke, like slyly putting
lice in somebody’s clothes or gnats in somebody’s room.
Luther questioned, though, whether he should believe these rumors, and
concluded, “If it is true, I do not know whether we Germans are human
beings or devils. To be sure, there are immoderately coarse and wicked
people, and the devil is not inactive.”61 The same decade, the humanist
scholar Erasmus of Rotterdam voiced very similar views relating to ve-
nereal disease in his writings on marriage. In a colloquy he published in
1529 on an “Unequal Match”— between a beautiful young woman and
a pox- infested old man— one speaker observes of the pox that “this dis-
ease is accompanied by a mortal hatred, so that whoever is in its clutches
takes pleasure in infecting as many others as possible, even though doing
so is no help to him. If deported, they may possibly escape; they can fool
others at night or take advantage of persons who don’t know them.”62
Nearly two centuries later, Daniel Defoe would reprise such concerns
in his fi ctionalized A Journal of the Plague Year. The author included a
self- consciously tentative account, set off with a parenthetical note— “(if
the Story be true)”— of a woman attacked by a sick man in the streets of
London, who kissed her and declared that “he had the Plague, and why
should not she have it as well as he.”63
Others envisioned harnessing disease to achieve political revenge
and warfare. In Timon of Athens, a satirical play Shakespeare wrote for
the London stage in the early seventeenth century, the titular charac-
61. Martin Luther, Luther: Letters of Spiritual Counsel, ed. and trans. Theodore G.
Tappert (London: SCM Press, 1955), 243. Readers may wish to compare Luther’s words
with the widely reported belief held by some people that sex with a virgin might cure vene-
real disease and, later, HIV infection; see Rachel Jewkes, “Child Sexual Abuse and HIV
Infection,” Sexual Abuse of Young Children in Southern Africa, ed. Linda Richter, An-
drew Dawes, and Craig Higson- Smith (Cape Town: HSRC Press, 2004), 130– 36.
62. Desiderius Erasmus, “A Marriage in Name Only, or the Unequal Match,” Collected
Works of Erasmus: Colloquies, trans. and annot. Craig R. Thompson (Toronto: University
of Toronto Press, 1997), 852.
63. Daniel Defoe, A Journal of the Plague Year, ed. Louis Landa (Oxford: Oxford Uni-
versity Press, 1990), 160.
What Came Before Zero? 63
ter urges two prostitutes, Phrynia and Timandra, to spread their infec-
tion across Athens and bring infectious revenge upon his former- friends-
turned- enemies and social chaos to the city he has abandoned.64 Such
a desire to use disease to sow terror later became realized in a North
American colonial context more than a century later. Correspondence
between two senior British army offi cers in 1763 outlines plans for an
incident of biological warfare. Dismayed at the threat posed by Native
American uprisings, Sir Jeffery Amherst asked: “Could it not be con-
trived to send the small- pox among these disaffected tribes of Indians?”
Colonel Henry Bouquet replied that he would “try to inoculate the ——
with some blankets that may fall in their hands, and take care not to get
the disease myself.”65
Focussing on syphilis permits us to further trace the theme of revenge
through the nineteenth and twentieth centuries, with examples that blur
divisions between fi ction and reality. In “Bed No. 29” (1884), a short
story by Guy de Maupassant, the mistress of a French army captain be-
comes infected by the Prussian soldiers who invade her town while he is
away at the front. When the captain later visits his sick lover in hospital,
she explains her desire to avenge herself, by foresaking treatment and
sleeping with as many enemy soldiers as possible. “‘And I poisoned them
too, all, all that I could.’”66 Even more resonant for our purposes, how-
ever, is a letter Maupassant wrote in 1877 to a friend, in which he shared
news of his recent diagnosis with syphilis. The writer also provided, with
a shockingly boastful misogyny, a rare instance of an individual claim-
ing to pass on his disease intentionally. With words that eerily anticipate
those attributed to the French Canadian Dugas in Shilts’s book a cen-
tury later, Maupassant wrote, “Allelujah, I’ve got the pox, so I don’t have
to worry about catching it any more, and I screw the street whores and
trollops, and afterwards I say to them ‘I’ve got the pox.’ They are afraid
and I just laugh.”67
64. Louis F. Qualtiere and William W. E. Slights, “Contagion and Blame in Early Mod-
ern England: The Case of the French Pox,” Literature and Medicine 22, no. 1 (2003): 1– 24.
65. John Joseph Heagerty, Four Centuries of Medical History in Canada and a Sketch
of the Medical History of Newfoundland (Toronto: Macmillan Canada, 1928), 43.
66. “Bed No. 29,” The Complete Short Stories of Guy de Maupassant (New York: P. F.
Collier and Son, 1903), 390; Claude Quétel, History of Syphilis, trans. Judith Braddock
and Brian Pike (Cambridge: Polity Press, 1992), 124.
