And the Band Played On
AND THE BAND PLAYED ON
Also by Randy Shilts
The Mayor of Castro Street: The Life and Times of Harvey Milk
Conduct Unbecoming: Gays and Lesbians in the U.S. Military
AND THE BAND PLAYED ON
POLITICS, PEOPLE, AND THE AIDS EPIDEMIC
20TH ANNIVERSARY EDITION
RANDY SHILTS
For Ann Neuenschwander
CONTENTS
ACKNOWLEDGMENTS
DRAMATIS PERSONAE
THE BUREAUCRACY
PROLOGUE
PART I. BEHOLD, A PALE HORSE
1. The Feast of the Hearts
PART II. BEFORE/1980
2. Glory Days
3. Beaches of the Dispossessed
4. Foreshadowing
5. Freeze Frames
PART III. PAVING THE ROAD/1981
6. Critical Mass
7. Good Intentions
8. The Prettiest One
9. Ambush Poppers
10. Golf Courses of Science
11. Bad Moon Rising
PART IV. THE GATHERING DARKNESS/1982
12. Enemy Time
13. Patient Zero
14. Bicentennial Memories
15. Nightsweats
16. Too Much Blood
17. Entropy
18. Running on Empty
19. Forced Feeding
20. Dirty Secrets
21. Dancing in the Dark
PART V. BATTLE LINES/JANUARY–JUNE 1983
22. Let It Bleed
23. Midnight Confessions
24. Denial
25. Anger
26. The Big Enchilada
27. Turning Points
28. Only the Good
29. Priorities
30. Meanwhile
31. AIDSpeak Spoken Here
32. Star Quality
PART VI. RITUALS/JULY-DECEMBER 1983
33. Marathons
34. Just Another Day
35. Politics
36. Science
37. Public Health
38. Journalism
39. People
PART VII. LIGHTS & TUNNELS/1984
40. Prisoners
41. Bargaining
42. The Feast of the Hearts, Part II
43. Squeeze Play
44. Traitors
45. Political Science
46. Downbound Train
47. Republicans and Democrats
48. Embarrassed
49. Depression
50. The War
PART VIII. THE BUTCHER’S BILL/1985
51. Heterosexuals
52. Exiles
53. Reckoning
54. Exposed
55. Awakening
56. Acceptance
57. Endgame
PART IX. EPILOGUE/AFTER
58. Reunion
59. The Feast of the Hearts, Part III
NOTES ON SOURCES
INDEX
ACKNOWLEDGMENTS
I would not have been able to write this book if I had not been a reporter at the San Francisco Chronicle, the only daily newspaper in the United States that did not need a movie star to come down with AIDS before it considered the epidemic a legitimate news story deserving thorough coverage. Because of the Chronicle’s enlightened stance, I have had free rein to cover this epidemic since 1982; since 1983, I have spent virtually all my time reporting on AIDS. My reporting provided the core of this book. While this newspaper’s commitment is a credit to all levels of Chronicle management, I particularly want to thank my city editor, Alan Mutter, who believed in the value of this story long before it was fashionable. I’m also grateful to the following Chronicle colleagues for their guidance and assistance: Katy Butler, David Perlman, Jerry Burns, Keith Power, and Kathy Finberg. The Chronicle’s library staff, especially Charlie Malarkey, also helped immensely.
My newspaper reporting would never have been transformed into a book if it were not for the faith of my editor at St. Martin’s Press, Michael Denneny. He believed in this project when most in publishing doubted that the epidemic would ever prove serious enough to warrant a major book. I’m also grateful to the confidence of my agent, Fred Hill.
A number of other people helped me edit the manuscript. Without the constant encouragement, hand-holding, and insightful editing of Doris Ober, I could never have made it to the end of what became a very long tome. I’m also grateful to Katie Leishman and Rex Adkins for devoting their extraordinary editing talents to the manuscript.
The research phase of the book required much travel and would not have been tolerable without hosts such as Poul Birch Eriksen in Copenhagen, Mark Pinney in New York City, and Bob Canning and Steve Sansweet in Los Angeles. I’m also thankful to Frank Robinson, who kept voluminous files on the epidemic and generously shared them all with me. Among the other people who charitably opened their files to me were Tim Westmoreland, Dan Turner, David Nimmons, Jeff Richardson, Lawrence Schulman, Tom Murray of The Sentinel, Don Michaels of the Washington Blade, Terry Biern of the American Foundation for AIDS Research, and Jim Kepner of the AIDS History Project at the International Gay and Lesbian Archives in Los Angeles. Steve Unger and Fred Hoffman provided expert computer assistance. I would be remiss if I didn’t acknowledge the help I got from the media relations staffs of San Francisco General Hospital, Pasteur Institute, National Cancer Institute, National Institute for Allergy and Infectious Diseases, and especially Chuck Fallis at the Centers for Disease Control. They made my job much easier.
