Patient Zero: Hero or Criminal
NOTE: The article below was originally written by Guy Babineau and published in Vancouver's Xtra West in December 2004. It was first re-published in November 2007 and again on 26 April 2011 to coincide with the discussion "Patient Zero, Gaétan Dugas: Hero or Criminal" at Ryerson University, Toronto, by Richard McKay (King's College, London).
Interview with Richard McKay about Gaétan Dugas by Matt Mills (Xtra), April 2011.
The cherry trees were Bob Tivey's idea. In the late autumn of 1985 Tivey, the first executive director of AIDS Vancouver, and a few others planted three cherry trees at a memorial service for three gay men from Vancouver who were among the first to die of AIDS. Volunteers got busy with shovels and began digging holes, one hole for each tree, one tree for each man: Cedar Debley, Ray Scott and Gaëtan Dugas.
This was long before Dugas would become the subject of lurid front-page headlines and indignant condemnation on talk shows across North America for being Patient Zero — the Plague Rat of AIDS — as he was cast in the 1987 melodramatic bestseller And The Band Played On: People, Politics and the AIDS Epidemic, written by San Francisco Chronicle reporter Randy Shilts. There were no television cameras at the planting, no reporters nor bible thumpers. No one came to blame. Yet even the fresh Pacific breeze could not mask an ever so subtle stench of blame in the air, like the scent of blood leading to a kill.
"At first we were given permission from the City to plant them in Stanley Park," Tivey says over the phone from Toronto, where he now lives. "But then someone got the idea that if we did it then everyone would want to do it, and there were expressions of concern about what it would do to the park's ecology. So they changed their minds and gave us an alternate location. One that's not protected from the elements. And it isn't really an ideal place for cherry trees."
It was late morning. The small group of people huddled together beneath the pelting rain near the shoreline on an exposed patch of land wedged between Stanley Park and the posh Bayshore Inn hotel. They were oblivious to the dull roar of nearby traffic along West Georgia. Behind them, the high-rise apartments of downtown's West End held a silent vigil. Past the Coal Harbour marina, beyond the jagged tree line of the park's towering firs, thick clouds brooded above the North Shore mountains. Although a chill wind blew from off the water, those present were warmed by thoughts of remembrance as they prepared to bid farewell to their friends.
The trees' branches were bare but come early spring they would burst with blossoms, signalling the advent of new life. Starting in late February, they would begin to bloom above the crocuses and daffodils, fluttering down to form sensual drifts of pink and white petals, defying the grey concrete of Vancouver's rainy streets. It's funny, though, how you can appreciate something as familiar as cherry blossoms without realizing that beyond the surface appeal there is a lot going on that doesn't meet the eye as nature prepares for the deliverance of shocking red fruit.
For centuries cherry trees, particularly the blossoms, have held deep significance and a variety of meanings for different nations. In Japan, they have long been a symbol of self-sacrifice and spirituality. In America, the cherry tree has been a symbol of deception versus the truth. We all know the story about George Washington not being able to tell a lie after he chopped down a you-know-what. But when Japan gave the US a gift of several cherry trees early in the 20th century, the American administration of the time burned them in a public bonfire, a display of the government's desire to prevent foreign pests from infesting American plants. This incident is apparently central to the biotic history of North America and the ongoing attempt to contain and control natural biological elements that might alter indigenous flora and fauna. But nature rarely respects manmade obstacles. It always seems to find a point of entry — or departure — through the borders of geography and skin via wind, water and the ways of men.
Whatever significance cherry blossoms may have held for the group gathered on that wet Vancouver day 22 years ago, the trees seemed a suitable way to honour their friends, who had died amidst a circus of conflicting and contradictory theories about AIDS. They died afraid. They died not knowing why. AIDS had appeared in a sparkling new PC, VCR and Walkman world filling up with new ways to be entertained or distracted, the perfect petri dish for incubating a culture in which moral assumption can be presented as fact.
