And the Band Played On

  Dr. Selma Dritz at the San Francisco Public Health Department’s Bureau of Communicable Disease Control promptly reported the Kaposi’s sarcoma diagnosis of Gary Walsh to the Centers for Disease Control, where it was included among the new reported diagnoses released on Wednesday morning, February 2. It was the week that the number of AIDS cases in the United States exceeded 1,000. By this time, the nineteen-month-old epidemic had stricken 1,025 nationally, including 501 in New York State and 221 in California. At least 394 Americans were now dead from the syndrome. Nearly one in four cases had been reported to federal officials over the past two months alone; more than 100 had died in the past eight weeks. Since December, two more foreign countries had reported their first AIDS cases, putting the epidemic officially in sixteen nations worldwide.

  24

  DENIAL

  February 7, 1983

  CAPITOL, WASHINGTON, D.C.

  Mary Kraus Whitesell smiled as she stepped carefully into the office of Congressman Phil Burton on that blustering February morning. She was so proud of her son Billy she could burst. Of course, Bill had always shown an interest in politics. That could be laid to his father, Mike Kraus; Bill was so much like Mike in every way, right down to his infernal stubbornness.

  Even though Bill had earned top grades and was named a National Merit Scholar in his senior year at Cincinnati’s St. Xavier High School, Mary knew he had been an unhappy child. When both sons separately moved to San Francisco and announced that they were gay, Mary wondered whether they could truly be happy in this life-style that she didn’t know much about. Mary hadn’t told many of her friends in Cincinnati that her sons were gay; they wouldn’t understand.

  More recently, Mary, who had remarried, had been reading about AIDS. It made her vaguely worried, so she paid sharp attention to anything that appeared in the papers or the Cincinnati television newscasts. Bill said he was in Washington now to get more money for AIDS research. Mary noticed, however, that Bill avoided telling her much about the disease itself and what it might be doing in San Francisco.

  Bill Kraus beamed when Congressman Burton hunkered through the waiting room and insisted that Mary come into his own spacious office. Burton was considered a political tiger on Capitol Hill; Bill couldn’t believe he could turn into such a teddy bear for his mom.

  “I want you to know how helpful Bill has been to me—I don’t know what I’d do without him,” Burton said, smiling.

  Mary could tell from the way Bill talked about the congressman that Burton had become something of a father figure to her younger son.

  Bill took Mary and her husband Ernie to the Capitol dining room for lunch. Mary still couldn’t get over how proud and excited she was for Bill, who had grown so handsome and self-assured over the past few years. After so much unhappiness, he finally had made it.

  Bill Kraus hadn’t realized what a mess AIDS lobbying was in until he assembled the Capitol’s half-dozen or so openly gay congressional aides with the leaders of the two national gay groups for a meeting on this snowy Monday morning. Most of the work on behalf of AIDS funding came from three people: Bill Kraus in Burton’s office; Michael Housh, another Milk Club activist who worked in the office of San Francisco’s second congressional representative, Barbara Boxer; and Tim Westmoreland in his pivotal role as the Health Subcommittee’s counsel. The seven-year-old Gay Rights National Lobby, or GRNL, had not grasped the severity of the epidemic as a congressional issue, so the gay community’s one full-time lobbyist on the Hill, Steve Endean, had spent 1982 and early 1983 pursuing the agenda he had for years, signing up sponsors for a federal gay rights bill. GRNL had achieved success in enlisting seventy-one co-sponsors for the legislation, but both Bill Kraus and Tim Westmoreland knew the measure would not pass Congress for years, perhaps decades, and that more short-term efforts were needed for AIDS funding. GRNL, however, wasn’t interested.

  The nation’s second national gay group, the National Gay Task Force, or NGTF, had divided up Capitol responsibilities with GRNL by announcing it would handle the gay community’s relations with the executive branch of the government. Bill Kraus was at a loss as to what that meant at a time when the executive branch was aligned with raving anti-gay fundamentalists, but agendas were slow to change in a community that had long viewed civil rights as its priority issue. Bill assembled congressional aides from Los Angeles, San Francisco, and New York for the first such meeting of gay aides ever held in the Capitol. This fact alone worried Bill, who was convinced that East Coast closet cases would be the death of the gay movement.

