June 9, 2023 • 50 mins
How doctors and scientists responded to the arrival of a strange and terrifying new disease.
You can find a list of books, articles, and documentaries we used in our research at bit.ly/fiascopod.
If you like this series, mark your calendars: a new season of Fiasco is coming July 27, 2023, exclusively on Audible. Fiasco: Vigilante tells the story of a shooting that took place in 1984 on the New York City subway, leaving four Bronx teenagers gravely wounded and turning a man named Bernie Goetz into a national folk hero. Fiasco: Vigilante offers a panoramic but intimate view of how this era-defining story unfolded, giving voice for the first time to key players, and immersing listeners in the gritty, paranoid world of ’80s New York City. Listen to the trailer now at adbl.co/vigilante, only on Audible.
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hey, this is Leon Napok. I'm the host of Fiasco,
but you may also know me from the podcasts Slowburn,
Think Twice, Michael Jackson, and Backfired the Vaping Wars. I'm
excited to be sharing with you the next season of Backfired,
titled Attention Deficit, which is now available exclusively on Audible.
Backfired is a podcast about the business of unintended consequences.
(00:20):
In the first season, my co host Ril Pardess and
I dove deep into the world of vaping and how
the well intentioned quest for a safer cigarette went awry.
Now we're tackling ADHD and how the push to destigmatize
this hard to define childhood diagnosis has led to an
explosion of stimulant use in kids as well as adults.
It's a story about the promise of psychiatry to fix
(00:41):
our brains and the power of the pharmaceutical industry to
shape how we and our doctors think about what's wrong
with us. To hear both seasons of Backfired, go to
audible dot com slash Backfired and start a free trial
that's audible dot com. Slash Backfired is intended for mature audiences.
(01:02):
For a list of books, articles, and documentaries we used
in our research. Follow the link in the show notes.
Speaker 2 (01:14):
This is the Gay Life ksam's Public affairs show for
gentlemen who prefer gentlemen, for women who prefer women, and
for people who prefer people. You don't have to be
gay to listen. Good Evening, I'm Randy Alfred Tonight. Our
discussion is on the new diseases, the so called gay
cancer and Later. In January of nineteen eighty two, a
(01:34):
radio show in San Francisco featured an interview with a
local nurse. His name was Bobby Campbell. Good Evening, Bobby,
Good Evening, Randy. Let's start the story at the beginning.
Speaker 1 (01:45):
Campbell was twenty nine years old. About a year earlier,
he had gotten sick from an unusual infection and spent
four days in the hospital. It turned out there was
something wrong with his immune system.
Speaker 3 (01:57):
I found that I had a low white blood cell count,
which which is the main mechanism the body uses to
fight off infection.
Speaker 1 (02:03):
Not long after his hospital stay, Campbell went on a
hiking trip with his boyfriend on the California coast. Afterwards,
he noticed purple spots on the soles of his feet.
He figured they were blood blisters from all the walking
he'd been doing. But then a few weeks past and
the spots still hadn't gone away. Campbell and his boyfriend
(02:23):
got worried. There had just been a few newspaper stories
published about a rare form of skin cancer afflicting gay
men in New York in San Francisco. It was called
Capussi's sarcoma.
Speaker 3 (02:35):
My boyfriend he said, oh, well, you know, cop, she
does appear on the on the feet and legs. I said,
feet and legs.
Speaker 4 (02:41):
How did you feel?
Speaker 3 (02:43):
It can't be me. I can't have this. It's not this,
It's just a bloodlister. It's something else.
Speaker 1 (02:51):
Campbell got a biopsy. It showed that he did have
Capussi's sarcoma, the disease some had started calling gay cancer.
Speaker 2 (03:00):
As a health professional, surely you had read of it.
Speaker 3 (03:03):
As a matter of fact, I had not read of it.
It's so rare that until nineteen eighty one it was
mentioned in medical dermatology textbooks with one paragraph and sort
of glossed over onto the next thing.
Speaker 1 (03:14):
Campbell wanted to warn other gay men, especially those who
didn't share his relatively privileged position.
Speaker 3 (03:20):
I really feel very fortunate in some ways, and that
I have a lover who cares for me. I have
real good health insurance, I can be on medical leave
of absence. I have a lot of things going for me,
and I'm worried about someone who may develop this disease
and yet not have those pluses. So hopefully in my
being a blabbermouth in this way has some payoff for
(03:42):
this hypothetical person on Caster Street of Santa Monica Boulevard
or whatever.
Speaker 1 (03:46):
This interview with Bobby Campbell is the earliest recording I've
been able to find of someone talking in the first
person about having AIDS. Of course, Campbell didn't know that's
what it was, yet he just thought he had cancer,
not realizing it was a symptom of something even worse.
To me, that's what's so extraordinary about hearing him talk
(04:07):
about it. He just knows so little about what's coming,
and yet he's already certain that it's important and that
people need to know about it.
Speaker 2 (04:16):
You've never been a closet cancer patient.
Speaker 3 (04:18):
No, I've never been a closet cancer patient. I tend
to be very disclosing in the things that happened to me,
But I just thought that the more I talked about it,
the better it would be for me, and the better
it would be for other people in my community.
Speaker 1 (04:31):
To help spread the word, Campbell took polaroid photos of
his feet and put them on a poster. He hung
it in the front window of a pharmacy on Castro
Street in San Francisco. He also started writing a column
in a local gay newspaper and distributed informational leaflets to
other gay men while inhabiting a drag persona he called
Sister Florence Nightmare, registered nurse.
Speaker 2 (04:53):
So I think it's very brave of you to be
here publicly discussing a very private and life threatening of situation,
and I want to commend you and thank you for that.
Speaker 3 (05:03):
If I don't feel brave so much as maybe I
show off, I am, but it's I don't know. I
feel comfortable in doing it, and as a healthcare professional
and an articulate person, I have a story to tell
and I'm happy to do it.
Speaker 1 (05:18):
It would be another six months before Bobby Campbell's disease
was given the name we know it by today. It
would be a year before its underlying cause was identified
as a virus that destroyed the immune system, and it
would be more than a decade before an effective treatment
was developed.
Speaker 3 (05:35):
Anything you want to add before we close for the evening,
Take care of yourselves, brothers and sisters. You're the only
one you've got.
Speaker 1 (05:48):
This season of Fiasco is about the early years of
the AIDS epidemic, when a diagnosis was tantamount to a
death sentence.
Speaker 5 (05:56):
AID syndrome has spread in epidemic, proportions of the victims
have died.
Speaker 1 (06:01):
Over the course of eight episodes, you'll hear the story
of a scandal unlike any we've covered before. It's a
story about denial and misinformation.
Speaker 6 (06:10):
People are saying you can catch as from a mosquito
bite are in swimming.
Speaker 1 (06:14):
Pools, and the politics of a disease that intensified old
prejudices and activated new ones.
Speaker 7 (06:19):
I believe that God does not judge people.
Speaker 4 (06:21):
God judges sin.
Speaker 1 (06:23):
It's also a story about what people do in the
absence of scientific clarity, when the authorities they depend on
an answer to can't or won't figure out what to do.
We'll return to Bobby Campbell in a bit. For now,
(06:44):
I want to go back to the fall of nineteen
eighty when a group of doctors and scientists scattered around
the country first became aware that something inexplicable was happening
to gay men. I'm Leon Napok from Audible and Prologue projects.
This is Fiasco, season five, the AIDS Crisis.
Speaker 5 (07:05):
It's mysterious, it's deadly, and it's baffling medical science.
Speaker 8 (07:09):
A new deadly disease that no one understands, not where
it comes from, how to treat it, or how to
stop it from spreading.
Speaker 4 (07:16):
A great medical puzzle. It's known as gay plague.
Speaker 5 (07:19):
They are violating the laws of nature, and nature is
striking back.
Speaker 9 (07:23):
What I was hearing was from patients. My circle of
friends are disappearing.
Speaker 4 (07:28):
And within just five years, almost everyone I knew was
dead or dying.
Speaker 1 (07:43):
One night in the fall of nineteen eighty, doctor Jeffrey
Green was called into work to see a new patient.
It was after midnight and the man needed Green's urgent attention.
Speaker 9 (07:54):
I remember everything I remember about this patient because it
was probably one of the most poignant moments of my life.
It was about one o'clock in the morning, but when
I saw him, he was in the intensive care unit
and he was being intubated, being put on a breathing
machine because he was gasping for breath and very short
(08:15):
on oxygen and he needed to be put on the
breathing machine for survival. Had a very high fever, and
I was confused. I didn't know what was going on.
Speaker 1 (08:27):
Green was working in the Infectious disease unit at Bellevue
Hospital in Manhattan. Bellevue was one of the biggest public
hospitals in the country and an especially interesting place to
be an infectious disease specialist because it was cheaper and
more accessible than the private hospitals in town. Bellevue served
as a safety net for patients from all walks of life,
(08:49):
and because it was in New York. Many Bellvue patients
were people from abroad carrying diseases that were uncommon in America.
As Green put it, he and his colleagues saw a
little bit of everything.
Speaker 9 (09:01):
They could be three four, five or even more new
patients per day in terms of consultations, and I would
go see those patients to give my opinion as to
what was going on, to help make diagnoses, and to
help in orchestrating the treatment.
Speaker 1 (09:17):
The patient Green saw that night in nineteen eighty had
the initials HW. He was thirty eight years old. A
round of tests confirmed that there was something seriously wrong
with his lungs.
Speaker 4 (09:29):
Very poor oxygenation.
Speaker 9 (09:30):
His chest X ray was almost white, very advanced pneumonia
in all five lobes of the lung.
Speaker 1 (09:36):
There didn't seem to be anything about HW's medical history
that could explain what was happening to him.
Speaker 4 (09:42):
Before he was in debated.
Speaker 9 (09:43):
I was able to get a medical history, which previous
to that admission was pretty benign. He was a guy
in his thirties. He was a gay man. He was
in the last throes of life. He lived long enough
to go for an open lung biopsy, which is where
(10:03):
the surgeon takes the patient to the operating room and
through the rib takes a wedge of lung tissue to
examine to see what we might be dealing with. And
it was on that tissue that he saw these five
different infections.
Speaker 1 (10:17):
Each of the five infections HW was fighting was extremely
rare on its own. For all five to show up
in one young, apparently healthy person was unheard of. Taken together,
the infections seemed to suggest some kind of immune suppression.
Someone with a healthy immune system could have fought them
off without even knowing they had been exposed. HW had
(10:42):
other symptoms too, and I.
Speaker 9 (10:44):
Remember seeing this very large purple lesion on the patient's nose.
But we had bigger fish to fry, you know, with
this guy, so we weren't so concerned about his skin lesion.
Speaker 1 (10:54):
The only thing that was clear was that HW's immune
system had somehow gone haywire.
Speaker 9 (11:00):
I realized that this patient had to have come in
with severe immune suppression for whatever reason.
Speaker 4 (11:06):
We weren't sure, but we felt.