Just a few weeks before this memorial service took place, on November 2, 1985, actor Rock Hudson had died of AIDS and the world finally started to pay attention to the disease, even though gay people had been contending with it for years. This was partly because he was a famous He-man movie star who'd made a TV comeback guest starring on the prime-time soap opera Dynasty, partly because he was a Republican and a pal of President Ronald Reagan's. Although for years he had successfully hidden his very active sex life with other men — which continued unabated and 'unprotected' while he was ill — Hudson's public persona as a heterosexual leading man made him the first posthumous poster boy for AIDS.
Fame is immune to fidelity. Just as Ann Baxter stole glory from Bette Davis in the 1950 movie All About Eve, there was someone younger and prettier waiting in the wings, an A-list homosexual whose B-movie walk-on would wipe Rock Hudson off the map, a person who would become the "IT Girl" of AIDS.
As the last soil was patted down over their roots, Tivey hoped that one day people would admire the cherry trees and remember Cedar Debley, Ray Scott and Gaëtan Dugas with respect. Little did he know.
Anyone who has read And The Band Played On will recognize this as one of many humdingers used to qualify the character of Gaëtan Dugas, the gorgeous French-Canadian flight attendant who hopped cities as easily as he hopped beds. Dugas hops off the page too, no small feat in Shilts' breathtakingly researched but problematic opus chronicling events during the first few years of AIDS. When it first hit bookstores, it flew off the shelves. Everyone wanted to read about the Patient Zero guy.
"The Appalling Saga of Patient Zero" shrieked Time magazine. "Patient Zero: The Man Who Brought AIDS to California" screamed the cover of California magazine, with an illustration of a blurry flight attendant coming off a plane. "The Man Who Gave Us AIDS" shouted the New York Post. "The Monster Who Gave Us AIDS" caterwauled that Star tabloid. "The Columbus of AIDS" yelled the National Review. The Vancouver Sun bleated, "Book traces AIDS to Montreal airline steward." (Not once in the book does it say he lived in Montreal. He was from Quebec City and lived in Dartmouth, Toronto, San Francisco and Vancouver.)
The term Patient Zero refers to the 'hub' of an epidemiological study conducted very early on in the epidemic by the Centers for Disease Control (CDC) in Atlanta, Georgia. The study traced the sexual contacts of one group of gay men with AIDS who had had sex with each other before anyone knew that AIDS was caused by a virus, or realized that it had already been with us for at least a decade, if not decades. Randy Shilts claimed that the study had been leaked to him by an unnamed source. The sections that refer to Dugas comprise a grand total of about 10 pages in a 630-page book.
Shilts was an ambitious reporter, the first out gay man to write about gay issues for a large circulation mainstream newspaper, and the first person to cover AIDS. He was also the author of a well-received book, The Mayor of Castro Street, which was about the gay San Francisco politician Harvey Milk who was murdered by a fellow city councillor at City Hall.
Before his death from AIDS in 1994, Shilts would complete a book condemning the treatment of gays in the US military, Conduct Unbecoming. As with his AIDS epic, it would garner a mixture of extreme praise and extreme scorn common to the careers of successful journalists. In And The Band Played On, Shilts' purpose was allegedly to expose the internecine government turf wars (which he did), egos within the medical establishment (which he did) and bitchiness and paranoia among gay men (which he overdid) that blocked timely AIDS funding, research, education and treatment. Much of the book is important historically, although it is disconcerting to still see And The Band Played On praised as the seminal or definitive book about AIDS — nearly two decades after it was published!
Though it's long been discredited by medical authorities, the Patient Zero myth persists today. Dugas continues to be called a monster, serial killer or psycho in literature published by a range of "family values" and anti-gay "Christian" groups. Much of the mainstream media still refers to his incarnation as Patient Zero. His name crops up as the subject of questions in university exams and his dubious reputation is perpetuated in classrooms around the world where And The Band Played On is mandatory reading.
Shilts' engaging, made-for-TV-movie docudrama format caused people to interpret the book as a soap opera. His stunningly researched examination of government corruption, professional narcissism and gay politics got sidetracked. The media picked up on the parts concerning Dugas, whom Shilts unleashed as the proverbial evil beauty who will stop at nothing to get what he/she wants: Joan Collins sporting Kaposi's Sarcoma (KS) lesions instead of padded shoulders.
