And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition (73 page)

A year before, Gary Walsh had been among the thirty-five AIDS sufferers to sign a letter asking that
Bay Area Reporter
editor Paul Lorch be fired. Lorch pulled out the letter when he heard that Gary had died and drew a line through Gary’s name.

February 24

Gary had wanted Beatles’ songs for his memorial service, so the 300 mourners who went to the chapel at the community center where the Shanti Project held its services were treated to the strains of “Let It Be” as they entered. By now, AIDS funerals had taken on the cast of social events for many in the gay community. Among those who gathered for the service were aspiring gay political personages who may not have known Gary but understood that this was a correct event to attend. However, most in the crowd were people whose lives Gary had touched—his old boyfriends and psychotherapy clients, friends, and the other AIDS sufferers to whom he had lent so much support.

Given the times, AIDS services had taken a high-tech twist, and so Gary was able to appear in full-color at his own funeral in a videotape of an interview he had given three months before. People were warmed by Gary’s talk of visions of people who promised to help him to “the other side.” It was a strange paradox to see people smiling at the mystic visions of a man who had achieved acclaim for putting one over on Jerry Falwell.

Rick and Angie Walsh weren’t sure what to make of the practiced rituals of AIDS death. Still, Rick wept openly when Lu Chaikin concluded the service with her eulogy.

“How do you describe a star whose too-brief journey lit up so many lives?” Lu asked. “And now I say to my sweet, dearest friend—go well and be at peace. And as we had so often promised, we will always be with each other, with love.”

Everybody sang “Amazing Grace,” and as the people left, Matt played Gary’s favorite song, “All You Need Is Love.”

February 26, 1984

C
ENTERS FOR
D
ISEASE
C
ONTROL,
A
TLANTA

The vial with two ounces of LAV arrived at the Atlanta airport shortly after midnight. Given the fact that the last batch of LAV, packed in dry ice in Paris and shipped to Atlanta through the mail, had been dead on arrival, Dr. Cy Cabradilla from the CDC molecular virology lab took no chances this time, clearing the virus’s passage through New York quarantine authorities himself and personally waiting for the plane from JFK airport to arrive. As soon as he got the virus back to his CDC lab, Cabradilla started tests to make sure it had survived. By the next morning, he had isolated the virus and begun growing it in lymphocytes extracted from the umbilical cords of newborn infants. With this virus, the CDC could make its own antibody tests, which would allow researchers to trace LAV in the blood and tissue samples they had been collecting in the two and a half years of AIDS work.

By the end of the week, excitement had spread through the cluster of brick buildings on Clifton Road. The virus was growing rapidly. Soon, lab staffers were to test stored specimens. One after another, the blood revealed the presence of LAV antibodies. The positive antibody tests came from all the AIDS risk groups, including gay men, Haitians, drug abusers, hemophiliacs, addicts’ female sexual partners and their babies. Fresh blood samples from AIDS patients were flown in from Los Angeles and San Francisco, and the results were the same. These people were infected with LAV. The French had discovered the cause of AIDS.

March

W
ASHINGTON,
D.C.

“We know we have the cause of AIDS for sure,” said Bob Gallo.

Jim Curran had flown to Washington from Atlanta with the codes on 200 blood samples of AIDS cases and controls that the Centers for Disease Control had sent Gallo in January. Sitting with Gallo in a French restaurant, Curran compared the code numbers for the various samples to the HTLV-III antibody tests Gallo had performed on the blood. Gallo’s lab work was right on target; Curran could see that Gallo had isolated the long-sought AIDS virus. Curran also figured that the retrovirus was the same virus isolated by the French a year earlier. Curran was relieved both research groups had discovered the same virus separately, convinced that the dual studies would hasten the acceptance of the discovery in the scientific world. Gallo was evasive when Curran asked him when the National Cancer Institute would release its conclusions.

Gallo was reticent to provide much information, both because of the tensions between the CDC and the NCI, and because the question of how to announce the HTLV-III discovery had become so entwined with election-year politicking that it was out of Gallo’s hands. The NCI director, Dr. Vincent Devita, had wanted to go public with the information, but was overruled by Assistant Secretary for Health Edward Brandt, who had been informed of the discovery in February. Rather than be heralded as an accomplishment of the National Cancer Institute or the National Institutes of Health, credit for the breakthrough was to go to the Reagan administration. The announcement would counter liberal criticism that the government had dragged its feet on AIDS research. With Democratic presidential hopefuls becoming more critical of federal AIDS funding, the administration was eager to eliminate AIDS as a possible issue in the November presidential election. Brandt ordered that any announcement would be made by Health and Human Services Secretary Margaret Heckler when she determined it was wisest to proceed.

