And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition (34 page)

Gaetan Dugas was not alone among AIDS patients at the bathhouses. Bobbi Campbell, who had made his self-avowed role as a KS Poster Boy into something of a crusade, was also going to bathhouses, although he denied having sex with people. Gay doctors had told Dritz that several other patients still went as well. The situation was intolerable, Dritz thought, and she had no doubt as to what she would like to do. There was only the question of whether it would stand up in court. These people should be locked up, particularly Gaetan. Dritz started talking to city attorneys to see what laws existed to empower such action.

Two more states reported their first cases of Acquired Immune Deficiency Syndrome in the month of November. Altogether, 788 AIDS cases in thirty-three states had been reported to CDC since the epidemic was first detected in June 1981. About 400 of these cases were in the New York City area, accounting for half the AIDS diagnoses in the country, while 10 percent more were in San Francisco, the second hardest-hit city. The AIDS casualties had quadrupled in the first eleven months of 1982. It was exactly one year since Ken Home, the first AIDS case reported to the CDC, had died in a dark hospital room on November 30, 1981; by November 30, 1982, nearly 300 were dead nationwide.

December 1

N
ATIONAL
C
ANCER
I
NSTITUTE,
B
ETHESDA

Robert Gallo was supposed to be the star of the day, but there was growing interest in AIDS, so the National Cancer Advisory Board put Jim Curran on the agenda of their regular Wednesday meeting as a prelude to Gallo’s talk. It was just as well because the peripatetic Gallo was late. He came in while Jim was in the midst of his thirty-minute dissertation on the iceberg and the vast numbers of asymptomatic carriers who were probably spreading AIDS now without even knowing about it. Toward the end of the meeting, Gallo finally walked to the front of the room, clearly relishing the applause of his colleagues. It was a sweet vindication for his work. After Gallo’s problems in the late 1970s, when his career took a nosedive because of a mistake in his cancer studies, he had become the fading star of the NCI. But he had hung in there and made his Human T-cell Leukemia virus discovery and was fresh from winning the prestigious Lasker Award. Now he was, inarguably, one of the nation’s foremost retrovirologists.

Curran had spent much of the year trying to jawbone such prominent scientists into working on AIDS, with little success. Curran also was filled with talk from Don Francis, who kept insisting that AIDS could well be caused by a retrovirus, like feline leukemia. As the applause faded and Gallo approached the lectern, Curran made his move. “You’ve won one award,” he told Gallo, loud enough to be heard in the microphone. “You should come back when you win another award for working on AIDS.”

Gallo smiled graciously as he shook Curran’s hand. Curran wondered if he had overstepped his bounds. In the hierarchy of government science, he knew, the CDC was considered the minor league to the NCI’s New York Yankees. There was the hint of the brash upstart in his comment.

For his part, Gallo had had it up to here with this goddamn disease. At the prodding of Max Essex, who had found HTLV antibodies in the serums of two AIDS patients, Gallo’s lab had searched through AIDS blood in hopes of finding some retrovirus. He later estimated that perhaps 10 percent of his lab time in 1982 had been spent on the baffling disease. He considered that quite enough. If the truth be known, AIDS had always created some discomfort for Gallo, who hailed from traditional Italian-Catholic stock in New Jersey. There was all this dirty talk of 1,100 partners, fist-fucking, and other exotic sexuality; frankly, Gallo found it embarrassing to talk about. Besides, the lab research had been so damned frustrating.

The work had turned up one intriguing clue. Because the genetic material of retroviruses is made of RNA that must be transcribed to DNA for the construction of viral duplicates, retroviruses need a special enzyme to reproduce—the reverse transcriptase enzyme. By November, Gallo’s lab had found evidence of reverse transcriptase in the infected lymphocytes of AIDS patients. This enzyme, in effect, had left the footprints of a retrovirus all over the lymphocytes. But it was impossible to find the damned retrovirus itself. That was the rub.