The book periodically turns into Touched By A Fallen Angel. How could anyone who looks so good and seem so nice be so bad? Because he's the spawn of Satan, that's how. In between devouring hunks of raw liver, Dugas looks around a bar and announces jokingly to friends that "I am the prettiest one." Shilts really likes this line. He uses it several times. It even shows up during interior monologues inside Dugas' head during questionably fictionalized scenes ostensibly set up to convey his self-delusion that, despite his advancing illness, he is still the prettiest one. (Shilts also implants numerous spiritual "visions" into the minds of dying PWAs. It is a good idea to read parts of the book with a bottle of antacid tablets handy.)
Shilts seems obsessed with good-looking men. With few exceptions the gay men described physically in the book are good-looking. The plainer Janes are faceless. As for Dugas' comment, it should not be taken at face value. What attractive young gay man — or anyone young and good-looking of any gender or sexual preference — hasn't at some point cockily thought him/herself to be the hottest tomato on the dance floor? Whom among us hasn't heard a friend or two mention slim pickings at the club or party with the casual toss-away line, "I was the best-looking/youngest/cutest/hottest/prettiest one there." Rarely are these kinds of comments intended to be taken seriously, yet, as in the case of the fish that keeps getting bigger as the story is retold, casual comments can often be twisted to suit someone else's purpose.
It's bad enough that Shilts presumes to speak on behalf of every gay man, but take a look at what he's saying. Dugas is what "every" man wants: in other words, to have sex whenever he feels like it. Dugas doesn't die of AIDS, he dies becoming what every man feared. Homosexual desire — sex — causes a man to turn into something fearful. Homosexuality doesn't just lead to illness; it becomes illness.
The press ate it up.
In Shilts's version of events, in the early '80s there was no real gay life outside of a limited coterie of generally well-heeled, mostly white professional men in either New York or San Francisco, whose world is set up as a stage for a battle between good and evil. Individuals and groups that clamour for gay men to stop doing the nasty and to close all the bathhouses, and gay men who fit nicely into the mainstream's status quo, are portrayed as level headed and given plenty of air time. We get occasional glimpses of most others — leftists, drag queens, party boys, intellectuals, artists, so-called activists, other gay journalists — as infantilized flakes who put sex first and safety last. They enter and exit buzzing ominously like mosquitoes at a picnic.
Even though Shilts writes that Dugas was popular, a loyal friend and had a loving family — Catholic, no less — to whom he returned just before his death, these facts were overshadowed by attention-grabbing grand guignol like this:
It was around this time [June 1982] that rumors began on Castro Street about a strange guy at the Eighth and Howard bathhouse, a blond with a French accent. He would have sex with you, turn up the lights in the cubicle, and point out his Kaposi's Sarcoma lesions.
"I've got gay cancer," he'd say. "I'm going to die and so are you."
The sub-chapter ends abruptly. What happened next? Did Dugas yell "Ooga-booga!" and bite off the head of a chicken while his eyes rolled round to the back of his head? Notice that Shilts tells us we're hearing rumours and that no name is identified as the source for the story. Similar short scenes crop up a couple of times elsewhere in the book. Early on in the book, another bathhouse vignette transpires in which Gaëtan looks at his KS lesions and says, "Gay cancer. Maybe you'll get it too." Shilts wasn't there. The partner is not named.
No matter how you slice it, all that these moments amount to is speculation or innuendo based on hearsay supported by a brief apologia at the back of And The Band Played On in which Shilts claims that nothing in the book has been fictionalized. Then he explains that for the sake of narrative flow he has reconstructed scenes, recounted conversations and attributed observations to people in what seems to have been a rather imaginative process.
A number of individuals and organizations in both San Francisco and Vancouver were contacted for this article but no one was able to confirm the Patient Zero bathhouse story. Yet it continues to be rehashed, reiterated and reinterpreted all over the place. For example, in the Pro-life Encyclopedia, a cheerless document published by the American Life League, an anti-abortion group who claim to be serving God. One chapter dedicated to the immorality of homosexuals misinterprets the Dugas story to drive home the point: "According to homosexual Randy Shilts in his book And the Band Played On, the person responsible for bringing the AIDS virus to the United States was the French-Canadian airline steward Gaëtan Dugas."