67. Maupassant quoted in Quétel, History of Syphilis, 130. Beyond coincidence, it is
diffi cult to explain the unusual similarity between Maupassant’s words and their context
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More typical than his personal exploits may be the way that Maupas-
sant infused contemporary worries surrounding venereal disease into his
fi ctional writing. It is worth noting that similar concerns about syphilis
and other sexually transmitted infections were on the increase in Amer-
ican urban gay communities in the 1970s and early 1980s. This period
also witnessed an effl orescence of American gay literature, with novels
from such New York authors as Larry Kramer and Andrew Holleran
exploring the haunts and pastimes of urban gay men.68 Holleran’s 1978
novel, Dancer from the Dance, featured a brief reference to a “vengeful
queen” whose alleged actions are reminiscent of the mistress in Maupas-
sant’s short story. Sutherland, one of the book’s main characters, scorn-
fully describes one blond man as the bearer of a very small penis, declar-
ing that “the boy became so bitter about his fate that when he developed
a case of syphilis he went to the Baths and infected everyone he could
who sported an enormous organ.”69
Given the ease with which many stories of deliberate disease trans-
mission have been fi ctionalized, there is a cautionary tale to be told
about how some of them have recirculated. For instance, in 2003 a po-
litical analyst produced a study of a young man in New York state who
stood accused of infecting thirteen y
oung women with HIV. In one sec-
tion of his book, the author surveyed past epidemics and, citing a his-
tory of the plague written in 1926, found that “some did intentionally in-
fect others . . . [and in several] cases, those who were infected preferred
not to suffer alone.” The doubtful stories in the book he cited included
a jealous tale of a classics scholar who deliberately infected his archri-
val with a contaminated manuscript— originally published as a fi ctional
short story by Bettina von Arnim, a German literary scholar closely con-
nected with Goethe and the Grimm brothers— and Luther’s fearful pass-
with the rumors associated with Dugas more than a century later. Scholars knew of the
existence of Maupassant’s letter to Robert Pinchon before it appeared for auction in late
1984, but it seems that only fragments of this document were published— and crucially not
the passage referring to “street whores and trollops”— while it remained in private hands.
See Quétel, History of Syphilis, 128, 295n52; and Guy de Maupassant, Correspondance /
Guy de Maupassant, vol. 1, ed. Jacques Suffel (Geneva: Edito- service, 1973), 117.
68. Jennifer Brier, Infectious Ideas: U.S. Political Responses to the AIDS Crisis
( Chapel Hill, NC: University of North Carolina Press, 2009), 15– 19.
69. Andrew Holleran, Dancer from the Dance (1978; repr., New York: Perennial Press,
2001), 53.
What Came Before Zero? 65
ing on of tales he had heard.70 It is relatively easy to uncover tales of de-
liberate disease spreading when surveying the history of disease.71 It is
far more diffi cult, however, to infer human motivation and intentional-
ity, or to demonstrate that the stories represent anything more than the
cultural fears of a historically specifi c period.72 Unless there there is sub-
stantial evidence to the contrary, one might do well, therefore, to exer-
cise strong skepticism of any story alleging that a sick person was delib-
erately attempting to infect others.
Beauty, Sexual Activity, and the Threat of Disease
“I am the prettiest one.”73
The readers of And the Band Played On would receive their main in-
troduction to Gaétan Dugas with these words, a few pages after catch-
ing an initial glimpse of the character in a mirror— a fi tting fi rst appear-
ance given the narcissistic role Shilts had him play.74 The setting Shilts
chose to present Dugas’s backstory is a San Francisco dance venue dur-
ing the city’s Gay Freedom Day celebrations in 1980. The scene is fi lled
with drugs, loud music, and sexual competition, aspects of the commer-
70. Thomas Shevory, Notorious H.I.V.: The Media Spectacle of Nushawn Williams
(Minneapolis: University of Minnesota Press, 2004), 113– 14; Johannes Nohl, The Black
Death: A Chronicle of the Plague, trans. C. H. Clarke (London: George Allen and Unwin,
1926), 136– 38, 161– 80; [Bettina von] Arnim, “Les aventures d’un manuscrit,” Revue ger-
manique 9, no. 26 (1837): 149– 85.
71. Compare Baldwin, Disease and Democracy, 90, 127.
72. See, for example, Paul Slack’s assessment of such accusations during plague out-
breaks in sixteenth- and seventeenth- century England. He concludes that they reside in
the realm of hearsay and rumor and are more clearly indicative of the divisive impact of
the plague on social relationships; Slack, Impact of Plague, 292– 93. For a discussion of the
urban legends surrounding AIDS, see Gary Alan Fine, “Welcome to the World of AIDS:
Fantasies of Female Revenge,” Western Folklore 46, no. 3 (1987): 192– 97; Jan Harold
Brunvand, Curses! Broiled Again! (London: W. W. Norton, 1989), 195– 205.
