“He said to me that he really did not want to go on a respirator. It got to the point where he really couldn’t breathe, even with the oxygen mask. And I could see that he was becoming somewhat delusional. So I went to the doctor, and I said something is wrong here. They said they were going to take him upstairs to make him more comfortable. And they put him on a respirator. They didn’t tell us. Two hours later he was on a respirator, hands tied down, with a tube in his mouth. He couldn’t speak.” The next day he was still on the respirator, but his hands had been untied: “He could write, so I still have some of the things he wrote. I had to fly back to San Francisco because I was working full-time at the San Francisco Examiner. Jack was on a respirator and became comatose. He died two weeks later. Then I flew back for the funeral.” One of Fitzsimmons’s closest friends at his law firm was Susan Thomases—not yet famous as one of Bill and Hillary Clinton’s confidantes. “Susan ended up being the person who organized Jack’s funeral,” Gefter remembered.
BACK IN SAN FRANCISCO, Gefter was still in a relationship with John McCarron: “I had been fucking John. And we were having unsafe sex. I fucked John for most of the relationship. At the end of the relationship he started fucking me. John maintained that he was HIV-negative. But he had never been tested. And this caused a rupture in our relationship over the course of a year. I had been tested twice, and I was HIV-negative at this point in time. When I questioned John about his sexual behavior, he maintained that he had had very little sex. And he was certain that he was HIV-negative.
“But there was no basis for this conclusion. None. In fact I was not convinced at all. Gina Kolata wrote a story in the Times about the fact that the virus could hide in macrophages in the system—for six months, or even much longer. And as a result, antibodies don’t appear. So there might have been a lot of false HIV-negative results. I panicked. I thought, that is why I continue to be HIV-negative. In the article a doctor named Jay Levy is quoted extensively, and he is at UC in San Francisco. So I called him, and I said, ‘I am a prime candidate for your study because given my history I am such a prime candidate to be HIV-positive, and I don’t understand why I’m not.’ And he does all these tests. The virus is nowhere to be found in my body. That’s the result of his tests. I am simply clean. So I have all this documentation that I am HIV-negative. And I say, ‘John, we are having unsafe sex. I am fucking you, I don’t come inside you, but I’m in you, I could be exposed to the virus.’ And he refuses to have the test.
“Then Jack [Fitzsimmons] gets sick and dies.”
When Gefter returned to San Francisco from Fitzsimmons’s funeral, he withdrew completely from John McCarron; within a month they had broken up. “The juxtaposition of Jack dying of AIDS and John refusing to be tested and my being HIV-negative scared me a lot.”
Four months later, in January 1988, John came down with “a very severe flu. Jack dies in July of eighty-seven. And it turns out that John has the virus. He had very high fevers, and he had flu-like symptoms. He had pneumonia. It’s Pneumocystis and these are the first symptoms of the disease.
“I am mortified. But also really upset. I’m concerned about John—upset that he is sick. Mortified for myself. I had a relationship with him for a year. We were having unsafe sex. He kept assuring me that he was HIV-negative. And we broke up because he wouldn’t have the test. And four months later he’s diagnosed.
“I’m furious.”
Like thousands of others in the epidemic, Gefter returned to his ex-lover after he got sick to take care of him. “I went to the hospital every day. The first time he saw me after the diagnosis, he burst into tears, and he apologized profusely. And he felt awful. A month later I went to be tested again.
“And I was negative.
“He was in and out of the hospital half a dozen times for a year. We were no longer boyfriends, but I would take care of him a lot. I would visit him. I would take care of him every day. When he got out of the hospital, I would bring him things. I was a very good caregiver. The horror story, though, with John is, when John got really sick, he disintegrated over the course of a year really quite rapidly. He died in January of eighty-nine. He had said to any number of people that he didn’t want to die at the hospital, he wanted to die at home. Three days before he dies, it’s very clear that there’s no hope. The doctor tells me there’s no hope. He says that he has exhausted every medical procedure and that if John wants to go home this is the opportunity to tell him. So the doctor says, ‘Do you want to tell him this?’
“I say, ’Okay.’”
Gefter told John there was nothing more the doctor could do for him. “If you want to go home, you have to let me know so that we can set up a full-time nurse at home.
“And he says to me: ‘Are you telling me that I’m going to die?’
“And I say, ‘Yes, that’s what the doctor told me.’
“And he was furious, and he blamed me. He thought I was lying to him, he thought I was saying this just to make him feel horrible. He would not talk to me.
“That was it. And he died three days later.
“I continued to go see him, and I sat with him, and he became increasingly comatose, and I was there anyway. Basically what I did was play him music that he loved, like arias, and Mozart, and all that. But he wouldn’t forgive me. So that was really quite horrible.
“A week later it’s John’s funeral. We have a funeral on a boat, which sails out from the piers into San Francisco Bay. It’s at nine o’clock in the morning. I’m coming from Sausalito and I get on the Golden Gate Bridge at eight-twenty and there is bumper-to-bumper traffic—stalled. This is highly unusual. So it stalled for at least fifteen or twenty minutes. And I’m panicking because I’m going to miss John’s boat.
