Patient Zero and the Making of the AIDS Epidemic
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they wouldn’t publish our writing, you know, that I wanted to do what-
ever I could, and I regret it. I really regret it.”91
From mid- 1982 onward, these stories circulated orally— through face-
to- face interactions and telephone conversations— and more traceably in
print.92 They bore strong similarities to fears that traveled easily in much
older epidemics. One fl ash point emerged in San Francisco between
August and December 1982, as the cluster study directed attention to
the possibility of a sexually transmissible agent and as the city’s newly
founded Kaposi’s Sarcoma Foundation intensifi ed its public- education
drive. Later, as fears mounted alongside rising case numbers, echoes of
these stories sounded throughout 1983, with the aforementioned exam-
ples in Village Voice and Time in the spring and summer and others in
New York and San Francisco later in the autumn. As the author of one
letter to the New York Native wrote in October 1983: “There is a rumor
abroad that some known victims of AIDS, a deadly disease apparently
transmitted through sexual contact, continue to engage in promiscuous
sex with uninfected strangers, apparently on the theories (a) that some-
one else gave it to them and they’re going to repay the favor (never mind
that no uninfected person gave AIDS to anyone) and/or (b) they’re un-
der a death sentence so don’t give a damn what happens to anybody else
but need to live live live until they die.”93 Shilts also wrote a newspaper
article in November 1983 about Selma Dritz’s efforts to ban people with
AIDS from baths. He quoted the public health offi cial as saying, “We
kept hearing through informal community channels that some (AIDS
patients) were going to the baths.” She continued, employing similar ex-
planations for this behavior: “We can understand that they’re trying to
get everything they can when they have a life- threatening disease, but
they shouldn’t be taking other people down with them.”94
In Canada, Gaétan Dugas would fi nd himself surrounded by rumors
91. Richard Berkowitz, interview with author, New York City, April 25, 2008, record-
ing C1491/24, tape 1, side B, BLSA.
92. Andrew Holleran parodied some of these telephone rumors in his semifi ctionalized
“Journal of the Plague Year,” Christopher Street, November 1982, 15– 21. Marcus Conant
recalled phoning Alvin Friedman- Kien, for example, to discuss Dugas’s local attendance
of San Francisco bathhouses; Conant, “Founding the KS Clinic,” 167.
93. L. Craig S[c]hoonmaker, “Local ’Phobe,” letter to the editor, New York Native,
October 24, 1983.
94. Randy Shilts, “Some AIDS Patients Still Going to the Baths,” San Francisco
Chronicle, November 15, 1983, 4; emphasis added.
Locating Gaétan Dugas’s Views 319
in Vancouver in mid- 1983. In addition to focusing on this Canadian city
in Band, Shilts referred to “a gay newspaper in Edmonton” which had,
by March 1983, “written a story about an airline steward with AIDS who
was popping into Alberta and screwing people in the bathhouses.”95
Moving more or less chronologically, it is worth examining some of these
examples in greater detail to evaluate their reliability, from the San
Francisco fl ash point fl aring in the second half of 1982 to the available
evidence for Vancouver. Before doing so, however, it is necessary to ad-
dress the example Shilts cited in the Edmonton gay newspaper.
Edmonton
Fine Print, the main newspaper serving Edmonton’s lesbian and gay com-
munity during this time, had a short- lived existence, with seven issues
published between February and October 1983. A review of the articles
and correspondence during this period reveals some of the contradictory
responses of community members as they began to pay more attention
to an epidemic which had appeared, until then, to be confi ned to other
cities. Jokes about KS and herpes being the marks of social outcasts and
skeptical questions wondering whether AIDS might be a “grotesque ex-
termination plot” would give way to efforts to provide information about
the condition and raise money to fi ght the epidemic.96 The city would not
see a reported case until July 1984, and some residents believed Edmon-
ton was too remote and cold to be affected.97 Fears about the risks be-
falling “innocent individuals” in Edmonton would be at the heart of the
story Shilts cited, though the item in question was not a news article.
In July 1983, a reader’s letter was published in which he shared a “mat-
ter of great concern” told to him the previous month, concerning an in-
cident that had taken place in May. Like Defoe’s fi ctional narrator from
A Journal of the Plague Year, he prefaced a dark story of disease trans-
mission with the disclaimer that it might not be true. Indeed, the letter’s
95. Shilts focuses on the Vancouver rumors in Band, 251, and refers to the Edmonton
newspaper “story” in Band, 247.
96. For example, Grayson Sherman, “Oh Come All Ye Faithful,” Fine Print, February
1983, 17; Brian Chittock, “AIDS: A Case of Homophobia,” Fine Print, April 1983, 10– 11;
“GATE Sponsors Informational Program on AIDS,” Fine Print, May 1983, 21; advertise-
ment for July 18th Calgary AIDS Benefi t, Fine Print, July 1983, 11.
97. Testimony of Michael Phair to the Krever commission on April 21, 1994, Verbatim
Transcripts of Commission, 34:6810.