  Bill had amassed the depressing statistics on AIDS funding and presented them to the group. The president’s new budget called for a 7 percent real decrease in money for the CDC, once inflation was factored in. Under the current budget for the fiscal year ending in September 1984, the entire National Institutes of Health had proposed spending only $9.4 million on AIDS, or about two-tenths of one percent of the agency’s budget.

  Even more aggravating to Bill Kraus was the delay in National Cancer Institute grants, the money that researchers had been waiting for since September 1981. Privately, NIH officials had told Bill that the proposals were not up to normal standards. They were not “focused,” Bill kept hearing. So far, the National Cancer Institute had released only $340,000 in funds to applicants for the extramural grants. Scientists, meanwhile, told Bill that the low approval scores on unapproved grants was merely another example of National Institutes of Health dillydallying on the AIDS epidemic. How can you “focus” a grant application concerning a disease that has been known to exist for only twenty months? Any attempt to get such a focus would be highly artificial, given the fact that nobody knew even what caused the disease, much less how to focus research against it. The NIH was applying its ordinary standards to an extraordinary situation, they said. A lot of research would have to be shooting in the dark. To all this, NIH officials would wink that AIDS research involved a bunch of amateurs—hardly any of them were over thirty-five years old—and you couldn’t expect the federal government to throw money at a problem. Not in these days.

  To make matters worse, Bill Kraus had heard rumors circulating among AIDS researchers nationally about internecine warfare at the NIH. The always-simmering rivalry between the National Cancer Institute and the National Institute for Allergy arid Infectious Diseases had apparently exploded over AIDS. Now that AIDS was established as an infectious disease, NIAID wanted more of the action; the NCI argued that it had been working on the disease first, back when NIAID was ignoring it. Neither agency was talking much to the other, hampering anything like a concerted NIH assault on AIDS.

  “We’ve got to get to work on this,” moaned Bill. “Doesn’t anybody up here care?”

  Bill Kraus wanted to start making noise, hold angry press briefings, and begin militating for more funds. Tim Westmoreland was impressed with Bill’s street-politician smarts but considered his approach to Congress “blunt-instrument politics,” as he later confided. You just don’t walk into the U.S. House of Representatives, start screaming, and hope to prevail because you are right. Moral indignation did not win House appropriations. These things took maneuvering, said Tim Westmoreland, the consummate congressional insider. And they took time. Bill was relieved when the meeting was over. God, how he hated to be diplomatic, he told Michael Housh, especially with those fools who didn’t see AIDS as the top item of the gay agenda. What good were gay rights if they were all dead?

  The next day, officials of the National Institute for Allergy and Infectious Diseases took Bill Kraus and other gay leaders on a three-hour tour and briefing on NIAID’s efforts against AIDS. With elaborate pie charts and complex scientific language, an eight-page memo showed that NIAID already had “propelled” a “large effort” against the epidemic. The memorandum used many of the bloated numbers about tens of millions of dollars in immune system research floated to Tim Westmoreland the month before. Now, however, the NIAID portfolio of “studies relevant to patients with AIDS,” t
he memo stated, “is approximately $27 million.” Somehow millions more had been added to the month-old numbers given to Tim Westmoreland.

  Washington was all white and virtually paralyzed by the blizzards that swept across its broad avenues and majestic monuments on the last day of Bill Kraus’s visit. Bill stayed with Michael Housh and his lover Rick Pacurar. The three played together like children in the snow, making snowmen and snow angels. That night, however, Bill turned serious, recalling the snow that had drifted around his father’s freshly dug grave exactly twenty-five years ago that month.

  Michael Housh had always noticed a dark side to Bill Kraus. It came out not only in his cynical humor but also in a certain downcast view he extended to his life in general, whether it was his inability to keep a relationship going or his frustrations with AIDS funding. Only now, however, could Michael trace the darkness back to something in Bill’s life.