“Finally I turn on the radio. It turns out the reason for the traffic is an ACT UP demonstration at the tollbooth of the Golden Gate Bridge. I am going to miss the funeral of my ex-lover who died of AIDS because of an ACT UP demonstration! It is really so perverse, I burst out laughing. Anyway, they hold the boat because several of us were late, and they figured out why. So we went out on the boat, and his ashes were poured into the bay. But it was just unbelievable.
“I would hear about half a dozen people who died over the course of three or four months. And then all of a sudden I would read someone’s obituary in the Times and I would burst into tears. I mean five or six people would die and it would have virtually no effect on me. And then I read Tucker Ashworth’s obituary in the Times. I didn’t even know that he was sick. We had had an affair in the mid-seventies and I wasn’t very close to him. But I read his obituary and I just burst into tears. There was a picture above his obituary and his cheeks were sunken and he didn’t look like the man I knew.
“What would happen to me was an individual would serve as a symbol of all of the losses intermittently. So his death was a floodgate for me.
“It was worse in San Francisco than New York because it’s a smaller city and everyone’s death was more visible somehow. And it seemed to me that more people were dying in San Francisco than in New York, but I think it was just because it’s a smaller place. The difference between San Francisco and New York is that San Francisco as a city and a community rallied admirably to the epidemic. They set up all kinds of home care programs. There was support on every level, medically, socially, and San Francisco to me was just such an enlightened model for the way human beings should respond to one another.
“I don’t know if I feel guilty. I guess my behavior would exhibit a kind of survivor’s guilt because over the years I have toyed with danger in terms of having unsafe sex and any psychologist will tell you that that’s survivor’s guilt. What I feel on some level is that there is some reason that I’m supposed to be alive. And I don’t know what that is. But it’s not that I feel like I’m being protected exactly, but I feel that it’s not in my destiny to have this virus. And that’s the best I can do. I don’t know. I don’t feel secure. I feel lucky. My doctor has said that there
are some people who are resistant to the virus. It’s that simple. Some people don’t get colds. Some people don’t get the virus.”
Gefter’s doctor’s suspicion about the ability of some people to resist the virus is widespread in the gay community because many people who engaged in high-risk activity in the early eighties never became infected.
In 1996, there was apparent confirmation of this theory from a study that found that some people had CD4 cells that were pumping out ten times the normal levels of substances called chemokines, which can prevent HIV’s reproduction in the test tube. The people with these unusual cells had remained uninfected despite repeated sexual contacts with carriers of the virus.
Two studies published in 1996 indicated that a small percentage of people carry certain genes that either prevent infection altogether, or create a much longer lag time between the moment they are infected and the onset of the disease. Men with the best overall genetic profiles had lag times about seven years longer than men with the least favorable ones. At the time the study was published, half of the adults infected with the HIV virus developed the disease within ten years of infection.
Gefter believed that the overall impact of the epidemic had been to “make the community much more humane.”
“It’s unfortunate that it’s taken something like this to bring the gay community closer together and enable it to operate from its humanity. It wasn’t going in that direction pre-AIDS. It was actually going in the opposite direction.
“We were all objects to each other. I think because of AIDS we became human beings to each other.”
ONE OF LARRY KRAMER’S most persistent complaints was about the failure of The New York Times and Mayor Edward I. Koch to make it clear from the beginning that AIDS was a crisis—and a communicable disease that gay men needed to avoid. But considering the degree of hostility that gay leaders encountered when they tried to make these points, it’s unlikely that anything Koch could have said would have done much to influence the behavior of gay men. Dan William, a prominent gay New York doctor, was denounced as a “monogamist … stirring panic” just for suggesting that bathhouses should be required to post warning signs about the epidemic and the dangers of promiscuous sex. In 1982, according to Randy Shilts, “More gays were furious” at William “than at anybody in the Koch administration.”
Kramer’s most famous piece about the epidemic, entitled “1,112 and Counting,” was printed in the New York Native on March 14, 1983, and reprinted in many other gay newspapers across the country. “If this article doesn’t scare the shit out of you, we’re in real trouble,” Kramer wrote. “Our continued existence as gay men upon the face of the earth is at stake. Unless we fight for our lives, we shall die.” It was one of his most effective polemics, and it included his usual criticism of The New York Times for what he considered inadequate coverage of the epidemic. But Kramer’s piece was actually published five weeks after an extremely comprehensive, six-thousand-word analysis of the epidemic had been published in The New York Times Magazine.
The article, by the medical writer Robin Marantz Henig, was thorough, sensible and well written. Even though the precise method of AIDS transmission had not yet been finally determined, the fourth paragraph of the article stated, “The mysterious AIDS organism is generally thought to be a virus or other infectious agent (as opposed to a bacterium) and to be spread in bodily secretions, especially blood and semen.”
