1 00:00:00,440 --> 00:00:03,000 Speaker 1: Hey, this is Leon Napok. I'm the host of Fiasco, 2 00:00:03,240 --> 00:00:05,640 Speaker 1: but you may also know me from the podcasts Slowburn, 3 00:00:05,840 --> 00:00:09,240 Speaker 1: Think Twice, Michael Jackson, and Backfired the Vaping Wars. I'm 4 00:00:09,280 --> 00:00:11,880 Speaker 1: excited to be sharing with you the next season of Backfired, 5 00:00:12,000 --> 00:00:15,960 Speaker 1: titled Attention Deficit, which is now available exclusively on Audible. 6 00:00:16,800 --> 00:00:20,320 Speaker 1: Backfired is a podcast about the business of unintended consequences. 7 00:00:20,840 --> 00:00:23,279 Speaker 1: In the first season, my co host Ril Pardess and 8 00:00:23,320 --> 00:00:25,680 Speaker 1: I dove deep into the world of vaping and how 9 00:00:25,680 --> 00:00:28,440 Speaker 1: the well intentioned quest for a safer cigarette went awry. 10 00:00:28,960 --> 00:00:32,879 Speaker 1: Now we're tackling ADHD and how the push to destigmatize 11 00:00:32,880 --> 00:00:35,879 Speaker 1: this hard to define childhood diagnosis has led to an 12 00:00:35,920 --> 00:00:38,720 Speaker 1: explosion of stimulant use in kids as well as adults. 13 00:00:39,000 --> 00:00:41,560 Speaker 1: It's a story about the promise of psychiatry to fix 14 00:00:41,640 --> 00:00:44,640 Speaker 1: our brains and the power of the pharmaceutical industry to 15 00:00:44,680 --> 00:00:47,600 Speaker 1: shape how we and our doctors think about what's wrong 16 00:00:47,640 --> 00:00:50,239 Speaker 1: with us. To hear both seasons of Backfired, go to 17 00:00:50,240 --> 00:00:53,600 Speaker 1: audible dot com slash Backfired and start a free trial 18 00:00:54,040 --> 00:01:01,760 Speaker 1: that's audible dot com. Slash Backfired is intended for mature audiences. 19 00:01:02,360 --> 00:01:05,080 Speaker 1: For a list of books, articles, and documentaries we used 20 00:01:05,080 --> 00:01:07,720 Speaker 1: in our research. Follow the link in the show notes. 21 00:01:14,840 --> 00:01:17,800 Speaker 2: This is the Gay Life ksam's Public affairs show for 22 00:01:17,880 --> 00:01:20,880 Speaker 2: gentlemen who prefer gentlemen, for women who prefer women, and 23 00:01:20,959 --> 00:01:23,360 Speaker 2: for people who prefer people. You don't have to be 24 00:01:23,400 --> 00:01:26,959 Speaker 2: gay to listen. Good Evening, I'm Randy Alfred Tonight. Our 25 00:01:26,959 --> 00:01:30,640 Speaker 2: discussion is on the new diseases, the so called gay 26 00:01:30,720 --> 00:01:34,840 Speaker 2: cancer and Later. In January of nineteen eighty two, a 27 00:01:34,959 --> 00:01:38,000 Speaker 2: radio show in San Francisco featured an interview with a 28 00:01:38,040 --> 00:01:42,279 Speaker 2: local nurse. His name was Bobby Campbell. Good Evening, Bobby, 29 00:01:42,400 --> 00:01:44,920 Speaker 2: Good Evening, Randy. Let's start the story at the beginning. 30 00:01:45,319 --> 00:01:48,800 Speaker 1: Campbell was twenty nine years old. About a year earlier, 31 00:01:48,840 --> 00:01:51,800 Speaker 1: he had gotten sick from an unusual infection and spent 32 00:01:51,920 --> 00:01:55,040 Speaker 1: four days in the hospital. It turned out there was 33 00:01:55,080 --> 00:01:56,800 Speaker 1: something wrong with his immune system. 34 00:01:57,040 --> 00:01:59,720 Speaker 3: I found that I had a low white blood cell count, 35 00:01:59,760 --> 00:02:01,880 Speaker 3: which which is the main mechanism the body uses to 36 00:02:01,880 --> 00:02:02,640 Speaker 3: fight off infection. 37 00:02:03,240 --> 00:02:06,280 Speaker 1: Not long after his hospital stay, Campbell went on a 38 00:02:06,360 --> 00:02:10,800 Speaker 1: hiking trip with his boyfriend on the California coast. Afterwards, 39 00:02:10,919 --> 00:02:13,920 Speaker 1: he noticed purple spots on the soles of his feet. 40 00:02:14,200 --> 00:02:16,359 Speaker 1: He figured they were blood blisters from all the walking 41 00:02:16,400 --> 00:02:19,880 Speaker 1: he'd been doing. But then a few weeks past and 42 00:02:19,919 --> 00:02:23,880 Speaker 1: the spots still hadn't gone away. Campbell and his boyfriend 43 00:02:23,960 --> 00:02:27,400 Speaker 1: got worried. There had just been a few newspaper stories 44 00:02:27,440 --> 00:02:30,440 Speaker 1: published about a rare form of skin cancer afflicting gay 45 00:02:30,480 --> 00:02:34,000 Speaker 1: men in New York in San Francisco. It was called 46 00:02:34,200 --> 00:02:35,440 Speaker 1: Capussi's sarcoma. 47 00:02:35,919 --> 00:02:37,680 Speaker 3: My boyfriend he said, oh, well, you know, cop, she 48 00:02:37,840 --> 00:02:40,040 Speaker 3: does appear on the on the feet and legs. I said, 49 00:02:40,040 --> 00:02:40,920 Speaker 3: feet and legs. 50 00:02:41,919 --> 00:02:42,720 Speaker 4: How did you feel? 51 00:02:43,800 --> 00:02:47,160 Speaker 3: It can't be me. I can't have this. It's not this, 52 00:02:47,320 --> 00:02:48,880 Speaker 3: It's just a bloodlister. It's something else. 53 00:02:51,680 --> 00:02:54,960 Speaker 1: Campbell got a biopsy. It showed that he did have 54 00:02:55,080 --> 00:02:59,959 Speaker 1: Capussi's sarcoma, the disease some had started calling gay cancer. 55 00:03:00,680 --> 00:03:03,000 Speaker 2: As a health professional, surely you had read of it. 56 00:03:03,800 --> 00:03:06,400 Speaker 3: As a matter of fact, I had not read of it. 57 00:03:06,400 --> 00:03:08,840 Speaker 3: It's so rare that until nineteen eighty one it was 58 00:03:09,080 --> 00:03:12,000 Speaker 3: mentioned in medical dermatology textbooks with one paragraph and sort 59 00:03:12,000 --> 00:03:13,399 Speaker 3: of glossed over onto the next thing. 60 00:03:14,000 --> 00:03:17,720 Speaker 1: Campbell wanted to warn other gay men, especially those who 61 00:03:17,720 --> 00:03:20,040 Speaker 1: didn't share his relatively privileged position. 62 00:03:20,960 --> 00:03:22,799 Speaker 3: I really feel very fortunate in some ways, and that 63 00:03:22,919 --> 00:03:24,959 Speaker 3: I have a lover who cares for me. I have 64 00:03:25,520 --> 00:03:28,840 Speaker 3: real good health insurance, I can be on medical leave 65 00:03:28,880 --> 00:03:31,680 Speaker 3: of absence. I have a lot of things going for me, 66 00:03:32,120 --> 00:03:34,760 Speaker 3: and I'm worried about someone who may develop this disease 67 00:03:34,800 --> 00:03:38,880 Speaker 3: and yet not have those pluses. So hopefully in my 68 00:03:39,000 --> 00:03:42,120 Speaker 3: being a blabbermouth in this way has some payoff for 69 00:03:42,240 --> 00:03:45,600 Speaker 3: this hypothetical person on Caster Street of Santa Monica Boulevard 70 00:03:45,680 --> 00:03:46,120 Speaker 3: or whatever. 71 00:03:46,840 --> 00:03:50,240 Speaker 1: This interview with Bobby Campbell is the earliest recording I've 72 00:03:50,280 --> 00:03:52,960 Speaker 1: been able to find of someone talking in the first 73 00:03:52,960 --> 00:03:57,640 Speaker 1: person about having AIDS. Of course, Campbell didn't know that's 74 00:03:57,640 --> 00:04:00,000 Speaker 1: what it was, yet he just thought he had cancer, 75 00:04:00,800 --> 00:04:03,480 Speaker 1: not realizing it was a symptom of something even worse. 76 00:04:04,720 --> 00:04:07,240 Speaker 1: To me, that's what's so extraordinary about hearing him talk 77 00:04:07,280 --> 00:04:10,440 Speaker 1: about it. He just knows so little about what's coming, 78 00:04:11,000 --> 00:04:13,920 Speaker 1: and yet he's already certain that it's important and that 79 00:04:13,960 --> 00:04:15,360 Speaker 1: people need to know about it. 80 00:04:16,000 --> 00:04:17,880 Speaker 2: You've never been a closet cancer patient. 81 00:04:18,040 --> 00:04:20,840 Speaker 3: No, I've never been a closet cancer patient. I tend 82 00:04:20,839 --> 00:04:23,000 Speaker 3: to be very disclosing in the things that happened to me, 83 00:04:23,360 --> 00:04:25,920 Speaker 3: But I just thought that the more I talked about it, 84 00:04:26,000 --> 00:04:27,680 Speaker 3: the better it would be for me, and the better 85 00:04:27,720 --> 00:04:30,960 Speaker 3: it would be for other people in my community. 86 00:04:31,200 --> 00:04:34,320 Speaker 1: To help spread the word, Campbell took polaroid photos of 87 00:04:34,360 --> 00:04:37,320 Speaker 1: his feet and put them on a poster. He hung 88 00:04:37,360 --> 00:04:39,640 Speaker 1: it in the front window of a pharmacy on Castro 89 00:04:39,720 --> 00:04:43,400 Speaker 1: Street in San Francisco. He also started writing a column 90 00:04:43,400 --> 00:04:47,320 Speaker 1: in a local gay newspaper and distributed informational leaflets to 91 00:04:47,360 --> 00:04:50,719 Speaker 1: other gay men while inhabiting a drag persona he called 92 00:04:50,880 --> 00:04:53,280 Speaker 1: Sister Florence Nightmare, registered nurse. 93 00:04:53,440 --> 00:04:55,120 Speaker 2: So I think it's very brave of you to be 94 00:04:55,240 --> 00:05:00,760 Speaker 2: here publicly discussing a very private and life threatening of situation, 95 00:05:01,279 --> 00:05:03,120 Speaker 2: and I want to commend you and thank you for that. 96 00:05:03,680 --> 00:05:06,920 Speaker 3: If I don't feel brave so much as maybe I 97 00:05:07,040 --> 00:05:10,760 Speaker 3: show off, I am, but it's I don't know. I 98 00:05:11,000 --> 00:05:13,640 Speaker 3: feel comfortable in doing it, and as a healthcare professional 99 00:05:13,640 --> 00:05:17,120 Speaker 3: and an articulate person, I have a story to tell 100 00:05:17,160 --> 00:05:18,800 Speaker 3: and I'm happy to do it. 101 00:05:18,800 --> 00:05:22,040 Speaker 1: It would be another six months before Bobby Campbell's disease 102 00:05:22,200 --> 00:05:25,000 Speaker 1: was given the name we know it by today. It 103 00:05:25,040 --> 00:05:28,080 Speaker 1: would be a year before its underlying cause was identified 104 00:05:28,080 --> 00:05:31,600 Speaker 1: as a virus that destroyed the immune system, and it 105 00:05:31,640 --> 00:05:34,520 Speaker 1: would be more than a decade before an effective treatment 106 00:05:34,720 --> 00:05:35,320 Speaker 1: was developed. 