Patient Zero and the Making of the AIDS Epidemic
Page 37
San Francisco (hereafter cited as SFAF Records).
89. For more on the 1987 Helms amendment, see Crimp, “Promiscuity in an Epi-
demic,” 256– 66.
Figure 4.5 A palimpsest of hostile views in the archives, ca. 1988. Annotated photocopy
of “Patient Zero” page from People magazine (December 28, 1987, 47), 21.6 × 35.5 cm
(photograph 13.9 × 15.2 cm, excluding frame), annotation in red pen, mailed to the San
Francisco AIDS Foundation soon after publication. Courtesy of Archives and Special
Collections, Library and Center for Knowledge Management, University of California,
San Francisco. Curiously, the anonymous author, one of People magazine’s 24.5 million
readers (according to Donald M. Elliman Jr., “Publisher’s Letter,” People, December 28,
1987), restrains him- or herself from spelling out the apparently intended word Bastards
in full, despite the general tone of the message and the word Pervert being on full display.
For the writer of the message, it seems clear that Dugas had become the “face of AIDS.”
224
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Figure 4.6 “Proud Lives— Gaetan
Dugas (1984),” Q Magazine, May
1988, 14; framed photograph mea-
sures 6.2 × 8.6 cm. Courtesy of
the British Columbia Gay and
Lesbian Archives. In the wake
of the publicity for And the Band
Played On, a periodical serv-
ing the lesbian and gay commu-
nity in Vancouver— Dugas’s pen-
ultimate place of residence before
his death in 1984— reappropriated
the widely distributed photograph
from 60 Minutes and People maga-
zine. Here, noting that he was “an
original founder of the AIDS Van-
couver support group,” the maga-
zine’s editor, Rob Joyce, countered
the media’s depiction of Dugas as
a sociopath and included his image
in a group photo tribute, alongside
those of other local men who had
died of AIDS.
to the People magazine piece, which focused on Dugas’s “fi erce sexual
drive [which] gave impetus to an epidemic,” this defi ant entry attempts
to reclaim Dugas’s reputation, offering him instead as one of the found-
ers of AIDS Vancouver’s support group. The second, a rather audacious
and self-
congratulatory half-
page advertisement by California Maga-
zine in the New York Times, praised its scoop of running the “Patient
Giving a Face to the Epidemic 225
Zero” story as an article before any other publication— this, as we have
seen, had been one of the earliest sales for any part of Shilts’s book. In
this version, we see that Dugas’s head has been removed from its orig-
inal shoulders and pasted onto a body dressed in a suit and tie to give
the semblance of a fl ight attendant’s identity badge, complete with a
forged signature and the almost comically ironic phrase (given the fre-
quent recycling of this particular image), “not transferable.” If anything,
this advertisement only served to amplify the impression that Dugas had
single- handedly launched the American AIDS epidemic, which raised
the ire of some AIDS activists. Protesters from a San Francisco chap-
ter of ACT UP reproduced the advertisement in a call to action for their
members (fi g. 4.7). In each of these occurrences, one sees an image that
has been seized by certain groups and deployed according to their par-
ticular agendas. In each, Dugas’s status as a patient and his role as a sick
person in a new epidemic was contested, his image used to give force
and to personalize each party’s claims. As picture and story traveled
across the continent and overseas, reaching new publics, they took on
new meanings and signifi cance.
While the CDC’s cluster study had, in 1982, offered compelling evi-
dence for some readers that AIDS was caused by a sexually transmissi-
ble agent, the 1987 “Patient Zero” story provided in its turn a seductive
explanation to make sense of the early hidden spread of the epidemic.
The fact that an early case subject had been a sexually active fl ight at-
tendant could explain how AIDS had spread across the country, while
the man’s resistance to public health offi cials confi rmed age- old appre-
hensions about the role that willful disease spreading played in an epi-
demic. Abraham Verghese, an AIDS physician who wrote sensitively of
his experiences in a southern American town treating patients affl icted
by the disorder, was among those who used the story to map a mental
image of sexual connection and viral transmission, one which linked
his more remote community to the early urban epicenters of AIDS. “I
couldn’t help refl ecting,” Verghese wrote, thinking of the partner of one
of his patients who had lived in San Francisco, “that Otis had been in
the Castro— 1978 to 1985— at the height of the silent spread of the vi-
rus through the gay community there. Otis had probably celebrated Gay
Pride Week, been on the same dance fl oor with Gaetan Dugas— Patient
Zero.” With italic font suggesting a nervous shiver, the doctor ventured
an unfi nished thought: “It was not beyond the realm of the possible to
226
chapter 4
Figure 4.7 ACT- UP San Francisco protests California Magazine’s claim that it “discov-
ered the cause” of “the AIDS epidemic in America,” 1988; photocopied advertisement
with typed activist message; 43.9 × 29.7 cm. Courtesy of the Gay, Lesbian, Bisexual, Trans-
gender Historical Society. The original advertisement appeared in the New York Times
in August 1988 to promote California Magazine’s “involving journalism.” Declaring that
Dugas was “the cause” of AIDS, the advertisement breathlessly notes that he “continued
to infect up to 250 men a year. Even after U.S. health offi cials begged him to stop.” Re-
sponding to these damaging claims, the San Francisco chapter of ACT UP distributed this
photocopied leafl et, urging protesters to demand that the magazine “stop the spread of
fear and ignorance!!” Drawing on transnational networks, these AIDS activists are
most likely referring to critiques of And the Band Played On published by the British jour-
nalist Duncan Campbell in the New Statesman and Capital Gay in March 1988. Campbell
interviewed William Darrow, the CDC researcher, who explained that the hypothesis of
a short incubation period for HIV infection could no longer be maintained. Darrow told
Campbell that he had urged Shilts not to use the names of AIDS patients nor to place re-
liance on the cluster study’s original hypotheses. Tim Kingston, a San Francisco reporter
and activist, relayed Campbell’s fi ndings to gay San Francisco readers the following month
in Coming Up! magazine.