Speaker 9 (11:08):
That the only way that he could have had all
these things simultaneously would be basically an immune system that
had died before he did.
Speaker 1 (11:21):
Jeffrey Green was one of the first doctors in the
world to notice that a strange and deadly new disease
was spreading in the United States. It was not how
he thought his career would turn out. Growing up during
the nineteen fifties in a sheltered, middle class neighborhood in
Queen's Green always imagined that being a doctor would be
a job in which he got paid to help sick
(11:41):
people get better.
Speaker 4 (11:43):
I was birthed by my family's GP. He used to make.
Speaker 9 (11:47):
House calls, come give shots in the house, make me
feel better.
Speaker 4 (11:50):
When I was sick.
Speaker 9 (11:51):
You know, he was like part of the family really,
and as I was thinking about my future, even as
a very young kid, you know, I always thought being
a doctor would be a thing that I would like
to try.
Speaker 1 (12:03):
By the time Green entered medical school in nineteen seventy two,
doctors who made house calls were pretty much a thing
of the past. Instead, Green went into the field of
infectious disease.
Speaker 10 (12:15):
Communicable diseases recognize no boundaries, always watchful for epidemics. Practicing
physicians constitute the first line of defense.
Speaker 9 (12:24):
I liked the idea of finding a problem, diagnosing a problem,
and fixing a problem. Infectious diseases was the only one
that attracted me. We had tools to actually cure people.
I mean, sometimes people didn't make it, but for the
most part, patients who got admitted with severe infections got better.
Speaker 1 (12:43):
The science of treating infectious diseases had advanced to an
almost unthinkable degree during the twentieth century. For much of history,
diseases like pneumonia and tuberculosis had routinely proved fatal. By
the time Green entered the field, the vast majority of
patients seeking treatment for infections could be cured in a
matter of days.
Speaker 10 (13:03):
Now, at last, the hidden enemy could be examined under
the probing such light of science. The hunt was on
for contagious diseases and their causes, wherever they existed.
Speaker 1 (13:17):
Green's patient HW died just eight days after Green started
taking care of him. To the doctor, it looked like
a freak occurrence, not an accident, just deeply confusing.
Speaker 9 (13:31):
It was something nobody had ever seen. Of course, this
was a one and only case. This was case one.
Speaker 1 (13:38):
Case two walked into Bellevue a few weeks later. Once again,
Green noted that the patient was gay and was suffering
from a strange infection in his lungs. Not long after,
Green was making rounds at the hospital when he overheard
a conversation about yet another patient.
Speaker 9 (13:56):
While I was doing my note in this little cubicle,
the other four or five people were discussing this case,
and I was sort of listening peripherally to what was
going on. And then I heard them snap an X
ray into the X ray box, and I looked over
my shoulder at the X ray, and I said, to them,
is that patient gay?
Speaker 1 (14:19):
The other doctors were shocked. How could Green possibly know
such an intimate detail about a patient? He had never met.
Speaker 4 (14:27):
The guy who was presenting.
Speaker 9 (14:28):
He was standing and holding this blue plastic folder with
all the papers of his admission in his hand. He
dropped it on the floor and the guy said to me, how.
Speaker 4 (14:38):
Did you know that? And I said, I don't know.
I don't know how I knew it.
Speaker 9 (14:43):
And then later in the day I said, I know
how I knew it, because that X ray looks like
HW's X ray, the patient number one.
Speaker 1 (14:51):
Within several months, Green says he had encountered about a
dozen patients who, like HW, were afflicted by rare forms
of pneumonia and skin lesions. As you heard Bobby Campbell
say in his interview on The Gay Life, those skin
lesions were capaces sarcoma, a rare form of cancer typically
found in people from sub Saharan Africa and older Mediterranean men.
(15:15):
Some of Green's patients had other, even more unusual symptoms,
including ones associated with diseases typically carried by animals, not people.
Speaker 9 (15:24):
We had typocarcosis, which is a pigeon fungus that caused
the meningitis, you know. We had toxoplasmosis. We had disseminated
microbacterial diseases, which is again a typical.
Speaker 1 (15:37):
Why these rare infections were suddenly popping up with a
textbook medical mystery into many doctors, including Green, The fact
that the first few cases had all presented in gay
men seemed like a really important clue.
Speaker 9 (15:52):
It's a little embarrassing to discuss this because I thought
we were looking at a gay disease. The first three
or four cases that I saw were in people who
were gay, so it wasn't that.
Speaker 4 (16:06):
Unusual for me to jump to that conclusion.
Speaker 1 (16:09):
It was the only clear connection Green could see between
the patients. Soon, his assumption was that anyone suffering from
this new affliction had to be gay, even if they
refused to admit it.
Speaker 9 (16:23):
What happened was on case number four, the guy came
in with numasisters pneumonia, and he also passed away, but
before he did, he absolutely denied being gay. And I
can't tell you how many times I asked the guy.
He must have thought I was a freak or something,
because I kept asking him, are you sure you're not gay?
And after he passed away, I reached out to this
(16:48):
woman who I became friendly with while she was visiting,
and I said, what's a story?
Speaker 4 (16:52):
I mean, was he gay. You know, he's not gay.
Speaker 9 (16:56):
And I said, well, so where did he live? He
said so he was living in a halfway house for
drug addicts.
Speaker 1 (17:03):
Intravenous drug users were known to be at high risk
for any disease that could be spread through blood, like
hepatitis B or C. But when Green went to Harlem
to visit the halfway house, he learned something that seemed
to confirm his original assumption.
Speaker 9 (17:18):
And I talked to people who knew him, and I
started asking him the same question, and everyone said, no,
he wasn't gay.
Speaker 4 (17:27):
But someone said, but he turned gay tricks.
Speaker 1 (17:30):
Green wasn't exactly sure what that meant, and asked the
person to elaborate, and he.
Speaker 9 (17:35):
Said, well, to make money for his habit, he you know,
he would go with men.
Speaker 4 (17:38):
He would go with women, he would you know.
Speaker 9 (17:40):
So, I said, finally I figured it out. It is
something to do with gay sex or whatever.
Speaker 1 (17:47):
Looking back, it's striking how easy it was to conclude
that the new disease was quote unquote gay related. Even
when he was faced with someone with a history of
intravenous drug use, Green remained and convinced that the patient's
sexuality was the key factor. As more cases emerged in
(18:12):
early nineteen eighty one. Green was sure that he was
seeing something totally novel, and without knowing the cause, the
best he could do was try to use existing treatments
for his patient's symptoms. The trouble was the cases he
was seeing sometimes required specialized medications that could be difficult
to obtain. For instance, to treat numicistas pneumonia, Green needed
(18:35):
a drug called pentamidine, but because the demand for pantamidine
was usually incredibly low, it wasn't profitable for drug companies
to market it. Instead, pantamidine was controlled and dispensed by
the Centers for Disease Control in Atlanta, Georgia. The CDC
so yet have to request it.
Speaker 9 (18:54):
They would take a history and if you had the
requisite answers, they would release one patience worth of pentamidine
for a treatment course of two to three weeks.
Speaker 1 (19:05):
The CDC was established in nineteen forty six primarily to
combat malaria.
Speaker 10 (19:11):
CDC is one of the task forces of the Public
Health Service.
Speaker 1 (19:16):
It quickly evolved into an all purpose first response service
for various medical emergencies.
Speaker 10 (19:22):
Ready to help each state in its fife against communicable diseases.
Speaker 1 (19:27):
Anytime there was a major disease outbreak, the CDC was there,
doing the investigative legwork and providing assistance to doctors and
nurses on the ground. As a result, the CDC had
a hand in some of the greatest achievements of the
modern era, including the eradication of polio in the United
States and smallpox all over the world.
Speaker 7 (19:47):
And historic victory over a dread disease. Here scientists usher
in a new medical age with the monumental reports that
proved the vaccine against crippling polio to be a sensational success.
Speaker 1 (19:58):
The CDC had special outposts at major airports where they
distributed medications to the doctors who needed them. That was
where doctor Green would get his pentamidine.
Speaker 4 (20:08):
I would get in.
Speaker 9 (20:09):
My car and drive to JFK and I think there
is a CDC quarantine office and they had the shipment
waiting for me, and I get back on the car,
drive back to Bellevue and hang the drug.
Speaker 4 (20:24):
Soon.
Speaker 1 (20:25):
The trip to JFK Airport was part of Green's regular routine,
but a CDC technician fielding his requests for pentamidine noticed
that Green was not giving a reason for why his
patients had numicistus pneumonia. The technician knew that it usually
only appeared in patients who had compromised immune systems, like
kids with leukemia or people who had received organ transplants.
(20:48):
But Green wasn't indicating anything like that on the forms
he was filling out. So either he was doing something
wrong or there was an inexplicable new outbreak happening, one
that the CDC needed to get on top of immediately,
So the technician alerted her supervisor. Though the details were sketchy,
there appeared to be a growing cluster of numisistus cases
(21:10):
in New York. As it turned out, Green's requests for
pantamidine were not the only troubling signal popping up on
the CDC's radar at this time. By the late spring
of nineteen eighty one, multiple physicians around the country had
started asking the agency for help treating young gay men
with inexplicable symptoms. Among the CDC officials on the receiving
(21:34):
end of these requests was doctor Mary Geinan.
Speaker 11 (21:37):
We started getting phone calls from physicians saying, you know,
I have this young man in the intensive care unit
and he's dying and I don't know what's wrong with him.
Speaker 1 (21:50):
Geynan was a specialist in venereal disease, so when a
written report on some kind of outbreak among gay men
came into the CDC, she was asked to review it.
Speaker 11 (22:01):
Since it wasn't a disease that we knew about, there
was no expert in CDC about it, but all of
these men also had herpes virus infections, so they asked
me to make a comment on it.
Speaker 1 (22:17):
The report would turn out to be a foundational document
in the history of AIDS. He was co authored by
a young doctor in Los Angeles, whom you'll hear more
about later in the series. For now, all you need
to know is that he was seeing numacistus cases at
pretty much the same exact time as Jeffrey Green, and
when Mary Gynan had a chance to review his findings,
(22:39):
she knew the CDC had to get involved. Mary Guynan
(22:59):
studied Comis Street in college, but when she got her
degree in nineteen sixty one, she found that nobody was
willing to hire her.
Speaker 11 (23:07):
After I graduated as a chemist, I was living in
New York and the New York Times Want Dads was
segregated by gender. There was a help wanted male and
a help wanted female, and there was never a job
listing for a chemist in the help Wanted Female. So
I finally found a job at a chewing gum factory.
Speaker 12 (23:31):
What's new in the Magic Land of Chicklets.
Speaker 11 (23:34):
My job was to make new flavors for chewing gum.
Speaker 13 (23:38):
Well great them orange Bradberry.
Speaker 11 (23:42):
I was in a laboratory. I had all these different
flavors and I would mix them and taste them.