That time was rapidly approaching. Gallo had submitted six papers to the medical journal
Science,
all nailing down HTLV-III as the cause of AIDS. Already, the researcher had isolated the virus in forty-eight patients, many more independent isolates than the French had obtained for their LAV. By the time Gallo met with Curran, Heckler had also been briefed on HTLV-III. Now, it was up to her to make the discovery public.

Bob Gallo had politics of his own to consider. Like a number of NCI researchers, he was worried that this concrete evidence of the infectious cause of AIDS would put the syndrome firmly under the aegis of the National Institute for Allergy and Infectious Diseases, and the NCI would lose its central role in AIDS research. Gallo also continued to be obsessed with whether the Pasteur Institute would get credit for the discovery of the AIDS virus. He was suspicious of Curran, aware that the CDC had embarked on cooperative studies with the French after Jean-Claude Chermann had addressed the CDC in February. To keep his advantage, therefore, Gallo told the CDC as little as possible about NCI studies. When discussing the virus with Curran, he made no reference to the six
Science
papers or the forty-eight isolates.

S
AN
F
RANCISCO
C
LUB
B
ATHS

Larry Littlejohn pulled a towel around his waist and began his informal inspection of the city’s largest gay bathhouse. Although he had once enjoyed weekly bathhouse romps, he hadn’t stepped into the tubs for a year. The sprawling sex palaces reminded Littlejohn of how far the city’s sex industry had come since he had moved to San Francisco in 1962. His first home in San Francisco had been the Embarcadero YMCA, a precursor to the modern bathhouse. After Littlejohn helped organize the city’s pioneering gay group, the Society of Individual Rights, in 1964, he had opened one of the city’s first private sex clubs. He took some credit as one of the businessmen who introduced a whole generation of gay San Franciscans to the joys of orgy sex.

In the years since then, Larry Littlejohn had served two terms as president of the Society of Individual Rights and was widely recognized as one of the city’s first gay activists. He had at one time or another walked into every sex club and bathhouse in San Francisco, developing a personal preference for the more leather-oriented establishments. AIDS was a distant concern until he read Larry Kramer’s “1,112 and Counting.” A cursory examination of the evidence led him to believe that AIDS was a sexually transmitted disease, which drew him to one quick conclusion: The bathhouses couldn’t go on as they were without killing thousands of gay San Franciscans.

Through 1983, Larry Littlejohn wrote various letters to San Francisco Public Health Director Mervyn Silverman, the board of supervisors, and the AIDS organizations, pointing out what he considered to be a rather logical argument for stopping bathhouse sex. He assumed somebody would act. After all, lives were at stake. A city health department that would yank a restaurant license for cockroach infestation certainly would pull a bathhouse license for fostering a far more lethal activity. Yet, by the first months of 1984, it was clear that nobody would do anything. Most recently, Dr. Silverman had written Littlejohn that bathhouses were valuable sites for AIDS education. That was what had brought Littlejohn to the city’s largest bathhouse in early March. He wanted to see what kind of education patrons got.

Littlejohn walked out of the locker room and down the hall; he saw none of the safe-sex posters Silverman had ordered posted nine months before. At the dimly lit end of another hall, he did find a poster—in the least conspicuous place possible. The active orgy rooms and the squealing behind the closed doors of private cubicles at the Club Baths that night also implied to Littlejohn that patrons were not perusing safe-sex guidelines before exchanging bodily fluids.

Silverman obviously did not want to take responsibility for protecting the public health, Littlejohn thought. And gay politicos were still talking about whether it was permissible to talk about bathhouse closure. The day after his bathhouse inspection, therefore, Littlejohn called a friend who had been instrumental in placing initiatives on the San Francisco ballot. Littlejohn knew what Mayor Dianne Feinstein had learned a year ago. In San Francisco, you can put just about anything on the city ballot. In his apartment just one block from the Club Baths, Littlejohn drew up an initiative that would ban sexual activity from the city’s bathhouses. He knew that such an initiative would force every politician in the city of San Francisco to take a stand on bathhouse sex. And it would force Silverman to explain to the city’s electorate exactly why bathhouses were such wonderful sites for AIDS education, if such an explanation could be seriously made. The debate had gone on long enough, Littlejohn decided: It was time to call the question.