On page 429 of And The Band Played On, Shilts wrote, "Whether Dugas actually was the person who brought AIDS to North America is ultimately unanswerable." When he was cornered during the book's publicity campaign Shilts emphatically insisted that it was absurd to think one man was responsible for AIDS. He also stated quite clearly during interviews that he drew his own conclusion that Dugas was Patient Zero.
Still, the Pro-Life Encyclopedia continues with: "It is estimated that he had sex with at least three thousand men and his sexual activity did not slow down a bit after he was diagnosed with the AIDS virus in 1980."
They have generously provided Gaëtan with 500 extra sex partners. And The Band Played On alleges that Dugas may have had as many as 2,500 sex partners. Dugas was never diagnosed with an AIDS virus. He died before the HIV was announced.
Many people have heard some variation of the following: After a one-night stand with a woman he just met, a man wakes up the next morning to find the words Welcome to the world of AIDS scrawled in lipstick on his bathroom mirror. The woman has sworn to pass it on to every man she can seduce as payback for getting AIDS from an ex-lover.
This 'AIDS Mary' urban legend, an apocryphal story that has been making the rounds for years and reinforces the insupportable notion that AIDS is caused by bad people who practice bad behaviour, has been traced by folklorists back to 1987, the year And The Band Played On was published.
Gaëtan is an unusual name in the United States, not a name you'd easily forget in a sea of Steves, Davids and Michaels. In our Sex and The City world it's not uncommon to discover that a friend or acquaintance has slept with someone you've slept with who has slept with someone else you know knows. Sometimes, just for the heck of it, people will sit down with their friends and try to connect the dots. Of course, some of the dots will be missing — names that can't be remembered — and some of the dots will have shuffled around and moved on, so the ultimate outcome is an inaccurate picture. It would take painfully meticulous cross-referencing with input from other people to provide a map of seductions anywhere close to the truth. What, though, if someone's reputation depended on it? Or life? The promiscuity of men is nothing compared to the promiscuity of statistics.
Epidemiologists know that. They study the migratory patterns of a disease from one given point to see where it has gone or is going, how it got or gets there, and ultimately how to stop it from continuing on its travels. Their purpose is not to find out whom to blame. Epidemiological studies are not released to the public without official sanction and without the appropriate checks and balances having been done because sometimes, even at the last moment, they can turn out to be a wild goose chases. Even when a study is released, no names are attached because throughout history societies have stigmatized people afflicted with life-threatening illness. Too often, disease is so closely associated with who has it that in the eyes of society, the person is the disease; "he had become what every man feared."
Dugas did cooperate along with many others on a CDC study, that much is certain. On several occasions The CDC paid for his airline tickets and hotel rooms. It is possible Dugas could have been Patient Zero but we'll never know. Even if he was, Patient Zero does not mean what some people think it means. A chart was drawn to connect the dots of men who'd had sex with one another, starting in California. The "hub" dot was someone labelled Patient O, as in the letter "O" from "Out of California." At some point O became Zero, for the sake of convenience. It is not a variation on ground zero nor does it mean zero as an indicator of the first case. The term Patient Zero is completely arbitrary. Zero means nothing.
"The CDC would never under any condition release the name of Patient Zero or anyone participating in a study," Jim Curran says by phone from Atlanta. Curran was in charge of the CDC's HIV/AIDS division in the first years of the epidemic and appears prominently throughout And The Band Played On. Today he is the Dean of Health Sciences at Emory University in Atlanta.
"The idea that one man could cross a border and spread AIDS is stupid," says Curran. "That's just the general xenophobia of nations. Gaëtan said he didn't believe that what he had was transmitted through sex. He was in denial."
Twenty-three years after the death of Gaëtan Dugas we still can't explain the genesis of HIV. How then can we rely on an inconclusive, unofficial study done in the early '80s to condemn one man - any man - for spreading AIDS here or anywhere else? What purpose does that serve? And whose?