In addition, Gallo’s staff couldn’t keep the lymphocytes alive. They died. Any leukemia virus, Gallo knew, caused the proliferation of cells, not their death. People with leukemia have too many white blood cells. When Gallo’s staff added lymphocytes from the blood from AIDS patients, however, to lymphocytes in culture, the lymphocytes would die without any proliferation. The frustration was galling and, by November, Gallo had made what would prove to be among the most important decisions of his career. He gave up. Sure, he would let his name go on some research papers that were to be published in the spring, linking HTLV to AIDS. But his research wasn’t getting anywhere. In November, his lab staff took the AIDS cultures they’d been studying and slipped them into the round metal liquid nitrogen freezers of Gallo’s Tumor Cell Biology Laboratory. For the time being, at least, he was done with AIDS research.

P
ASTEUR
I
NSTITUTE,
P
ARIS

“Is there a retrovirologist in the house?”

The audience gave a collective groan. By now, many of the doctors in attendance had heard about how the unorthodox Dr. Willy Rozenbaum had to change hospitals because he refused to give up his studies on this strange new disease. He was respected as the continent’s foremost clinical authority on the epidemic, but he was also known to be thoroughly wrapped up in his own almost childlike enthusiasm. He couldn’t resist the play on the old Groucho Marx line, “Is there a doctor in the house?,” when he gave his lecture on SIDA, as the French called AIDS, at the august Pasteur Institute.

Toward the end of the talk, he got around to explaining his opening joke. Some researchers at the NCI and the CDC were hypothesizing that a retrovirus caused AIDS. His working group on AIDS was trying to recruit laboratory assistance to help find the virus. “Is there a retrovirologist in the house?” he asked again.

After the talk, Francoise Brun-Vezinet approached Rozenbaum with an idea. She had studied under Dr. Jean-Claude Chermann, one of France’s most famous retrovirologists. She’d ask him for help.

Brun-Vezinet quickly called Chermann. Meanwhile, by coincidence, officials were approaching the Pasteur Institute’s leading virologist, Dr. Luc Montagnier, about AIDS. The Pasteur Institute’s pharmaceutical company, which generated a good portion of the revenue that financed the privately run institute, was frantic over rumors about the hepatitis vaccine. Pasteur Production had the license to manufacture the vaccine in France. The vaccine was derived from the plasma of gay men, and with the hemophiliac cases, people were worried that the inoculations might transmit AIDS. Although Montagnier learned that an American researcher, Dr. Don Francis, already had done research on the vaccine and found no link between AIDS and the vaccine inoculations, Montagnier agreed he would look into it further. The inquiry from Brun-Vezinet was fortunate; both Montagnier and Chermann agreed to make the Pasteur’s retrovirus labs available to the research.

December 9, 1982

S
AN
F
RANCISCO
C
ITY
H
ALL

The reporters walked swiftly down the long, oak-paneled hallway leading into Mayor Diane Feinstein’s office. She had called the press conference today because once again the San Francisco Board of Supervisors had enacted a law that no other municipal governing body in the nation had even considered, and the mayor did not like it one bit. At issue was Supervisor Harry Britt’s “domestic partners’ ordinance,” more indelicately called the “live-in lovers’ law,” which recognized the legitimacy of unmarried relationships, most notably homosexual relationships. The law extended to domestic partners of city employees the same benefits as those granted to spouses of married employees. The ordinance also established a legal procedure through which unmarried couples could record their relationship with the city clerk’s office and gain some form of legal recognition for their partnership. Given the times, Britt had also drafted a clause that gave unmarried partners the same visitation rights as spouses in city hospitals and bereavement leave to attend a lover’s funeral. Mayor Feinstein had decided to veto the law.

“On a personal level, this legislation causes me deep personal anguish,” the mayor told the reporters. “I would like to be able to sign legislation that recognizes the needs of single persons, but such legislation must not divide our community.”

By “divide our community,” Feinstein was talking about the maelstrom that had enveloped the proposal in recent days. Just one day before, Roman Catholic Archbishop John Quinn made a rare foray into city politics by publicly prodding Feinstein to veto the law, saying that “to reduce the sacred covenant of marriage and family by inference or analogy to a ‘domestic partnership’ is offensive to reasonable persons and injurious to our legal, cultural, moral, and societal heritage.” The proposal, Quinn said, was a “radical repudiation of fundamental values and institutions.”