Speaker 14 (23:47):
A world of flavor from the Magic Land of Chicklets.
Speaker 1 (23:51):
And eventually Gynan decided to go to medical school, where
she became interested in smallpox and got accepted into a
training program at the CDC. There, she worked on the
agency's medical Detective Squad, the Epidemic Intelligence Service.
Speaker 11 (24:07):
The Epidemic Intelligence Service is a training program for epidemiologists.
The worldwide symbol of a field epidemiologist is the hole
in the soul, evidence that we have worn out our
shoes tracking down vital clues.
Speaker 1 (24:27):
Geynan ended up getting a job in the CDC's Venereal
Disease Control Division. By nineteen eighty one, she was an
expert on genital herpes infection.
Speaker 11 (24:37):
I became doctor Herpes. People call me from all over
the world. I had rock stars calling me from Australia.
They had genital herpes, and I say, I'm sorry, I
can't offer you.
Speaker 1 (24:50):
Anything long distance phone calls from rock stars. Aside, being
doctor herpes wasn't exactly glamorous. Even within the CED, Venereal
disease was considered an unsavory specialty.
Speaker 5 (25:04):
Nice people don't talk about VD.
Speaker 6 (25:06):
Perhaps that's why America is in the middle of the
greatest venereal disease epidemic and its history.
Speaker 11 (25:12):
People said, what's a nice girl like you doing a
thing like that? It was considered to be people who
couldn't get regular jobs took this job.
Speaker 10 (25:22):
Venereal disease is almost as prevalent as the common cold.
One problem in dealing with VD is the reluctance of
many of the infective de seek treatment.
Speaker 11 (25:30):
I worked in a venereal disease clinic one day a week,
and when I would come back, if I saw some
of my colleagues say say to me, oh, my goodness,
did you wash your hands.
Speaker 1 (25:42):
Guidan's time at the CDC coincided with the rise of
a new administration in Washington. Ronald Reagan had run on
a pledge to slash the federal budget, and when he
got into office, he wasted no time delivering on that promise.
Speaker 15 (25:55):
I've already placed a freeze on hiring replacements for those
who retire government service. I've ordered a cut in government travel,
the number of consultants to the government, and the buying
of office equipment and other items.
Speaker 1 (26:09):
At the CDC, everything became more difficult, buying new equipment,
securing additional research funding, and traveling to investigate outbreaks. For
fiscal year nineteen eighty two, the Center for Infectious Diseases
faced overall budget cuts of up to fifty nine percent.
So that was the state of play. When Gaynan read
(26:30):
the report from Los Angeles about a mysterious cluster of
numisistus cases in gay men.
Speaker 11 (26:36):
I read it and it was like incredible. I knew
that something terrible was happening because these are all homosexual men,
and two of them had died, and nobody knew why.
So I sent it up the hierarchy of approval all
the way to the top, and I sent it to
(26:56):
my supervisor, who wrote on the paper.
Speaker 1 (26:59):
Hot stuff guidance. Supervisor was doctor Jim Currn, a senior
researcher in the CDC's Veneurial Diseases Division.
Speaker 14 (27:08):
It was circulated to my disc I would say perhaps
ten days before it was published. On June fifth, nineteen eighty.
Speaker 1 (27:15):
One, Kerran happened to be going to a conference on
sexually transmitted diseases, and he asked some of his fellow
attendees if they'd seen anything like what was being described
in the report.
Speaker 14 (27:25):
We talked to the doctors who were working with people
in the gay community and gay physicians themselves, and they
told us that they too were seeing cases that were
very unusual. And there were some doctors in New York
who were also calling us about this rare cancer kapasci
sarcoma that was being seen in New York.
Speaker 1 (27:45):
One month after the new Massisus report was published, the
CDC followed up with a second one documenting the cases
of capasi sarcoma. The New York Times covered it that
same day on page twenty under the headline rare cancer
in forty one homosexuals. The article cited Kerran in saying
there was no apparent danger to non homosexuals from contagion.
(28:09):
That same week, Kerran traveled to New York for his
first in person meeting with a patient suffering from the
new disease.
Speaker 14 (28:16):
And we went to see one individual patient and as
we talked about our past, we said, you know, we
are exactly the same age.
Speaker 1 (28:27):
The patient was an actor, and as he and Kerran
started chatting, they found they had a lot more in
common than just their age. They were both from Detroit,
and they were both raised Catholic. In fact, they even
went to rival Catholic prep schools. Both had left Michigan
for college, one to Notre Dame, the other to Yale.
(28:47):
And now one was a doctor trying to diagnose the other.
Speaker 14 (28:50):
And then he had these skin lesions on his face.
His question to me, of course a doctor expert from CDC,
will these go away? I be able to get rid
of him so I can continue my acting career. And
of course I'd never seen a patient in my life
with Kappa she sarcoma, so I didn't know.
Speaker 1 (29:10):
Kurran kept tabs on the patient as his condition worsened
over the following months.
Speaker 14 (29:15):
He had went from a tall, handsome actor to having
lost almost half his body weight, all of his hair.
And I will always think how similar our background was
on how he died. This inexplicable death. What made us different.
I guess it was because he was a gay man
(29:37):
and I was straight. That he went to New York
and was exposed in the epicenter of this horrible disease
to something neither one of us knew what at that point,
and he died and I was living there to study it.
Speaker 1 (30:01):
Not long after the CDC published its report on Numisistus pneumonia,
the agency created a centralized task force to investigate the situation.
Jim curn was put in charge.
Speaker 14 (30:12):
So at the time they asked me to share it,
and I was assigned disease detectives from a variety of areas.
Virology because perhaps this was a virus cancer assigned somebody
to us, and we had some laboratory people assigned to us,
and a statistician assigned to us, and we thought it
could well be sexually transmitted, so std people were actually
(30:36):
assigned from my own group.
Speaker 1 (30:38):
Before the task force did anything else, they set out
to confirm that what they were seeing was in fact
a new phenomenon. To that end, they reviewed hospital records
in the eighteen largest cities in the country to see
how many previous cases of pneumaicistus or other rare infections
there had been.
Speaker 14 (30:55):
What we found was virtually there were no cases before
nineteen seventy eight, and there were none outside New York
and California except one case in Atlanta, so we were
reassured that this was new.
Speaker 1 (31:08):
Different people on the task force had different ideas about
what was making people sick, but a central animating question
was why the disease seemed to be disproportionately affecting gay men.
Speaker 14 (31:22):
Some people thought it was related to allogenetic semen, that
if you were exposed to hundreds of different semen, you
could become allergic to it, and that allergy would cause
the reaction to damage your immune system. Some people thought
it was an environmental cause, since many people who have
sex with each other go to the same places, maybe
(31:43):
there was some kind of contaminant.
Speaker 1 (31:45):
The so called environmental theories posited that maybe something about
the environments where gay men congregated was causing them to
get sick. A leading early hypothesis was that the disease
was caused by poppers, the inhalable muscle relaxings that many
gay men were using in clubs to get high and
to make it easier to have anal sex. Mary Guinan
(32:06):
and other members of the CDC task Force thought the
chemicals used to make poppers might be causing some kind
of reaction in people's immune systems, or that maybe a
bad batch had made it onto the street.
Speaker 11 (32:18):
Poppers were available all over the place, so one of
the things that I wanted to do was to see
what they contained.
Speaker 1 (32:27):
Guidan heard she could find poppers at adult bookstores around Manhattan,
so she went to New York in search of samples.
Speaker 11 (32:34):
They would actually have a place to have sex inside
the bookstore, and they sold poppers. It was a bookstore
in Greenwich Village.
Speaker 1 (32:43):
I think Geynan brought the poppers back to CDC headquarters
in Atlanta to be tested, and I brought them in.
Speaker 11 (32:50):
We sent them over to various people within CDC to
see if they were but it was There wasn't any
real connection.
Speaker 1 (33:03):
The poppers theory endured long after it fell out of
favor with scientists. There are a few reasons why. For
one thing, it made it possible to blame the new
disease on a substance specifically associated with gay nightlife and vice,
but also more generally, it held out the promise of
a simple smoking gun. If the illness really was caused
(33:26):
by some kind of environmental factor, and solving the problem
could be as straightforward as isolating it and getting rid
of it. Not surprisingly, the people who made poppers got
pretty defensive about their product. Here's a clip from the
Gay Life radio show in which they interviewed a manufacturer
named W. J.
Speaker 4 (33:45):
Freezer.
Speaker 12 (33:46):
There is absolutely no evidence whatsoever linking alcohol, nitrites or
any other nitrites with Carposi sacoma, the so called gay cancer.
The CDC was asked by the press whether poppers had
been eliminated as a factor. CDC replied, and quite properly,
(34:06):
that nothing has as yet been eliminated. That response has
been blown way out of proportion.
Speaker 1 (34:13):
Well, Jim Curran wanted the answer to be poppers too,
but he and his colleagues at the CDC were fairly
convinced from the start that what they were seeing was
most likely a virus. Their suspicion was that the new
disease might be similar to hepatitis B, which was transmissible
through blood and other bodily fluids, and could be spread
(34:35):
through sex and intravenous drug use. If that was how
the new disease worked too. That would mean it didn't
actually discriminate based on sexuality. Even if it was true
that for now it was spreading mostly among gay men,
it would inevitably cross over into other populations. In July
(34:59):
of nineteen eight, one current CDC task force was preparing
to send teams to New York, Atlanta, Los Angeles, and
San Francisco. The goal was to interview gay men who
were showing symptoms of the new disease and compare them
to a control group. Doctor Gynan was sent to San Francisco,
where she met with her subjects in a cheap hotel
room in the Tenderloin district.
Speaker 11 (35:21):
It was all sorts of questions, first about drug use
and about sexual behavior. And we all had to ask
the same questions, what kinds of sex, what kind of drugs?
How many sex partners have you had in the past year.
And I was just amazed at how cooperative these people were.
(35:42):
They would be counting the number of sex partners they had.
They'd say I had two or three thousand partners in
their lifetime. And so people afterwards said to me, oh,
they were just bragging about Let's see, they were not
They were bragging, they were telling the truth. They were
(36:02):
trying to help.
Speaker 1 (36:04):
After administering the questionnaire, Guynan collected patient samples.
Speaker 11 (36:08):
The patient would sit on the barstool of the kitchenette
and I would take blood from them. And I had
to pack up all the specimens in these boxes with
dry ice in it to keep them cold, and they
had to be there at CDC within twenty four hours.
I then had to get those specimens to the post
(36:30):
office before the post office closed.
Speaker 1 (36:33):
Gyan was working fourteen hour days during her trip to
San Francisco, conducting interviews and drawing blood samples herself. It
didn't always go smoothly.
Speaker 11 (36:43):
This one young man came in who was very tall
and built like a football player, and as I was
putting the needle into his arm, he fainted and fell
on top of me. We both fell on the floor,
and I tried to pull the tourniquet from his arm
because it was bleeding. All the blood was coming out
(37:07):
and I couldn't get it. And I finally pulled the
needle out, and when I pulled it out, I stuck
it into the palm of my left hand.
