How Don Francis Helped Corrupt the Hard Drive of AIDS Research
How James Curran Helped Corrupt the Hard Drive of AIDS Research
How Mary Guinan Helped Corrupt the Hard Drive of AIDS Research
How Don Francis Helped Corrupt the Hard Drive of AIDS Research
Donald Francis, the epidemiological superstar of Shilts's book, And the Band Played On, is also the star of the titanic HIV mistake that led to the HHV-6 spectrum catastrophe. Shilts’s unfortunate hero worship begins with this description of the man: "Although he was only thirty-eight, Dr. Don Francis was one of the most eminent experts on epidemics at the CDC, having been among the handful of epidemiologists who literally wiped smallpox off the face of the earth in the 1970s." (ATBPO p.73) Harvard retrovirologist Myron Essex thought Francis "had gained an international reputation for singular brilliance.” (ATBPO p.73) The early days among the crew that crafted the official AIDS paradigm in the early 80s was off to a great start as a rather grandiose mutual admiration society. That might have been an early telltale sign of a groupthink catastrophe in the making.
Donald Francis had worked with Essex at Harvard on feline leukemia. No more precise nucleus of the tragic HIV mistake can be found than the moment when Francis (according to Shilts) decided that Gay Related Immunodeficiency (GRID, as it was known early on) was feline leukemia in people because both diseases were marked by weakened immune systems and opportunistic infections. Feline leukemia is not the only animal disease to behave that way, but Francis's myopic familiarity with feline leukemia would tragically keep all other more likely possibilities at bay while he pursued his pet theory under the guidance of his Harvard mentor and future Harvard AIDS millionaire.
A sure recipe for hubristic mischief could be found in the fact that Francis seemed so very sure of himself and his intuitions. He was also very sure that other people with their competing ideas for the aetiology of the mysterious epidemic were dead wrong. According to Shilts, "Francis didn't think the gay health problems were being caused by cytomegalovirus or the other familiar viruses under discussion. They had been around for years and hadn't killed anybody. It was something new; it could even be a retrovirus, Francis said." (ATBPO p.73) Saying it “could be a retrovirus” was disingenuous because other possible causes that were not retroviral were not welcome at the table. Ironically and tragically, Shilts foolishly celebrates this determined rush to judgment: "Francis was already convinced. He quickly became the leading CDC proponent of the notion that a new virus that could be spread sexually was causing immune deficiencies in gay men." (ATBPO p.74) Both epidemiology and virology were rather quickly being carved into stone with horrific consequences.
Donald Francis was the human embodiment of a stern, uncompromising public health message that can be heard constantly playing over the P.A. system in And the Band Played On. The questionable behavior of all other scientists at the time and what Shilts perceives as the self-destructive dithering of gay leaders is judged harshly against what Shilts considers the courageous, take-no-prisoners approach that Francis had supposedly taken during epidemics he had worked on. "Years of stamping out epidemics in the Third World had also instructed Francis on how to stop a new disease. You find the source of contagion, surround it, and make sure it doesn't spread." (ATBPO p.107) Couldn't be any simpler than that. But nobody, Shilts included, was stopping to ask if Francis was fighting the last epidemiological war rather than the new one.
Francis had a no-nonsense approach, a manly approach, one Shilts clearly admires. While Francis will be the voice of moral testosterone throughout Band, according to Shilts’s black and white schema, it falls to the gay community to play the role of denial ridden, weak-kneed, self-destructive imbeciles. In the dark days of the early epidemic only the wise-beyond-his-years Francis sees the light and knows what to do. The Francis buzz word is "control." Dr. Donald Francis knew how to "control" epidemics. If only the dopes at the top of the nation’s AIDS effort, and the epidemics uncooperative gay victims had let him take control.