imagine that Otis had slept with the Air Canada fl ight steward, or slept
with someone who had slept with Gaetan, or . . .”90 Other readers, by
contrast, focused on Dugas’s apparently willful transmission of his in-
fection. Jim Kepner was a gay rights pioneer who had been active in the
90. Abraham Verghese, My Own Country: A Doctor’s S
tory (New York: Vintage
Books, 1994), 286– 87.
Giving a Face to the Epidemic 227
Mattachine Society and lived in Los Angeles. In a personal chronology
of the AIDS epidemic, he decided that although Dugas was “affl icted
with KS in June 80, he did not plant the fi rst seeds of AIDS in the U.S.”
Nonetheless, Kepner continued, “he typifi ed many who felt their sexual
freedom must not be limited, & felt that if they’d gotten it, they should
pass it on.”91
And the Band Played On and the media attention accompanying its
release drew the ire of people with AIDS and members and allies of les-
bian and gay communities. One PWA wrote to Coming Up! and the Bay
Area Reporter, two San Francisco- based gay periodicals, shortly before
his death to complain about the repercussions the book had for people
living with the disease: “As a PWA (person with AIDS), I myself am in-
furiated by this book. It makes gay people look like rabid infected dis-
ease carriers who can’t wait to give AIDS to someone else. [Shilts] him-
self has admitted that perhaps he got a little carried away with Patient
Zero. I encourage everyone in the Gay community to steal this book and
burn it.”92 Another San Francisco PWA activist, Dan Turner, would de-
plore the fact that Shilts was making money from victim blaming: “As a
person who has been living with AIDS longer than Mr. Shilts has been
writing about it, I found his pot- boiler shots reprehensible. He does not
speak for me.”93 Lon Nungesser, a social psychologist with KS whose
work had also been published by St. Martin’s Press, railed against Shilts
as “the most dangerous anti- gay voice in America” and questioned the
motives and ethics of his publisher.94
A woman, from Orillia, Ontario, wrote to the Toronto Sun to com-
plain that the newspaper’s recent publication of the “Patient Zero” fea-
ture had “undone much of what your more responsible journalists have
tried to accomplish in educating your readers about AIDS and the gay
91. Emphasis in original; see “The AIDS Record: A Chronological Account,” unpub-
lished typescript, February 1, 1993, s.v. March 30, 1984, Jim Kepner Collection, ONE Na-
tional Gay and Lesbian Archives at the USC [University of Southern California] Librar-
ies, Los Angeles.
92. Jerry A. Lazier, “Gay Aunt Mary,” Coming Up! February 1988, 3; Jerry A. Lazier,
“Aunt Mary Shilts,” Bay Area Reporter [San Francisco], January 14, 1988, 8.
93. Dan Turner, letter to the editor, San Francisco Chronicle, August 16, 1988, folder:
D. Turner Corresp., box 2, Dan Turner Papers, 1990– 10, Gay, Lesbian, Bisexual, Trans-
gender Historical Society, San Francisco; Shilts written as “Schilts” in original. Turner evi-
dently did not appreciate how Shilts had used his interview; see chapter 3.