Speaker 1 (37:19):
Geynan didn't know whether she had just given herself the disease.
Sitting in the hotel room covered in someone else's blood.
She improvised, I.
Speaker 11 (37:30):
Tried to squeeze my palm of my hand to get
any blood in it that might have gone in there.
I was not sure what I was going to do here.
I was in San Francisco with all sorts of needles
on the counter and a man unconscious in my room
with blood all over him and me.
Speaker 1 (37:51):
Finally, the man woke up and apologized.
Speaker 11 (37:54):
He said he always faced at the sight of blood.
So I asked him if he would stay on the
floor while I got the specimens, because I needed to
get those specimens, and I did.
Speaker 1 (38:06):
The incident would haunt Geyan for several years, especially when
she developed a lesion on her arm that looked like
it could be Capasi sarcoma. Her secretary at the time
was so afraid of catching it that she quit. It
was not until nineteen eighty five that a blood test
showed that Guynan had not been infected. When Guyinan and
(38:30):
her colleagues on the CDC Task Force analyzed the data
they had collected, one finding stood out people with diagnosed
cases had had way more sexual partners over the course
of their lives.
Speaker 4 (38:42):
Than the control group.
Speaker 1 (38:44):
The finding seemed to bolster the hypothesis that members of
the task force had held from the beginning that the
new disease was a virus that was transmissible through sex
and could therefore infect anyone, not just gay men. According
to Kerrn, that was the reason the CDC never adopted
the term gay related immune deficiency or GRID, which was
(39:05):
used in much of the early media coverage.
Speaker 10 (39:08):
Doctors have even coined a new word for these conditions, GRIDS,
gay related infectious diseases.
Speaker 1 (39:14):
For the most part, though there was no early media coverage.
Jim Curran again, there was virtually no coverage in the
mainstream media in the first year or so. The people
who did good coverage were people with the New York
Native the gay publications, but there was essentially nothing in
the New York Times or nothing on mainstream TV. Even
(39:36):
the scores of new cases were discovered and the number
of deaths continued to climb, the biggest news outlets in
America barely followed up on the CDC's early reports from
the summer of nineteen eighty one. Then that winter, Kerran
heard from a veteran health reporter at the Wall Street Journal.
He said he wanted to write a long story on
the disease, so Kerran flew to New York to meet
(39:59):
with him.
Speaker 14 (40:00):
I remember having lunch with him at Uncle Ty's Hunan Juan,
and we talked for hours, and he wrote this very
long story in the Wall Street Journal and they wouldn't publish.
So he called me back and he said, they think
this is just a story about gay men, and this
is the first time I've ever had a story turned down.
Speaker 1 (40:19):
Current pushed back, noting that the disease almost certainly didn't
just affect gay men, and I.
Speaker 14 (40:25):
Said, well, there is heterosexual transmission two very likely couldn't
totally prove it, but we're having good examples of it.
So they published a very short article that said heterosexuals
get aids two.
Speaker 1 (40:39):
The Wall Street Journal article was published on February twenty fifth,
nineteen eighty two, under the headline new often fatal illness
and homosexuals turns up in women coma heterosexual males. Over
the course of the coming year, as the article's central
thesis became increasingly evident, more media outlets began to pay attention.
Speaker 5 (41:00):
Federal health officials consider it an epidemic, yet you rarely
hear a thing about it.
Speaker 1 (41:04):
In August, CBS ran its first ever nightly news report
on the epidemic.
Speaker 6 (41:08):
It's a disease first detected in the gay community that
has now spread beyond that, a disease experts are now
calling a national epidemic. There is a one in five
chance a victim will die within the first year of
the illness.
Speaker 1 (41:21):
The report included an interview with Bobby Campbell, conducted seven
months after his appearance on the Gay Life radio show.
Speaker 3 (41:29):
It was devastating, you know, at that time, I was
twenty nine years old.
Speaker 6 (41:32):
For Bobby Campbell, it is a race against time. How
long before he and others who have this disease finally
have answers, finally have the hope of a cure.
Speaker 1 (41:42):
The CBS report noted that while most of the known
cases have been found in gay men, other groups were
starting to get sick too.
Speaker 6 (41:49):
Now It's been detected in Haitian refugees and in some
people with hemophilia, a disease that prevents blood clotting so
the patient needs frequent blood transfusions.
Speaker 1 (42:02):
Soon, these high risk groups were nicknamed the four HS.
Homosexuals heroin users, haitians, and people with hemophilia. All of
a sudden, gay related immune deficiency no longer seemed like
an accurate descriptor. In September of nineteen eighty two, the
CDC gave the disease its permanent name.
Speaker 5 (42:23):
Acquired immune deficiency syndrome. It's mysterious, its deadly, and its
baffling medical science. Once thought to affect only promiscuous homosexual males,
AIDS is now spreading in epidemic proportions to other segments
of the population.
Speaker 1 (42:41):
With that, AIDS was officially not just a gay disease,
at least as far as most doctors and scientists were concerned.
In practice, though, the wider world remained largely indifferent, and
what little public discussion there was of AIDS often continued
to place the blame on gay men.
Speaker 16 (42:59):
Gays are being called all the dangerous and violent group
that corrupts children and infects the community with AIDS.
Speaker 1 (43:15):
It's probably obvious why I wanted to make this podcast,
Living through COVID nineteen. I wanted to know what it
was like the last time American society was transformed by
a deadly virus. I wasn't expecting easy parallels. I just
wanted to know how it felt to live through it,
the early years in particular, and what it had to
tell us about the thing we've all been living through lately.
(43:38):
As you'll hear over the course of our series, there
are certain things all epidemics have in common. The confusion
and fear, the scapegoating and paranoia, the difficulty of addressing
a new existential threat that requires human beings to change
their behavior en Mass. Marcus Conant, a pioneering AIDS doctor
(43:58):
you'll hear more about later, says the echoes between epidemics
are unavoidable.
Speaker 17 (44:03):
It's well documented from the time of the Black Death
in thirteen forty eight. With almost every epidemic, people respond
to the epidemic in exactly the same predictable ways. The
first thing they do is they deny that it's even occurred.
You know, it's not happening, and then they want to
blame someone for having caused it, as if that will
(44:26):
make it not have happened and go away.
Speaker 1 (44:29):
Still, the AIDS crisis was and continues to be a
singular disaster. This is in large part because of who
got sick and died first, but it's also because of
who responded and who didn't. I feel compelled to say
that our series will not offer a comprehensive picture of
everything that went wrong or everyone who was affected. Our
(44:53):
goal is just to be specific, to try to understand
why this particular epidemic unfolded the way it did, and
why has been allowed to kill more than thirty million
people worldwide. For Jeffrey Green, the experience of being a
doctor changed completely once he began treating people with AIDS.
(45:17):
He had gone into medicine and specialized an infectious disease
because you wanted to cure people. Now, somehow, just a
few years into his career, his job was to tell
young patients there was really nothing he could do.
Speaker 9 (45:31):
And I began talking to some of the oncologists at
the hospital.
Speaker 4 (45:34):
I said, how do you guys do this?
Speaker 9 (45:36):
I mean, patients dying, you know, in seven months, eight months,
a year, two years. I'd give him, you know, and
then I feel like I've succeeded with two years' survival.
And they said, well, you just add up all the
years that you've kept people alive, and that's the way
you have to think about it. And they pulled me back.
(45:57):
My colleagues pulled me back.
Speaker 1 (46:00):
Green still has dreams about some of the people with
AIDS he has treated over the years. In one of
those dreams, he's running from one waiting room to another,
all of them filled with dying men.
Speaker 9 (46:12):
So recurring nightmare that I have is running in an
office that has fifteen different rooms and not being able
to keep up, and I'm running from room to room,
and I feel that type of in the dream, that
panic attack reoccurring.
Speaker 1 (46:28):
Green is haunted by another image too. As part of
his work treating people with AIDS, he started doing what
his family doctor had done all those years ago. He
made house calls. To this day, Green thinks about something
he saw while visiting a patient in a brownstone in Manhattan.
Speaker 9 (46:47):
And I went to see him because he was dying
and he was too weak to come to the office.
And he had set up a cot like a hospital bed,
I guess, in the middle of his aviary, which was
his living room. And there were these exotic birds that
you know, very large Brazilian colorful cockatoos and other kinds
(47:10):
of fancy birds.
Speaker 4 (47:13):
And when I walked in the door, his partner lit
me in.
Speaker 9 (47:17):
What I saw was a skeleton on the bed on
his back, looking at the ceiling. There was a white,
gorgeous bird, maybe a foot tall, on his chest, and
it looked like.
Speaker 4 (47:32):
A bird of prey.
Speaker 9 (47:35):
Or a scavenger bird that was gonna wait till he
died to eat him. It was I'd wake up at
night once or twice a month with that image in
my head.
Speaker 13 (47:46):
Still they fall around, they are fall and round, they
(48:16):
are fallund me the strong GUYSI.
Speaker 12 (48:26):
Masie.
Speaker 1 (48:30):
On the next episode of Fiasco, the revolutionary first stirrings
of AIDS activism in New York City.
Speaker 8 (48:36):
People who were sick were organizing and taking care of
each other. We really weren't even looking that much to
the healthcare establishment because they didn't want to deal with us.
It was a whole different kind of of activism.
Speaker 1 (48:50):
Fiasco is presented by Audible Originals and Prologue Projects. The
show is produced by Andrew Parsons, Sam Graham Felsen, Madeline
kaplan Ula Coppa, and me Leon Nafock. Editorial support by
Nola Wawas and Jessica Miller. Our researcher is Francis Carr.
Archival research by Michelle Sullivan. This season's music is composed
(49:12):
by Edith Mudge additional music by Nick Sylvester of God Mode,
Joel Saint, Julian and Dan English, Noah Hect and Joe Valley.
Our theme song is by Spatial Relations Music Licensing courtesy
of Anthony Roman. Our credits song this week is They
Are Falling All Around Me by Bernice Johnson Reagan from
(49:33):
the recording Give Your Hands The Struggle courtesy of Smithsonian
Folkways Recordings. Additional thanks to tro Essex Music Group. Audio
mix by Erica Wong, with additional support from Selina Urabe.
Our artwork is designed by Teddy Blanks at Chips and Y.
David Blum is the editor in chief of Audible Originals.
(49:56):
Mike Charzik is the vice president of Audible Studios. Zac
ro Us is head of acquisition and Development for Audible.
Thanks to Archive dot Org, Annabel Bacon, Carrie Baker, Brandon Ellis,
Alice Gregory, Chris Horton, Stephen Fisher, Ben Frisch, Akiva Gottlieb,
Andrew Jacobs, Giannis Kulpa, Stephen Phillips, Horst, Willi Paskin, Lisa Pollock,
(50:18):
Bill Rutland, Aichris Gondaraja, and Sasha Weiss. Special thanks to
Randy Alfred and Peter Yassi. Next week, episode two.