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author expressed hope that the matter was not “just a rumour”— despite
the suspicious sign that the story related to a friend of friends of friends,
and despite acknowledging that “serious consequences” might occur if
he was repeating an untrue tale. Yet the author felt compelled to risk
this possibility to share his “anger and outrage” at the incident that his
friends had related to him: “Friends of theirs had an out of town visitor
from Vancouver stay over this past Victoria Day weekend. He promptly
told them that he was a victim of and did have AIDS. Having a friend tell
you that he or she has AIDS would be diffi cult for anyone; however this
friend also told them that as someone had given him the disease it was
not going to prevent him from enjoying life. An admirable attitude for
anyone who is a victim of this presently incurable disease.” Having built
dramatic tension, the writer rapidly switched gears: “At this point my
heart went out to him, until I was told that he went out to the bars and
picked someone up; and also did more than have this fellow just spend
the night.” The author was outraged that this man may have “knowingly
passed on his unfortunate illness to an innocent victim [who might] pass
it on to others unknowingly, and so on.” Emphasizing the dangers posed
by such a malicious infected outsider, he continued, “Right here, right
now might well be the beginnings of an epidemic some months or short
years in the future. From most reports this horrible disease is showing
little signs of abating and one reason may be because a
ssholes like this
guy needed to get his rocks off.” The writer invited readers to share his
view that “this person has a disgusting, sickening attitude, one that may
indeed destroy many [people’s] lives. Just because someone ‘gave’ AIDS
to him.” He ended his letter bleakly, asking, “Can we survive attitudes
like these from within our own community?”98
Although the letter’s contents provide a weak substantiation of
Shilts’s claim— a man with AIDS from Vancouver, perhaps Dugas, may
have had a (possibly unprotected) sexual contact in Edmonton— the ex-
ample is more useful in other ways. At a time when concern about AIDS
was rising, and when little information was known locally in the ab-
sence of AIDS cases, one can interpret the author’s decision to share the
rumor as fulfi lling several important functions. First, by narrating his
story, he could make sense of how a distant threat might affect his com-
98. Keith Dennis, “Alberta Beef,” letter to the editor, Fine Print, July 1983, 2, 22. A re-
view of all issues published during this journal’s run from February to October 1983 re-
vealed this letter to be the sole item resembling Shilts’s cited source.
Locating Gaétan Dugas’s Views 321
munity: through the actions of a conscienceless stranger and not, per-
haps, through the existing travel patterns and contacts of local residents
that might link them sexually to other, more affected areas.99 Second,
in a time of confusion, sending a letter allowed the man to channel his
uncertainty into action.100 Third, some experimental psychologists hy-
pothesize that by telling and listening to emotionally arousing stories,
individuals trigger the release of endorphins that increase their ability
to withstand pain and also increase their sense of communal bonding.101
The letter writer, like others before and after him who would share sto-
ries of whose veracity they could not be certain, could feel better by do-
ing so. Not only might he gain some physical and psychological relief,
but by boldly asserting his moral expectations for shared behavior, he
might also feel more of a sense of closeness with his fellow community
members.
San Francisco
A sample of articles and letters appearing between January and Decem-
ber 1982 in the Bay Area Reporter ( BAR), one of San Francisco’s most
widely read and sensational gay newspapers of the time, illuminates a
similar range of community responses to the emerging syndrome: initial
dark humor giving way to uncertainty, suspicion, and fear. During this
year the city would see its total reported caseload rise to nearly 120, with
initially infrequent notices about KS giving rise to sustained coverage.102
In April 1982, Arthur Evans, a gay activist who frequently wrote to the
editor under the pseudonym “The Red Queen,” submitted a tongue- in-
cheek letter, poking fun at the newspaper’s recent multipart feature arti-
cle about the Cauldron, an S/M (sadomasochism) club in the city’s South
99. See Diane Goldstein’s discussion on the prevalence of “stranger danger” in lay be-
liefs about AIDS, in D. Goldstein, Once Upon a Virus, 159– 62.
100. For a compelling example of a historian making sense of the appearance of similar
rumors in diverse locations, see Wim Klooster, “Slave Revolts, Royal Justice, and a Ubiq-
uitous Rumor in the Age of Revolutions,” William and Mary Quarterly, 3rd ser., 71, no. 3
(2014): 401– 24.
101. R. I. M. Dunbar et al., “Emotional Arousal When Watching Drama Increases
Pain Threshold and Social Bonding,” Royal Society Open Science 3 (September 21, 2016):
doi: 10.1098/rsos.160288.
102. Michelle Cochrane, When AIDS Began: San Francisco and the Making of an Epi-
demic (London: Routledge, 2004), 149.