107 00:05:35,920 --> 00:05:38,040 Speaker 3: Anything you want to add before we close for the evening, 108 00:05:38,520 --> 00:05:41,280 Speaker 3: Take care of yourselves, brothers and sisters. You're the only 109 00:05:41,279 --> 00:05:41,800 Speaker 3: one you've got. 110 00:05:48,200 --> 00:05:50,880 Speaker 1: This season of Fiasco is about the early years of 111 00:05:50,920 --> 00:05:54,520 Speaker 1: the AIDS epidemic, when a diagnosis was tantamount to a 112 00:05:54,520 --> 00:05:55,120 Speaker 1: death sentence. 113 00:05:56,040 --> 00:06:00,719 Speaker 5: AID syndrome has spread in epidemic, proportions of the victims 114 00:06:00,720 --> 00:06:01,159 Speaker 5: have died. 115 00:06:01,400 --> 00:06:04,279 Speaker 1: Over the course of eight episodes, you'll hear the story 116 00:06:04,320 --> 00:06:07,960 Speaker 1: of a scandal unlike any we've covered before. It's a 117 00:06:08,000 --> 00:06:10,840 Speaker 1: story about denial and misinformation. 118 00:06:10,440 --> 00:06:12,760 Speaker 6: People are saying you can catch as from a mosquito 119 00:06:12,800 --> 00:06:14,560 Speaker 6: bite are in swimming. 120 00:06:14,200 --> 00:06:17,400 Speaker 1: Pools, and the politics of a disease that intensified old 121 00:06:17,440 --> 00:06:19,640 Speaker 1: prejudices and activated new ones. 122 00:06:19,839 --> 00:06:21,880 Speaker 7: I believe that God does not judge people. 123 00:06:21,920 --> 00:06:22,800 Speaker 4: God judges sin. 124 00:06:23,200 --> 00:06:25,760 Speaker 1: It's also a story about what people do in the 125 00:06:25,800 --> 00:06:30,159 Speaker 1: absence of scientific clarity, when the authorities they depend on 126 00:06:30,480 --> 00:06:33,880 Speaker 1: an answer to can't or won't figure out what to do. 127 00:06:40,960 --> 00:06:44,120 Speaker 1: We'll return to Bobby Campbell in a bit. For now, 128 00:06:44,360 --> 00:06:46,400 Speaker 1: I want to go back to the fall of nineteen 129 00:06:46,440 --> 00:06:50,000 Speaker 1: eighty when a group of doctors and scientists scattered around 130 00:06:50,040 --> 00:06:54,159 Speaker 1: the country first became aware that something inexplicable was happening 131 00:06:54,200 --> 00:06:59,960 Speaker 1: to gay men. I'm Leon Napok from Audible and Prologue projects. 132 00:07:00,320 --> 00:07:04,360 Speaker 1: This is Fiasco, season five, the AIDS Crisis. 133 00:07:05,040 --> 00:07:09,200 Speaker 5: It's mysterious, it's deadly, and it's baffling medical science. 134 00:07:09,279 --> 00:07:13,040 Speaker 8: A new deadly disease that no one understands, not where 135 00:07:13,080 --> 00:07:15,360 Speaker 8: it comes from, how to treat it, or how to 136 00:07:15,400 --> 00:07:16,480 Speaker 8: stop it from spreading. 137 00:07:16,760 --> 00:07:19,600 Speaker 4: A great medical puzzle. It's known as gay plague. 138 00:07:19,680 --> 00:07:22,520 Speaker 5: They are violating the laws of nature, and nature is 139 00:07:22,560 --> 00:07:23,320 Speaker 5: striking back. 140 00:07:23,360 --> 00:07:26,120 Speaker 9: What I was hearing was from patients. My circle of 141 00:07:26,240 --> 00:07:28,600 Speaker 9: friends are disappearing. 142 00:07:28,080 --> 00:07:30,640 Speaker 4: And within just five years, almost everyone I knew was 143 00:07:30,640 --> 00:07:31,320 Speaker 4: dead or dying. 144 00:07:43,360 --> 00:07:46,880 Speaker 1: One night in the fall of nineteen eighty, doctor Jeffrey 145 00:07:46,920 --> 00:07:49,520 Speaker 1: Green was called into work to see a new patient. 146 00:07:50,200 --> 00:07:53,720 Speaker 1: It was after midnight and the man needed Green's urgent attention. 147 00:07:54,200 --> 00:07:57,080 Speaker 9: I remember everything I remember about this patient because it 148 00:07:57,120 --> 00:08:00,840 Speaker 9: was probably one of the most poignant moments of my life. 149 00:08:04,560 --> 00:08:08,160 Speaker 9: It was about one o'clock in the morning, but when 150 00:08:08,160 --> 00:08:10,040 Speaker 9: I saw him, he was in the intensive care unit 151 00:08:10,120 --> 00:08:12,640 Speaker 9: and he was being intubated, being put on a breathing 152 00:08:12,680 --> 00:08:14,960 Speaker 9: machine because he was gasping for breath and very short 153 00:08:15,000 --> 00:08:17,520 Speaker 9: on oxygen and he needed to be put on the 154 00:08:17,560 --> 00:08:21,559 Speaker 9: breathing machine for survival. Had a very high fever, and 155 00:08:21,960 --> 00:08:23,880 Speaker 9: I was confused. I didn't know what was going on. 156 00:08:27,680 --> 00:08:30,680 Speaker 1: Green was working in the Infectious disease unit at Bellevue 157 00:08:30,680 --> 00:08:34,400 Speaker 1: Hospital in Manhattan. Bellevue was one of the biggest public 158 00:08:34,440 --> 00:08:38,200 Speaker 1: hospitals in the country and an especially interesting place to 159 00:08:38,240 --> 00:08:42,080 Speaker 1: be an infectious disease specialist because it was cheaper and 160 00:08:42,120 --> 00:08:45,880 Speaker 1: more accessible than the private hospitals in town. Bellevue served 161 00:08:45,880 --> 00:08:49,360 Speaker 1: as a safety net for patients from all walks of life, 162 00:08:49,400 --> 00:08:52,400 Speaker 1: and because it was in New York. Many Bellvue patients 163 00:08:52,400 --> 00:08:56,960 Speaker 1: were people from abroad carrying diseases that were uncommon in America. 164 00:08:57,040 --> 00:08:59,640 Speaker 1: As Green put it, he and his colleagues saw a 165 00:08:59,640 --> 00:09:00,840 Speaker 1: little bit of everything. 166 00:09:01,240 --> 00:09:04,839 Speaker 9: They could be three four, five or even more new 167 00:09:04,920 --> 00:09:08,280 Speaker 9: patients per day in terms of consultations, and I would 168 00:09:08,320 --> 00:09:11,360 Speaker 9: go see those patients to give my opinion as to 169 00:09:11,400 --> 00:09:14,360 Speaker 9: what was going on, to help make diagnoses, and to 170 00:09:14,440 --> 00:09:16,520 Speaker 9: help in orchestrating the treatment. 171 00:09:17,000 --> 00:09:19,959 Speaker 1: The patient Green saw that night in nineteen eighty had 172 00:09:19,960 --> 00:09:24,760 Speaker 1: the initials HW. He was thirty eight years old. A 173 00:09:24,840 --> 00:09:28,000 Speaker 1: round of tests confirmed that there was something seriously wrong 174 00:09:28,080 --> 00:09:29,199 Speaker 1: with his lungs. 175 00:09:29,480 --> 00:09:30,599 Speaker 4: Very poor oxygenation. 176 00:09:30,840 --> 00:09:34,439 Speaker 9: His chest X ray was almost white, very advanced pneumonia 177 00:09:34,480 --> 00:09:35,880 Speaker 9: in all five lobes of the lung. 178 00:09:36,360 --> 00:09:39,640 Speaker 1: There didn't seem to be anything about HW's medical history 179 00:09:39,760 --> 00:09:41,640 Speaker 1: that could explain what was happening to him. 180 00:09:42,240 --> 00:09:43,200 Speaker 4: Before he was in debated. 181 00:09:43,200 --> 00:09:45,520 Speaker 9: I was able to get a medical history, which previous 182 00:09:45,640 --> 00:09:49,640 Speaker 9: to that admission was pretty benign. He was a guy 183 00:09:49,679 --> 00:09:53,720 Speaker 9: in his thirties. He was a gay man. He was 184 00:09:54,240 --> 00:09:59,160 Speaker 9: in the last throes of life. He lived long enough 185 00:09:59,200 --> 00:10:03,600 Speaker 9: to go for an open lung biopsy, which is where 186 00:10:03,679 --> 00:10:06,719 Speaker 9: the surgeon takes the patient to the operating room and 187 00:10:06,800 --> 00:10:09,960 Speaker 9: through the rib takes a wedge of lung tissue to 188 00:10:10,040 --> 00:10:12,800 Speaker 9: examine to see what we might be dealing with. And 189 00:10:12,840 --> 00:10:14,760 Speaker 9: it was on that tissue that he saw these five 190 00:10:14,800 --> 00:10:16,920 Speaker 9: different infections. 191 00:10:17,800 --> 00:10:21,479 Speaker 1: Each of the five infections HW was fighting was extremely 192 00:10:21,600 --> 00:10:25,360 Speaker 1: rare on its own. For all five to show up 193 00:10:25,440 --> 00:10:30,520 Speaker 1: in one young, apparently healthy person was unheard of. Taken together, 194 00:10:30,960 --> 00:10:34,160 Speaker 1: the infections seemed to suggest some kind of immune suppression. 195 00:10:34,840 --> 00:10:37,160 Speaker 1: Someone with a healthy immune system could have fought them 196 00:10:37,160 --> 00:10:42,040 Speaker 1: off without even knowing they had been exposed. HW had 197 00:10:42,080 --> 00:10:44,199 Speaker 1: other symptoms too, and I. 198 00:10:44,120 --> 00:10:47,800 Speaker 9: Remember seeing this very large purple lesion on the patient's nose. 199 00:10:48,440 --> 00:10:50,440 Speaker 9: But we had bigger fish to fry, you know, with 200 00:10:50,480 --> 00:10:53,480 Speaker 9: this guy, so we weren't so concerned about his skin lesion. 201 00:10:54,280 --> 00:10:57,400 Speaker 1: The only thing that was clear was that HW's immune 202 00:10:57,400 --> 00:10:59,320 Speaker 1: system had somehow gone haywire. 203 00:11:00,000 --> 00:11:02,559 Speaker 9: I realized that this patient had to have come in 204 00:11:03,280 --> 00:11:06,439 Speaker 9: with severe immune suppression for whatever reason. 205 00:11:06,480 --> 00:11:09,119 Speaker 4: We weren't sure, but we felt. 206 00:11:08,880 --> 00:11:11,920 Speaker 9: That the only way that he could have had all 207 00:11:12,000 --> 00:11:15,600 Speaker 9: these things simultaneously would be basically an immune system that 208 00:11:15,679 --> 00:11:20,559 Speaker 9: had died before he did. 209 00:11:21,640 --> 00:11:24,000 Speaker 1: Jeffrey Green was one of the first doctors in the 210 00:11:24,040 --> 00:11:27,080 Speaker 1: world to notice that a strange and deadly new disease 211 00:11:27,280 --> 00:11:30,160 Speaker 1: was spreading in the United States. It was not how 212 00:11:30,200 --> 00:11:33,360 Speaker 1: he thought his career would turn out. Growing up during 213 00:11:33,360 --> 00:11:36,240 Speaker 1: the nineteen fifties in a sheltered, middle class neighborhood in 214 00:11:36,320 --> 00:11:39,679 Speaker 1: Queen's Green always imagined that being a doctor would be 215 00:11:39,720 --> 00:11:41,760 Speaker 1: a job in which he got paid to help sick 216 00:11:41,800 --> 00:11:42,720 Speaker 1: people get better. 217 00:11:43,400 --> 00:11:47,360 Speaker 4: I was birthed by my family's GP. He used to make. 218 00:11:47,200 --> 00:11:49,800 Speaker 9: House calls, come give shots in the house, make me 219 00:11:49,840 --> 00:11:50,280 Speaker 9: feel better. 