Speaker 13 (50:27):
Say Masson.
Speaker 1 (50:32):
V sure to let me
Speaker 12 (50:37):
From
Hey, this is Leon Napok. I'm the host of Fiasco,
but you may also know me from the podcasts Slowburn,
Think Twice, Michael Jackson, and Backfired the Vaping Wars. I'm
excited to be sharing with you the next season of Backfired,
titled Attention Deficit, which is now available exclusively on Audible.
Backfired is a podcast about the business of unintended consequences.
(00:20):
In the first season, my co host Ril Pardess and
I dove deep into the world of vaping and how
the well intentioned quest for a safer cigarette went awry.
Now we're tackling ADHD and how the push to destigmatize
this hard to define childhood diagnosis has led to an
explosion of stimulant use in kids as well as adults.
It's a story about the promise of psychiatry to fix
(00:41):
our brains and the power of the pharmaceutical industry to
shape how we and our doctors think about what's wrong
with us. To hear both seasons of Backfired, go to
audible dot com slash Backfired and start a free trial
that's audible dot com. Slash Backfired is intended for mature audiences.
(01:02):
For a list of books, articles, and documentaries we used
in our research. Follow the link in the show notes.
Speaker 2 (01:14):
This is the Gay Life ksam's Public affairs show for
gentlemen who prefer gentlemen, for women who prefer women, and
for people who prefer people. You don't have to be
gay to listen. Good Evening, I'm Randy Alfred Tonight. Our
discussion is on the new diseases, the so called gay
cancer and Later. In January of nineteen eighty two, a
(01:34):
radio show in San Francisco featured an interview with a
local nurse. His name was Bobby Campbell. Good Evening, Bobby,
Good Evening, Randy. Let's start the story at the beginning.
Speaker 1 (01:45):
Campbell was twenty nine years old. About a year earlier,
he had gotten sick from an unusual infection and spent
four days in the hospital. It turned out there was
something wrong with his immune system.
Speaker 3 (01:57):
I found that I had a low white blood cell count,
which which is the main mechanism the body uses to
fight off infection.
Speaker 1 (02:03):
Not long after his hospital stay, Campbell went on a
hiking trip with his boyfriend on the California coast. Afterwards,
he noticed purple spots on the soles of his feet.
He figured they were blood blisters from all the walking
he'd been doing. But then a few weeks past and
the spots still hadn't gone away. Campbell and his boyfriend
(02:23):
got worried. There had just been a few newspaper stories
published about a rare form of skin cancer afflicting gay
men in New York in San Francisco. It was called
Capussi's sarcoma.
Speaker 3 (02:35):
My boyfriend he said, oh, well, you know, cop, she
does appear on the on the feet and legs. I said,
feet and legs.
Speaker 4 (02:41):
How did you feel?
Speaker 3 (02:43):
It can't be me. I can't have this. It's not this,
It's just a bloodlister. It's something else.
Speaker 1 (02:51):
Campbell got a biopsy. It showed that he did have
Capussi's sarcoma, the disease some had started calling gay cancer.
Speaker 2 (03:00):
As a health professional, surely you had read of it.
Speaker 3 (03:03):
As a matter of fact, I had not read of it.
It's so rare that until nineteen eighty one it was
mentioned in medical dermatology textbooks with one paragraph and sort
of glossed over onto the next thing.
Speaker 1 (03:14):
Campbell wanted to warn other gay men, especially those who
didn't share his relatively privileged position.
Speaker 3 (03:20):
I really feel very fortunate in some ways, and that
I have a lover who cares for me. I have
real good health insurance, I can be on medical leave
of absence. I have a lot of things going for me,
and I'm worried about someone who may develop this disease
and yet not have those pluses. So hopefully in my
being a blabbermouth in this way has some payoff for
(03:42):
this hypothetical person on Caster Street of Santa Monica Boulevard
or whatever.
Speaker 1 (03:46):
This interview with Bobby Campbell is the earliest recording I've
been able to find of someone talking in the first
person about having AIDS. Of course, Campbell didn't know that's
what it was, yet he just thought he had cancer,
not realizing it was a symptom of something even worse.
To me, that's what's so extraordinary about hearing him talk
(04:07):
about it. He just knows so little about what's coming,
and yet he's already certain that it's important and that
people need to know about it.
Speaker 2 (04:16):
You've never been a closet cancer patient.
Speaker 3 (04:18):
No, I've never been a closet cancer patient. I tend
to be very disclosing in the things that happened to me,
But I just thought that the more I talked about it,
the better it would be for me, and the better
it would be for other people in my community.
Speaker 1 (04:31):
To help spread the word, Campbell took polaroid photos of
his feet and put them on a poster. He hung
it in the front window of a pharmacy on Castro
Street in San Francisco. He also started writing a column
in a local gay newspaper and distributed informational leaflets to
other gay men while inhabiting a drag persona he called
Sister Florence Nightmare, registered nurse.
Speaker 2 (04:53):
So I think it's very brave of you to be
here publicly discussing a very private and life threatening of situation,
and I want to commend you and thank you for that.
Speaker 3 (05:03):
If I don't feel brave so much as maybe I
show off, I am, but it's I don't know. I
feel comfortable in doing it, and as a healthcare professional
and an articulate person, I have a story to tell
and I'm happy to do it.
Speaker 1 (05:18):
It would be another six months before Bobby Campbell's disease
was given the name we know it by today. It
would be a year before its underlying cause was identified
as a virus that destroyed the immune system, and it
would be more than a decade before an effective treatment
was developed.
Speaker 3 (05:35):
Anything you want to add before we close for the evening,
Take care of yourselves, brothers and sisters. You're the only
one you've got.
Speaker 1 (05:48):
This season of Fiasco is about the early years of
the AIDS epidemic, when a diagnosis was tantamount to a
death sentence.
Speaker 5 (05:56):
AID syndrome has spread in epidemic, proportions of the victims
have died.
Speaker 1 (06:01):
Over the course of eight episodes, you'll hear the story
of a scandal unlike any we've covered before. It's a
story about denial and misinformation.
Speaker 6 (06:10):
People are saying you can catch as from a mosquito
bite are in swimming.
Speaker 1 (06:14):
Pools, and the politics of a disease that intensified old
prejudices and activated new ones.
Speaker 7 (06:19):
I believe that God does not judge people.
Speaker 4 (06:21):
God judges sin.
Speaker 1 (06:23):
It's also a story about what people do in the
absence of scientific clarity, when the authorities they depend on
an answer to can't or won't figure out what to do.
We'll return to Bobby Campbell in a bit. For now,
(06:44):
I want to go back to the fall of nineteen
eighty when a group of doctors and scientists scattered around
the country first became aware that something inexplicable was happening
to gay men. I'm Leon Napok from Audible and Prologue projects.
This is Fiasco, season five, the AIDS Crisis.
Speaker 5 (07:05):
It's mysterious, it's deadly, and it's baffling medical science.
Speaker 8 (07:09):
A new deadly disease that no one understands, not where
it comes from, how to treat it, or how to
stop it from spreading.
Speaker 4 (07:16):
A great medical puzzle. It's known as gay plague.
Speaker 5 (07:19):
They are violating the laws of nature, and nature is
striking back.
Speaker 9 (07:23):
What I was hearing was from patients. My circle of
friends are disappearing.
Speaker 4 (07:28):
And within just five years, almost everyone I knew was
dead or dying.
Speaker 1 (07:43):
One night in the fall of nineteen eighty, doctor Jeffrey
Green was called into work to see a new patient.
It was after midnight and the man needed Green's urgent attention.
Speaker 9 (07:54):
I remember everything I remember about this patient because it
was probably one of the most poignant moments of my life.
It was about one o'clock in the morning, but when
I saw him, he was in the intensive care unit
and he was being intubated, being put on a breathing
machine because he was gasping for breath and very short
(08:15):
on oxygen and he needed to be put on the
breathing machine for survival. Had a very high fever, and
I was confused. I didn't know what was going on.
Speaker 1 (08:27):
Green was working in the Infectious disease unit at Bellevue
Hospital in Manhattan. Bellevue was one of the biggest public
hospitals in the country and an especially interesting place to
be an infectious disease specialist because it was cheaper and
more accessible than the private hospitals in town. Bellevue served
as a safety net for patients from all walks of life,
(08:49):
and because it was in New York. Many Bellvue patients
were people from abroad carrying diseases that were uncommon in America.
As Green put it, he and his colleagues saw a
little bit of everything.
Speaker 9 (09:01):
They could be three four, five or even more new
patients per day in terms of consultations, and I would
go see those patients to give my opinion as to
what was going on, to help make diagnoses, and to
help in orchestrating the treatment.
Speaker 1 (09:17):
The patient Green saw that night in nineteen eighty had
the initials HW. He was thirty eight years old. A
round of tests confirmed that there was something seriously wrong
with his lungs.
Speaker 4 (09:29):
Very poor oxygenation.
Speaker 9 (09:30):
His chest X ray was almost white, very advanced pneumonia
in all five lobes of the lung.
Speaker 1 (09:36):
There didn't seem to be anything about HW's medical history
that could explain what was happening to him.
Speaker 4 (09:42):
Before he was in debated.
Speaker 9 (09:43):
I was able to get a medical history, which previous
to that admission was pretty benign. He was a guy
in his thirties. He was a gay man. He was
in the last throes of life. He lived long enough
to go for an open lung biopsy, which is where
(10:03):
the surgeon takes the patient to the operating room and
through the rib takes a wedge of lung tissue to
examine to see what we might be dealing with. And
it was on that tissue that he saw these five
different infections.
Speaker 1 (10:17):
Each of the five infections HW was fighting was extremely
rare on its own. For all five to show up
in one young, apparently healthy person was unheard of. Taken together,
the infections seemed to suggest some kind of immune suppression.
Someone with a healthy immune system could have fought them
off without even knowing they had been exposed. HW had
(10:42):
other symptoms too, and I.
Speaker 9 (10:44):
Remember seeing this very large purple lesion on the patient's nose.
But we had bigger fish to fry, you know, with
this guy, so we weren't so concerned about his skin lesion.
Speaker 1 (10:54):
The only thing that was clear was that HW's immune
system had somehow gone haywire.
Speaker 9 (11:00):
I realized that this patient had to have come in
with severe immune suppression for whatever reason.
Speaker 4 (11:06):
We weren't sure, but we felt.
Speaker 9 (11:08):
That the only way that he could have had all
these things simultaneously would be basically an immune system that
had died before he did.
Speaker 1 (11:21):
Jeffrey Green was one of the first doctors in the
world to notice that a strange and deadly new disease
was spreading in the United States. It was not how
he thought his career would turn out. Growing up during
the nineteen fifties in a sheltered, middle class neighborhood in
Queen's Green always imagined that being a doctor would be
a job in which he got paid to help sick
(11:41):
people get better.