73. Shilts, Band, 21. Dugas is seen closely examining his refl ection in a mirror on p. 11.
74. See Robin Metcalfe, “Light in the Loafers: The Gaynor Photographs of Gaëtan
[ sic] Dugas and the Invention of Patient Zero,” in Image and Inscription: An Anthology of
Contemporary Canadian Photography, ed. Robert Bean (Toronto, 2005), 72– 73. Metcalfe
suggests that the depiction of Dugas could represent a modern version of Oscar Wilde’s
Dorian Gray.
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cialized gay male life in urban San Francisco of which Shilts was known
to be critical. “Gaetan,” Shilts wrote, “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 invit-
ing smile, and his laugh could fl ood color into a room of black and white.
He bought his clothes in the trendiest shops of Paris and London. He va-
cationed in Mexico and on the Caribbean beaches. Americans tumbled
for his soft Quebeçois [ sic] accent and his sensual magnetism.”75 Shilts
allowed little room for irony in the fl ight attendant’s remark about his
own attractiveness, which suggests his opinion that Dugas believed his
own joke completely and belies a narrow reading of Shilts’s source ma-
terial, the notes from his interviews with Dugas’s friends. Soon after in
the book, like a vampire closing in on his prey— on Halloween, no less—
Dugas lures a victim at an upscale nightclub by smiling “in a particu-
larly winning way.” His target cannot resist; “and before long Jack and
Gaetan Dugas slipped away from the crowd and into the night.”76
Beauty that masked an underlying danger of infection is another
theme that can claim a long history. Medieval literature drew on mytho-
logical and biblical references for the construction of beautiful women
as dangerous temptresses. As one early modern writer noted, Helen of
Troy, the quintessential beautiful woman, was unable to remain faithful
to her husband and generated an unparalleled war in the ancient world.
Eve, Delilah, and Judith were similarly seen to have tempted men and
led them to their downfall. Under the Renaissance ideas of balance,
women granted greater than normal attributes of beauty would also have
received greater than normal capacities for vice. Not only was this a tale
that built on medical and ecclesiastical images of women as ready vessels
75. Shilts, Band, 21. Metcalfe remarks on the book’s insistence on “misspelling the
word ‘Québécois,’ as if to emphasize the otherness of a language whose strange rules of
orthography normal people really cannot be expected to master” (“Light in the Loaf-
ers,” 74).
76. Shilts, Band, 41. Some have noted the similarity between Dugas’s depiction as “the
very Dracula of AIDS,” particularly his employment as a fl ight attendant, and the cos-
mopolitan, mobile vampires of the nineteenth century and in gothic literature. See Judith
Williamson, “Aids and Perceptions of the Grim Reaper,” Metro 80 (1989): 2– 6; Ellis Han-
son, “Undead,” in Inside/Out: Lesbian Theories, Gay Theories, ed. Diana Fuss (Lon-
don: Routledge, 1991), 332; Teresa A. Goddu, “Vampire Gothic,” American Literary His-
tory 11, no. 1 (1999): 126.
What Came Before Zero? 67
of contagion, but it was also deemed a warning against the dangers of ex-
treme beauty, which men found diffi cult to resist.77
In her examination of early moder
n Venetian attempts to isolate
prostitutes, as well as women so beautiful they were seen to risk draw-
ing sin to themselves, the historian Laura McGough outlines a tale of
syphilis origins in which the disease could be traced to “the most beauti-
ful prostitute.”78 According to Pietro Rostinio, a sixteenth- century Ital-
ian medical writer, the prostitute had a putrefying sore at the opening
of her womb and was blamed not only for spreading the disease but also
for creating it within her own body. The friction and warmth of inter-
course combined with the humidity of her vagina led to the contami-
nation of the penetrating male member. As Rostinio explained, “And
this illness began to stain one man, then two, and three, & one hundred,
because this woman was a prostitute and most beautiful, and since hu-
man nature is desirous of coitus, many women had sexual relations with
these men (and became) infected with this illness.”79 McGough defi nes
this fi gure as a sixteenth- century “Patient Zero”— fulfi lling the criteria
of attractiveness and point of origin— and noted that Renaissance writ-
ers viewed extreme beauty as rarely occurring in nature. If it did, it was
almost a deformity, which defi ed the importance of balance, modera-
tion, and harmony advocated by Renaissance aesthetics. Any over allo-
ca tion of beauty would, it was thought, be accompanied by an equiva-
lent endowment of vice.80 Later works would also hold both beauty and
vice in the same frame. The embodiment of the pox shifted from the im-
age of the lone male sufferer to that of the female “source” between the
sixteenth and eighteenth centuries; by the nineteenth century, the illus-
tration for a French translation of Fracastoro’s Syphilis was the image of
a skull- faced female, suggestive of syphilitic decay, luring a man behind
the guise of a beautiful mask.81
The idea of beauty out of balance was also suggested by some mem-
bers of New York’s urban gay community in the early 1980s. In an ar-
ticle in Christopher Street magazine, one critic referred to his own gay
77. Laura J. McGough, “Quarantining Beauty: The French Disease in Early Modern
Venice,” in Siena, Sins of the Flesh, 221.
78. Ibid., 211– 37.
79. Quoted in ibid., 211.