220 00:11:50,360 --> 00:11:51,040 Speaker 4: When I was sick. 221 00:11:51,600 --> 00:11:53,280 Speaker 9: You know, he was like part of the family really, 222 00:11:53,440 --> 00:11:57,280 Speaker 9: and as I was thinking about my future, even as 223 00:11:57,280 --> 00:11:59,200 Speaker 9: a very young kid, you know, I always thought being 224 00:11:59,240 --> 00:12:02,120 Speaker 9: a doctor would be a thing that I would like 225 00:12:02,200 --> 00:12:02,640 Speaker 9: to try. 226 00:12:03,400 --> 00:12:06,680 Speaker 1: By the time Green entered medical school in nineteen seventy two, 227 00:12:07,280 --> 00:12:09,439 Speaker 1: doctors who made house calls were pretty much a thing 228 00:12:09,440 --> 00:12:13,160 Speaker 1: of the past. Instead, Green went into the field of 229 00:12:13,200 --> 00:12:14,120 Speaker 1: infectious disease. 230 00:12:15,240 --> 00:12:21,719 Speaker 10: Communicable diseases recognize no boundaries, always watchful for epidemics. Practicing 231 00:12:21,760 --> 00:12:24,680 Speaker 10: physicians constitute the first line of defense. 232 00:12:24,840 --> 00:12:29,440 Speaker 9: I liked the idea of finding a problem, diagnosing a problem, 233 00:12:29,480 --> 00:12:33,000 Speaker 9: and fixing a problem. Infectious diseases was the only one 234 00:12:33,000 --> 00:12:36,040 Speaker 9: that attracted me. We had tools to actually cure people. 235 00:12:36,080 --> 00:12:38,760 Speaker 9: I mean, sometimes people didn't make it, but for the 236 00:12:38,800 --> 00:12:42,760 Speaker 9: most part, patients who got admitted with severe infections got better. 237 00:12:43,480 --> 00:12:46,600 Speaker 1: The science of treating infectious diseases had advanced to an 238 00:12:46,640 --> 00:12:50,959 Speaker 1: almost unthinkable degree during the twentieth century. For much of history, 239 00:12:51,160 --> 00:12:55,800 Speaker 1: diseases like pneumonia and tuberculosis had routinely proved fatal. By 240 00:12:55,840 --> 00:12:58,840 Speaker 1: the time Green entered the field, the vast majority of 241 00:12:58,880 --> 00:13:01,880 Speaker 1: patients seeking treatment for infections could be cured in a 242 00:13:01,920 --> 00:13:02,920 Speaker 1: matter of days. 243 00:13:03,520 --> 00:13:06,360 Speaker 10: Now, at last, the hidden enemy could be examined under 244 00:13:06,400 --> 00:13:09,280 Speaker 10: the probing such light of science. The hunt was on 245 00:13:09,440 --> 00:13:13,000 Speaker 10: for contagious diseases and their causes, wherever they existed. 246 00:13:17,720 --> 00:13:22,200 Speaker 1: Green's patient HW died just eight days after Green started 247 00:13:22,200 --> 00:13:25,680 Speaker 1: taking care of him. To the doctor, it looked like 248 00:13:25,720 --> 00:13:30,120 Speaker 1: a freak occurrence, not an accident, just deeply confusing. 249 00:13:31,000 --> 00:13:34,200 Speaker 9: It was something nobody had ever seen. Of course, this 250 00:13:34,360 --> 00:13:37,559 Speaker 9: was a one and only case. This was case one. 251 00:13:38,600 --> 00:13:43,000 Speaker 1: Case two walked into Bellevue a few weeks later. Once again, 252 00:13:43,520 --> 00:13:46,520 Speaker 1: Green noted that the patient was gay and was suffering 253 00:13:46,520 --> 00:13:50,360 Speaker 1: from a strange infection in his lungs. Not long after, 254 00:13:50,920 --> 00:13:53,720 Speaker 1: Green was making rounds at the hospital when he overheard 255 00:13:53,760 --> 00:13:56,080 Speaker 1: a conversation about yet another patient. 256 00:13:56,920 --> 00:13:59,679 Speaker 9: While I was doing my note in this little cubicle, 257 00:14:00,360 --> 00:14:02,600 Speaker 9: the other four or five people were discussing this case, 258 00:14:02,640 --> 00:14:04,600 Speaker 9: and I was sort of listening peripherally to what was 259 00:14:04,640 --> 00:14:08,040 Speaker 9: going on. And then I heard them snap an X 260 00:14:08,120 --> 00:14:10,719 Speaker 9: ray into the X ray box, and I looked over 261 00:14:10,760 --> 00:14:15,439 Speaker 9: my shoulder at the X ray, and I said, to them, 262 00:14:16,160 --> 00:14:19,600 Speaker 9: is that patient gay? 263 00:14:19,720 --> 00:14:23,720 Speaker 1: The other doctors were shocked. How could Green possibly know 264 00:14:23,800 --> 00:14:26,840 Speaker 1: such an intimate detail about a patient? He had never met. 265 00:14:27,000 --> 00:14:27,960 Speaker 4: The guy who was presenting. 266 00:14:28,000 --> 00:14:31,400 Speaker 9: He was standing and holding this blue plastic folder with 267 00:14:31,800 --> 00:14:34,400 Speaker 9: all the papers of his admission in his hand. He 268 00:14:34,480 --> 00:14:38,200 Speaker 9: dropped it on the floor and the guy said to me, how. 269 00:14:38,040 --> 00:14:40,760 Speaker 4: Did you know that? And I said, I don't know. 270 00:14:41,720 --> 00:14:42,680 Speaker 4: I don't know how I knew it. 271 00:14:43,240 --> 00:14:45,080 Speaker 9: And then later in the day I said, I know 272 00:14:45,120 --> 00:14:47,160 Speaker 9: how I knew it, because that X ray looks like 273 00:14:47,480 --> 00:14:49,800 Speaker 9: HW's X ray, the patient number one. 274 00:14:51,520 --> 00:14:54,960 Speaker 1: Within several months, Green says he had encountered about a 275 00:14:54,960 --> 00:14:59,000 Speaker 1: dozen patients who, like HW, were afflicted by rare forms 276 00:14:59,000 --> 00:15:03,400 Speaker 1: of pneumonia and skin lesions. As you heard Bobby Campbell 277 00:15:03,440 --> 00:15:06,240 Speaker 1: say in his interview on The Gay Life, those skin 278 00:15:06,360 --> 00:15:10,360 Speaker 1: lesions were capaces sarcoma, a rare form of cancer typically 279 00:15:10,440 --> 00:15:14,200 Speaker 1: found in people from sub Saharan Africa and older Mediterranean men. 280 00:15:15,240 --> 00:15:18,680 Speaker 1: Some of Green's patients had other, even more unusual symptoms, 281 00:15:19,240 --> 00:15:23,760 Speaker 1: including ones associated with diseases typically carried by animals, not people. 282 00:15:24,720 --> 00:15:28,720 Speaker 9: We had typocarcosis, which is a pigeon fungus that caused 283 00:15:28,760 --> 00:15:33,840 Speaker 9: the meningitis, you know. We had toxoplasmosis. We had disseminated 284 00:15:33,880 --> 00:15:37,320 Speaker 9: microbacterial diseases, which is again a typical. 285 00:15:37,480 --> 00:15:40,560 Speaker 1: Why these rare infections were suddenly popping up with a 286 00:15:40,560 --> 00:15:45,680 Speaker 1: textbook medical mystery into many doctors, including Green, The fact 287 00:15:45,680 --> 00:15:48,360 Speaker 1: that the first few cases had all presented in gay 288 00:15:48,440 --> 00:15:51,880 Speaker 1: men seemed like a really important clue. 289 00:15:52,280 --> 00:15:57,480 Speaker 9: It's a little embarrassing to discuss this because I thought 290 00:15:57,480 --> 00:16:00,160 Speaker 9: we were looking at a gay disease. The first three 291 00:16:00,240 --> 00:16:03,120 Speaker 9: or four cases that I saw were in people who 292 00:16:03,200 --> 00:16:05,880 Speaker 9: were gay, so it wasn't that. 293 00:16:06,120 --> 00:16:08,960 Speaker 4: Unusual for me to jump to that conclusion. 294 00:16:09,520 --> 00:16:12,680 Speaker 1: It was the only clear connection Green could see between 295 00:16:12,720 --> 00:16:16,960 Speaker 1: the patients. Soon, his assumption was that anyone suffering from 296 00:16:17,000 --> 00:16:20,320 Speaker 1: this new affliction had to be gay, even if they 297 00:16:20,360 --> 00:16:21,360 Speaker 1: refused to admit it. 298 00:16:23,080 --> 00:16:26,920 Speaker 9: What happened was on case number four, the guy came 299 00:16:26,960 --> 00:16:31,240 Speaker 9: in with numasisters pneumonia, and he also passed away, but 300 00:16:31,360 --> 00:16:35,400 Speaker 9: before he did, he absolutely denied being gay. And I 301 00:16:35,480 --> 00:16:37,200 Speaker 9: can't tell you how many times I asked the guy. 302 00:16:37,280 --> 00:16:39,720 Speaker 9: He must have thought I was a freak or something, 303 00:16:39,760 --> 00:16:42,920 Speaker 9: because I kept asking him, are you sure you're not gay? 304 00:16:43,080 --> 00:16:48,040 Speaker 9: And after he passed away, I reached out to this 305 00:16:48,080 --> 00:16:51,000 Speaker 9: woman who I became friendly with while she was visiting, 306 00:16:51,160 --> 00:16:52,440 Speaker 9: and I said, what's a story? 307 00:16:52,480 --> 00:16:55,200 Speaker 4: I mean, was he gay. You know, he's not gay. 308 00:16:56,240 --> 00:16:58,200 Speaker 9: And I said, well, so where did he live? He 309 00:16:58,240 --> 00:17:02,160 Speaker 9: said so he was living in a halfway house for 310 00:17:02,280 --> 00:17:02,960 Speaker 9: drug addicts. 311 00:17:03,800 --> 00:17:06,560 Speaker 1: Intravenous drug users were known to be at high risk 312 00:17:06,680 --> 00:17:09,240 Speaker 1: for any disease that could be spread through blood, like 313 00:17:09,280 --> 00:17:13,080 Speaker 1: hepatitis B or C. But when Green went to Harlem 314 00:17:13,119 --> 00:17:16,240 Speaker 1: to visit the halfway house, he learned something that seemed 315 00:17:16,240 --> 00:17:17,960 Speaker 1: to confirm his original assumption. 316 00:17:18,680 --> 00:17:23,359 Speaker 9: And I talked to people who knew him, and I 317 00:17:23,400 --> 00:17:26,199 Speaker 9: started asking him the same question, and everyone said, no, 318 00:17:26,240 --> 00:17:26,880 Speaker 9: he wasn't gay. 319 00:17:27,000 --> 00:17:29,400 Speaker 4: But someone said, but he turned gay tricks. 320 00:17:30,320 --> 00:17:33,200 Speaker 1: Green wasn't exactly sure what that meant, and asked the 321 00:17:33,240 --> 00:17:35,040 Speaker 1: person to elaborate, and he. 322 00:17:35,040 --> 00:17:37,719 Speaker 9: Said, well, to make money for his habit, he you know, 323 00:17:37,760 --> 00:17:38,640 Speaker 9: he would go with men. 324 00:17:38,680 --> 00:17:40,199 Speaker 4: He would go with women, he would you know. 325 00:17:40,720 --> 00:17:44,160 Speaker 9: So, I said, finally I figured it out. It is 326 00:17:44,600 --> 00:17:47,280 Speaker 9: something to do with gay sex or whatever. 