Speaker 4 (11:43):
I was birthed by my family's GP. He used to make.
Speaker 9 (11:47):
House calls, come give shots in the house, make me
feel better.
Speaker 4 (11:50):
When I was sick.
Speaker 9 (11:51):
You know, he was like part of the family really,
and as I was thinking about my future, even as
a very young kid, you know, I always thought being
a doctor would be a thing that I would like
to try.
Speaker 1 (12:03):
By the time Green entered medical school in nineteen seventy two,
doctors who made house calls were pretty much a thing
of the past. Instead, Green went into the field of
infectious disease.
Speaker 10 (12:15):
Communicable diseases recognize no boundaries, always watchful for epidemics. Practicing
physicians constitute the first line of defense.
Speaker 9 (12:24):
I liked the idea of finding a problem, diagnosing a problem,
and fixing a problem. Infectious diseases was the only one
that attracted me. We had tools to actually cure people.
I mean, sometimes people didn't make it, but for the
most part, patients who got admitted with severe infections got better.
Speaker 1 (12:43):
The science of treating infectious diseases had advanced to an
almost unthinkable degree during the twentieth century. For much of history,
diseases like pneumonia and tuberculosis had routinely proved fatal. By
the time Green entered the field, the vast majority of
patients seeking treatment for infections could be cured in a
matter of days.
Speaker 10 (13:03):
Now, at last, the hidden enemy could be examined under
the probing such light of science. The hunt was on
for contagious diseases and their causes, wherever they existed.
Speaker 1 (13:17):
Green's patient HW died just eight days after Green started
taking care of him. To the doctor, it looked like
a freak occurrence, not an accident, just deeply confusing.
Speaker 9 (13:31):
It was something nobody had ever seen. Of course, this
was a one and only case. This was case one.
Speaker 1 (13:38):
Case two walked into Bellevue a few weeks later. Once again,
Green noted that the patient was gay and was suffering
from a strange infection in his lungs. Not long after,
Green was making rounds at the hospital when he overheard
a conversation about yet another patient.
Speaker 9 (13:56):
While I was doing my note in this little cubicle,
the other four or five people were discussing this case,
and I was sort of listening peripherally to what was
going on. And then I heard them snap an X
ray into the X ray box, and I looked over
my shoulder at the X ray, and I said, to them,
is that patient gay?
Speaker 1 (14:19):
The other doctors were shocked. How could Green possibly know
such an intimate detail about a patient? He had never met.
Speaker 4 (14:27):
The guy who was presenting.
Speaker 9 (14:28):
He was standing and holding this blue plastic folder with
all the papers of his admission in his hand. He
dropped it on the floor and the guy said to me, how.
Speaker 4 (14:38):
Did you know that? And I said, I don't know.
I don't know how I knew it.
Speaker 9 (14:43):
And then later in the day I said, I know
how I knew it, because that X ray looks like
HW's X ray, the patient number one.
Speaker 1 (14:51):
Within several months, Green says he had encountered about a
dozen patients who, like HW, were afflicted by rare forms
of pneumonia and skin lesions. As you heard Bobby Campbell
say in his interview on The Gay Life, those skin
lesions were capaces sarcoma, a rare form of cancer typically
found in people from sub Saharan Africa and older Mediterranean men.
(15:15):
Some of Green's patients had other, even more unusual symptoms,
including ones associated with diseases typically carried by animals, not people.
Speaker 9 (15:24):
We had typocarcosis, which is a pigeon fungus that caused
the meningitis, you know. We had toxoplasmosis. We had disseminated
microbacterial diseases, which is again a typical.
Speaker 1 (15:37):
Why these rare infections were suddenly popping up with a
textbook medical mystery into many doctors, including Green, The fact
that the first few cases had all presented in gay
men seemed like a really important clue.
Speaker 9 (15:52):
It's a little embarrassing to discuss this because I thought
we were looking at a gay disease. The first three
or four cases that I saw were in people who
were gay, so it wasn't that.
Speaker 4 (16:06):
Unusual for me to jump to that conclusion.
Speaker 1 (16:09):
It was the only clear connection Green could see between
the patients. Soon, his assumption was that anyone suffering from
this new affliction had to be gay, even if they
refused to admit it.
Speaker 9 (16:23):
What happened was on case number four, the guy came
in with numasisters pneumonia, and he also passed away, but
before he did, he absolutely denied being gay. And I
can't tell you how many times I asked the guy.
He must have thought I was a freak or something,
because I kept asking him, are you sure you're not gay?
And after he passed away, I reached out to this
(16:48):
woman who I became friendly with while she was visiting,
and I said, what's a story?
Speaker 4 (16:52):
I mean, was he gay. You know, he's not gay.
Speaker 9 (16:56):
And I said, well, so where did he live? He
said so he was living in a halfway house for
drug addicts.
Speaker 1 (17:03):
Intravenous drug users were known to be at high risk
for any disease that could be spread through blood, like
hepatitis B or C. But when Green went to Harlem
to visit the halfway house, he learned something that seemed
to confirm his original assumption.
Speaker 9 (17:18):
And I talked to people who knew him, and I
started asking him the same question, and everyone said, no,
he wasn't gay.
Speaker 4 (17:27):
But someone said, but he turned gay tricks.
Speaker 1 (17:30):
Green wasn't exactly sure what that meant, and asked the
person to elaborate, and he.
Speaker 9 (17:35):
Said, well, to make money for his habit, he you know,
he would go with men.
Speaker 4 (17:38):
He would go with women, he would you know.
Speaker 9 (17:40):
So, I said, finally I figured it out. It is
something to do with gay sex or whatever.
Speaker 1 (17:47):
Looking back, it's striking how easy it was to conclude
that the new disease was quote unquote gay related. Even
when he was faced with someone with a history of
intravenous drug use, Green remained and convinced that the patient's
sexuality was the key factor. As more cases emerged in
(18:12):
early nineteen eighty one. Green was sure that he was
seeing something totally novel, and without knowing the cause, the
best he could do was try to use existing treatments
for his patient's symptoms. The trouble was the cases he
was seeing sometimes required specialized medications that could be difficult
to obtain. For instance, to treat numicistas pneumonia, Green needed
(18:35):
a drug called pentamidine, but because the demand for pantamidine
was usually incredibly low, it wasn't profitable for drug companies
to market it. Instead, pantamidine was controlled and dispensed by
the Centers for Disease Control in Atlanta, Georgia. The CDC
so yet have to request it.
Speaker 9 (18:54):
They would take a history and if you had the
requisite answers, they would release one patience worth of pentamidine
for a treatment course of two to three weeks.
Speaker 1 (19:05):
The CDC was established in nineteen forty six primarily to
combat malaria.
Speaker 10 (19:11):
CDC is one of the task forces of the Public
Health Service.
Speaker 1 (19:16):
It quickly evolved into an all purpose first response service
for various medical emergencies.
Speaker 10 (19:22):
Ready to help each state in its fife against communicable diseases.
Speaker 1 (19:27):
Anytime there was a major disease outbreak, the CDC was there,
doing the investigative legwork and providing assistance to doctors and
nurses on the ground. As a result, the CDC had
a hand in some of the greatest achievements of the
modern era, including the eradication of polio in the United
States and smallpox all over the world.
Speaker 7 (19:47):
And historic victory over a dread disease. Here scientists usher
in a new medical age with the monumental reports that
proved the vaccine against crippling polio to be a sensational success.
Speaker 1 (19:58):
The CDC had special outposts at major airports where they
distributed medications to the doctors who needed them. That was
where doctor Green would get his pentamidine.
Speaker 4 (20:08):
I would get in.
Speaker 9 (20:09):
My car and drive to JFK and I think there
is a CDC quarantine office and they had the shipment
waiting for me, and I get back on the car,
drive back to Bellevue and hang the drug.
Speaker 4 (20:24):
Soon.
Speaker 1 (20:25):
The trip to JFK Airport was part of Green's regular routine,
but a CDC technician fielding his requests for pentamidine noticed
that Green was not giving a reason for why his
patients had numicistus pneumonia. The technician knew that it usually
only appeared in patients who had compromised immune systems, like
kids with leukemia or people who had received organ transplants.
(20:48):
But Green wasn't indicating anything like that on the forms
he was filling out. So either he was doing something
wrong or there was an inexplicable new outbreak happening, one
that the CDC needed to get on top of immediately,
So the technician alerted her supervisor. Though the details were sketchy,
there appeared to be a growing cluster of numisistus cases
(21:10):
in New York. As it turned out, Green's requests for
pantamidine were not the only troubling signal popping up on
the CDC's radar at this time. By the late spring
of nineteen eighty one, multiple physicians around the country had
started asking the agency for help treating young gay men
with inexplicable symptoms. Among the CDC officials on the receiving
(21:34):
end of these requests was doctor Mary Geinan.
Speaker 11 (21:37):
We started getting phone calls from physicians saying, you know,
I have this young man in the intensive care unit
and he's dying and I don't know what's wrong with him.
Speaker 1 (21:50):
Geynan was a specialist in venereal disease, so when a
written report on some kind of outbreak among gay men
came into the CDC, she was asked to review it.
Speaker 11 (22:01):
Since it wasn't a disease that we knew about, there
was no expert in CDC about it, but all of
these men also had herpes virus infections, so they asked
me to make a comment on it.
Speaker 1 (22:17):
The report would turn out to be a foundational document
in the history of AIDS. He was co authored by
a young doctor in Los Angeles, whom you'll hear more
about later in the series. For now, all you need
to know is that he was seeing numacistus cases at
pretty much the same exact time as Jeffrey Green, and
when Mary Gynan had a chance to review his findings,
(22:39):
she knew the CDC had to get involved. Mary Guynan
(22:59):
studied Comis Street in college, but when she got her
degree in nineteen sixty one, she found that nobody was
willing to hire her.
Speaker 11 (23:07):
After I graduated as a chemist, I was living in
New York and the New York Times Want Dads was
segregated by gender. There was a help wanted male and
a help wanted female, and there was never a job
listing for a chemist in the help Wanted Female. So
I finally found a job at a chewing gum factory.
Speaker 12 (23:31):
What's new in the Magic Land of Chicklets.
Speaker 11 (23:34):
My job was to make new flavors for chewing gum.
Speaker 13 (23:38):
Well great them orange Bradberry.
Speaker 11 (23:42):
I was in a laboratory. I had all these different
flavors and I would mix them and taste them.
Speaker 14 (23:47):
A world of flavor from the Magic Land of Chicklets.
Speaker 1 (23:51):
And eventually Gynan decided to go to medical school, where
she became interested in smallpox and got accepted into a
training program at the CDC. There, she worked on the
agency's medical Detective Squad, the Epidemic Intelligence Service.
Speaker 11 (24:07):
The Epidemic Intelligence Service is a training program for epidemiologists.
The worldwide symbol of a field epidemiologist is the hole
in the soul, evidence that we have worn out our
shoes tracking down vital clues.