  His father’s death was very painful, Bill said. He was only ten years old and had felt so alone; it was even worse when the family moved away from bucolic Fort Mitchell, Kentucky, to nearby Cincinnati. And there was that memory, that awful visual image that returned to his nightmares, of the Kraus family plot in the Milwaukee graveyard buried deep in drifting snow the day they buried his dad. Ice. The frozen-hard ground into which they lowered the casket. Once Bill had seen an Ingmar Bergman movie in which a casket was being lowered into the ground of a cold Swedish winter, and Bill had bitten his knuckles so hard that they bled. It was so much like that awful February day twenty-five years ago, the day that was the end of his childhood.

  He had never communicated well with his mother, Bill went on, and never really knew happiness until he went away to Ohio State University. He paused, his eyes following the ornate woodwork in Rick and Michael’s living room.

  “I think I’m going to get it,” Bill said.

  Michael didn’t know what he was talking about.

  “I think I’m going to get AIDS,” Bill continued. “I’ve known it for a while.”

  “A lot of people are worried about AIDS,” Michael said. “You’re being melodramatic. You’re perfectly healthy.”

  Bill shook his head. “I just know it. Before this is over, I’m going to have it.”

  PASTEUR INSTITUTE, PARIS

  Willy Rozenbaum could not contain his excitement. Days before, Professor Luc Montagnier had called, saying: “We’ve found something. Can you come over and tell us about this SIDA?”

  Rozenbaum, Montagnier, Francoise Barre, Francoise Brun-Vezinet, and Jean-Claude Chermann had gathered in Montagnier’s office on the Pasteur campus. A new human retrovirus had been discovered, Montagnier announced. He said they would test the new virus to see whether it was HTLV, but it didn’t appear to be like the leukemia at all. It was cytopathic, dramatically killing the T-lymphocytes.

  Rozenbaum laid out all that he knew about SIDA, describing some of the horrible deaths that had unfolded. All he could do was watch helplessly, he said. Treating one disease did no good because another disease would erupt a day later and kill the patient. Until they knew what caused the actual immune deficiency, there could be no effective treatment for SIDA.

  Although he knew the idea lacked scientific proof, Rozenbaum had no doubt that the Pasteur team had discovered the cause of SIDA. A retrovirus—it made perfect sense.

  Much work needed to be done, Montagnier cautioned. The group needed to start meeting weekly, every Saturday, in Montagnier’s office. They would start preparing a paper on this new human retrovirus for medical journals.

  At the next meeting of the working group of doctors that Willy Rozenbaum and Jacques Leibowitch had assembled a year earlier, Rozenbaum enthusiastically explained the Pasteur’s findings. Leibowitch was immediately doubtful that the Pasteur people had found anything but HTLV. By then, of course, the flamboyant doctor’s antipathy for the Pasteur Institute was well known. In the fall, Leibowitch had applied for an immunologist’s job at Pasteur Production, the commercial arm of the institute. He was turned down for the post and was still furious.

  At the study group meeting, the scientists argued bitterly over the significance of the discovery. Rozenbaum felt the Pasteur Institute had found the cause of AIDS. Leibowitch was certain that nothing of any significance could come from Pasteur. The National Cancer Institute—now there was a major-league institution, Leibowitch said. As for Willy Rozenbaum, Leibowitch thought privately, he was like a child.

  Across the country, the blood issue also was drawing battle lines among gay community leaders. A split had engulfed the Bay Area Physicians for Human Rights and its national parent group, the American Association of Physicians for Human Rights (AAPHR), after the Bay Area leaders revealed they would urge gay men to cooperate with the local blood bank in screening themselves out as blood donors. As a compromise, however, the Irwin Memorial Blood Bank did not directly ask whether donors were gay, instead inquiring only whether people giving blood were suffering from swollen lymph nodes, nightsweats, and other overt signs of immune deficiency.