327 00:17:47,800 --> 00:17:51,080 Speaker 1: Looking back, it's striking how easy it was to conclude 328 00:17:51,080 --> 00:17:55,520 Speaker 1: that the new disease was quote unquote gay related. Even 329 00:17:55,520 --> 00:17:57,439 Speaker 1: when he was faced with someone with a history of 330 00:17:57,520 --> 00:18:01,320 Speaker 1: intravenous drug use, Green remained and convinced that the patient's 331 00:18:01,359 --> 00:18:12,399 Speaker 1: sexuality was the key factor. As more cases emerged in 332 00:18:12,440 --> 00:18:15,359 Speaker 1: early nineteen eighty one. Green was sure that he was 333 00:18:15,359 --> 00:18:20,000 Speaker 1: seeing something totally novel, and without knowing the cause, the 334 00:18:20,040 --> 00:18:22,680 Speaker 1: best he could do was try to use existing treatments 335 00:18:22,680 --> 00:18:26,280 Speaker 1: for his patient's symptoms. The trouble was the cases he 336 00:18:26,359 --> 00:18:30,320 Speaker 1: was seeing sometimes required specialized medications that could be difficult 337 00:18:30,320 --> 00:18:35,280 Speaker 1: to obtain. For instance, to treat numicistas pneumonia, Green needed 338 00:18:35,320 --> 00:18:39,880 Speaker 1: a drug called pentamidine, but because the demand for pantamidine 339 00:18:39,920 --> 00:18:43,960 Speaker 1: was usually incredibly low, it wasn't profitable for drug companies 340 00:18:44,000 --> 00:18:48,280 Speaker 1: to market it. Instead, pantamidine was controlled and dispensed by 341 00:18:48,280 --> 00:18:52,119 Speaker 1: the Centers for Disease Control in Atlanta, Georgia. The CDC 342 00:18:53,080 --> 00:18:54,399 Speaker 1: so yet have to request it. 343 00:18:54,520 --> 00:18:57,119 Speaker 9: They would take a history and if you had the 344 00:18:57,160 --> 00:19:02,440 Speaker 9: requisite answers, they would release one patience worth of pentamidine 345 00:19:02,880 --> 00:19:04,919 Speaker 9: for a treatment course of two to three weeks. 346 00:19:05,800 --> 00:19:09,919 Speaker 1: The CDC was established in nineteen forty six primarily to 347 00:19:09,960 --> 00:19:10,920 Speaker 1: combat malaria. 348 00:19:11,359 --> 00:19:14,560 Speaker 10: CDC is one of the task forces of the Public 349 00:19:14,600 --> 00:19:15,360 Speaker 10: Health Service. 350 00:19:16,320 --> 00:19:19,679 Speaker 1: It quickly evolved into an all purpose first response service 351 00:19:19,800 --> 00:19:22,280 Speaker 1: for various medical emergencies. 352 00:19:22,280 --> 00:19:26,480 Speaker 10: Ready to help each state in its fife against communicable diseases. 353 00:19:27,600 --> 00:19:31,320 Speaker 1: Anytime there was a major disease outbreak, the CDC was there, 354 00:19:31,640 --> 00:19:35,080 Speaker 1: doing the investigative legwork and providing assistance to doctors and 355 00:19:35,160 --> 00:19:38,880 Speaker 1: nurses on the ground. As a result, the CDC had 356 00:19:38,880 --> 00:19:41,000 Speaker 1: a hand in some of the greatest achievements of the 357 00:19:41,040 --> 00:19:44,639 Speaker 1: modern era, including the eradication of polio in the United 358 00:19:44,640 --> 00:19:47,560 Speaker 1: States and smallpox all over the world. 359 00:19:47,920 --> 00:19:51,440 Speaker 7: And historic victory over a dread disease. Here scientists usher 360 00:19:51,560 --> 00:19:54,040 Speaker 7: in a new medical age with the monumental reports that 361 00:19:54,160 --> 00:19:58,480 Speaker 7: proved the vaccine against crippling polio to be a sensational success. 362 00:19:58,920 --> 00:20:02,159 Speaker 1: The CDC had special outposts at major airports where they 363 00:20:02,200 --> 00:20:05,960 Speaker 1: distributed medications to the doctors who needed them. That was 364 00:20:06,000 --> 00:20:08,120 Speaker 1: where doctor Green would get his pentamidine. 365 00:20:08,680 --> 00:20:09,720 Speaker 4: I would get in. 366 00:20:09,720 --> 00:20:14,360 Speaker 9: My car and drive to JFK and I think there 367 00:20:14,440 --> 00:20:19,480 Speaker 9: is a CDC quarantine office and they had the shipment 368 00:20:19,560 --> 00:20:22,160 Speaker 9: waiting for me, and I get back on the car, 369 00:20:22,240 --> 00:20:24,080 Speaker 9: drive back to Bellevue and hang the drug. 370 00:20:24,680 --> 00:20:24,920 Speaker 4: Soon. 371 00:20:25,280 --> 00:20:28,800 Speaker 1: The trip to JFK Airport was part of Green's regular routine, 372 00:20:29,760 --> 00:20:33,800 Speaker 1: but a CDC technician fielding his requests for pentamidine noticed 373 00:20:33,800 --> 00:20:36,119 Speaker 1: that Green was not giving a reason for why his 374 00:20:36,240 --> 00:20:40,800 Speaker 1: patients had numicistus pneumonia. The technician knew that it usually 375 00:20:40,880 --> 00:20:44,359 Speaker 1: only appeared in patients who had compromised immune systems, like 376 00:20:44,440 --> 00:20:48,400 Speaker 1: kids with leukemia or people who had received organ transplants. 377 00:20:48,840 --> 00:20:51,600 Speaker 1: But Green wasn't indicating anything like that on the forms 378 00:20:51,600 --> 00:20:54,399 Speaker 1: he was filling out. So either he was doing something 379 00:20:54,440 --> 00:20:59,120 Speaker 1: wrong or there was an inexplicable new outbreak happening, one 380 00:20:59,119 --> 00:21:02,159 Speaker 1: that the CDC needed to get on top of immediately, 381 00:21:03,160 --> 00:21:07,360 Speaker 1: So the technician alerted her supervisor. Though the details were sketchy, 382 00:21:07,720 --> 00:21:10,960 Speaker 1: there appeared to be a growing cluster of numisistus cases 383 00:21:10,960 --> 00:21:16,520 Speaker 1: in New York. As it turned out, Green's requests for 384 00:21:16,560 --> 00:21:19,840 Speaker 1: pantamidine were not the only troubling signal popping up on 385 00:21:19,880 --> 00:21:23,639 Speaker 1: the CDC's radar at this time. By the late spring 386 00:21:23,680 --> 00:21:27,159 Speaker 1: of nineteen eighty one, multiple physicians around the country had 387 00:21:27,160 --> 00:21:30,280 Speaker 1: started asking the agency for help treating young gay men 388 00:21:30,359 --> 00:21:34,480 Speaker 1: with inexplicable symptoms. Among the CDC officials on the receiving 389 00:21:34,560 --> 00:21:37,040 Speaker 1: end of these requests was doctor Mary Geinan. 390 00:21:37,520 --> 00:21:41,679 Speaker 11: We started getting phone calls from physicians saying, you know, 391 00:21:41,760 --> 00:21:46,320 Speaker 11: I have this young man in the intensive care unit 392 00:21:46,920 --> 00:21:50,320 Speaker 11: and he's dying and I don't know what's wrong with him. 393 00:21:50,720 --> 00:21:54,399 Speaker 1: Geynan was a specialist in venereal disease, so when a 394 00:21:54,440 --> 00:21:57,280 Speaker 1: written report on some kind of outbreak among gay men 395 00:21:57,480 --> 00:22:00,879 Speaker 1: came into the CDC, she was asked to review it. 396 00:22:01,280 --> 00:22:04,600 Speaker 11: Since it wasn't a disease that we knew about, there 397 00:22:04,680 --> 00:22:08,280 Speaker 11: was no expert in CDC about it, but all of 398 00:22:08,320 --> 00:22:13,760 Speaker 11: these men also had herpes virus infections, so they asked 399 00:22:13,840 --> 00:22:16,520 Speaker 11: me to make a comment on it. 400 00:22:17,040 --> 00:22:20,080 Speaker 1: The report would turn out to be a foundational document 401 00:22:20,160 --> 00:22:23,200 Speaker 1: in the history of AIDS. He was co authored by 402 00:22:23,200 --> 00:22:25,600 Speaker 1: a young doctor in Los Angeles, whom you'll hear more 403 00:22:25,640 --> 00:22:29,280 Speaker 1: about later in the series. For now, all you need 404 00:22:29,320 --> 00:22:31,920 Speaker 1: to know is that he was seeing numacistus cases at 405 00:22:31,920 --> 00:22:35,720 Speaker 1: pretty much the same exact time as Jeffrey Green, and 406 00:22:35,800 --> 00:22:38,520 Speaker 1: when Mary Gynan had a chance to review his findings, 407 00:22:39,000 --> 00:22:59,280 Speaker 1: she knew the CDC had to get involved. Mary Guynan 408 00:22:59,359 --> 00:23:02,240 Speaker 1: studied Comis Street in college, but when she got her 409 00:23:02,240 --> 00:23:05,560 Speaker 1: degree in nineteen sixty one, she found that nobody was 410 00:23:05,600 --> 00:23:06,520 Speaker 1: willing to hire her. 411 00:23:07,240 --> 00:23:09,840 Speaker 11: After I graduated as a chemist, I was living in 412 00:23:09,840 --> 00:23:13,639 Speaker 11: New York and the New York Times Want Dads was 413 00:23:13,680 --> 00:23:18,119 Speaker 11: segregated by gender. There was a help wanted male and 414 00:23:18,160 --> 00:23:21,600 Speaker 11: a help wanted female, and there was never a job 415 00:23:21,680 --> 00:23:25,400 Speaker 11: listing for a chemist in the help Wanted Female. So 416 00:23:25,560 --> 00:23:30,840 Speaker 11: I finally found a job at a chewing gum factory. 417 00:23:31,560 --> 00:23:34,200 Speaker 12: What's new in the Magic Land of Chicklets. 418 00:23:34,600 --> 00:23:38,000 Speaker 11: My job was to make new flavors for chewing gum. 419 00:23:38,320 --> 00:23:41,480 Speaker 13: Well great them orange Bradberry. 420 00:23:42,000 --> 00:23:44,439 Speaker 11: I was in a laboratory. I had all these different 421 00:23:44,440 --> 00:23:47,440 Speaker 11: flavors and I would mix them and taste them. 422 00:23:47,680 --> 00:23:51,080 Speaker 14: A world of flavor from the Magic Land of Chicklets. 423 00:23:51,240 --> 00:23:55,760 Speaker 1: And eventually Gynan decided to go to medical school, where 424 00:23:55,760 --> 00:23:58,960 Speaker 1: she became interested in smallpox and got accepted into a 425 00:23:59,000 --> 00:24:02,760 Speaker 1: training program at the CDC. There, she worked on the 426 00:24:02,760 --> 00:24:06,960 Speaker 1: agency's medical Detective Squad, the Epidemic Intelligence Service. 427 00:24:07,320 --> 00:24:14,240 Speaker 11: The Epidemic Intelligence Service is a training program for epidemiologists. 428 00:24:14,920 --> 00:24:19,480 Speaker 11: The worldwide symbol of a field epidemiologist is the hole 429 00:24:19,520 --> 00:24:22,879 Speaker 11: in the soul, evidence that we have worn out our 430 00:24:22,920 --> 00:24:25,000 Speaker 11: shoes tracking down vital clues. 431 00:24:27,960 --> 00:24:30,920 Speaker 1: Geynan ended up getting a job in the CDC's Venereal 432 00:24:30,960 --> 00:24:35,000 Speaker 1: Disease Control Division. By nineteen eighty one, she was an 433 00:24:35,000 --> 00:24:36,920 Speaker 1: expert on genital herpes infection. 