Did Shilts consider the ramifications of his portrayal of Dugas? He had an HIV test while he was working on the manuscript of And The Band Played On, instructing his doctor not to reveal the results until he had finished. Like many gay men who came out in the '70s, he would have had reason for concern. Subconsciously, the fear, anger and worry would doubtless colour one's attitude. Shilts did not disclose that he was HIV-positive while publicizing the book. He thought it would have a prohibitive affect on media attention. And he was probably right.
"Don't blame Randy. Blame me," says Michael Denneny over the phone from his New York office. Denneny is the editor at St Martin's Press who worked with Shilts on And The Band Played On. Around the time the advance publicity for the book went out to the media, Newsweek ran a story on AIDS. Consequently, the major papers told the publisher that they would not be covering And The Band Played On. That AIDS had been "done."
Denneny asked a crackerjack publicist who used to work for St. Martin's Press to read the book and see if he could a find a hook that would grab the media's attention. The publicist came back with one idea: focus the PR material on Gaëtan Dugas and the Patient Zero story.
"It's the worst kind of yellow journalism. I admit I got my hands dirty," says Denneny, today. "Randy was horrified. He didn't want to do it but I pointed out to him that if we didn't no one would read the book and we'd sell 5,000 copies that would end up collecting dust on the shelves."
Grudgingly, Shilts made his Sophie's Choice.
Dugas' two closest friends, both Air Canada flight attendants, were horrified. So was Bob Tivey. He could not believe his eyes when he watched the television coverage: "Gaëtan Dugas is named as Patient Zero in the North American AIDS epidemic." "Promiscuous French-Canadian flight attendant responsible for the rapid spread of AIDS in the US."
"They weren't talking about the man I knew," Tivey tells me. He had agreed to talk with Shilts when the reporter made a trip to Vancouver while he was researching the book: on the condition that Shilts would not use Dugas' name. Tivey did not mention anything about Dugas' sexual habits. At the time, Tivey suspected that Shilts had broken confidentiality to cash in and sell more books. "I had a battle with Randy on Good Morning America. I was very upset."
Tivey had known the very young and very pretty Dugas in the early 1970s in Toronto where they would frequently run into each other at a Yonge Street bar called The Quest. Dugas stood at about five feet, seven inches, had a good body, green eyes, sandy blond hair and, according to Tivey, wonderful skin. Years later, they reconnected in Vancouver where Dugas lived for the last two years of his life. Dugas had been a hairdresser in Toronto but now he was a flight attendant. He had matured into a handsome man. But he was self-conscious about a KS lesion on his cheek and didn't like to be photographed.
"He was a very bright guy," recalls Tivey. "When he set his mind on something he'd find out all about it, as he did with this illness. And he was very witty. He was interesting because he'd travelled everywhere. He had a camp sense of humour. He was into fashion and dressed well. He was one of the party boys and I guess he didn't want the party to end. We were all having lots of sex in those days. No one thought twice about it. If you can imagine getting a mysterious disease that no one knows where it comes from or how you get it and then people are starting to say that you are the cause of it. . . . He wasn't a bad person. He was not an 'evil sociopath.' . . . I remember one night when I was visiting his apartment. He passed me a glass of red wine and I had a chill. I could sense that this was the beginning of something."
Terry Goodwin's on the phone from Nova Scotia. Gaëtan "was just one of the boys in the office, no different from anyone else," he says. Goodwin was a receptionist in one of Dugas' doctors' offices, a doctor who was taking on many of the new AIDS cases in Vancouver. "Gaëtan was just another pawn in the war. Everyone was promiscuous those days. He seemed nice enough to me."
Then there's Gerald Obre, an ex-Torontonian who speaks to me by phone from his Vancouver apartment. "If he was a horrible person I certainly never saw that side of him," he says. Obre used to hang out with Dugas in the Toronto club scene in the early '80s, before Dugas moved to Vancouver. "We'd chat and dance: he loved to dance. Everyone knew him but I never heard anyone ever say anything bad about him. I thought he was a nice guy. They made him a scapegoat."