Francis's African experiences were epidemiologically formative. He had worked on Ebola Fever in Africa in 1976 and he will now look at this new disease through Ebola-colored glasses: " . . . the disease [Ebola] was a bloodborne virus, wickedly spreading both through sexual intercourse, because infected lymphocytes were in victims' semen, and through the sharing of needles in local bush hospitals.” (ATBPO p.118) Shilts also looks at "AIDS" and public health itself through Francis’s Ebola glasses: "When it became obvious that the disease was spreading through autopsies and ritual contact with corpses during the funerary process, Dr. Don Francis, on loan to the World Health Organization from the CDC, had simply banned local rituals and unceremoniously buried the corpses. Infected survivors were removed from the community and quarantined until it was clear that they could no longer spread the fever. Within weeks, the disease disappeared as mysteriously as it had come. The tribespeople were furious that their millennia-old rituals had been forbidden by these arrogant young doctors from other continents. The wounded anger twisted their faces." (ATBPO p.118) This passage is a key to understanding the moral of And the Band Played On, and the theme Shilts also promulgated in his publicity campaign for his bestselling book. It becomes the schtick he will hector his own community with. For “tribespeople” fill in the word “gays.“ If only the government had acted, had done something, anything, sooner. But what? Clearly Shilts wanted the country, under Dr. Francis—as a kind of extra-political AIDS Czar—to go into the same emergency mode reflected in the kind of ritual-banning measures he took toward the benighted tribespeople in Africa. In a manner of speaking, in a perfect Donald Francis public health universe gay rituals (i.e. sex) would be banned, infected people would be removed from the community and quarantined. Whenever anyone will talk about the government not doing enough after Band, what will always be disingenously unsaid is what a heavy-handed government could have done if it had wanted to. In the name of doing something—anything—involving a not much loved minority, things could have gotten extremely dicey in the inconvenient Bill of Rights sense, and there is nothing about what one detects in the character of either Francis or Shilts in the book to suggest that they would have done anything other than cheer such a development on. Gay men performed many foolish, politically self-defeating acts throughout the epidemic, but applauding Shilt's silly message about the heterosexist government of a heterosexist country not doing enough, with all its dark unconsidered implications of what draconian things might have been done in the name of dealing with a public health emergency, is surely one of the most foolish. Anything done under the biased auspices of Don Francis during the early days of the epidemic, can now be appreciated as an example of an incompetent government with questionable motives doing too much too fast and using poor judgment.
The impatient Dr. Francis considered the ideas of those at the National Institutes of Health who were looking at alternative theories like amyl nitrite or sperm as the cause of AIDS to be "ludicrous." (ATBPO p.119) Instead of suffering these fools, Francis set up his own laboratories and went to work to lay down the foundation for what would turn out to be the CDC’s greatest mistake in its history. As for gay people, like the indigenous people of Francis’s African epidemics, "Customs and rituals would have to be dramatically changed, and he knew from his hepatitis work in the gay community that customs involving sex were the most implacable behaviors to try to alter." (ATBPO p.119) Yeah, changing gay customs is like herding cats.
Shilts portrays Francis as a man of destiny: "Don Francis viewed his life as an accumulation of chance decision that had put him in the right place at the right time.” (ATBPO p. 128) In retrospect, perhaps destiny had brought together exactly the wrong man, the wrong institution, the wrong epidemic at the wrong time to create the most perfect coalescence of misbegotten epidemiology and virology in history. Shilts swoons over the synchronicities of the Donald Francis life journey thus far: "By chance after chance, Don Francis felt he had been delivered to this moment in early March 1982, when it all fit together. The retrovirology, the cat leukemia, the experience with African epidemics, and the long work with the gay community—it all let him see something very clearly." (ATBPO p.128) Oy vey.
Francis looked through the world through the retroviral lenses of Myron Essex. Francis had completed his doctorate on retroviruses and he was like the hammer that sees the world in terms of nails. It is a curious factoid of history that originally Francis thought that AIDS was co-factorial: Shilts reports he said, "Combine these two diseases—feline leukemia and hepatitis—and you have the immune deficiency." (ATBPO p.129) If Francis had only kept his co-factorial notion alive, there would have at least been a small chance that the HIV mistake might have corrected itself quickly rather than rolling out thirty years of hell on earth. Co-factors might have kept minds from closing
To Francis, the conclusions were painfully obvious, and it was also clear what needed to be done. The Center for Disease Control needed "to launch some educational campaigns among gays to prevent the disease.” (ATBPO p.129) The Great White Doctor had arrived among the ignorant, indigenous gays of America. The gay "implacable" behaviors had to change. Cut to the gay versions of "twisted faces" and "wounded anger" Shilts described in Africa.