434 00:24:37,680 --> 00:24:40,560 Speaker 11: I became doctor Herpes. People call me from all over 435 00:24:40,600 --> 00:24:44,800 Speaker 11: the world. I had rock stars calling me from Australia. 436 00:24:45,400 --> 00:24:48,960 Speaker 11: They had genital herpes, and I say, I'm sorry, I 437 00:24:49,119 --> 00:24:50,080 Speaker 11: can't offer you. 438 00:24:50,000 --> 00:24:55,840 Speaker 1: Anything long distance phone calls from rock stars. Aside, being 439 00:24:55,960 --> 00:25:01,360 Speaker 1: doctor herpes wasn't exactly glamorous. Even within the CED, Venereal 440 00:25:01,400 --> 00:25:03,919 Speaker 1: disease was considered an unsavory specialty. 441 00:25:04,359 --> 00:25:06,440 Speaker 5: Nice people don't talk about VD. 442 00:25:06,960 --> 00:25:09,000 Speaker 6: Perhaps that's why America is in the middle of the 443 00:25:09,040 --> 00:25:11,639 Speaker 6: greatest venereal disease epidemic and its history. 444 00:25:12,040 --> 00:25:15,199 Speaker 11: People said, what's a nice girl like you doing a 445 00:25:15,320 --> 00:25:18,879 Speaker 11: thing like that? It was considered to be people who 446 00:25:18,960 --> 00:25:21,760 Speaker 11: couldn't get regular jobs took this job. 447 00:25:22,400 --> 00:25:25,960 Speaker 10: Venereal disease is almost as prevalent as the common cold. 448 00:25:26,200 --> 00:25:28,800 Speaker 10: One problem in dealing with VD is the reluctance of 449 00:25:28,840 --> 00:25:30,480 Speaker 10: many of the infective de seek treatment. 450 00:25:30,600 --> 00:25:33,880 Speaker 11: I worked in a venereal disease clinic one day a week, 451 00:25:33,920 --> 00:25:36,159 Speaker 11: and when I would come back, if I saw some 452 00:25:36,200 --> 00:25:39,240 Speaker 11: of my colleagues say say to me, oh, my goodness, 453 00:25:39,760 --> 00:25:41,040 Speaker 11: did you wash your hands. 454 00:25:42,160 --> 00:25:45,520 Speaker 1: Guidan's time at the CDC coincided with the rise of 455 00:25:45,560 --> 00:25:49,399 Speaker 1: a new administration in Washington. Ronald Reagan had run on 456 00:25:49,440 --> 00:25:52,040 Speaker 1: a pledge to slash the federal budget, and when he 457 00:25:52,040 --> 00:25:55,480 Speaker 1: got into office, he wasted no time delivering on that promise. 458 00:25:55,880 --> 00:25:59,040 Speaker 15: I've already placed a freeze on hiring replacements for those 459 00:25:59,040 --> 00:26:03,439 Speaker 15: who retire government service. I've ordered a cut in government travel, 460 00:26:03,920 --> 00:26:06,800 Speaker 15: the number of consultants to the government, and the buying 461 00:26:06,840 --> 00:26:08,880 Speaker 15: of office equipment and other items. 462 00:26:09,560 --> 00:26:14,400 Speaker 1: At the CDC, everything became more difficult, buying new equipment, 463 00:26:14,680 --> 00:26:20,119 Speaker 1: securing additional research funding, and traveling to investigate outbreaks. For 464 00:26:20,160 --> 00:26:23,920 Speaker 1: fiscal year nineteen eighty two, the Center for Infectious Diseases 465 00:26:24,000 --> 00:26:27,199 Speaker 1: faced overall budget cuts of up to fifty nine percent. 466 00:26:28,200 --> 00:26:30,600 Speaker 1: So that was the state of play. When Gaynan read 467 00:26:30,600 --> 00:26:33,760 Speaker 1: the report from Los Angeles about a mysterious cluster of 468 00:26:33,840 --> 00:26:35,600 Speaker 1: numisistus cases in gay men. 469 00:26:36,119 --> 00:26:39,280 Speaker 11: I read it and it was like incredible. I knew 470 00:26:39,320 --> 00:26:44,800 Speaker 11: that something terrible was happening because these are all homosexual men, 471 00:26:44,920 --> 00:26:49,200 Speaker 11: and two of them had died, and nobody knew why. 472 00:26:50,680 --> 00:26:54,520 Speaker 11: So I sent it up the hierarchy of approval all 473 00:26:54,560 --> 00:26:56,600 Speaker 11: the way to the top, and I sent it to 474 00:26:56,640 --> 00:26:59,640 Speaker 11: my supervisor, who wrote on the paper. 475 00:26:59,400 --> 00:27:04,520 Speaker 1: Hot stuff guidance. Supervisor was doctor Jim Currn, a senior 476 00:27:04,560 --> 00:27:07,520 Speaker 1: researcher in the CDC's Veneurial Diseases Division. 477 00:27:08,040 --> 00:27:11,360 Speaker 14: It was circulated to my disc I would say perhaps 478 00:27:11,440 --> 00:27:15,720 Speaker 14: ten days before it was published. On June fifth, nineteen eighty. 479 00:27:15,480 --> 00:27:18,320 Speaker 1: One, Kerran happened to be going to a conference on 480 00:27:18,400 --> 00:27:21,600 Speaker 1: sexually transmitted diseases, and he asked some of his fellow 481 00:27:21,600 --> 00:27:24,360 Speaker 1: attendees if they'd seen anything like what was being described 482 00:27:24,359 --> 00:27:25,359 Speaker 1: in the report. 483 00:27:25,680 --> 00:27:29,280 Speaker 14: We talked to the doctors who were working with people 484 00:27:29,320 --> 00:27:33,080 Speaker 14: in the gay community and gay physicians themselves, and they 485 00:27:33,200 --> 00:27:35,479 Speaker 14: told us that they too were seeing cases that were 486 00:27:35,600 --> 00:27:38,440 Speaker 14: very unusual. And there were some doctors in New York 487 00:27:38,440 --> 00:27:41,920 Speaker 14: who were also calling us about this rare cancer kapasci 488 00:27:42,040 --> 00:27:44,520 Speaker 14: sarcoma that was being seen in New York. 489 00:27:45,560 --> 00:27:48,600 Speaker 1: One month after the new Massisus report was published, the 490 00:27:48,600 --> 00:27:52,000 Speaker 1: CDC followed up with a second one documenting the cases 491 00:27:52,080 --> 00:27:55,760 Speaker 1: of capasi sarcoma. The New York Times covered it that 492 00:27:55,800 --> 00:27:59,640 Speaker 1: same day on page twenty under the headline rare cancer 493 00:28:00,280 --> 00:28:04,879 Speaker 1: in forty one homosexuals. The article cited Kerran in saying 494 00:28:04,960 --> 00:28:08,520 Speaker 1: there was no apparent danger to non homosexuals from contagion. 495 00:28:09,440 --> 00:28:12,560 Speaker 1: That same week, Kerran traveled to New York for his 496 00:28:12,600 --> 00:28:15,320 Speaker 1: first in person meeting with a patient suffering from the 497 00:28:15,320 --> 00:28:15,920 Speaker 1: new disease. 498 00:28:16,800 --> 00:28:20,760 Speaker 14: And we went to see one individual patient and as 499 00:28:20,800 --> 00:28:24,679 Speaker 14: we talked about our past, we said, you know, we 500 00:28:24,720 --> 00:28:26,440 Speaker 14: are exactly the same age. 501 00:28:27,040 --> 00:28:29,920 Speaker 1: The patient was an actor, and as he and Kerran 502 00:28:30,000 --> 00:28:32,760 Speaker 1: started chatting, they found they had a lot more in 503 00:28:32,800 --> 00:28:35,920 Speaker 1: common than just their age. They were both from Detroit, 504 00:28:36,440 --> 00:28:39,400 Speaker 1: and they were both raised Catholic. In fact, they even 505 00:28:39,440 --> 00:28:43,000 Speaker 1: went to rival Catholic prep schools. Both had left Michigan 506 00:28:43,040 --> 00:28:46,880 Speaker 1: for college, one to Notre Dame, the other to Yale. 507 00:28:47,160 --> 00:28:50,360 Speaker 1: And now one was a doctor trying to diagnose the other. 508 00:28:50,760 --> 00:28:54,200 Speaker 14: And then he had these skin lesions on his face. 509 00:28:54,800 --> 00:28:58,280 Speaker 14: His question to me, of course a doctor expert from CDC, 510 00:28:58,880 --> 00:29:01,920 Speaker 14: will these go away? I be able to get rid 511 00:29:01,920 --> 00:29:05,080 Speaker 14: of him so I can continue my acting career. And 512 00:29:05,160 --> 00:29:07,200 Speaker 14: of course I'd never seen a patient in my life 513 00:29:07,200 --> 00:29:09,320 Speaker 14: with Kappa she sarcoma, so I didn't know. 514 00:29:10,280 --> 00:29:13,240 Speaker 1: Kurran kept tabs on the patient as his condition worsened 515 00:29:13,240 --> 00:29:14,880 Speaker 1: over the following months. 516 00:29:15,240 --> 00:29:19,440 Speaker 14: He had went from a tall, handsome actor to having 517 00:29:19,520 --> 00:29:22,960 Speaker 14: lost almost half his body weight, all of his hair. 518 00:29:24,760 --> 00:29:28,800 Speaker 14: And I will always think how similar our background was 519 00:29:29,440 --> 00:29:34,280 Speaker 14: on how he died. This inexplicable death. What made us different. 520 00:29:35,240 --> 00:29:37,080 Speaker 14: I guess it was because he was a gay man 521 00:29:37,720 --> 00:29:40,600 Speaker 14: and I was straight. That he went to New York 522 00:29:41,000 --> 00:29:44,000 Speaker 14: and was exposed in the epicenter of this horrible disease 523 00:29:44,440 --> 00:29:47,920 Speaker 14: to something neither one of us knew what at that point, 524 00:29:48,880 --> 00:29:59,920 Speaker 14: and he died and I was living there to study it. 525 00:30:01,920 --> 00:30:05,680 Speaker 1: Not long after the CDC published its report on Numisistus pneumonia, 526 00:30:06,200 --> 00:30:09,720 Speaker 1: the agency created a centralized task force to investigate the situation. 527 00:30:10,680 --> 00:30:12,400 Speaker 1: Jim curn was put in charge. 528 00:30:12,840 --> 00:30:14,920 Speaker 14: So at the time they asked me to share it, 529 00:30:15,040 --> 00:30:19,640 Speaker 14: and I was assigned disease detectives from a variety of areas. 530 00:30:19,840 --> 00:30:25,080 Speaker 14: Virology because perhaps this was a virus cancer assigned somebody 531 00:30:25,120 --> 00:30:28,160 Speaker 14: to us, and we had some laboratory people assigned to us, 532 00:30:28,160 --> 00:30:31,600 Speaker 14: and a statistician assigned to us, and we thought it 533 00:30:31,640 --> 00:30:36,040 Speaker 14: could well be sexually transmitted, so std people were actually 534 00:30:36,080 --> 00:30:37,840 Speaker 14: assigned from my own group. 