I remain indebted to my brothers Reed Shilts, Russell Dennis Shilts III, and Gary Shilts for their support during the long writing process. I’m also blessed by some terrific friends who stuck by me during the insanity of this project: Janie Krohn, Bill Reiner, David Israels, Bill Cagle, Will Pretty, and Rich Shortell. Thanks also to the friends of Bill W. who sustained me with their experience, strength, and hope.
Ultimately, a reporter is only as good as his sources. The people to whom I remain most grateful are the hundreds who shared their time with me both during my newspaper reporting and during the book research. Many were scientists and doctors who carved large blocks of time out of hectic schedules. My deep background and off-the-record sources were also invaluable; you know who you are, and I thank you.
The people for whom I will always bear special reverence are those who were suffering from AIDS and who gave some of their last hours for interviews, sometimes while they were on their deathbeds laboring for breath. When I’d ask why they’d take the time for this, most hoped that something they said would save someone else from suffering. If there is an act that better defines heroism, I have not seen it.
DRAMATIS PERSONAE
DR. FRANCOISE BARRE, a researcher with the Pasteur Institute, the first to isolate the AIDS virus.
DR. BOB BIGGAR, a researcher with the Environmental Epidemiology branch of the National Cancer Institute.
FRANCES BORCHELT, a San Francisco grandmother.
DR. EDWARD BRANDT, Assistant Secretary for Health of the U.S. Department of Health and Human Services.
JOE BREWER, a gay psychotherapist in San Francisco’s Castro Street neighborhood.
HARRY BRITT, the only openly gay member of San Francisco’s board of supervisors, the local equivalent of a city council.
U.S. REPRESENTATIVE PHILIP BURTON, a staunch liberal who represented San Francisco in Congress.
U.S. REPRESENTATIVE SALA BURTON succeeded her husband in Congress.
MICHAEL CALLEN, a rock singer who organized the People With AIDS Coalition in New York City.
LU CHAIKIN, a lesbian psychotherapist in San Francisco’s Castro Street neighborhood
DR. JEAN-CLAUDE CHERMANN, pan of the Pasteur Institu
te team that first isolated the AIDS virus.
DR. MARCUS CONANT, a dermatologist affiliated with the University of California at San Francisco.
DR. JAMES CURRAN, an epidemiologist and director of AIDS research efforts at the U.S. Centers for Disease Control in Atlanta.
WILLIAM DARROW, a sociologist and epidemiologist involved with AIDS research at the Centers for Disease Control.
DR. WALTER DOWDLE, director of the Center for Infectious Diseases.
DR. SELMA DRITZ, assistant director of the Bureau of Communicable Disease Control at the San Francisco Department of Public Health.
GAETAN DUGAS, a French-Canadian airline steward for Air Canada, one of the first North Americans diagnosed with AIDS.
DR. MYRON “MAX” ESSEX, a retrovirologist with Harvard University School of Public Health.
SANDRA FORD, a drug technician at the Centers for Disease Control.
DR. WILLIAM FOEGE, director of the Centers for Disease Control during the first years of the AIDS epidemic.
DR. DONALD FRANCIS, a retrovirologist who directed laboratory efforts for AIDS research at the Centers for Disease Control.
DR. ROBERT GALLO, a retrovirologist with the National Cancer Institute in Bethesda.
DR. MICHAEL GOTTLIEB, an immunologist with the University of California at Los Angeles.
ENRIQUE “KICO” GOVANTES, a gay San Francisco artist, lover of Bill Kraus.
DR. JAMES GROUNDWATER, a dermatologist who treated San Francisco’s first reported AIDS case.
DR. MARY GUINAN, an epidemiologist involved with early AIDS research at the Centers for Disease Control.
MARGARET HECKLER, Secretary of the U.S. Department of Health and Human Services from early 1983 through the end of 1985.
KEN HORNE, the first reported AIDS case in San Francisco.
DR. HAROLD JAFFE, an epidemiologist with the AIDS program at the Centers for Disease Control.
CLEVE JONES, a San Francisco gay activist, organizer of the Kaposi’s Sarcoma Research and Education Foundation.
LARRY KRAMER, novelist, playwright, and film producer, organizer of Gay Men’s Health Crisis in New York City.
BILL KRAUS, prominent San Francisco gay leader, aide to U.S. Reps. Philip and Sala Burton.
MATTHEW KRIEGER, a San Francisco graphic designer, lover of Gary Walsh.