A nice guy he may have been, but Tivey was aware that there was mounting antipathy toward Dugas as his conditioned worsened. "We walked into a bar one evening and everyone moved to the other side of the room. I thought the place would tip over."
Dugas didn't bring AIDS to Vancouver. The first death occurred in 1981. But people here were growing frightened as gay men returning from trips to New York and San Francisco brought back one horror story after another. In 1983, eager to get a jumpstart on what looked like an impending epidemic, the first community meeting of what would become AIDS Vancouver (AV) was held, and it was packed. Dugas showed up at the microphone, commandeering the meeting with one specific question after another. It would later be written in the press that Dugas caused "a scene" but that seems to be an exaggeration.
Vancouver City Councillor Gordon Price was there. "All I could see was his back, and he was wearing leather. He had a lot of questions. And opinions. He seemed upset that people were saying that he had caused it [AIDS]."
"The minutes from one of the early AIDS Vancouver meetings, maybe that first one, I'm not sure, included something like, 'What will we do about GD?'" Doug Elliott says over the phone from Toronto. Elliott is a legal advisor to the Canadian AIDS Society and represented the organization at the Krever Commission of Inquiry on the Blood System in Canada. A story about The Plague at 20 by the Globe and Mail's health reporter Andre Picard in the Jun 30, 2001 edition of the newspaper said that Dugas had been driven out of Vancouver. Picard was unable to provide a source for this 'fact' and passed the ball to Doug Elliott.
"It was probably a case of exaggeration," says Elliott. "It's understandable. People were concerned about [Dugas'] behaviour. His doctor was concerned. There was a 'neighbourhood watch' to keep an eye out for him at the bars and if he was out of sorts or, you know, in his cups, someone would take him by the arm and talk to him. He was all over the map but people wanted to respect his privacy. He wasn't driven out of town that I know of."
Price recalls the tenor of the times in Vancouver. "We didn't have the hysteria that occurred other places. We're a pretty tolerant community. I mean, look at where we live."
The real criminal in the case of Patient Zero is not Gaëtan Dugas but the spread of half-truths as fact. Blaming Randy Shilts doesn't serve a purpose, either. Writers aren't God. We are fallible and we are not always aware when our own demons leap onto the page, invisible to us but crystal clear to others.
After his death, Michael Bronski wrote: "The fault here lies not so much with Randy Shilts, but with the context and parameters set up from the mainstream press and media about what is acceptable. . . . The far more pressing question is how long will it be before lesbian and gay writers will be able to write truthfully from the heart and the head about their lives and be taken seriously both by themselves and the heterosexual world."
In a world where 8,200 people die each day from AIDS, in which almost 40 million people are living with HIV/AIDS — 90 percent heterosexual, 10 percent homosexual — we can't sacrifice consideration for the lives of others for the sake of ideologies, whatever they may be.
Prowling monsters don't spread AIDS. Ignorance does, and poverty.
On his last visit to Vancouver a few months ago Bob Tivey was glad to see that the cherry trees are still there. They're struggling, untended and generally unnoticed, but they have defiantly stood their ground. They have endured. Tivey thinks it might be time to give them a plaque.
Gaëtan Dugas died on Mar 30, 1984 of kidney failure exacerbated but not caused by AIDS. The Vancouver Sun said that he was 28 but he was really 31.
Robert Louis Stevenson once wrote, "So long as we are loved by others we are indispensable; and no man is useless while he has a friend." Many mean things have been said about Gaëtan Dugas over the years but they are deafened by the one true way we can measure the worth of a man; that he had a friend.
Bob Tivey says he liked Gaëtan Dugas and proved it with a cherry tree. I don't think he's telling a lie.
NOVEMBER 2007 - EDITOR'S NOTE: A University of Arizona evolutionary biologist announced 29 October 2007 that genetic studies prove that AIDS came to the United States in about 1969 via Haiti, and before that, Africa. Other studies suggest it was introduced to human populations in central Africa about 1930, likely when people slaughtered chimpanzees for meat. The announcement finally dispenses with previous attempts to scapegoat Canadian flight attendant Gaëtan Dugas for spreading the virus throughout North America. Dugas died wrongly believing he had killed thousands.