That same week, another question was being called at the Irwin Memorial Blood Bank in San Francisco. The woman who had inadvertently raised the issue was Mary Richards Johnstone, a wealthy matron from the affluent suburb of Belvedere.

During heart surgery in December 1982, Mary Johnstone had received twenty units of Irwin blood. Eight days after the operation, she was struck by a mysterious lung virus. She barely survived that ordeal, but in the succeeding months she was plagued continuously with exhausting fevers and strange ailments like oral candidiasis. The doctors couldn’t explain what was wrong with her.

Only in February 1984, while leafing through her medical files, did Mary Johnstone see the October 19, 1983, letter from one physician to another at the University of California Medical Center, where she had her surgery. “We have discovered that one of her blood donors is an AIDS patient,” the letter said. The doctors had concealed this from Mary Johnstone, however, and if she had not happened across the correspondence, there is no indication she would ever have been informed. Later, the fifty-five-year-old housewife kept her sense of humor when her doctor concluded that she was suffering from the syndrome. “Here I’ve got AIDS,” she said, “and I didn’t even have any fun getting it.”

In Los Angeles, meanwhile, a thirty-eight-year-old nurse who had received a blood transfusion during a hysterectomy was ailing from
Pneumocystis.
Her condition had been watched anxiously by Los Angeles health officials ever since one of the donors for her November 1982 transfusion answered affirmatively to Question 44 of the questionnaire given to all local AIDS patients: “Have you been a blood or plasma donor in the last five years?”

Within two weeks of the transfusion, the nurse was suffering from lymphadenopathy. Blood tests showed that her T-4 lymphocytes were beginning to disappear.

The two cases marked the first time two adults were proven to have AIDS after being transfused with the blood of diagnosed AIDS patients. In all the other suspected transfusion AIDS cases tracked by the Centers for Disease Control, the donors had fit into the high-risk groups for AIDS but had not actually been diagnosed with CDC-defined AIDS. The first transfusion AIDS case, detected at the University of California at San Francisco in December 1982, was an infant, raising questions about congenital immune deficiency.

The blood industry had discounted all previous transfusion AIDS cases in evaluating the extent of the transfusion AIDS problem. With these two adult cases and the San Francisco baby, however, there were now three cases featuring both a donor and recipient who suffered from the syndrome. Altogether, the CDC counted seventy-three transfusion AIDS cases by March 12, including the twenty-four hemophiliacs. Of these, twenty-two already had died. When the stories of Mary Johnstone and the Los Angeles nurse came out in March, however, faithful medical writers almost unanimously followed the blood bankers’ rhetoric that they were the first two adults diagnosed with transfusion AIDS in the United States.

Despite the unstinting support of the news media, Brian McDonough, president of the Irwin Memorial Blood Bank, faced a dilemma with Mary Johnstone’s diagnosis. Two of the three AIDS cases to which the blood industry did admit had come from Irwin blood. Another fourteen diagnosed AIDS patients were among Irwin donors in recent years, McDonough also knew. Mary Johnstone was only one of twenty-two recipients whom the blood bank was tracking for signs of AIDS. Already, eleven of these people were having problems with their immune systems. Most significantly, at least one of the donors had given blood after the deferral screening had begun last year. When asked by the blood bank why he had donated, he explained that he never considered himself at high risk for the disease, even though he was a sexually active gay man. It wasn’t like he was some fist-fucker who hung out in leather bars.

With Mary Johnstone’s husband making noises about a lawsuit, McDonough decided his blood bank could no longer take the wait-and-see attitude that characterized his industry’s response to the AIDS problem. He knew he would face the wrath of the blood industry for breaking ranks, but he made his decision nonetheless. Even before disclosing the Johnstone case, the Irwin Memorial Blood Bank announced that, as of May 1, the blood bank would begin testing for antibodies to the core of the hepatitis B virus, the test that the Centers for Disease Control had urged blood bankers to start in January 1983.

“Self-exclusion has not worked well enough in the San Francisco area,” McDonough said, “and some individuals are giving blood who should not.” In announcing that the testing would begin in May, Dr. Herbert Perkins, the Irwin medical director, tried to reassure a jittery public about the safety of the blood supply. The risk of getting AIDS is extremely low, he said, and was less than 1 chance in 500,000.