This article contained everything a prudent gay man needed to know, if he was determined to avoid infection. “Some doctors hesitate to urge celibacy or monogamy on patients for whom casual sex is a way of life,” Henig wrote, “but most seem to think the evidence is compelling enough to advocate just that.”
“I strongly recommend that my patients be very circumspect and cautious in their future sexual contacts,” says Dr. Dan William, a Manhattan internist who treats primarily homosexual men. In his practice of some 2,000 patients, he has seen 24 cases of AIDS.
“I tell my patients what the epidemiologists know—which isn’t much,” says Dr. William. “We are more or less convinced that we are dealing with a sexually transmissible agent. Large numbers of contacts—or a small number of indiscriminate contacts—increase the probability of exposure. In addition, a patient’s susceptibility to any infectious disease is much greater.” Dr. William counsels monogamy, and, he adds, “It’s important for a patient to emphasize to his sex contact that he must not bring any new diseases home with him.”
Many doctors go even further. They urge patients to eliminate anal intercourse,* which frequently results in bleeding or trauma to the mucosal lining and is a possible source of AIDS transmission. They advise their homosexual patients to use condoms, which are thought to inhibit the spread of similarly transmitted diseases such as hepatitis B.
As a result of articles like this one, by the middle of 1983, any gay man sophisticated enough to be a reader of the Times already knew that unprotected anal intercourse was probably the most dangerous activity he could engage in. The worst blunder of the federal government was its failure to use television to reach people who weren’t reading the Times, to make sure they knew about the dangers of the epidemic.
Reagan’s alliance with the religious right, and its squeamishness about explicit descriptions of unsafe sex, combined to prevent the comprehensive sex education that young people desperately needed to avoid infection. Members of the Moral Majority believed that it would be worse to describe gay sex to young people than it was to deprive them of the information they might require to stay healthy. This attitude was another indication of the persistence of the myth that homosexuality was contagious—even though Reagan himself had publicly rejected that idea during the battle over the Briggs amendment that would have banned gay teachers from California’s public schools.
Five years into the epidemic, one important member of the Reagan administration finally delivered a direct attack on the criminally irresponsible attitude toward AIDS education which the president’s religious allies had encouraged. In October 1986, Surgeon General C. Everett Koop issued a blistering report.
“Many people, especially our youth, are not receiving information that is vital to their future health and well-being because of our reticence in dealing with the subjects of sex, sexual practices and homosexuality,” the surgeon general wrote. “This silence must end. We can no longer afford to sidestep frank, open discussions about sexual practices—homosexual and heterosexual. Education about AIDS should start at an early age so that children can grow up knowing the behaviors to avoid to protect themselves from exposure to the AIDS virus.”
Koop said AIDS education should begin “at the lowest grade possible” in elementary school and be “reinforced at home” by parents. And he made it clear that anal intercourse—described in explicit detail in his report—had to be one of the activities young children were educated about for their own protection. But neither Reagan nor George Bush nor Bill Clinton would ever do anything significant to implement these extremely sensible recommendations.
The refusal to educate the young about the specifics of how this disease was transmitted was one of the worst scandals of the early years of the AIDS epidemic—and it persists, twenty-five years after the epidemic began.
Another unconscionable mistake was the fierce opposition of the American Red Cross and other leading blood bankers to what they considered expensive tests, which could have protected the blood supply much earlier and prevented many AIDS infections through transfusion.
The miracle was that hundreds of thousands of men did change their sexual activities dramatically beginning in 1983—and that those changes saved their lives. In big cities and small towns across the country, there were sharp drops in the rate of anal gonorrhea infections—the most reliable indicator of safer sex practices. And after the HIV test became available, the rate of new HIV infections among gay men declined for several years in a row.
As Kramer pointed out, the tragedy at the beginning wa
s that so many people believed “that giving up careless sex until this blows over is worse than death.” In the New York Native, he wrote, “How can they value life so little and cocks and asses so much? Come with me, guys, while I visit a few of our friends in Intensive Care at NYU. Notice the looks in their eyes. … They’d give up sex forever if you could promise them life.”
Students of the epidemic assumed that once it became clear that most kinds of sex were relatively safe, while only one—unprotected anal intercourse—was frequently fatal, it would be fairly easy to convince the vast majority of gay men to abstain from that singularly lethal act. It was disheartening to discover that this kind of lifesaving behavior modification would be much more difficult to accomplish than anyone had suspected—because the emotions surrounding sex and survival are so complicated, especially during a sexually transmitted epidemic.
AS MORE AND MORE of their friends fell ill, the gay identity of some men began to merge with an AIDS identity, to the point where they felt that they weren’t really gay unless they had also been infected. Charles Gibson was one of those men.
Gibson had grown up in Louisville, and fell in love with New York City when he was twelve, during his first visit in 1964. Even at that age, he figured out how to take the subway by himself and how to use the Empire State Building as his “compass.” He came back to live in New York seven years later and went to work for the Children’s Television Workshop. There he met Richard Hunt, who was one of the original Muppets. Soon they began a long on-again, off-again affair.
The Gay Metropolis Page 41