Often when a detective makes a major wrong turn, the suspect is right there in front of him. In Francis's attempts to fulfill the destiny of his retroviral dissertation, he overlooked the most obvious viral suspect of all, the one the size of a barn that was just staring at the CDC researchers, begging to be discovered. Francis memorialized this Missed Opportunity when he himself wrote in one of the very first books on the epidemic (a collection of essays on AIDS edited by Kevin Cahill) "Blood sampling of the intravenous drug users also revealed that although many were infected with cytomegalovirus, the viral strains were different. This was strong evidence that this herpes virus, which many scientists considered a strong candidate for a causative agent, had not developed some new virulent strain.” (Cahill Book p.??) No single strain emerged, lending further weight to Don Francis's hypothesis that a new virus, not CMV was at work. If only he had wondered if there was some new DNA virus that resembled CMV in some way that was hidden in the mix, the retroviral obsession might not have ultimately ruled the day. And then of course the HHV-6 spectrum pandemic and Holocaust II might never have happened.
Anyone who disagreed with Francis during this early period of the epidemic was considered stupid or stubborn. (This is how eras of abnormal and totalitarian science get their start in putative democracies.) We're constantly told throughout Shilts's book that Francis hoped "somebody would see how catastrophic the epidemic would become.” (ATBPO p.147) Ironic, when you consider that indeed an apocalyptic catastrophe was coming and Francis himself was actually inadvertently taking a leadership role in making the key mistakes that would help to make it happen.
An amusing note is struck when Shilts points out that Francis wanted more labs to work on "AIDS" research because "they might get off on a bum lead and retard research at a time when people were dying." (ATBPO p.151) Francis, as it turns out, might live to see his name become synonymous with bum leads, and as far as dying is concerned, the show had only just begun.
There is no place that Shiltsian worship of Francis wouldn't go. He even followed Francis to bed: "The dream came to Don Francis often during those long, frustrating nights in the gathering darkness of 1982. Just beyond his reach, a faint orange light was suspended, shimmering with promise. It was The Answer, the solution to the puzzle. He reached for it, stretching so he could draw the light toward him. But it drifted farther and farther out. The answer was always there before him, tantalizingly close, and still beyond his grasp. Don's wife usually awoke him at that point. His mournful groaning would disturb the kids." (ATBPO p.159) Or, perhaps, in retrospect, it was just indigestion.
Our dreamer-scientist is portrayed as the solitary man of reason in an obstinate, irrational world: "The logical science of GRID demanded that logical steps be taken . . . or people would die needlessly. However, as would be the case with just about every policy aspect of the epidemic, logic would not be the prevailing modus operandi." (ATBPO p.170) “The logical science of GRID” is perhaps the most oxymoronic phrase in the history of phrases. In what sounds now like ironic chutzpah, Shilts had the nerve to write "Science was not working at its best, accepting new information with an unbiased eye and beginning appropriate investigations." (ATBPO p.171) From a Kuhnian promontory, one must ask whose unbiased eye it is, who decides what is appropriate? But why even bother accepting new or contradictory information if you're being beamed up to “the Answer” by an orange light?
By January 1983, Don Francis is pounding his fists on tables. He is enraged at the blood banks. No one was doing enough to "control" the disease. There were fools full of denial everywhere and people shortsighted enough to express concerns about trifles like civil liberties in the face of the mounting death toll. Shilts, as usual, opined that the “problem, of course, was that such considerations constantly overshadowed concerns of medicine and public health." (ATBPO p.224) Public health logic is inexorable and very useful for those in the emotional blackmail game. Only Francis knew exactly what needed to be done. "In his windowless office in Phoenix, he began laying out his own long-range plans for getting ahead of the epidemic." (ATBPO p.232) He wanted an outside advisory group of immunologists and retrovirologists to guide the CDC. New-fangled retrovirologists—not old fashioned virologists.
With his retroviral thinking cap on, Francis wanted to hone in on implacable retrovirus-spreading sexual behaviors of the gays: One of his almost salivating tough love memo's said, "I feel that to control AIDS we are obligated to try and do something to modify sexual activity. No doubt neither the fear of gonorrhea nor syphilis nor hepatitis B has decreased the number of sexual partners among homosexual men. But fear of AIDS might. [Emphasis mine] It seems mandatory for CDC to spread word of AIDS to all areas of the country. We have the network of VD clinics by which this word can be spread. Why not try?"(ATBPO p.233) Word certainly had no trouble spreading—and turning everything in its path into Holocaust II. Thus a biased, gay-obsessed presumption about the nature of AIDS was seamlessly stitched into the thinking and public health message right from the get-go. Every time the nature of the epidemic would be discussed, it would send a clear anti-gay message. Every time a public health warning about the epidemic would be given, it would repeat the biased conventional homodemiological wisdom. If it was not consciously a big lie, it was a Big Mistake being promoted with the same effective propagandistic techniques. And over time the Big Mistake would evolve smoothly and inexorably into the Big Self-deception and the Big Lie.
