40 years ago today, the first domestic cases of a rare pneumonia in a few gay men were reported. Like the beginnings of many diseases, it flew under the radar. It was the summer of 1981 and the Yuppies were in bloom. Stonewall had been 11 years earlier, but gays were much more in the closet than out. Most people did not know that they knew a gay person. (Honest.) And initially, as “GRID” (gay-related immune deficiency) spread, it was ignored by most people since it was completely outside of their “worlds”.
Lesson 1: We are ALL connected.
By early 1982, we knew that AIDS was found in the blood supply, and could be spread that way, initially affected hemophiliacs. Again, a subset of the population. In his book “Reimagining AIDS”, Robert Root-Bernstein described even earlier cases of AIDS, dating back close to a hundred years. For a few cases, in the 20th century, there were saved tissue samples shown to have HIV. The rest is anecdotal. But we came to learn this disease came from Africa, zoonotic from monkeys, and likely entered the US during the 4th of July celebrations in 1976. For a clear and accurate history, Randy Shilts “And the Band Played On” (the book, not the movie) is highly recommended.
As the disease spread, the Reagan administration refused to do anything. ANYTHING. With the exception of Anthony Fauci, who was a true hero, along with a number of other medical researchers and practitioners. The fear and hatred of “middle America” was palpable as the idiots recommended rounding up all the gay men in America and putting them in camps to “save” the rest of the country.
As doctors, we started to see afflicted patients. And there was nothing we could do. There was no treatment, and we didn’t know if AIDS was spread by sex and blood, or also by tears and sweat. I remember my first AIDS patient. He was the brother of an existing patient, and she wanted him to see me for a problem unrelated to AIDS. I met with my staff and explained what we knew, and that I planned to see him as the last patient of the day, and that none of them needed to stay. But they were adamant: they would all wear masks and gloves, disinfect before he came in and after he left. He would be a regular patient because he was a human being. We treated humans. We didn’t discriminate.
The first visit, he came clutching a bottle of shark cartilage, the hydroxychloroquine of the day, and asked if I thought it would help. I sadly said no, but it wouldn’t hurt him, and he could take it if it gave him hope.
Lesson 2: Look for hope in the darkness.
In 1987, AZT became the first treatment available. It took almost a decade for HAART to be released. These drugs worked to a certain extent to extend lives but had very serious side effects. Treatment regimens were severe: drugs needed to be taken on a precise schedule, and there were many pills on a daily basis. Compliance was difficult.
In 1988, Surgeon General Everett Coop had a brochure “Understanding AIDS” mailed to every household in the US. The disease was now rampant, and while worse in certain populations than others, it affected people in all walks of life.
Eventually, there were better and better treatments, along with a difficult Public Health campaign to decrease transmission. The blood supply was tested (something both the Reagan Administration and the Red Cross initially fought), meaning that transfusions became safe, thus cutting off that mode of transmission. Many bathhouses were closed, and the term “safe sex” came into common usage. Albeit, not without a fight. Worldwide, cases still spread to this day for a variety of reasons, but treatments are available to make AIDS a chronic disease, and not an automatic death sentence.
Lesson 3: Science works, sadly not always as quickly as we’d like.
Medical research has changed leaps and bounds since the 1980’s. Due to technology and worldwide interaction and sharing, science was able to sequence Covid in a matter of weeks, whereas understanding what the HIV virus was took years. There were fights about who deserved credit for HIV advances in both understanding and treatment: that is very different today.
Another difference was that back in the 80’s, there was a group called Act-Up. (Read about Larry Kramer to fully grasp what they did.) They were in the streets, protesting, yelling, doing anything and everything to bring light to the problem, and to get the scientific community to work towards cures. Today, in the US, we see covidiots who work strongly against vaccines and Public Health initiatives. Science decades ago was slower, but people believed in it.
Lesson 4: There will always be idiots amongst us.
As I write this, I have tears in my eyes. I remember Tommy, Pat, Zoom and Ronnie: friends lost early. Good men all.
Back in the 1980’s, Anthony Fauci was my hero. His dedication, his smarts…and in the winter of 2020, I was glad he was still at NIH. He is fast becoming the target of the right, and they will needle him verbally and in writing. The difference now is that he’s needed security protection since last year when the covidiots started threatening his life, and the lives of his family.
There will always be disease. There will always be loss and there will always be heroes. Science will continue to fight the good fight against those diseases we know about, and those left to emerge. It is incumbent on all of us to do our best to support science: through donations to research organizations, electing candidates who fight for science, and to show love and compassion to the afflicted as we wait for science to get to solid treatments, vaccines and cures.