  At its national convention, AAPHR issued its national policy, calling for hepatitis B core antibody testing and opposing the elimination of gay men from the donor pool, except for those “who think they may be at increased risk for AIDS.” Said the AAPHR statement, “We object strongly to the attempts by some members of the blood products and banking community to identify gay men by questionnaire and exclude them from blood donation. These attempts are an unnecessary invasion of individual privacy and grossly misrepresent the issues to the American people.” In Washington, gay leaders were successful in persuading Red Cross officials to back off from their plans for sexual-orientation questions and, instead, to work with gay activists to develop a donor policy the gay politicians could support. One longtime veteran of gay politics, Frank Kameny, said he would “advise fellow gays to lie” if the local blood bank officials proceeded with screening.

  In New York, the National Gay Task Force rounded up virtually every gay leader in Manhattan to stand on the steps of the New York Blood Center for a press conference denouncing efforts to screen donors. As he scanned the group, Michael Callen, a leader in the newly formed New York chapter of People With AIDS, relished the irony of the press conference. He knew that virtually every gay man there had had hepatitis B and that most had engaged in the kind of sexual activities that put them at high risk for AIDS. Not one of them could in good conscience donate blood, Callen thought, and here they were, exuding self-righteous indignation at the thought that someone would suggest they did not have the right to make such donations.

  The question of risk-reduction guidelines was even more problematical for gay groups. At its national convention, AAPHR released its tepid proposals for “healthful gay male sexuality.” Sensitive to concerns that the group not be “sex-negative,” the guidelines assured gay men that there was nothing wrong with having sex, but that they should check their partners for KS lesions, swollen lymph nodes, and overt symptoms of AIDS. It might be a good idea to have fewer partners, the guidelines also suggested tentatively. The Gay Men’s Health Crisis in New York had put the accumulated wisdom of homosexual physicians in one phrase: “Have as much sex as you want, but with fewer people and HEALTHY people.” Complicated considerations of asymptomatic carriers—the people who looked perfectly healthy while they deposited a dose of AIDS virus—were not weighed for the guidelines, even though they were well documented in the medical literature.

  In San Francisco, the more cautious Bay Area Physicians for Human Rights was still holding committee meetings to wrangle over every phrase of risk-reduction guidelines. Some doctors were squeamish about the very idea of telling people what to do in bed. The remainder felt it best to take their time and be prudent so they didn’t say anything wrong. Meanwhile, calls still deluged the KS Foundation from people wondering what they could do to protect themselves. Foundation leaders could only suggest they call back, once the gay doctors finished their committee meetings.

  In Washing
ton, friends told Tim Westmoreland he was turning gloomy because of his propensity for warning them about their sex lives and AIDS. The disease was a problem of New Yorkers and San Franciscans, friends told him. Westmoreland started to feel like a guy talking airline safety in a crowded airport. In a guest editorial for the local gay paper, the Washington Blade, he wrote a long warning about the ramifications the epidemic could have for years to come. There may come a time when insurance companies refuse to insure gay men or try to eliminate AIDS diseases from insurance protection, Westmoreland warned. “To some extent the insurance industry exists to discriminate among risks and to pool or avoid them,” he wrote. For this, other gays denounced Westmoreland as an alarmist.

  ORLY INTERNATIONAL AIRPORT, PARIS

  The airline steward eyed the thermos warily while the handsome young scientist took his seat. Passengers craned to see from where the smoke was coming. Jacques Leibowitch explained to the supervising attendant that he was a scientist taking specimens to the National Cancer Institute in Bethesda. This was top-priority science. The smoke was only liquid nitrogen. No, he couldn’t open it. The young scientist’s charm prevailed and he settled into his seat, with the smoking thermos beside him.

  Pasteur Production had paid his way to Bethesda, not to deliver these specimens, he laughed to himself, but to pick up the antibodies to HTLV for Drs. Luc Montagnier and Jean-Claude Chermann. Leibowitch also carried a letter from Montagnier explaining the French discovery.

  Jacques Leibowitch desperately wanted to prove the Pasteur Institute wrong. He’d do anything he could to help Dr. Robert Gallo prove that his virus, HTLV, was the cause of this epidemic. Leaving nothing to chance, he had even taken biopsies of lymph nodes from one of his sister’s Zairian AIDS patients that he planned to hand-deliver to Gallo. Oh, how he loved getting one over on those assholes at the Pasteur Institute.