Francis was so committed to his retroviral explanation of AIDS that he could not let any anomalous or contradictory data get in the way of his retroviral, venereal and gay paradigm. He had created what Hannah Arendt might have called an “epidemiological image.” He began to build an empire around his AIDS paradigm, firing off memos insisting that "as part of CDC's continuing pursuit of the cause of AIDS, a laboratory with retrovirus capabilities is necessary at CDC." (ATBPO p.266) He moved to Atlanta and assumed the title of "Lab Director for the AIDS Activities Office." A great time was about to be had by all.
The CDC bureaucracy that Francis had to deal with is portrayed in the Shilts book as unenlightened and slow to respond to the AIDS mensch. Historians will have to do some homework here and figure out if maybe there were some unsung heroes of insurgency at the CDC who actually took the correct measure of Francis and acted appropriately. Sabotage of the Francis agenda might in retrospect have been the work of unrecognized saints. Shilts portrays Francis as someone who was heroically willing to go outside legal channels to achieve his worthy (in his own visionary mind) goals. Francis was willing to spend money without congressional authorization. (Yes, AIDS now had its own Oliver North.) Francis was often so busy with his "AIDS activities" that he didn't have time to write up findings for publications. Why write up findings for publications when people were dying? This was an implacable gay behavior emergency. Not bothering to write things up is a chronically disturbing meme in the abnormal science of AIDS as we shall see in the forthcoming chapter on the HIV/AIDS shenanigans up at the National Cancer Institute.
Francis is characterized as the voice of sanity compared to Shilts's portrayal of Robert Gallo, the scientist who will claim—with guns blazing—to have discovered the true AIDS retrovirus. There was a curious meeting in July, 1983 (two years after the first formal newspaper reporting of the sighting of the epidemic) at the CDC which "had been called to try to coordinate the search for the retrovirus responsible for Acquired Immune Deficiency Syndrome." (ATBPO p.349) Historians who like to know what people knew and when they knew it will chomp at the bit to figure out the prescience of knowing it was a retrovirus before they had found it. There will always be the whiff of phoniness about the search for a predetermined cause and that phoniness will certainly give birth to all kinds of conspiracy theories as historians excavate this somewhat hazy period at the CDC.
Shilts’s depiction of Gallo's vainglory and hair-trigger temper serve only to increase the number of halos floating above Don Francis's head. When Francis tries to recruit one of Gallo's assistants (also known as flunkies), Gallo goes ballistic, which is not surprising as the story about what really goes on in Gallo's lab will reveal later in the decade. The skeletons in that scientific closet are a Halloween unto themselves. The Gallo assistant who jumps ship receives the usual Gallo going-away gift for such an occasion: "I will destroy you," Gallo says to the man, according to Shilts. (ATBPO p.368)
Without understanding the disturbing implications, Shilts haplessly does a decent job of providing a snapshot of the political pressure that the CDC was under to name something (perhaps anything—and this retrovirus fit that bill) as the cause of AIDS: "James Mason, the CDC director, had a blunt directive for Don Francis on March 21  'Get it done,' he instructed. In his scientific notebook, Don Francis wrote PRESSURE and underlined the word twice. The heat was on to resolve the ‘AIDS’ mystery, and Francis didn't have any doubts that the proximity of the presidential election motivated the unusual administrative concern." (ATBPO p.434)
Historians will have to ask themselves if the roots of the titanic mistake made on HIV, AIDS and HHV-6 was actually just driven by the politics of a presidential election year. Was it just that tragically simple? Did the dynamics of one presidential race give birth to the era of mistaken, abnormal science that will refuse to correct itself for three decades? Did “Get it done!” lead, as night follows day, to Holocaust II?