Speaker 1 (24:27):
Geynan ended up getting a job in the CDC's Venereal
Disease Control Division. By nineteen eighty one, she was an
expert on genital herpes infection.
Speaker 11 (24:37):
I became doctor Herpes. People call me from all over
the world. I had rock stars calling me from Australia.
They had genital herpes, and I say, I'm sorry, I
can't offer you.
Speaker 1 (24:50):
Anything long distance phone calls from rock stars. Aside, being
doctor herpes wasn't exactly glamorous. Even within the CED, Venereal
disease was considered an unsavory specialty.
Speaker 5 (25:04):
Nice people don't talk about VD.
Speaker 6 (25:06):
Perhaps that's why America is in the middle of the
greatest venereal disease epidemic and its history.
Speaker 11 (25:12):
People said, what's a nice girl like you doing a
thing like that? It was considered to be people who
couldn't get regular jobs took this job.
Speaker 10 (25:22):
Venereal disease is almost as prevalent as the common cold.
One problem in dealing with VD is the reluctance of
many of the infective de seek treatment.
Speaker 11 (25:30):
I worked in a venereal disease clinic one day a week,
and when I would come back, if I saw some
of my colleagues say say to me, oh, my goodness,
did you wash your hands.
Speaker 1 (25:42):
Guidan's time at the CDC coincided with the rise of
a new administration in Washington. Ronald Reagan had run on
a pledge to slash the federal budget, and when he
got into office, he wasted no time delivering on that promise.
Speaker 15 (25:55):
I've already placed a freeze on hiring replacements for those
who retire government service. I've ordered a cut in government travel,
the number of consultants to the government, and the buying
of office equipment and other items.
Speaker 1 (26:09):
At the CDC, everything became more difficult, buying new equipment,
securing additional research funding, and traveling to investigate outbreaks. For
fiscal year nineteen eighty two, the Center for Infectious Diseases
faced overall budget cuts of up to fifty nine percent.
So that was the state of play. When Gaynan read
(26:30):
the report from Los Angeles about a mysterious cluster of
numisistus cases in gay men.
Speaker 11 (26:36):
I read it and it was like incredible. I knew
that something terrible was happening because these are all homosexual men,
and two of them had died, and nobody knew why.
So I sent it up the hierarchy of approval all
the way to the top, and I sent it to
(26:56):
my supervisor, who wrote on the paper.
Speaker 1 (26:59):
Hot stuff guidance. Supervisor was doctor Jim Currn, a senior
researcher in the CDC's Veneurial Diseases Division.
Speaker 14 (27:08):
It was circulated to my disc I would say perhaps
ten days before it was published. On June fifth, nineteen eighty.
Speaker 1 (27:15):
One, Kerran happened to be going to a conference on
sexually transmitted diseases, and he asked some of his fellow
attendees if they'd seen anything like what was being described
in the report.
Speaker 14 (27:25):
We talked to the doctors who were working with people
in the gay community and gay physicians themselves, and they
told us that they too were seeing cases that were
very unusual. And there were some doctors in New York
who were also calling us about this rare cancer kapasci
sarcoma that was being seen in New York.
Speaker 1 (27:45):
One month after the new Massisus report was published, the
CDC followed up with a second one documenting the cases
of capasi sarcoma. The New York Times covered it that
same day on page twenty under the headline rare cancer
in forty one homosexuals. The article cited Kerran in saying
there was no apparent danger to non homosexuals from contagion.
(28:09):
That same week, Kerran traveled to New York for his
first in person meeting with a patient suffering from the
new disease.
Speaker 14 (28:16):
And we went to see one individual patient and as
we talked about our past, we said, you know, we
are exactly the same age.
Speaker 1 (28:27):
The patient was an actor, and as he and Kerran
started chatting, they found they had a lot more in
common than just their age. They were both from Detroit,
and they were both raised Catholic. In fact, they even
went to rival Catholic prep schools. Both had left Michigan
for college, one to Notre Dame, the other to Yale.
(28:47):
And now one was a doctor trying to diagnose the other.
Speaker 14 (28:50):
And then he had these skin lesions on his face.
His question to me, of course a doctor expert from CDC,
will these go away? I be able to get rid
of him so I can continue my acting career. And
of course I'd never seen a patient in my life
with Kappa she sarcoma, so I didn't know.
Speaker 1 (29:10):
Kurran kept tabs on the patient as his condition worsened
over the following months.
Speaker 14 (29:15):
He had went from a tall, handsome actor to having
lost almost half his body weight, all of his hair.
And I will always think how similar our background was
on how he died. This inexplicable death. What made us different.
I guess it was because he was a gay man
(29:37):
and I was straight. That he went to New York
and was exposed in the epicenter of this horrible disease
to something neither one of us knew what at that point,
and he died and I was living there to study it.
Speaker 1 (30:01):
Not long after the CDC published its report on Numisistus pneumonia,
the agency created a centralized task force to investigate the situation.
Jim curn was put in charge.
Speaker 14 (30:12):
So at the time they asked me to share it,
and I was assigned disease detectives from a variety of areas.
Virology because perhaps this was a virus cancer assigned somebody
to us, and we had some laboratory people assigned to us,
and a statistician assigned to us, and we thought it
could well be sexually transmitted, so std people were actually
(30:36):
assigned from my own group.
Speaker 1 (30:38):
Before the task force did anything else, they set out
to confirm that what they were seeing was in fact
a new phenomenon. To that end, they reviewed hospital records
in the eighteen largest cities in the country to see
how many previous cases of pneumaicistus or other rare infections
there had been.
Speaker 14 (30:55):
What we found was virtually there were no cases before
nineteen seventy eight, and there were none outside New York
and California except one case in Atlanta, so we were
reassured that this was new.
Speaker 1 (31:08):
Different people on the task force had different ideas about
what was making people sick, but a central animating question
was why the disease seemed to be disproportionately affecting gay men.
Speaker 14 (31:22):
Some people thought it was related to allogenetic semen, that
if you were exposed to hundreds of different semen, you
could become allergic to it, and that allergy would cause
the reaction to damage your immune system. Some people thought
it was an environmental cause, since many people who have
sex with each other go to the same places, maybe
(31:43):
there was some kind of contaminant.
Speaker 1 (31:45):
The so called environmental theories posited that maybe something about
the environments where gay men congregated was causing them to
get sick. A leading early hypothesis was that the disease
was caused by poppers, the inhalable muscle relaxings that many
gay men were using in clubs to get high and
to make it easier to have anal sex. Mary Guinan
(32:06):
and other members of the CDC task Force thought the
chemicals used to make poppers might be causing some kind
of reaction in people's immune systems, or that maybe a
bad batch had made it onto the street.
Speaker 11 (32:18):
Poppers were available all over the place, so one of
the things that I wanted to do was to see
what they contained.
Speaker 1 (32:27):
Guidan heard she could find poppers at adult bookstores around Manhattan,
so she went to New York in search of samples.
Speaker 11 (32:34):
They would actually have a place to have sex inside
the bookstore, and they sold poppers. It was a bookstore
in Greenwich Village.
Speaker 1 (32:43):
I think Geynan brought the poppers back to CDC headquarters
in Atlanta to be tested, and I brought them in.
Speaker 11 (32:50):
We sent them over to various people within CDC to
see if they were but it was There wasn't any
real connection.
Speaker 1 (33:03):
The poppers theory endured long after it fell out of
favor with scientists. There are a few reasons why. For
one thing, it made it possible to blame the new
disease on a substance specifically associated with gay nightlife and vice,
but also more generally, it held out the promise of
a simple smoking gun. If the illness really was caused
(33:26):
by some kind of environmental factor, and solving the problem
could be as straightforward as isolating it and getting rid
of it. Not surprisingly, the people who made poppers got
pretty defensive about their product. Here's a clip from the
Gay Life radio show in which they interviewed a manufacturer
named W. J.
Speaker 4 (33:45):
Freezer.
Speaker 12 (33:46):
There is absolutely no evidence whatsoever linking alcohol, nitrites or
any other nitrites with Carposi sacoma, the so called gay cancer.
The CDC was asked by the press whether poppers had
been eliminated as a factor. CDC replied, and quite properly,
(34:06):
that nothing has as yet been eliminated. That response has
been blown way out of proportion.
Speaker 1 (34:13):
Well, Jim Curran wanted the answer to be poppers too,
but he and his colleagues at the CDC were fairly
convinced from the start that what they were seeing was
most likely a virus. Their suspicion was that the new
disease might be similar to hepatitis B, which was transmissible
through blood and other bodily fluids, and could be spread
(34:35):
through sex and intravenous drug use. If that was how
the new disease worked too. That would mean it didn't
actually discriminate based on sexuality. Even if it was true
that for now it was spreading mostly among gay men,
it would inevitably cross over into other populations. In July
(34:59):
of nineteen eight, one current CDC task force was preparing
to send teams to New York, Atlanta, Los Angeles, and
San Francisco. The goal was to interview gay men who
were showing symptoms of the new disease and compare them
to a control group. Doctor Gynan was sent to San Francisco,
where she met with her subjects in a cheap hotel
room in the Tenderloin district.
Speaker 11 (35:21):
It was all sorts of questions, first about drug use
and about sexual behavior. And we all had to ask
the same questions, what kinds of sex, what kind of drugs?
How many sex partners have you had in the past year.
And I was just amazed at how cooperative these people were.
(35:42):
They would be counting the number of sex partners they had.
They'd say I had two or three thousand partners in
their lifetime. And so people afterwards said to me, oh,
they were just bragging about Let's see, they were not
They were bragging, they were telling the truth. They were
(36:02):
trying to help.
Speaker 1 (36:04):
After administering the questionnaire, Guynan collected patient samples.
Speaker 11 (36:08):
The patient would sit on the barstool of the kitchenette
and I would take blood from them. And I had
to pack up all the specimens in these boxes with
dry ice in it to keep them cold, and they
had to be there at CDC within twenty four hours.
I then had to get those specimens to the post
(36:30):
office before the post office closed.
Speaker 1 (36:33):
Gyan was working fourteen hour days during her trip to
San Francisco, conducting interviews and drawing blood samples herself. It
didn't always go smoothly.
Speaker 11 (36:43):
This one young man came in who was very tall
and built like a football player, and as I was
putting the needle into his arm, he fainted and fell
on top of me. We both fell on the floor,
and I tried to pull the tourniquet from his arm
because it was bleeding. All the blood was coming out
(37:07):
and I couldn't get it. And I finally pulled the
needle out, and when I pulled it out, I stuck
it into the palm of my left hand.
Speaker 1 (37:19):
Geynan didn't know whether she had just given herself the disease.
Sitting in the hotel room covered in someone else's blood.
She improvised, I.
Speaker 11 (37:30):
Tried to squeeze my palm of my hand to get
any blood in it that might have gone in there.
I was not sure what I was going to do here.
I was in San Francisco with all sorts of needles
on the counter and a man unconscious in my room
with blood all over him and me.
