Medicine: The Appalling Saga of Patient Zero

A stunning book traces the mishandling of the AIDS epidemic

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Shilts, who is openly gay, is equally tough on the gay community, which, he says, transformed its civil rights movement in the '70s into "omnipresent carnality." In the face of rampant disease, he says, gay leaders resisted calling for sexual restraint, fearing that it would threaten their hard-won liberation. He adds that the owners of gay "back room" bars and bathhouses were prominent contributors to gay political groups and major advertisers in gay newspapers, and thus unduly influenced the debate. In one grim scene, a bathhouse owner tells a doctor at San Francisco General Hospital, "We're both in it for the same thing. Money. We make money at one end when they come to the baths. You make money from them on the other end when they come here."

Shilts says he interviewed more than 900 people. He lists dates for eleven interviews with Dr. James Curran, head of the CDC's AIDS program. The most poignant passages recount the first stirrings, before doctors knew there was such a disease. Shilts suggests that the first non-African victim may have been Margrethe Rask, a Danish physician who fell ill in 1976 while working in a primitive village hospital in Zaire and died of AIDS-related pneumonia in 1977. At about the time Rask succumbed, Shilts began interviewing physicians about the health implications of the gay sexual revolution. Often, in private, they noted the spread of various venereal and gastrointestinal diseases and worried about what would happen if a new disease appeared. Dr. Dan William of Manhattan warned, "The plethora of opportunities poses a public health ( problem that's growing with every new bath in town." That was in 1980, just a year before the doctors learned their worst fears had come true.

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