Francis played pivotal role in the CDC's ultimately disastrous judgment that LAV, the retrovirus discovered by the French in AIDS patients, was the cause of AIDS. The bums-rush speed with which Francis moved from deciding it was the cause to creating inexorable public health policies based on it was stunning. Within a very short time frame there was an action agenda from Francis, and according to Shilts, "With the cause of AIDS found, scientists could now get on with the business of controlling the spread of the epidemic and finding a vaccine." (ATBPO p.409) Indeed. Given that the CDC could control the information about the spread of the epidemic (the Arendtian image, so to speak), they could certainly give the appearance of controlling the actual epidemic. That’s how abnormal, totalitarian and ultimately psychotic science, works.
Ironically, maybe one of the most important inadvertent contributions that Don Francis made to ultimately undermining the HIV/AIDS paradigm was his inability to create a model for "AIDS" by infecting monkeys with the retrovirus supposedly discovered by the French and Robert Gallo. This helped give birth to the first whistleblower of AIDS, retrovirologist Peter Duesberg, who used the failure to create an animal model as one of the arguments bolstering his growing doubts that the retrovirus was the real cause of AIDS. The health of those monkeys may have serendipitously saved all the people who heeded Duesberg’s warnings about HIV.
Shilts portrays Francis as an earnest man committed only to furthering the interests of public health, the perfect foil to Robert Gallo. As Gallo appeared at a press conference with Secretary of Health and Human Services, Margaret Heckler, to claim that the cause of AIDS had been found, Saint Francis watched in horror: "After years of frustration, the announcement of the HTLV-III discovery deserved elation, Don Francis thought as he watched the live Cable News Network coverage of the Heckler press conference in the CDC's television studio with other members of the AIDS Activities Office. Instead, he felt burdened by the conflicts he saw ahead. The French were being cheated of their recognition and the U.S. government had taken a sleazy path, claiming credit for something that had been done by others a year before. Francis was embarrassed by a government more concerned with election-year politics than with honesty. Moreover, he could see that suspicion would play greater, not a lesser role in the coming ‘AIDS’ research. Competition often made for good science, Francis knew, lending an edge of excitement to research. Dishonesty, however, muddied the field, taking the fun out of science and retarding future cooperation." (ATBPO p.451) Sleazy paths? Dishonesty? Suspicion? The world hadn’t seen anything yet.
Luckily for the health and civil liberties of the American people, Donald Francis, sooner rather than later "was beginning to feel beaten down." (ATBPO p.462 ) While others focused on a search for a treatment for "AIDS," Francis was itching to take it to the gay tribespeople and to “implement widespread voluntary testing for gay men."(ATBPO p.469 ) And gay men just couldn’t wait until he got his hands on them. The “voluntary testing,” of course, was based on his heterosexist notions of the epidemiology and virology of the disease. Francis penned a visionary nine-page program called "Operation AIDS Control" and his plan "employed the only two weapons with which health authorities could find the epidemic—blood testing and education." (ATBPO p.524) Luckily for the gay community, he never completely succeeded in getting the CDC into the full monty "control modality." But the early work of Francis succeeded in creating a paradigm that would help steer the AIDS agenda for three psychotic decades, one that implied that the only way to control the epidemic was to find ways to intervene medically and social-engineeringly in the lives of gay people. If liberation and privacy had been spoils of gay liberation, they were now under direct threat from the public health vision presented by Francis and his colleagues. According to Shilts, "Francis drew his two circles. One circle represented men infected with the AIDS virus; the other men who weren't. The point of AIDS control efforts, he said should be to make sure that everybody knows into which circle they fit." (ATBPO p.549) Dante couldn’t have drawn better circles for the gay community.
To their credit, not all gay men were eager to split their community up into Don Francis’s two circles. Some wondered whether these circles were a way of dividing and conquering the gay community. But for the majority of the gay community, who began to live their lives in the shadow of the two fraudulent circles, trusting in Francis’s vision proved a huge mistake. By 2010, one study of gay men showed that the big circle had not been protected from the real epidemic by avoiding contact with the smaller circle. One study showed that 60% of all gay men were testing positive for HHV-8 the so-called Kaposi‘s sarcoma virus, originally a marker for AIDS. Believing in HIV had not saved them from the real epidemic. (Note to come.)