Virtually every other religious leader had also lined up against the measure. The Episcopal bishop noted that “marriage as an institution has been under such heavy pressure,” while the Board of Rabbis of northern California also urged a veto, with the group’s president saying he would “look askance upon any legislation that would attempt to equate nonmarried adults, heterosexual or gay, to what our society deems as a marriage between a man and a woman.” Speaking for the city’s black churches, the city’s most politically powerful black minister, the Reverend Amos Brown, cast the issue in racial terms when he insisted that, “We, as blacks, particularly, come out of the extended family. It’s the only way we’ve been able to make it.”

In her veto message, Feinstein talked about the bill being poorly drafted and not specific enough, but the real issue, everyone knew, was whether homosexual relationships would be granted the same legitimacy as heterosexual relationships. To Bill Kraus, who had begun engineering the ordinance’s passage before leaving Britt’s office to work for Congressman Phillip Burton, there was no other point to the measure. Its intent was to frame into law a basic tenet of the gay liberation movement—that homosexuality as a life-style is equal to and on a par with heterosexuality. The veto, of course, was simply a reaffirmation of the fact that, as far as church and state were concerned, gay people had not yet achieved that equality; moreover, the veto underscored that the notion that homosexuals and their relationships should be granted such recognition was still repugnant to this society. Gay relationships were meant to be dirty secrets, and nothing more.

A spontaneous demonstration of 500 people coalesced on Castro Street that evening and thundered down to City Hall, chanting “Dump Dianne.” Feinstein’s appointees on various city commissions toyed briefly with the idea of a mass resignation. The talk was short-lived. Feinstein’s appointees, by definition, came from the more moderate wing of gay Democrats and were not given to the dramatics popular among members of the Harvey Milk Club.

Condemnations of the veto continued to pour in from gay activists around the country. Much of the criticism descended into vicious ad hominem attacks on Feinstein, characterizing her as a nasty bigot. Some politicos whispered that she had vetoed the ordinance because she was trying to lure the 1984 Democratic National Convention to San Francisco, where she hoped to be installed as a vice-presidential candidate. All this, of course, missed the point that, of all the big-league Democrats in the United States, Feinstein was undoubtedly the most consistently pro-gay voice. Two lesbian friends had held a sort of marriage ceremony in Feinstein’s backyard, outraging conservative voters. As a supervisor, she had authored the nation’s first gay rights ordinance in 1972, long before any other prominent politician had learned to even utter the G-word. Feinstein also talked convincingly of tolerance and civil rights. Indeed, the very political power she had helped nurture in more uncertain days a decade ago was the very reason she was stuck dealing with a “live-in lovers’ law” in the first place; no other mayor had even to come close to touching such an issue.

“We have been through a lot over the last twelve years,” said Feinstein in an interview she granted once it was clear that the veto was probably the singly most controversial act in her career. “But San Francisco remains an open, tolerant city, and on the subject of gay rights, it is probably the most enlightened city anywhere.”

Few could deny she was telling the truth, but the statement said less about how good things were for gays than how bad. For all the acceptance gays had gained, homosexuality still was not accepted as equal in the city they called Mecca. A prevailing morality that viewed homosexuals as promiscuous hedonists incapable of deep, sustaining relationships ensured that it would be impossible for homosexuals to legitimize whatever relationships they could forge. Prejudice has a way of fostering the very object of its hate.

In December 1982, at a time when gay people more than ever needed to be encouraged into relationships, they were told their partnerships were valueless by institutions that later scratched their heads and wondered why gays didn’t settle into couples when it was so clear their lives were at stake.

December 10

Dr. Dale Lawrence was in Washington when he got the conference call from his boss, Bruce Evatt at the CDC’s Division of Host Factors, and Drs. Harold Jaffe and Walt Dowdle. Lawrence knew that the call must be important to warrant the involvement of Dowdle, chief of the Center for Infectious Diseases. Evatt told Lawrence to get back to New York and interview the donors from that Bellevue Hospital transfusion case in the summer.

Lawrence recalled the case, immediately. He also remembered the fierce resistance the New York Blood Center, the nation’s largest blood bank, had put up at the notion of letting Lawrence contact their blood donors.

“Why the sudden turnaround?” Lawrence asked.

