And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition (44 page)

The music drifted around them while rain splattered on the windows, and Don Francis felt at home. He had found a group of people who cared about this epidemic, people who would get something done. With celebrities like Leonard Bernstein signing on, people would start listening, he thought. Finally, he would be able to start undertaking the work that needed to be done.

Monday, April 11

The AIDS epidemic earned its most important emblem of newsworthiness with the bundles of
Newsweek
magazine that appeared across the nation that day, featuring a cover on which a disembodied hand held a tube of blood. “Caution KS/AIDS,” read the sticker on the tube. The cover line stated: “EPIDEMIC: The Mysterious and Deadly Disease Called AIDS May Be the Public-Health Threat of the Century. How Did It Start? Can It Be Stopped?” As usual, the magazine cover was better at posing questions than the story would be at answering them, but with AIDS finally ensconced as a legitimate news story, an avalanche of coverage began. The revelations about transfusion AIDS in late December had started it all. In the first three months of 1983, 169 stories about the epidemic had run in the nation’s major newspapers and newsmagazines, more than four times the number of the last three months of 1982. Moreover, from April through June, these major news organs published an astonishing 680 stories. The media blitz on AIDS lasted into the summer and provided an unprecedented, albeit brief, degree of attention to the epidemic.

Every newspaper found its own angle to the story, although most papers, like the newsmagazines, handed it to their science writers, who preferred penning yarns about the people in the white coats. Occasionally, there was coverage of the trials of an AIDS patient, told in sudsy, soap opera-style journalism. In San Francisco, New York, and Los Angeles, these stories included polite homosexuals who went by their real names; in less cosmopolitan locales, the character of such stories invariably became let’s-call-him-Bob. Even the supermarket tabloids got into the act. The
Globe,
for one, ran a lengthy cover story saying that AIDS actually was part of King Tut’s curse, having followed the tour of the Tut treasures to the United States in the late 1970s. “Either Tutankhamen died from the disease or it was placed in the tomb to punish those who might later defile his grave,” said a former San Diego coroner who dabbled in archeology.

Two trends were most pronounced in the coverage. First was the complete lack of any story concerning the shortfalls of resources for AIDS research. Usually, there was a complaint about the lack of funds from a gay doctor and a heated denial from somebody at the Centers for Disease Control or the National Institutes of Health. That would be that. No more digging. No more research beyond perusing the government press releases. The profession that had toppled a president over a burglary less than a decade before had returned to the fold of official-statement journalism. This, of course, was not the case with other perils to the public health; other issues, such as toxic waste or even Tylenol, called for huge investigative teams and filing Freedom of Information Act requests. But there was something embarrassing about this whole story; you could tell by the cursory coverage and all the talk of “bodily fluids” instead of semen and anal intercourse.
Newsweek
called AIDS the “public health threat of the century” on its cover, but it never treated the epidemic as such in its newsroom. Nor did any other news organization outside San Francisco.

The media watchdogs had gone to sleep on this story. Because of it, government agencies on both the federal and local levels were left to deal—and to not deal—with the AIDS epidemic as they saw fit. This would not be obvious at first, for the government appeared to spring into action at the sight of this first media blitz. Later, however, the real quality of AIDS journalism was clear: Reportage would be like the Mississippi River that year, with much breadth but little depth.

The second trend was fascination with how San Francisco homosexuals were reacting to the AIDS crisis. By mid-spring, news crews were endlessly trooping up and down Castro Street for such stories. Of course, New York City had three times the AIDS cases and nearly one-half of the nation’s AIDS caseload. But there, you wouldn’t be able to get the mayor to say anything for your story because his office referred calls on AIDS to the health commissioner, and you wouldn’t find city programs to write about because there were no city programs, and you didn’t have the flurry of civic attention to AIDS because New York City officials seemed largely impervious to the fact that an epidemic existed. As the months wore on, San Francisco became AIDS City, U.S.A., not only in the popular imagination but in its own. The city’s gay men were as intently watched and studied as a newly discovered tribe of cave dwellers in an exotic tropical paradise.