Even his boss, James Curran, was not quite willing to turn over the epidemic to the gung-ho Donald Francis. A disgruntled Francis eventually left the CDC to go work in the San Francisco Health Department. Shilts leaves us with the impression that the proactive Don Francis could have saved the world if only the system hadn't gotten in his way. Francis had warned the world but he "had only been beaten by the system, and because of that the disease had won." (ATBPO p.600)
A disease had definitely won, but not the one Francis thought he had been fighting while wearing his venereal and retroviral glasses—the ones with the heterosexist frames.
How James Curran Helped Corrupt the Hard Drive of AIDS Research
The Centers for Disease Control’s James Curran was one of the chief architects of the original AIDS paradigm. Curran had the perfect medical background for laying down the formative heterosexually-biased interpretations of the early data that epidemiologists gathered about the sick gay men who were thought to be the patients zero of a new supposedly gay epidemic. Jacob Levinsen described Curran in The Story of AIDS and Black America: “ . . . Jim Curran, the Chief of the CDC’s Venereal Disease Control Division was tapped to head up a Kaposi’s Sarcoma and Opportunistic Infection Task Force. Despite being short staffed and underfunded, the Task Force managed to bring together experts from diverse fields like virology, cancer, and parasitic diseases in addition to a small team of epidemiological intelligence officers, who were the agency’s foot soldiers for disease prevention. . . . He had done quite a bit of work on hepatitis B with gay men in the 1970s, and he almost immediately suspected that the had a similar sexually transmitted and blood borne disease on their hands.” ( The Story of AIDS and Black America, p.??) And that suspicion paved the way for one of the biggest conceptual mistakes in the history of epidemiology.
According to Shilts’s Band, when Curran saw the first reports on PCP in gay men, he wrote an odd note to one of his colleagues saying “Hot stuff. Hot stuff.” (ATBPO p.67) Shilts also described a rather revealing meeting at a subsequent CDC conference at which Curran was briefed on the sexual behavior of gay men by a gay physician named David Ostrow. According to Shilts, “Ostrow mused on the years he had spent getting Curran and Dr. Jaffe [Curran’s CDC colleague] acculturated to the gritty details of gay sexual habits. . . . Curran had seemed uptight at the start, Ostrow thought, but he buckled down to his work. Both Jaffe and Curran were unusual in that federal officials rarely had any kind of contact with gays, and the few who did rarely wanted to hear detailed gymnastics of gay sex.” (ATBPO p. 68) They clearly buckled down to their work a little too well. With their heterosexual sense of noblesse oblige (venereal division), these high-level clap doctors gone wild, set out to understand what the mysterious new gay epidemic was all about. Gay men would have run for the hills or hidden in basements if they had known what would result from the efforts of these two quick learners about “the gymnastics of gay sex” who were headed their way. Again, I must point out, if only the CDC had recognized the 1980 DuBois CFS cases as the actual beginning of the AIDS/CFS/autism pandemic of HHV-6, the two quick learners might never have gotten their mitts on the “hot stuff’ that was happening in the gay community. They never would have become experts on the joy of gay sex.
Curran was married and the father of two children. Three days into what he thought was the sexually transmitted epidemic he was examining gay patients and, already, according to Shilts, he “was struck by how identifiably gay all the patients seemed to be (ATBPO p.70) These gays were apparently really gay, not the plainclothes kind who could pass. According to Shilts, these gays “hadn’t just peeked out of the closet yesterday.” (ATBPO p.71) It may have been the perceived intense gayness of the first patients—the really gay ones—that resulted in Curran’s huge, consequential mistake of erecting a mostly gay venereal epidemiological paradigm that would become the virtual thirty year hate crime against all gays, both the ones who could pass and the ones who were really gay. It wasn’t just the patients who were strange. The strangeness of the people who had the disease would inspire a strange new kind of science, epidemiology and virology that was in essence “homodemiology.” It was destined to make everything worse for gays and everyone else who had the bad luck of getting caught up in the CDC’s paradigm. And that would ultimately even include members of the heterosexual general population.
Shilts tried to capture Curran’s thought process when he wrote, “It was strange because diseases tended not to strike people on the basis of social group.” (ATBPO p.71) He added that “To Curran’s recollection . . . No epidemic had chosen victims on the basis of how they identified themselves in social terms, much less on the basis of sexual lifestyle. Yet, this identification and a propensity for venereal diseases were the only things the patients from three cities—New York, Los Angeles, and San Francisco—appeared to share. There had to be something within this milieu that was hazardous to these people’s health. (ATBPO p. 71) Well, there certainly was something about to enter this “milieu” that would be extremely hazardous to these people’s health, and that was Curran himself and his merry band of gay-sex-obsessed groupthinking epidemiologists who were about to hang the albatross of the venereal AIDS paradigm around the neck of the entire gay community.