535 00:30:38,000 --> 00:30:41,080 Speaker 1: Before the task force did anything else, they set out 536 00:30:41,120 --> 00:30:43,680 Speaker 1: to confirm that what they were seeing was in fact 537 00:30:43,760 --> 00:30:47,920 Speaker 1: a new phenomenon. To that end, they reviewed hospital records 538 00:30:47,920 --> 00:30:51,000 Speaker 1: in the eighteen largest cities in the country to see 539 00:30:51,040 --> 00:30:54,480 Speaker 1: how many previous cases of pneumaicistus or other rare infections 540 00:30:54,520 --> 00:30:55,120 Speaker 1: there had been. 541 00:30:55,480 --> 00:30:59,000 Speaker 14: What we found was virtually there were no cases before 542 00:30:59,080 --> 00:31:02,400 Speaker 14: nineteen seventy eight, and there were none outside New York 543 00:31:02,440 --> 00:31:06,080 Speaker 14: and California except one case in Atlanta, so we were 544 00:31:06,160 --> 00:31:07,560 Speaker 14: reassured that this was new. 545 00:31:08,440 --> 00:31:11,240 Speaker 1: Different people on the task force had different ideas about 546 00:31:11,240 --> 00:31:14,760 Speaker 1: what was making people sick, but a central animating question 547 00:31:15,080 --> 00:31:18,800 Speaker 1: was why the disease seemed to be disproportionately affecting gay men. 548 00:31:22,640 --> 00:31:27,080 Speaker 14: Some people thought it was related to allogenetic semen, that 549 00:31:27,160 --> 00:31:30,920 Speaker 14: if you were exposed to hundreds of different semen, you 550 00:31:30,960 --> 00:31:34,560 Speaker 14: could become allergic to it, and that allergy would cause 551 00:31:34,600 --> 00:31:37,760 Speaker 14: the reaction to damage your immune system. Some people thought 552 00:31:37,760 --> 00:31:40,760 Speaker 14: it was an environmental cause, since many people who have 553 00:31:40,840 --> 00:31:43,080 Speaker 14: sex with each other go to the same places, maybe 554 00:31:43,080 --> 00:31:44,320 Speaker 14: there was some kind of contaminant. 555 00:31:45,200 --> 00:31:49,080 Speaker 1: The so called environmental theories posited that maybe something about 556 00:31:49,080 --> 00:31:52,200 Speaker 1: the environments where gay men congregated was causing them to 557 00:31:52,200 --> 00:31:56,360 Speaker 1: get sick. A leading early hypothesis was that the disease 558 00:31:56,480 --> 00:32:00,240 Speaker 1: was caused by poppers, the inhalable muscle relaxings that many 559 00:32:00,320 --> 00:32:03,040 Speaker 1: gay men were using in clubs to get high and 560 00:32:03,120 --> 00:32:06,480 Speaker 1: to make it easier to have anal sex. Mary Guinan 561 00:32:06,600 --> 00:32:09,080 Speaker 1: and other members of the CDC task Force thought the 562 00:32:09,160 --> 00:32:12,080 Speaker 1: chemicals used to make poppers might be causing some kind 563 00:32:12,120 --> 00:32:15,720 Speaker 1: of reaction in people's immune systems, or that maybe a 564 00:32:15,760 --> 00:32:17,719 Speaker 1: bad batch had made it onto the street. 565 00:32:18,320 --> 00:32:21,040 Speaker 11: Poppers were available all over the place, so one of 566 00:32:21,080 --> 00:32:24,880 Speaker 11: the things that I wanted to do was to see 567 00:32:25,240 --> 00:32:26,800 Speaker 11: what they contained. 568 00:32:27,480 --> 00:32:31,040 Speaker 1: Guidan heard she could find poppers at adult bookstores around Manhattan, 569 00:32:31,560 --> 00:32:33,880 Speaker 1: so she went to New York in search of samples. 570 00:32:34,680 --> 00:32:37,520 Speaker 11: They would actually have a place to have sex inside 571 00:32:37,520 --> 00:32:41,920 Speaker 11: the bookstore, and they sold poppers. It was a bookstore 572 00:32:41,960 --> 00:32:43,240 Speaker 11: in Greenwich Village. 573 00:32:43,240 --> 00:32:47,160 Speaker 1: I think Geynan brought the poppers back to CDC headquarters 574 00:32:47,200 --> 00:32:50,200 Speaker 1: in Atlanta to be tested, and I brought them in. 575 00:32:50,600 --> 00:32:55,120 Speaker 11: We sent them over to various people within CDC to 576 00:32:55,160 --> 00:32:58,840 Speaker 11: see if they were but it was There wasn't any 577 00:32:58,920 --> 00:32:59,840 Speaker 11: real connection. 578 00:33:03,880 --> 00:33:06,880 Speaker 1: The poppers theory endured long after it fell out of 579 00:33:06,880 --> 00:33:11,080 Speaker 1: favor with scientists. There are a few reasons why. For 580 00:33:11,160 --> 00:33:13,760 Speaker 1: one thing, it made it possible to blame the new 581 00:33:13,800 --> 00:33:17,960 Speaker 1: disease on a substance specifically associated with gay nightlife and vice, 582 00:33:18,960 --> 00:33:22,120 Speaker 1: but also more generally, it held out the promise of 583 00:33:22,160 --> 00:33:26,520 Speaker 1: a simple smoking gun. If the illness really was caused 584 00:33:26,520 --> 00:33:30,200 Speaker 1: by some kind of environmental factor, and solving the problem 585 00:33:30,280 --> 00:33:33,160 Speaker 1: could be as straightforward as isolating it and getting rid 586 00:33:33,200 --> 00:33:36,959 Speaker 1: of it. Not surprisingly, the people who made poppers got 587 00:33:37,040 --> 00:33:40,360 Speaker 1: pretty defensive about their product. Here's a clip from the 588 00:33:40,400 --> 00:33:43,640 Speaker 1: Gay Life radio show in which they interviewed a manufacturer 589 00:33:43,800 --> 00:33:44,720 Speaker 1: named W. J. 590 00:33:45,000 --> 00:33:45,480 Speaker 4: Freezer. 591 00:33:46,240 --> 00:33:52,160 Speaker 12: There is absolutely no evidence whatsoever linking alcohol, nitrites or 592 00:33:52,200 --> 00:33:56,800 Speaker 12: any other nitrites with Carposi sacoma, the so called gay cancer. 593 00:33:57,240 --> 00:34:02,240 Speaker 12: The CDC was asked by the press whether poppers had 594 00:34:02,280 --> 00:34:06,560 Speaker 12: been eliminated as a factor. CDC replied, and quite properly, 595 00:34:06,800 --> 00:34:10,680 Speaker 12: that nothing has as yet been eliminated. That response has 596 00:34:10,719 --> 00:34:12,200 Speaker 12: been blown way out of proportion. 597 00:34:13,120 --> 00:34:16,879 Speaker 1: Well, Jim Curran wanted the answer to be poppers too, 598 00:34:17,840 --> 00:34:20,720 Speaker 1: but he and his colleagues at the CDC were fairly 599 00:34:20,760 --> 00:34:23,600 Speaker 1: convinced from the start that what they were seeing was 600 00:34:23,680 --> 00:34:28,000 Speaker 1: most likely a virus. Their suspicion was that the new 601 00:34:28,000 --> 00:34:31,879 Speaker 1: disease might be similar to hepatitis B, which was transmissible 602 00:34:31,920 --> 00:34:35,040 Speaker 1: through blood and other bodily fluids, and could be spread 603 00:34:35,040 --> 00:34:38,640 Speaker 1: through sex and intravenous drug use. If that was how 604 00:34:38,680 --> 00:34:41,600 Speaker 1: the new disease worked too. That would mean it didn't 605 00:34:41,640 --> 00:34:45,760 Speaker 1: actually discriminate based on sexuality. Even if it was true 606 00:34:45,800 --> 00:34:48,399 Speaker 1: that for now it was spreading mostly among gay men, 607 00:34:48,960 --> 00:34:59,160 Speaker 1: it would inevitably cross over into other populations. In July 608 00:34:59,280 --> 00:35:03,120 Speaker 1: of nineteen eight, one current CDC task force was preparing 609 00:35:03,120 --> 00:35:06,200 Speaker 1: to send teams to New York, Atlanta, Los Angeles, and 610 00:35:06,239 --> 00:35:09,560 Speaker 1: San Francisco. The goal was to interview gay men who 611 00:35:09,600 --> 00:35:12,600 Speaker 1: were showing symptoms of the new disease and compare them 612 00:35:12,640 --> 00:35:16,560 Speaker 1: to a control group. Doctor Gynan was sent to San Francisco, 613 00:35:16,800 --> 00:35:18,840 Speaker 1: where she met with her subjects in a cheap hotel 614 00:35:18,920 --> 00:35:20,320 Speaker 1: room in the Tenderloin district. 615 00:35:21,520 --> 00:35:24,480 Speaker 11: It was all sorts of questions, first about drug use 616 00:35:24,560 --> 00:35:28,600 Speaker 11: and about sexual behavior. And we all had to ask 617 00:35:28,640 --> 00:35:32,800 Speaker 11: the same questions, what kinds of sex, what kind of drugs? 618 00:35:33,560 --> 00:35:37,479 Speaker 11: How many sex partners have you had in the past year. 619 00:35:38,040 --> 00:35:42,200 Speaker 11: And I was just amazed at how cooperative these people were. 620 00:35:42,200 --> 00:35:45,080 Speaker 11: They would be counting the number of sex partners they had. 621 00:35:45,840 --> 00:35:51,319 Speaker 11: They'd say I had two or three thousand partners in 622 00:35:51,360 --> 00:35:54,960 Speaker 11: their lifetime. And so people afterwards said to me, oh, 623 00:35:55,000 --> 00:35:58,960 Speaker 11: they were just bragging about Let's see, they were not 624 00:35:59,600 --> 00:36:02,399 Speaker 11: They were bragging, they were telling the truth. They were 625 00:36:02,440 --> 00:36:03,280 Speaker 11: trying to help. 626 00:36:04,160 --> 00:36:08,040 Speaker 1: After administering the questionnaire, Guynan collected patient samples. 627 00:36:08,440 --> 00:36:12,799 Speaker 11: The patient would sit on the barstool of the kitchenette 628 00:36:13,000 --> 00:36:16,319 Speaker 11: and I would take blood from them. And I had 629 00:36:16,320 --> 00:36:19,600 Speaker 11: to pack up all the specimens in these boxes with 630 00:36:19,800 --> 00:36:21,960 Speaker 11: dry ice in it to keep them cold, and they 631 00:36:22,000 --> 00:36:25,440 Speaker 11: had to be there at CDC within twenty four hours. 632 00:36:25,960 --> 00:36:30,680 Speaker 11: I then had to get those specimens to the post 633 00:36:30,719 --> 00:36:32,880 Speaker 11: office before the post office closed. 634 00:36:33,800 --> 00:36:36,520 Speaker 1: Gyan was working fourteen hour days during her trip to 635 00:36:36,560 --> 00:36:41,040 Speaker 1: San Francisco, conducting interviews and drawing blood samples herself. It 636 00:36:41,080 --> 00:36:42,440 Speaker 1: didn't always go smoothly. 637 00:36:43,400 --> 00:36:46,440 Speaker 11: This one young man came in who was very tall 638 00:36:46,640 --> 00:36:50,279 Speaker 11: and built like a football player, and as I was 639 00:36:50,280 --> 00:36:54,760 Speaker 11: putting the needle into his arm, he fainted and fell 640 00:36:54,800 --> 00:36:58,040 Speaker 11: on top of me. We both fell on the floor, 641 00:36:58,880 --> 00:37:02,839 Speaker 11: and I tried to pull the tourniquet from his arm 642 00:37:03,200 --> 00:37:07,080 Speaker 11: because it was bleeding. All the blood was coming out 643 00:37:07,200 --> 00:37:10,799 Speaker 11: and I couldn't get it. And I finally pulled the 644 00:37:10,840 --> 00:37:15,120 Speaker 11: needle out, and when I pulled it out, I stuck 645 00:37:15,160 --> 00:37:17,400 Speaker 11: it into the palm of my left hand. 646 00:37:19,120 --> 00:37:22,560 Speaker 1: Geynan didn't know whether she had just given herself the disease. 