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of Market area. He explained that he had been inspired to set up a sep-
arate venue, named the Hanky, specializing in “snot.” Evans ended the
letter with a cryptic reference to CDC investigators: “They want to ask
me some questions about a Mr. Kaposi.”103 Known for writing letters
that criticized members of the city’s leather and S/M communities for
their approaches to sexual expression, it seems that the Red Queen was
also impugning them with an association with the emerging epidemic of
KS and pneumonia.104 Some members of this subcommunity responded
defi antly in kind: advertisements featuring a shirtless, mustached, and
muscular man in full leather gear appeared several times throughout the
fi rst half of 1982, boldly promoting “black plague wednesdays” at
the Boot Camp Club near 8th and Bryant.105
Over the next few weeks the tone shifted, from one of humorous word-
play to more anxious expressions. In May, one prominent member of the
Sisters of Perpetual Indulgence, a group of gay men working to promote
gay men’s sexual health, offered “a sick joke” to the editor, wonder-
ing “how Doctor Kaposi feels when he sees his name in blights.”106 On
June 24, a brief reference to the cluster study appeared with the head-
line “Infections suspected in KS, Pneumonia.” A week later, an anony-
mous correspondent offered “some unanswered questions that need to
be answered” before he could believe that “gays brought this awful dis-
ease upon ourselves by our sinful lifestyles and drugs we consume as
a culture.” The writer described how “the so- called Legionnaires Dis-
ease” had spread through a ventilation system, related stories of the US
government’s and CIA’s secret chemical and biological weapons testing,
and cited Fidel Castro’s recent fears of American attacks using “deadly
viruses and bacteria weapons.” After he noticed that several local bath-
103. The Red Queen, “S’not What You Think,” letter to the editor, BAR, April 29,
1982, 8. Evans’s reference to “snot,” or nasal mucus, directly parodied the Cauldron’s em-
phasis on “piss,” or urine, which was highlighted in Gary Pedler, “The Caldron Part II: In-
terview with the Owners,” BAR, April 22, 1982, 14- 16.
104. Hank Trout, “S & M Distinctions,” letter to the editor, BAR, July 1, 1982, 8. For
the early perceived associations between the city’s leather community and AIDS, see
Gayle Rubin, “Elegy for the Valley of Kings: AIDS and the Leather Community in San
Francisco, 1981– 1996,” in In Changing Times: Gay Men and Lesbians Encounter HIV/
AIDS, ed. Martin P. Levine, Peter M. Nardi, and John H. Gagnon (Chicago: University of
Chicago Press, 1997), 101– 44.
105. See, for example, BAR, February 25, 1982, 25; June 10, 1982, 29; and July 8, 1982, 30.
106. Sister Boom Boom, “Sis Boom Bah,” letter to the editor, BAR, May 20, 1982, 6.
Locating Gaétan Dugas’s Views 323
houses kept their windows closed, he explained that “certain things be-
gan to connect. If the C.I.A. had developed a virus that could break
down the immunity system of the body, what unwanted or undesired
group of people would they test it on? . . . Call me crazy, but fi rst answer
my questions!”107
By the end of the summer, we
ekly reports on the “gay cancer” had
made KS a common term for the newspaper’s readers. Considerable un-
certainty remained, however, as to what caused the cancer and whether it
was linked to an underlying condition of suppressed immunity.108 When
Marcus Conant spoke to an overfl owing crowd at a KS information fo-
rum held at the MCC Church in early August, his remarks were summa-
rized for BAR’s readers: “The doctors don’t know what causes certain
Gay men to have lower than normal immune levels; they don’t know how
Gay men catch the diseases, and they don’t know how to cure them.”
While the newspaper granted that “Conant said the ‘best guess’ on Ka-
posi’s is that it’s caused by ‘some transmissible agent,’” it noted that lack
of funds prevented further investigation. Accompanying this news item
was an article about Acquired Immune Defi ciency (AID), prepared by
the Gay Men’s Health Crisis of New York. In answer to the question of
whether the immune defi ciency could be treated, it noted that there was
“no certain treatment for AID [but] there are treatments for the cancers
and infections to which AID predisposes.”109
Later that month, Paul Dague, a therapist counseling patients at the
University of California– San Francisco (UCSF) KS clinic, received a
KS diagnosis himself. A journalist described how “the rumor spread
through the Gay community faster than the disease itself: A doctor who
was treating Gay victims of KS now has it!” In an interview, Dague dis-
missed any possibilities of contagion through casual contact, empha-
sizing that he only spoke with patients and did not touch them. To his
mind, the evidence for the cause of his KS was “inconclusive.” While he
echoed the remarks of his physician, Marcus Conant, that KS was “prob-
107. Name Withheld on Request, “KS Puzzles,” letter to the editor, BAR, July 1,
1982, 8.
108. See, for example, Richard B. Pearce, “Gay Compromise Syndrome: The Battle
Widens,” BAR, July 8, 1982, 15; Gay Men’s Health Crisis, “Another Epidemic: Acquired
Immune Defi ciency,” BAR, August 5, 1982, 1, 5; “Virus Linked to Cancer Outbreak in
Gay Community,” BAR, August 26, 1982, 4.
109. Gay Men’s Health Crisis, “Another Epidemic,” 5.
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ably sexually transmitted,” his interviewer immediately countered with