Speaker 1 (37:51):
Finally, the man woke up and apologized.
Speaker 11 (37:54):
He said he always faced at the sight of blood.
So I asked him if he would stay on the
floor while I got the specimens, because I needed to
get those specimens, and I did.
Speaker 1 (38:06):
The incident would haunt Geyan for several years, especially when
she developed a lesion on her arm that looked like
it could be Capasi sarcoma. Her secretary at the time
was so afraid of catching it that she quit. It
was not until nineteen eighty five that a blood test
showed that Guynan had not been infected. When Guyinan and
(38:30):
her colleagues on the CDC Task Force analyzed the data
they had collected, one finding stood out people with diagnosed
cases had had way more sexual partners over the course
of their lives.
Speaker 4 (38:42):
Than the control group.
Speaker 1 (38:44):
The finding seemed to bolster the hypothesis that members of
the task force had held from the beginning that the
new disease was a virus that was transmissible through sex
and could therefore infect anyone, not just gay men. According
to Kerrn, that was the reason the CDC never adopted
the term gay related immune deficiency or GRID, which was
(39:05):
used in much of the early media coverage.
Speaker 10 (39:08):
Doctors have even coined a new word for these conditions, GRIDS,
gay related infectious diseases.
Speaker 1 (39:14):
For the most part, though there was no early media coverage.
Jim Curran again, there was virtually no coverage in the
mainstream media in the first year or so. The people
who did good coverage were people with the New York
Native the gay publications, but there was essentially nothing in
the New York Times or nothing on mainstream TV. Even
(39:36):
the scores of new cases were discovered and the number
of deaths continued to climb, the biggest news outlets in
America barely followed up on the CDC's early reports from
the summer of nineteen eighty one. Then that winter, Kerran
heard from a veteran health reporter at the Wall Street Journal.
He said he wanted to write a long story on
the disease, so Kerran flew to New York to meet
(39:59):
with him.
Speaker 14 (40:00):
I remember having lunch with him at Uncle Ty's Hunan Juan,
and we talked for hours, and he wrote this very
long story in the Wall Street Journal and they wouldn't publish.
So he called me back and he said, they think
this is just a story about gay men, and this
is the first time I've ever had a story turned down.
Speaker 1 (40:19):
Current pushed back, noting that the disease almost certainly didn't
just affect gay men, and I.
Speaker 14 (40:25):
Said, well, there is heterosexual transmission two very likely couldn't
totally prove it, but we're having good examples of it.
So they published a very short article that said heterosexuals
get aids two.
Speaker 1 (40:39):
The Wall Street Journal article was published on February twenty fifth,
nineteen eighty two, under the headline new often fatal illness
and homosexuals turns up in women coma heterosexual males. Over
the course of the coming year, as the article's central
thesis became increasingly evident, more media outlets began to pay attention.
Speaker 5 (41:00):
Federal health officials consider it an epidemic, yet you rarely
hear a thing about it.
Speaker 1 (41:04):
In August, CBS ran its first ever nightly news report
on the epidemic.
Speaker 6 (41:08):
It's a disease first detected in the gay community that
has now spread beyond that, a disease experts are now
calling a national epidemic. There is a one in five
chance a victim will die within the first year of
the illness.
Speaker 1 (41:21):
The report included an interview with Bobby Campbell, conducted seven
months after his appearance on the Gay Life radio show.
Speaker 3 (41:29):
It was devastating, you know, at that time, I was
twenty nine years old.
Speaker 6 (41:32):
For Bobby Campbell, it is a race against time. How
long before he and others who have this disease finally
have answers, finally have the hope of a cure.
Speaker 1 (41:42):
The CBS report noted that while most of the known
cases have been found in gay men, other groups were
starting to get sick too.
Speaker 6 (41:49):
Now It's been detected in Haitian refugees and in some
people with hemophilia, a disease that prevents blood clotting so
the patient needs frequent blood transfusions.
Speaker 1 (42:02):
Soon, these high risk groups were nicknamed the four HS.
Homosexuals heroin users, haitians, and people with hemophilia. All of
a sudden, gay related immune deficiency no longer seemed like
an accurate descriptor. In September of nineteen eighty two, the
CDC gave the disease its permanent name.
Speaker 5 (42:23):
Acquired immune deficiency syndrome. It's mysterious, its deadly, and its
baffling medical science. Once thought to affect only promiscuous homosexual males,
AIDS is now spreading in epidemic proportions to other segments
of the population.
Speaker 1 (42:41):
With that, AIDS was officially not just a gay disease,
at least as far as most doctors and scientists were concerned.
In practice, though, the wider world remained largely indifferent, and
what little public discussion there was of AIDS often continued
to place the blame on gay men.
Speaker 16 (42:59):
Gays are being called all the dangerous and violent group
that corrupts children and infects the community with AIDS.
Speaker 1 (43:15):
It's probably obvious why I wanted to make this podcast,
Living through COVID nineteen. I wanted to know what it
was like the last time American society was transformed by
a deadly virus. I wasn't expecting easy parallels. I just
wanted to know how it felt to live through it,
the early years in particular, and what it had to
tell us about the thing we've all been living through lately.
(43:38):
As you'll hear over the course of our series, there
are certain things all epidemics have in common. The confusion
and fear, the scapegoating and paranoia, the difficulty of addressing
a new existential threat that requires human beings to change
their behavior en Mass. Marcus Conant, a pioneering AIDS doctor
(43:58):
you'll hear more about later, says the echoes between epidemics
are unavoidable.
Speaker 17 (44:03):
It's well documented from the time of the Black Death
in thirteen forty eight. With almost every epidemic, people respond
to the epidemic in exactly the same predictable ways. The
first thing they do is they deny that it's even occurred.
You know, it's not happening, and then they want to
blame someone for having caused it, as if that will
(44:26):
make it not have happened and go away.
Speaker 1 (44:29):
Still, the AIDS crisis was and continues to be a
singular disaster. This is in large part because of who
got sick and died first, but it's also because of
who responded and who didn't. I feel compelled to say
that our series will not offer a comprehensive picture of
everything that went wrong or everyone who was affected. Our
(44:53):
goal is just to be specific, to try to understand
why this particular epidemic unfolded the way it did, and
why has been allowed to kill more than thirty million
people worldwide. For Jeffrey Green, the experience of being a
doctor changed completely once he began treating people with AIDS.
(45:17):
He had gone into medicine and specialized an infectious disease
because you wanted to cure people. Now, somehow, just a
few years into his career, his job was to tell
young patients there was really nothing he could do.
Speaker 9 (45:31):
And I began talking to some of the oncologists at
the hospital.
Speaker 4 (45:34):
I said, how do you guys do this?
Speaker 9 (45:36):
I mean, patients dying, you know, in seven months, eight months,
a year, two years. I'd give him, you know, and
then I feel like I've succeeded with two years' survival.
And they said, well, you just add up all the
years that you've kept people alive, and that's the way
you have to think about it. And they pulled me back.
(45:57):
My colleagues pulled me back.
Speaker 1 (46:00):
Green still has dreams about some of the people with
AIDS he has treated over the years. In one of
those dreams, he's running from one waiting room to another,
all of them filled with dying men.
Speaker 9 (46:12):
So recurring nightmare that I have is running in an
office that has fifteen different rooms and not being able
to keep up, and I'm running from room to room,
and I feel that type of in the dream, that
panic attack reoccurring.
Speaker 1 (46:28):
Green is haunted by another image too. As part of
his work treating people with AIDS, he started doing what
his family doctor had done all those years ago. He
made house calls. To this day, Green thinks about something
he saw while visiting a patient in a brownstone in Manhattan.
Speaker 9 (46:47):
And I went to see him because he was dying
and he was too weak to come to the office.
And he had set up a cot like a hospital bed,
I guess, in the middle of his aviary, which was
his living room. And there were these exotic birds that
you know, very large Brazilian colorful cockatoos and other kinds
(47:10):
of fancy birds.
Speaker 4 (47:13):
And when I walked in the door, his partner lit
me in.
Speaker 9 (47:17):
What I saw was a skeleton on the bed on
his back, looking at the ceiling. There was a white,
gorgeous bird, maybe a foot tall, on his chest, and
it looked like.
Speaker 4 (47:32):
A bird of prey.
Speaker 9 (47:35):
Or a scavenger bird that was gonna wait till he
died to eat him. It was I'd wake up at
night once or twice a month with that image in
my head.
Speaker 13 (47:46):
Still they fall around, they are fall and round, they
(48:16):
are fallund me the strong GUYSI.
Speaker 12 (48:26):
Masie.
Speaker 1 (48:30):
On the next episode of Fiasco, the revolutionary first stirrings
of AIDS activism in New York City.
Speaker 8 (48:36):
People who were sick were organizing and taking care of
each other. We really weren't even looking that much to
the healthcare establishment because they didn't want to deal with us.
It was a whole different kind of of activism.
Speaker 1 (48:50):
Fiasco is presented by Audible Originals and Prologue Projects. The
show is produced by Andrew Parsons, Sam Graham Felsen, Madeline
kaplan Ula Coppa, and me Leon Nafock. Editorial support by
Nola Wawas and Jessica Miller. Our researcher is Francis Carr.
Archival research by Michelle Sullivan. This season's music is composed
(49:12):
by Edith Mudge additional music by Nick Sylvester of God Mode,
Joel Saint, Julian and Dan English, Noah Hect and Joe Valley.
Our theme song is by Spatial Relations Music Licensing courtesy
of Anthony Roman. Our credits song this week is They
Are Falling All Around Me by Bernice Johnson Reagan from
(49:33):
the recording Give Your Hands The Struggle courtesy of Smithsonian
Folkways Recordings. Additional thanks to tro Essex Music Group. Audio
mix by Erica Wong, with additional support from Selina Urabe.
Our artwork is designed by Teddy Blanks at Chips and Y.
David Blum is the editor in chief of Audible Originals.
(49:56):
Mike Charzik is the vice president of Audible Studios. Zac
ro Us is head of acquisition and Development for Audible.
Thanks to Archive dot Org, Annabel Bacon, Carrie Baker, Brandon Ellis,
Alice Gregory, Chris Horton, Stephen Fisher, Ben Frisch, Akiva Gottlieb,
Andrew Jacobs, Giannis Kulpa, Stephen Phillips, Horst, Willi Paskin, Lisa Pollock,
(50:18):
Bill Rutland, Aichris Gondaraja, and Sasha Weiss. Special thanks to
Randy Alfred and Peter Yassi. Next week, episode two.
Speaker 13 (50:27):
Say Masson.
Speaker 1 (50:32):
V sure to let me
Speaker 12 (50:37):
From
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Therapy Gecko
An unlicensed lizard psychologist travels the universe talking to strangers about absolutely nothing. TO CALL THE GECKO: follow me on https://www.twitch.tv/lyleforever to get a notification for when I am taking calls. I am usually live Mondays, Wednesdays, and Fridays but lately a lot of other times too. I am a gecko.