94. Lon G. Nungesser, letter to the editor, Coming Up! May 1988, 2– 3.
228
chapter 4
community in general.” It was bad enough, she asserted, to print the ex-
cerpt in full, but “to include the author’s declaration that Gaetan Dugas
was ‘what every man wanted from gay life’ is abominable.” Dugas was,
in her opinion, “criminally irresponsible, as well as perhaps psychoti-
cally promiscuous and immature, just the opposite of the overwhelming
majority of gay men.” To print the segment was, she opined, akin to sug-
gesting “that all heterosexual men seriously want to be murderous Ca-
sanovas, homicidal little boys unable to make a real and loving commit-
ment to a long- term partner.”95
Others agreed with this letter writer’s perspective. “Has the AIDS
crisis become just another soap opera?” asked one woman writing to the
Seattle Times, following its printing of the “Patient Zero” feature, which
she was disappointed to see had been published without any kind of edi-
torial contextualization. She wrote that she would hate for Dugas’s “so-
cial irresponsibility,” as it was portrayed, to be seen as “indicative of any
kind of universal attitude in the gay community. To put it bluntly, gay
people are not subversive, immoral and perverted heathens.”96 Stan Per-
sky, a gay Vancouver writer, drew criticism within the alternative press
for uncritically repeating Shilts’s tale of “Patient Zero” in a magazine ar-
ticle. He used the fl ight attendant’s “reckless sexual conduct” as an intro-
ductory example to frame the British Columbia provincial government’s
controversial 1987 legislative efforts to implement forcible isolation for
anyone with an infectious disease deemed likely to expose others.97 If, as
one later critic asked, Gaétan Dugas’s example was not representative of
gay men as a whole, as Persky had gone on to suggest, then why include
it in such a prominent way? The answer, some observers believed, was
that any drive to severely restrict the rights of people with AIDS rested
on the assumption that some dangerous “carriers” would attempt to in-
fect others.98 Dramatic examples like the one Shilts had crafted were vi-
tal for that project.
In 1989, a Vancouver Sun columnist wrote a petulant piece following
the death of Kevin Brown, a former acquaintance of Dugas who went on
95. Karen Moore, “Patient Zero Excerpt Showed Bad Judgment,” Toronto Star, De-
cember 29, 1987, A16, ProQuest (435693482).
96. Nora Stern, “‘The Band Played On’— Story of First AIDS Victim Was Overly Sen-
sational,” Seattle Times, November 12, 1987, A19, NewsBank (469938).
97. Stan Persky, “AIDS and the State,” This Magazine 22, no. 1, March/April (1988):
10– 14.
98. Emke, “Speaking of AIDS in Canada,” 486– 87.
Giving a Face to the Epidemic 229
to become an AIDS activist known across North America. In it, he criti-
cized Brown’s refusal “to condemn the [homosexual] practices that pass
on the HIV virus that leads to AIDS” and also mentioned Dugas as an
exemplar of these practices.99 The columnist’s writing provoked an an-
gry letter from a gay reader, who demanded that the journalist apolo-
gize for his “smear [of] Kevin Brown just days after his funeral.” What
the reader found most despicable was the journalist’s suggestion that
“there were any similarities between Kevin’s refusal to condemn the sex-
ual practices of gay men, and Gaetan Dugas who admitted that he was
out to infect as many men as possible in vengeance for his own diagnosis.
Mr. Lautens makes mention of both of these men as though they were
fi ghting a common cause.”100
There were thus many people, inside and outside North America’s
lesbian and gay communities, who accepted the depiction of Dugas in
Shilts’s book and the wider media coverage and who saw the dead fl ight
attendant’s actions as beyond the pale, completely unrepresentative of
the behavior of gay men in general. Others, including Jim Kepner, were
more mixed in their views, rejecting the notion that Dugas had intro-
duced the virus to North America but seeing him as representative of a
widely shared view that rejected any limits to sexual liberation.
/>
“Not Just a Hypothetical Case”
And the Band Played On was published in a year that proved to be piv-
otal in the emergence of a discourse advocating for the use of criminal
law to address HIV transmission. A front- page New York Times arti-
cle from June 1987 noted a number of recent cases, particularly in the
military, where individuals stood accused of willfully exposing other
persons to the virus. The article emphasized that although several of
these cases related to instances of spitting or biting— modes which had
not been demonstrated to pose a risk for transmission— these examples
still contributed to an effort to rework the public- health statutes in some
states, to the opposition of many public health offi cials and gay rights
99. Trevor Lautens, “As I Like It,” Vancouver Sun, June 7, 1989, A11, ProQuest
(243565235); Kahn, AIDS, The Winter War, 77– 79.
100. Michael Kalmuk, “An Apology Owed to Brown Family,” Vancouver Sun, June 22,
1989, A18, ProQuest (243552753).
230
chapter 4
activ ists. They feared that politicians had “seized on a handful of pecu-
liar and frivolous cases” to justify action that would lead to a negative ef-
fect on public health: it could make those most at risk for HIV infection
reluctant to get tested.101 Attention to this issue continued throughout
the summer of 1987, with Time magazine and the Los Angeles Times,
among others, featuring articles and polls on the topic.102 In a syndicated
newspaper column, a professor of public policy noted the sharp contrast
with the previous year, which had been, he thought, guided by robust sci-
entifi c research. In 1987, however, “the Year of the AIDS Politician,”
“sideshow” efforts intent on scapegoating led to calls for widespread
mandatory testing, quarantine of people with HIV, and “new criminal
penalties for that almost- mythical character, the deliberate spreader of
disease.”103
These developments played into the Reagan administration’s slow- to-
develop and socially conservative response to the epidemic. The most
important factor shaping the Republican administration’s response to
AIDS was the lead role taken by members of the Department of Educa-
tion. The department’s secretary, William Bennett, and the under secre-