Late Afternoon

N
ATIONAL
C
ANCER
I
NSTITUTE,
B
ETHESDA

Francis Anton Gallo was the son of immigrants from Turin, Italy, and he shared the northern Italians’ cool, intellectual disposition even after he forged an immigrant’s success story in Connecticut, rising from welder to metallurgist to president of the company where he once was among the proletarians. His wife’s family hailed from the warmer climes of Italy, and she luxuriated in that region’s warm, extroverted, and clannish qualities. The couple’s son, Robert, expressed both the charisma of his mother and the workaholism of his father.

The latter aspects of his personality were not evident in Robert Gallo’s early life in Waterbury, Connecticut. But the turning point of his life was in 1949, when he was thirteen and his younger sister contracted leukemia. This took Bob Gallo to Harvard University for hospital visits. There, he met a famous cancer expert named Sydney Faber, and he saw scientists in their laboratories struggling to save the lives of ailing children. His sister died from leukemia, but Bob Gallo’s fascination with research biology continued. Encouraged by an uncle who taught zoology at the University of Connecticut, Gallo found himself trailing after a research pathologist at a local Catholic hospital. The pathologist was the first cynic Gallo had ever met. Young Gallo tended more toward melodramatic flourishes than contemplation, but he slowly learned what critical thinking was. By his teen years, he was allowed to perform his own autopsies, as he dove passionately into his preoccupation; by the time he was eighteen, Bob Gallo knew he would spend his life at the bench, doing medical research.

Still, Gallo’s teen years were trying times. He was not an excellent student. He spent less time on homework than on the basketball court and was out late every night dating. Had he not broken his back during a basketball game and been confined to bed for nearly a year, he might never have blossomed from mediocrity. During his difficult recuperation, however, he read everything he could on biology. While in college, he slew scores of mice in a makeshift laboratory above his mother’s garage. After his residency at the University of Chicago, Gallo’s determination to stick to the research bench was hardened by his first assignment at the National Cancer Institute. By some macabre chance, he was assigned to work in the acute children’s leukemia ward at the National Institutes of Health hospital. From then on, he told himself, he would never work with patients again.

Gallo started to do research in 1966, and by 1970 he had embarked on the work that would earn him fame. At that time, substantial controversy had enveloped the theory that viruses might cause leukemia and even some forms of cancer. Gallo focused on retroviruses and by the mid-1970s was among the scientists to characterize the enzyme reverse transcriptase, the chemical that retroviruses secreted to replicate themselves in their victim cells. The work gave science the marker, a chemical footprint, that could aid in detecting retroviral infection. This alone represented a significant advance for retrovirology, yet few scientists appeared particularly impressed. After all, retroviruses were largely viewed as bugs of chickens, mice, and cats. What relevance did this have to humans?

Bob Gallo thought science was merely looking toward the obvious. When these animals were infected with a retrovirus, they shed virus like there was no tomorrow. It was easy to detect because there was so much of it. In humans, although the virus might be there, it was just not as easily detectable. What Gallo needed was a way to grow white blood cells in such quantities that he could prospect for retrovirus in a rich vein. He tried different culture media in attempts to keep human lymphocytes alive and multiplying in culture systems. In the process he discovered interleukin-2, a natural substance that stimulates T-cell multiplication. Adding interleukin-2 to cultures kept T-cells alive and multiplying continuously.