The first transfusion case was being announced that afternoon, the callers explained. The San Francisco people planned a press conference to issue warnings. The CDC was rushing a report of the case into its
MMWR
for release that day. They needed a strong case to present to the blood bankers. Evatt had met with the Food and Drug Administration’s blood advisory committee, made up largely of blood industry people, the Saturday before in Bethesda to tell them about the UCSF baby. As they had done all summer, the FDA officials and blood bankers insisted they needed more proof to believe the threat of AIDS from transfusions. Lawrence knew that Bruce Evatt had a reputation for planning his chess moves far in advance. Evatt had been concerned since the first word about hemophiliac cases nearly a year before; now he was going to prove that it was all real.

That Afternoon

U
NIVERSITY OF
C
ALIFORNIA
,
S
AN
F
RANCISCO

The press conference, with Selma Dritz and Art Ammann flanking Dr. Herbert Perkins from Irwin Memorial Blood Bank, sent a collective shudder through the conference room on Parnassus Hill.

“The etiology of AIDS remains unknown, but its reported occurrence among homosexual men, intravenous drug abusers, and persons with hemophilia suggest it may be caused by an infectious agent transmitted sexually or through exposure to blood or blood products,” the
MMWR
had reported carefully that morning. “If the infant’s illness described in this report is AIDS, its occurrence following receipt of blood products from a known AIDS case adds support to the infectious-agent hypothesis.”

This first public announcement that AIDS might be in the blood supply brought an angry reaction from blood bankers in the East. The CDC had, of course, meant the day’s
MMWR
to be a one-two punch to the blood industry, releasing not only the report on the first transfusion case but an update on five new cases of AIDS in hemophiliacs. In spite of that, Dr. Joseph Bove, who headed the FDA’s blood advisory committee and served as an officer of the American Association of Blood Banks, went on network television to say flatly that there still was no evidence that transfusions spread AIDS. Privately, some blood bankers thought the CDC was overstating the possibility of transfusion AIDS to get publicity and, therefore, more funding. The scientific community was aware of the severe problems health agencies were having in securing adequate funding under the Reagan administration. Some blood bankers, including some officials of the FDA, remained unconvinced that AIDS even existed.

The barrage of publicity given to the first transfusion AIDS case resulted in less notice of a report in that day’s
Journal of the American Medical Association
on evidence that strange brain disorders were appearing among AIDS patients. Often, neurological problems were the only early symptoms of AIDS, scientists had reported at a meeting of the American Neurological Association. Upon closer examination, three in four AIDS sufferers showed evidence of some brain damage. Doctors frequently missed the damage to the central nervous system, writing off the often-vague symptoms of dementia as related to stress or depression. Nevertheless, some patients were dying of brain disorders, their cerebral matter sometimes reduced to “a boggy mass.”

There was a doctor from New York University who had written an extensive study on the apparent infection of the central nervous system, but he refused to tell the reporter from the American Medical Association journal about his work because he had submitted his paper to a neurological journal, where it had been accepted for publication. The neurological journal might throw out the story if he publicly discussed his findings with the press, and that would hurt the doctor’s career in the publish-or-perish world of academic medicine. It was science as usual, and the
Journal of the American Medical Association
would just have to wait until the research was published in six months.

The Next Day

C
ASTRO
S
TREET,
S
AN
F
RANCISCO

The petitioners appeared on the corner of 18th and Castro streets with the rush of morning shoppers. Their scruffy long hair and unkempt demeanor were antithetical to the gay men whose own casual appearance was so entirely studied, but the people with their petitions stood under a sign that brought smiles to the gay faces. “Dump Dianne,” it said, and gay men did not hesitate to sign petitions to recall Dianne Feinstein as mayor.

For six months, members of the local White Panther Party had tried to scrounge enough signatures to put the recall on the San Francisco ballot. Their principal agenda was fervent opposition to Feinstein’s support for a local ordinance to outlaw handguns in the city. Although enacted, the law had been thrown out by a federal appeals court. That didn’t stop the remnants of this sixties radical group, known for taking occasional potshots at police officers who tarried too long near their Haight-Ashbury commune. They wanted to recall Mayor Feinstein simply for suggesting that guns should be outlawed. Their efforts, of course, were dismissed by the professional politicians, so nobody really noticed their appearance on Castro Street two days after the veto of the domestic partners’ ordinance. However, they filled petition after petition with the responsibly registered voters of the neighborhood.