When Shilts discussed Curran confronting “sociological issues” that were involved in the mysterious illness, it escaped Shilts that Curran and his associates were themselves sociological (and political) issues as they plopped themselves in the middle of the gay community (at a time when the community was most vulnerable and nearly hysterical) with all of their own peculiar heterosexual and heterosexist baggage. According to Shilts, “About a dozen staffers from all the disciplines potentially involved with the diseases volunteered for the working group. They included specialists in immunology, venereology, virology, cancer epidemiology, toxicology and sociology. Because the outbreak might be linked to the Gay Bowel Syndrome, parasitologists were called in. (ATBPO p. 71) The fact that any illness was labeled “Gay” should probably have been a red flag for the kind of heterosexist thinking that would soon be rolling across the gay community like a tsunami.
Once the guiding gay-obsessed premise (an example of a Arendtian “image“) was set, it was a matter of gay epidemiological garbage in and gay epidemiological garbage out. Questions with mistaken premises were about to lead the researchers and their medical victims down a deadly primrose path. Shilts summed up the basic direction of the inquiry: “Researchers also sought to determine whether the disease was indeed geographically isolated in the three gay urban centers. Did the detection of cases in the three centers make the patients appear to be only fast-lane gays because gay life tended toward the fast track in those cities? Was the disease all over gay America but in such low numbers that it had not been detected?” (ATBPO p. 81) Now we know, of course that there was indeed something else out there, but not just “all over gay America.” Something wasn’t playing by the rules of the CDC’s gay-obsessed epidemiology. Something was making even the heterosexual DuBois Atlanta cases of 1980 ill, and those non-fast-lane, non-gay cases represented what was going on all over straight general population America in a whole spectrum of ways. Biased epidemiological premises have consequences.
There is something almost laughable about the notion of Curran’s CDC working group going out into the gay world and asking themselves “What new element might have sparked this catastrophe.” (ATBPO p.82) One brand new element in the gay community that actually was the most significant spark for the coming catastrophe that was about to unfold was the CDC’s own incompetence and heterosexist epidemiology.
Given the way AIDS would evolve into the kind of abnormal science that doesn’t even require the usual rules of evidence, common sense and logic associated with real science, it is interesting that Curran did apply those old-fashioned rules early on when they were needed to build the venereal AIDS paradigm. Shilts wrote, “To prove an infectious disease, Curran knew, one had to establish Koch’s postulate. According to this century-old paradigm, you must take an infectious agent from one animal, put it into another, who becomes ill, and then take the infectious agent from the second and inject it into still a third subject, who becomes ill with the same disease.” (ATBPO p.105) Curran certainly tried to apply some semblance of the paradigm—or the logic of it anyway—when, by finding people who had AIDS often had slept with people who also had the disorder, he saw the links as a kind of epidemiological proof of transmission even though they weren’t strictly speaking the fulfillment of the animal experimentation inherent in Koch’s postulate. At least Curran knew the basic rules of science. Unfortunately these very same rules would subsequently be thrown out the window to maintain the belief that the retrovirus eventually linked to AIDS was the one true cause of AIDS. Had those Koch’s postulates been adhered to faithfully throughout the epidemic we might be calling HHV-6 the virus of acquired immunodeficiency today and there might have been no Holocaust II to write about.
The CDC, in an evolving and de facto manner, conducted something that could be called “the Atlanta AIDS/CFS/autism public relations experiment” at the expense of everyone‘s health. What I mean by that coinage is a kind of postmodern public health political experiment in which rather than truly controlling an epidemic by being truthful and effective and scientific, the public health institutions of the CDC and the NIH tried to control and manipulate everything the public knew about the epidemic of AIDS/CFS/autism. It may have been quasi-innocent and simply the product of unrecognized sexual bias and old-fashioned self-deception when it started, but it evolved into something far more sinister and destructive. In the early days of AIDS, as described by Shilts, Curran was seemingly the embodiment of good-egg innocence when it came to the realization that it would be necessary for him to figure out some way to get the media’s attention in order to increase public pressure for providing the funding the CDC needed for AIDS research. Unfortunately, the manipulation of the media by scientists or public health officials can—and did—have grave consequences for scientific, medical and epidemiological truth. In AIDS it became a kind of cancer.