With these discoveries, Bob Gallo’s career advanced smoothly—until the false alarm of 1976. It appeared that he had discovered a new virus, and proudly, Gallo announced that to the world. When it turned out that an animal virus had contaminated his cell line, and there was no new virus, Gallo’s reputation plummeted. It seemed that his life always swung to such extremes, so the researcher pushed on. In 1978, he discovered a new retrovirus, HTLV, but, fearing that his latest work would be dismissed because of his earlier problems, he labored until he could prove his case perfectly. This time he definitively showed that he had a retrovirus that caused leukemia. After publication of his findings in 1980, Gallo was a star again, receiving the coveted Albert Lasker Award. He became a recognized patriarch in the field of retrovirology. By the spring of 1983, another virus related to HTLV had been discovered by another scientist in Gallo’s lab, who dubbed it HTLV-II.

For all his accolades, Bob Gallo remained a controversial figure in science. Detractors considered him pompous and arrogant. In scientific politics, he could be ruthless, they said, often pointing back to the 1976 embroglio as proof that Gallo was not always reliable. Gallo himself saw the criticism as reflecting the shadow side of his character. Yes, he was arrogant and proud, but that was what was required from the few brave scientists who challenged nature to yield its secrets to them. Still, he knew that his strength was his destroyer; it would be a theme in the coming years.

On this Monday afternoon in Bethesda, Dr. Robert Gallo was restless, drawn back to the disease that had frustrated him the year before in the first scans for a retrovirus in AIDS blood. Jim Curran was trying to embarrass Gallo into working on the disease. Jacques Leibowitch was prodding him with constant phone calls from Paris. Despite his distaste for the whole subject of AIDS, he could see that the stakes were being redefined. One needed to look no further than the new cover of
Newsweek
to see that.

Officials at the National Cancer Institute were restless as well. With the imminent publication of the French research and the HTLV studies of Max Essex at Harvard, the institute knew it was time to get serious about AIDS. Deputy Director Peter Fishinger called a meeting for 4:30 P.M. in the conference room of the NCI director. Fishinger now grasped that the NCI response to the epidemic had been less than ideal, but he saw the problem as partly the result of the way the system was constructed. Health agencies did not have the budgets to fire off large sums to the brash young doctors who were virtually the only scientists involved in the epidemic up to that point. Just to get the first round of grants out, the NCI had dropped its standards below what it considered acceptable quality for research projects. With the media now starting to focus on the problem, however, all this was going to have to change.

This meeting marked the first gathering of the NCI Task Force on AIDS, said Fishinger, scanning the room. Dr. Bill Blattner from the family section of NCI’s cancer epidemiology unit was there, as were James Goedert and Bob Biggar, who were among the lonely NCI doctors who had worked on AIDS from the start. Anthony Fauci, who coordinated AIDS for the National Institute for Allergy and Infectious Diseases, also had sent a representative.

Robert Gallo spoke forcefully. The French claimed they had something, he noted. Somebody had even delivered a lymph node all the way from Paris for him to study.

“I believe a retrovirus is involved, and we’re going to prove it or disprove it within a year,” said Gallo. “We’re going to spend a year and nail this down one way or another.”

Fishinger promised Gallo that he could have the full resources of the NCI’s elite laboratory in Frederick, Maryland. He would make sure everybody worked with the retrovirologist. Dr. Sam Broder, who was the NCI’s clinical director, promised that Gallo would have “absolute priority” for tissue specimens from AIDS patients at the sprawling NIH hospital. Finally, the battle would be joined.

This date, April 11, 1983, was later cited by the officials of the National Cancer Institute as the turning point, the time that the institute became firmly committed to finding the cause of Acquired Immune Deficiency Syndrome. It was precisely one year, ten months, and seven days after the
MMWR
had announced the first twenty-six cases of Kaposi’s sarcoma in gay men, as well as the eighteen other mysterious cases of
Pneumocystis
and other unexplained opportunistic infections. Between the time of that announcement and the date of the NCI’s commitment to finding the cause of the disease, 1,295 Americans had contracted AIDS and 492 had died. Later, the Centers for Disease Control calculated that the numbers infected with the strange new virus behind the epidemic had grown by the tens of thousands, if not hundreds of thousands, during those twenty-two months.