647 00:37:23,680 --> 00:37:26,560 Speaker 1: Sitting in the hotel room covered in someone else's blood. 648 00:37:27,000 --> 00:37:30,040 Speaker 1: She improvised, I. 649 00:37:30,239 --> 00:37:33,200 Speaker 11: Tried to squeeze my palm of my hand to get 650 00:37:33,200 --> 00:37:35,399 Speaker 11: any blood in it that might have gone in there. 651 00:37:36,280 --> 00:37:39,120 Speaker 11: I was not sure what I was going to do here. 652 00:37:39,160 --> 00:37:43,200 Speaker 11: I was in San Francisco with all sorts of needles 653 00:37:43,360 --> 00:37:47,719 Speaker 11: on the counter and a man unconscious in my room 654 00:37:48,400 --> 00:37:50,040 Speaker 11: with blood all over him and me. 655 00:37:51,200 --> 00:37:53,720 Speaker 1: Finally, the man woke up and apologized. 656 00:37:54,800 --> 00:37:57,080 Speaker 11: He said he always faced at the sight of blood. 657 00:37:58,080 --> 00:38:00,640 Speaker 11: So I asked him if he would stay on the 658 00:38:00,680 --> 00:38:03,320 Speaker 11: floor while I got the specimens, because I needed to 659 00:38:03,320 --> 00:38:05,040 Speaker 11: get those specimens, and I did. 660 00:38:06,000 --> 00:38:09,799 Speaker 1: The incident would haunt Geyan for several years, especially when 661 00:38:09,800 --> 00:38:12,200 Speaker 1: she developed a lesion on her arm that looked like 662 00:38:12,239 --> 00:38:15,759 Speaker 1: it could be Capasi sarcoma. Her secretary at the time 663 00:38:15,960 --> 00:38:18,759 Speaker 1: was so afraid of catching it that she quit. It 664 00:38:18,800 --> 00:38:21,640 Speaker 1: was not until nineteen eighty five that a blood test 665 00:38:21,719 --> 00:38:30,480 Speaker 1: showed that Guynan had not been infected. When Guyinan and 666 00:38:30,520 --> 00:38:33,520 Speaker 1: her colleagues on the CDC Task Force analyzed the data 667 00:38:33,600 --> 00:38:38,600 Speaker 1: they had collected, one finding stood out people with diagnosed 668 00:38:38,600 --> 00:38:41,799 Speaker 1: cases had had way more sexual partners over the course 669 00:38:41,840 --> 00:38:43,000 Speaker 1: of their lives. 670 00:38:42,600 --> 00:38:43,520 Speaker 4: Than the control group. 671 00:38:44,760 --> 00:38:47,680 Speaker 1: The finding seemed to bolster the hypothesis that members of 672 00:38:47,680 --> 00:38:50,400 Speaker 1: the task force had held from the beginning that the 673 00:38:50,440 --> 00:38:53,400 Speaker 1: new disease was a virus that was transmissible through sex 674 00:38:53,800 --> 00:38:58,280 Speaker 1: and could therefore infect anyone, not just gay men. According 675 00:38:58,280 --> 00:39:01,640 Speaker 1: to Kerrn, that was the reason the CDC never adopted 676 00:39:01,680 --> 00:39:05,840 Speaker 1: the term gay related immune deficiency or GRID, which was 677 00:39:05,960 --> 00:39:08,160 Speaker 1: used in much of the early media coverage. 678 00:39:08,400 --> 00:39:11,600 Speaker 10: Doctors have even coined a new word for these conditions, GRIDS, 679 00:39:11,920 --> 00:39:13,840 Speaker 10: gay related infectious diseases. 680 00:39:14,400 --> 00:39:17,719 Speaker 1: For the most part, though there was no early media coverage. 681 00:39:17,920 --> 00:39:21,719 Speaker 1: Jim Curran again, there was virtually no coverage in the 682 00:39:21,760 --> 00:39:25,480 Speaker 1: mainstream media in the first year or so. The people 683 00:39:25,480 --> 00:39:29,200 Speaker 1: who did good coverage were people with the New York 684 00:39:29,280 --> 00:39:33,000 Speaker 1: Native the gay publications, but there was essentially nothing in 685 00:39:33,040 --> 00:39:36,839 Speaker 1: the New York Times or nothing on mainstream TV. Even 686 00:39:36,880 --> 00:39:39,560 Speaker 1: the scores of new cases were discovered and the number 687 00:39:39,600 --> 00:39:42,960 Speaker 1: of deaths continued to climb, the biggest news outlets in 688 00:39:43,000 --> 00:39:46,560 Speaker 1: America barely followed up on the CDC's early reports from 689 00:39:46,600 --> 00:39:50,920 Speaker 1: the summer of nineteen eighty one. Then that winter, Kerran 690 00:39:51,040 --> 00:39:53,680 Speaker 1: heard from a veteran health reporter at the Wall Street Journal. 691 00:39:54,600 --> 00:39:56,560 Speaker 1: He said he wanted to write a long story on 692 00:39:56,600 --> 00:39:59,480 Speaker 1: the disease, so Kerran flew to New York to meet 693 00:39:59,480 --> 00:39:59,799 Speaker 1: with him. 694 00:40:00,160 --> 00:40:03,560 Speaker 14: I remember having lunch with him at Uncle Ty's Hunan Juan, 695 00:40:04,120 --> 00:40:07,160 Speaker 14: and we talked for hours, and he wrote this very 696 00:40:07,200 --> 00:40:10,960 Speaker 14: long story in the Wall Street Journal and they wouldn't publish. 697 00:40:11,040 --> 00:40:13,799 Speaker 14: So he called me back and he said, they think 698 00:40:13,840 --> 00:40:16,160 Speaker 14: this is just a story about gay men, and this 699 00:40:16,200 --> 00:40:18,399 Speaker 14: is the first time I've ever had a story turned down. 700 00:40:19,200 --> 00:40:23,120 Speaker 1: Current pushed back, noting that the disease almost certainly didn't 701 00:40:23,160 --> 00:40:25,080 Speaker 1: just affect gay men, and I. 702 00:40:25,080 --> 00:40:29,360 Speaker 14: Said, well, there is heterosexual transmission two very likely couldn't 703 00:40:30,040 --> 00:40:32,759 Speaker 14: totally prove it, but we're having good examples of it. 704 00:40:33,120 --> 00:40:37,160 Speaker 14: So they published a very short article that said heterosexuals 705 00:40:37,160 --> 00:40:37,799 Speaker 14: get aids two. 706 00:40:39,040 --> 00:40:42,440 Speaker 1: The Wall Street Journal article was published on February twenty fifth, 707 00:40:42,520 --> 00:40:46,800 Speaker 1: nineteen eighty two, under the headline new often fatal illness 708 00:40:46,800 --> 00:40:52,000 Speaker 1: and homosexuals turns up in women coma heterosexual males. Over 709 00:40:52,000 --> 00:40:54,640 Speaker 1: the course of the coming year, as the article's central 710 00:40:54,680 --> 00:40:59,520 Speaker 1: thesis became increasingly evident, more media outlets began to pay attention. 711 00:41:00,239 --> 00:41:03,399 Speaker 5: Federal health officials consider it an epidemic, yet you rarely 712 00:41:03,440 --> 00:41:04,239 Speaker 5: hear a thing about it. 713 00:41:04,520 --> 00:41:07,800 Speaker 1: In August, CBS ran its first ever nightly news report 714 00:41:07,800 --> 00:41:08,560 Speaker 1: on the epidemic. 715 00:41:08,760 --> 00:41:11,400 Speaker 6: It's a disease first detected in the gay community that 716 00:41:11,440 --> 00:41:14,879 Speaker 6: has now spread beyond that, a disease experts are now 717 00:41:14,880 --> 00:41:17,799 Speaker 6: calling a national epidemic. There is a one in five 718 00:41:17,920 --> 00:41:20,279 Speaker 6: chance a victim will die within the first year of 719 00:41:20,320 --> 00:41:21,760 Speaker 6: the illness. 720 00:41:21,920 --> 00:41:25,760 Speaker 1: The report included an interview with Bobby Campbell, conducted seven 721 00:41:25,760 --> 00:41:28,440 Speaker 1: months after his appearance on the Gay Life radio show. 722 00:41:29,080 --> 00:41:31,320 Speaker 3: It was devastating, you know, at that time, I was 723 00:41:31,400 --> 00:41:32,319 Speaker 3: twenty nine years old. 724 00:41:32,520 --> 00:41:36,160 Speaker 6: For Bobby Campbell, it is a race against time. How 725 00:41:36,160 --> 00:41:38,800 Speaker 6: long before he and others who have this disease finally 726 00:41:38,840 --> 00:41:41,960 Speaker 6: have answers, finally have the hope of a cure. 727 00:41:42,320 --> 00:41:45,000 Speaker 1: The CBS report noted that while most of the known 728 00:41:45,080 --> 00:41:48,239 Speaker 1: cases have been found in gay men, other groups were 729 00:41:48,239 --> 00:41:49,439 Speaker 1: starting to get sick too. 730 00:41:49,800 --> 00:41:53,279 Speaker 6: Now It's been detected in Haitian refugees and in some 731 00:41:53,320 --> 00:41:57,000 Speaker 6: people with hemophilia, a disease that prevents blood clotting so 732 00:41:57,040 --> 00:41:59,160 Speaker 6: the patient needs frequent blood transfusions. 733 00:42:02,880 --> 00:42:06,880 Speaker 1: Soon, these high risk groups were nicknamed the four HS. 734 00:42:06,880 --> 00:42:12,239 Speaker 1: Homosexuals heroin users, haitians, and people with hemophilia. All of 735 00:42:12,239 --> 00:42:16,000 Speaker 1: a sudden, gay related immune deficiency no longer seemed like 736 00:42:16,040 --> 00:42:20,759 Speaker 1: an accurate descriptor. In September of nineteen eighty two, the 737 00:42:20,800 --> 00:42:23,560 Speaker 1: CDC gave the disease its permanent name. 738 00:42:23,680 --> 00:42:28,960 Speaker 5: Acquired immune deficiency syndrome. It's mysterious, its deadly, and its 739 00:42:29,080 --> 00:42:34,520 Speaker 5: baffling medical science. Once thought to affect only promiscuous homosexual males, 740 00:42:34,920 --> 00:42:38,960 Speaker 5: AIDS is now spreading in epidemic proportions to other segments 741 00:42:38,960 --> 00:42:39,759 Speaker 5: of the population. 742 00:42:41,120 --> 00:42:44,680 Speaker 1: With that, AIDS was officially not just a gay disease, 743 00:42:45,440 --> 00:42:48,320 Speaker 1: at least as far as most doctors and scientists were concerned. 744 00:42:49,200 --> 00:42:53,440 Speaker 1: In practice, though, the wider world remained largely indifferent, and 745 00:42:53,520 --> 00:42:57,000 Speaker 1: what little public discussion there was of AIDS often continued 746 00:42:57,040 --> 00:42:58,719 Speaker 1: to place the blame on gay men. 747 00:42:59,000 --> 00:43:01,759 Speaker 16: Gays are being called all the dangerous and violent group 748 00:43:01,840 --> 00:43:12,520 Speaker 16: that corrupts children and infects the community with AIDS. 749 00:43:15,640 --> 00:43:18,480 Speaker 1: It's probably obvious why I wanted to make this podcast, 750 00:43:19,400 --> 00:43:22,520 Speaker 1: Living through COVID nineteen. I wanted to know what it 751 00:43:22,560 --> 00:43:25,839 Speaker 1: was like the last time American society was transformed by 752 00:43:25,840 --> 00:43:29,960 Speaker 1: a deadly virus. I wasn't expecting easy parallels. I just 753 00:43:30,000 --> 00:43:31,920 Speaker 1: wanted to know how it felt to live through it, 754 00:43:32,400 --> 00:43:34,960 Speaker 1: the early years in particular, and what it had to 755 00:43:35,000 --> 00:43:37,440 Speaker 1: tell us about the thing we've all been living through lately. 