DR. MATHILDE KRIM, socially prominent cancer researcher, organized the AIDS Medical Foundation.
DR. DALE LAWRENCE, conducted early studies of AIDS in hemophiliacs and blood transfusion recipients for the Centers for Disease Control.
MICHAEL MALETTA, hair dresser who was one of San Francisco’s early AIDS cases.
DR. JAMES MASON, director of the Centers for Disease Control since late 1983, served as acting Assistant Secretary for Health in 1985.
RODGER MCFARLANE, executive director of the Gay Men’s Health Crisis in New York City.
DR. DONNA MILDVAN, AIDS researcher at Beth Israel Medical Center in Manhattan.
DR. LUC MONTAGNIER, head of the Pasteur Institute team that first isolated the AIDS virus.
JACK NAU, one of New York City’s early AIDS cases, a former lover of Paul Popham.
ENNO POERSCH, a graphic designer drawn into AIDS organizing because of the death of his lover, Nick, in early 1981.
PAUL POPHAM, Wall Street businessman, president of Gay Men’s Health Crisis.
DR. GRETHE RASK, Danish surgeon in Zaire, first westerner documented to have died of AIDS.
DR. WILLY ROZENBAUM, leading AIDS clinician in Paris.
DR. ARYE RUBINSTEIN, immunologist in the Bronx, among the first to detect AIDS in infants.
DR. DAVID SENCER, health commissioner of New York City.
DR. MERVYN SILVERMAN, director of the San Francisco Department of Public Health.
DR. PAUL VOLBERDING, director of the San Francisco General Hospital AIDS Clinic.
GARY WALSH, a San Francisco gay psychotherapist, early organizer of AIDS sufferers.
U.S. REPRESENTATIVE HENRY WAXMAN of Los Angeles, chair of House Subcommittee on Health and the Environment.
DR. JOEL WEISMAN, a prominent gay physician in Los Angeles, among the first to detect the AIDS epidemic.
RICK WELUKOFF, a Brooklyn schoolteacher who was among the nation’s first AIDS cases, close friend of Paul Popham.
TIM WESTMORELAND, counsel to the House Subcommittee on Health and the Environment.
DR. DAN WILLIAM, a prominent gay physician in New York City.
THE BUREAUCRACY
In the government of the United States, health agencies are part of the U.S. Department of Health and Human Services (HHS). Most of the key health and scientific research agencies fall under the umbrella of the U.S. Public Health Service (PHS), which is directed by the Assistant Secretary for Health of the Department of Health and Human Services. The National Institutes of Health (NIH), Food and Drug Administration (FDA), and Centers for Disease Control (CDC) are among the agencies that comprise the PHS.
The National Institutes of Health is comprised of various separate institutes that conduct most of the government’s laboratory research into health matters. Two of the largest institutes at the NIH are also the two that were most involved in AIDS research, the National Cancer Institute (NCI) and the National Institute of Allergy and Infectious Diseases (NIAID).
The Centers for Disease Control is comprised of different centers that handle various public health problems. The largest is the Center for Infectious Diseases, under which AIDS research has been handled through most of the epidemic. The Kaposi Sarcoma-Opportunistic Infections Task Force (KSOI Task Force), which changed its name to the AIDS Task Force, and later to the AIDS Activities Office, was part of the CID.
The Kaposi’s Sarcoma Research and Education Foundation (KS Foundation) was organized in San Francisco in early 1982. In 1983, it split into the National Kaposi’s Sarcoma/AIDS Research and Education Foundation (National KS Foundation), which dissolved in 1984, and the San Francisco Kaposi’s Sarcoma/AIDS Research Foundation. The latter group subsequently changed its name to the San Francisco AIDS Foundation.
The AIDS Medical Foundation was organized in New York City in 1983. In 1985, it merged with the National AIDS Research Foundation to become the American Foundation for AIDS Research (AmFAR).
AND THE BAND PLAYED ON
PROLOGUE
By October 2, 1985, the morning Rock Hudson died, the word was familiar to almost every household in the Western world.
AIDS.
Acquired Immune Deficiency Syndrome had seemed a comfortably distant threat to most of those who had heard of it before, the misfortune of people who fit into rather distinct classes of outcasts and social pariahs. But suddenly, in the summer of 1985, when a movie star was diagnosed with the disease and the newspapers couldn’t stop talking about it, the AIDS epidemic became palpable and the threat loomed everywhere.
Suddenly there were children with AIDS who wanted to go to school, laborers with AIDS who wanted to work, and researchers who wanted funding, and there was a threat to the nation’s public health that could no longer be ignored. Most significantly, there were the first glimmers of awareness that the future would always contain this strange new word. AIDS would become a part of American culture and indelibly change the course of our lives.