756 00:43:38,360 --> 00:43:40,799 Speaker 1: As you'll hear over the course of our series, there 757 00:43:40,840 --> 00:43:44,719 Speaker 1: are certain things all epidemics have in common. The confusion 758 00:43:44,840 --> 00:43:49,840 Speaker 1: and fear, the scapegoating and paranoia, the difficulty of addressing 759 00:43:49,880 --> 00:43:53,560 Speaker 1: a new existential threat that requires human beings to change 760 00:43:53,560 --> 00:43:58,400 Speaker 1: their behavior en Mass. Marcus Conant, a pioneering AIDS doctor 761 00:43:58,480 --> 00:44:02,160 Speaker 1: you'll hear more about later, says the echoes between epidemics 762 00:44:02,200 --> 00:44:03,080 Speaker 1: are unavoidable. 763 00:44:03,880 --> 00:44:06,440 Speaker 17: It's well documented from the time of the Black Death 764 00:44:06,520 --> 00:44:11,799 Speaker 17: in thirteen forty eight. With almost every epidemic, people respond 765 00:44:11,920 --> 00:44:16,239 Speaker 17: to the epidemic in exactly the same predictable ways. The 766 00:44:16,280 --> 00:44:19,440 Speaker 17: first thing they do is they deny that it's even occurred. 767 00:44:19,520 --> 00:44:22,440 Speaker 17: You know, it's not happening, and then they want to 768 00:44:22,520 --> 00:44:26,080 Speaker 17: blame someone for having caused it, as if that will 769 00:44:26,120 --> 00:44:29,320 Speaker 17: make it not have happened and go away. 770 00:44:29,360 --> 00:44:33,319 Speaker 1: Still, the AIDS crisis was and continues to be a 771 00:44:33,360 --> 00:44:37,319 Speaker 1: singular disaster. This is in large part because of who 772 00:44:37,440 --> 00:44:41,120 Speaker 1: got sick and died first, but it's also because of 773 00:44:41,120 --> 00:44:45,719 Speaker 1: who responded and who didn't. I feel compelled to say 774 00:44:45,760 --> 00:44:48,719 Speaker 1: that our series will not offer a comprehensive picture of 775 00:44:48,760 --> 00:44:53,640 Speaker 1: everything that went wrong or everyone who was affected. Our 776 00:44:53,719 --> 00:44:57,280 Speaker 1: goal is just to be specific, to try to understand 777 00:44:57,320 --> 00:45:01,200 Speaker 1: why this particular epidemic unfolded the way it did, and 778 00:45:01,320 --> 00:45:04,400 Speaker 1: why has been allowed to kill more than thirty million 779 00:45:04,480 --> 00:45:12,920 Speaker 1: people worldwide. For Jeffrey Green, the experience of being a 780 00:45:13,000 --> 00:45:17,239 Speaker 1: doctor changed completely once he began treating people with AIDS. 781 00:45:17,800 --> 00:45:20,640 Speaker 1: He had gone into medicine and specialized an infectious disease 782 00:45:20,719 --> 00:45:24,520 Speaker 1: because you wanted to cure people. Now, somehow, just a 783 00:45:24,560 --> 00:45:27,560 Speaker 1: few years into his career, his job was to tell 784 00:45:27,680 --> 00:45:30,160 Speaker 1: young patients there was really nothing he could do. 785 00:45:31,480 --> 00:45:33,680 Speaker 9: And I began talking to some of the oncologists at 786 00:45:33,680 --> 00:45:34,360 Speaker 9: the hospital. 787 00:45:34,960 --> 00:45:36,040 Speaker 4: I said, how do you guys do this? 788 00:45:36,160 --> 00:45:40,320 Speaker 9: I mean, patients dying, you know, in seven months, eight months, 789 00:45:40,600 --> 00:45:43,880 Speaker 9: a year, two years. I'd give him, you know, and 790 00:45:43,920 --> 00:45:49,000 Speaker 9: then I feel like I've succeeded with two years' survival. 791 00:45:49,480 --> 00:45:50,960 Speaker 9: And they said, well, you just add up all the 792 00:45:51,040 --> 00:45:53,040 Speaker 9: years that you've kept people alive, and that's the way 793 00:45:53,080 --> 00:45:57,040 Speaker 9: you have to think about it. And they pulled me back. 794 00:45:57,560 --> 00:45:58,920 Speaker 9: My colleagues pulled me back. 795 00:46:00,560 --> 00:46:03,080 Speaker 1: Green still has dreams about some of the people with 796 00:46:03,120 --> 00:46:06,400 Speaker 1: AIDS he has treated over the years. In one of 797 00:46:06,440 --> 00:46:09,240 Speaker 1: those dreams, he's running from one waiting room to another, 798 00:46:09,960 --> 00:46:11,839 Speaker 1: all of them filled with dying men. 799 00:46:12,640 --> 00:46:15,799 Speaker 9: So recurring nightmare that I have is running in an 800 00:46:15,840 --> 00:46:18,960 Speaker 9: office that has fifteen different rooms and not being able 801 00:46:19,000 --> 00:46:21,640 Speaker 9: to keep up, and I'm running from room to room, 802 00:46:22,320 --> 00:46:25,160 Speaker 9: and I feel that type of in the dream, that 803 00:46:25,239 --> 00:46:27,319 Speaker 9: panic attack reoccurring. 804 00:46:28,280 --> 00:46:31,880 Speaker 1: Green is haunted by another image too. As part of 805 00:46:31,920 --> 00:46:34,960 Speaker 1: his work treating people with AIDS, he started doing what 806 00:46:35,000 --> 00:46:38,560 Speaker 1: his family doctor had done all those years ago. He 807 00:46:38,640 --> 00:46:43,000 Speaker 1: made house calls. To this day, Green thinks about something 808 00:46:43,040 --> 00:46:46,239 Speaker 1: he saw while visiting a patient in a brownstone in Manhattan. 809 00:46:47,000 --> 00:46:48,880 Speaker 9: And I went to see him because he was dying 810 00:46:48,920 --> 00:46:52,120 Speaker 9: and he was too weak to come to the office. 811 00:46:52,719 --> 00:46:56,719 Speaker 9: And he had set up a cot like a hospital bed, 812 00:46:56,760 --> 00:46:59,920 Speaker 9: I guess, in the middle of his aviary, which was 813 00:47:00,160 --> 00:47:04,239 Speaker 9: his living room. And there were these exotic birds that 814 00:47:04,600 --> 00:47:10,399 Speaker 9: you know, very large Brazilian colorful cockatoos and other kinds 815 00:47:10,400 --> 00:47:13,360 Speaker 9: of fancy birds. 816 00:47:13,400 --> 00:47:16,000 Speaker 4: And when I walked in the door, his partner lit 817 00:47:16,040 --> 00:47:16,200 Speaker 4: me in. 818 00:47:17,160 --> 00:47:21,600 Speaker 9: What I saw was a skeleton on the bed on 819 00:47:21,680 --> 00:47:25,480 Speaker 9: his back, looking at the ceiling. There was a white, 820 00:47:26,000 --> 00:47:31,840 Speaker 9: gorgeous bird, maybe a foot tall, on his chest, and 821 00:47:32,280 --> 00:47:32,960 Speaker 9: it looked like. 822 00:47:32,920 --> 00:47:34,120 Speaker 4: A bird of prey. 823 00:47:35,320 --> 00:47:38,799 Speaker 9: Or a scavenger bird that was gonna wait till he 824 00:47:38,880 --> 00:47:43,120 Speaker 9: died to eat him. It was I'd wake up at 825 00:47:43,239 --> 00:47:46,200 Speaker 9: night once or twice a month with that image in 826 00:47:46,239 --> 00:47:46,640 Speaker 9: my head. 827 00:47:46,680 --> 00:48:15,640 Speaker 13: Still they fall around, they are fall and round, they 828 00:48:16,000 --> 00:48:25,319 Speaker 13: are fallund me the strong GUYSI. 829 00:48:26,320 --> 00:48:27,320 Speaker 12: Masie. 830 00:48:30,440 --> 00:48:34,440 Speaker 1: On the next episode of Fiasco, the revolutionary first stirrings 831 00:48:34,440 --> 00:48:36,400 Speaker 1: of AIDS activism in New York City. 832 00:48:36,920 --> 00:48:39,719 Speaker 8: People who were sick were organizing and taking care of 833 00:48:39,760 --> 00:48:41,759 Speaker 8: each other. We really weren't even looking that much to 834 00:48:41,840 --> 00:48:45,359 Speaker 8: the healthcare establishment because they didn't want to deal with us. 835 00:48:45,640 --> 00:48:49,640 Speaker 8: It was a whole different kind of of activism. 836 00:48:50,040 --> 00:48:54,279 Speaker 1: Fiasco is presented by Audible Originals and Prologue Projects. The 837 00:48:54,280 --> 00:48:58,040 Speaker 1: show is produced by Andrew Parsons, Sam Graham Felsen, Madeline 838 00:48:58,080 --> 00:49:03,080 Speaker 1: kaplan Ula Coppa, and me Leon Nafock. Editorial support by 839 00:49:03,160 --> 00:49:07,400 Speaker 1: Nola Wawas and Jessica Miller. Our researcher is Francis Carr. 840 00:49:07,840 --> 00:49:12,360 Speaker 1: Archival research by Michelle Sullivan. This season's music is composed 841 00:49:12,360 --> 00:49:16,400 Speaker 1: by Edith Mudge additional music by Nick Sylvester of God Mode, 842 00:49:16,600 --> 00:49:20,200 Speaker 1: Joel Saint, Julian and Dan English, Noah Hect and Joe Valley. 843 00:49:21,080 --> 00:49:25,680 Speaker 1: Our theme song is by Spatial Relations Music Licensing courtesy 844 00:49:25,800 --> 00:49:30,359 Speaker 1: of Anthony Roman. Our credits song this week is They 845 00:49:30,400 --> 00:49:33,759 Speaker 1: Are Falling All Around Me by Bernice Johnson Reagan from 846 00:49:33,760 --> 00:49:37,440 Speaker 1: the recording Give Your Hands The Struggle courtesy of Smithsonian 847 00:49:37,480 --> 00:49:43,600 Speaker 1: Folkways Recordings. Additional thanks to tro Essex Music Group. Audio 848 00:49:43,640 --> 00:49:47,560 Speaker 1: mix by Erica Wong, with additional support from Selina Urabe. 849 00:49:48,239 --> 00:49:51,319 Speaker 1: Our artwork is designed by Teddy Blanks at Chips and Y. 850 00:49:52,840 --> 00:49:55,640 Speaker 1: David Blum is the editor in chief of Audible Originals. 851 00:49:56,200 --> 00:49:59,719 Speaker 1: Mike Charzik is the vice president of Audible Studios. Zac 852 00:49:59,800 --> 00:50:02,240 Speaker 1: ro Us is head of acquisition and Development for Audible. 853 00:50:04,000 --> 00:50:08,440 Speaker 1: Thanks to Archive dot Org, Annabel Bacon, Carrie Baker, Brandon Ellis, 854 00:50:08,480 --> 00:50:12,920 Speaker 1: Alice Gregory, Chris Horton, Stephen Fisher, Ben Frisch, Akiva Gottlieb, 855 00:50:13,080 --> 00:50:18,080 Speaker 1: Andrew Jacobs, Giannis Kulpa, Stephen Phillips, Horst, Willi Paskin, Lisa Pollock, 856 00:50:18,280 --> 00:50:22,799 Speaker 1: Bill Rutland, Aichris Gondaraja, and Sasha Weiss. Special thanks to 857 00:50:22,880 --> 00:50:27,440 Speaker 1: Randy Alfred and Peter Yassi. Next week, episode two. 858 00:50:27,920 --> 00:50:29,880 Speaker 13: Say Masson. 859 00:50:32,680 --> 00:50:35,759 Speaker 1: V sure to let me 860 00:50:37,440 --> 00:50:48,240 Speaker 12: From