In 1982 Curran appeared before a group of gay physicians in New York and told them “It’s likely we’ll be working on this most of our lives.” (ATBPO p. 134) Historians one day will want to probe deeply into whether he knew anything that everyone else didn’t know at that point. At the very least, it was as though he was an inadvertent prophet. He and his colleagues were indeed in the process of screwing things up for many generations to come. Curran’s mistakes assured that his grandchildren’s grandchildren will probably still be working on this problem. If they’re not autistic.
Shilts, in another moment of ironic journalistic naiveté, wrote this about Curran: “As a federal employee Curran had a thin line to walk between honesty and loyalty” (ATBPO p. 144) when he was describing the AIDS situation to Congress. Shilts notes that Curran could not ask Congress for money when he testified, “but he could nudge facts toward logical conclusions.” (ATBPO p. 144) The nudging of facts would become an art form at the CDC over the next three decades and sometimes the facts that had to be nudged were so large they virtually had to be moved with bulldozers and the conclusions they were nudged towards were always more political than logical. One could almost faint from the irony of Curran telling Congress in 1982 (two years after those first Atlanta DuBois cases of immune dysfunction, “The epidemic may extend much further than currently described and may include other cancers as well as thousands of persons with immune defects.” (ATBPO p. 144) Had he or his colleagues at the CDC recognized the DuBois 1980 Atlanta cases as the canaries in the HHV-6 mine, he would have been talking about millions (if not billions) of cases and he would not have had to play games with words to get Congress and the White House to do the right thing financially. One disturbing aspect of his manner of thinking was reflected in how Shilts summed up his testimony: “With death rates soaring to 75 percent among people diagnosed with GRID for two years, the specter of 100 percent fatality from the syndrome loomed ahead, he added.” (ATBPO p.144) It would be nearly impossible to dial back on the distorted image of the epidemic he was presenting and frankly, dialing back on anything was something that the CDC (like the NIH) would turn out to be constitutionally unable to do. That, as we have said, is another sign that we are living in a period of totalitarian abnormal science.
Curran’s peculiar attitude towards gays surfaced revealingly again when Shilts described his refusal to meet Gaetan Dugas, the unfortunate gay man who would be eternally scapegoated in the echo chambers of the media as the “Patient Zero” of the AIDS epidemic because he had supposedly slept with a number of the original AIDS cases: “Jim Curran passed up the opportunity to meet Gaetan, the Quebecois version of Typhoid Mary. Curran had heard about the flamboyant [flight] attendant and frankly found every story about his sexual braggadocio to be offensive. Stereotypical gays irritated Curran in much the same way that he was uncomfortable watching Amos n’ Andy movies.” (ATBPO p.158) One doesn’t know quite where to begin on this one, except to note that Curran would be able to use his clap-doctor and gay-obsessed epidemiology to act on his feelings and beliefs about both stereotypical and non-stereotypical gays, and every other kind of gay in between. The way that Shilts described Gaetan Dugas should have been a warning to the whole gay community of what kind of medical and social treatment was in store for them: “Gaetan Dugas later complained to friends that the CDC had treated him like a laboratory rat during his stay in Atlanta, with little groups of doctors going in and out of his hospital room. He’d had his skin cancer for two years now, he said, and he was sick of being a guinea pig for doctors who didn’t have the slightest idea what they were doing.” (ATBPO p.158) Of course when those doctors eventually thought they had figured out what they were doing—that was precisely when they really didn’t really have a clue about what they were doing. The Holocaust II era of the gay guinea pig had only just begun. The CDC’s epidemiology would create a whole new gay stereotype. Curran’s difficulty in getting researchers to come into the field was the fallout of the gay and sexual way the frightening disease had been framed for the public—something that might never have happened if the DuBois 1980 wholesome heterosexual Atlanta cases had been the epidemiological and virological template for the epidemic rather than the kind of Amos n’ Andy gay people that made Curran so jiggy with embarrassment that he wouldn’t even meet with them.
It’s amazing how many people seem to have been assigned credit (by different sources) for bringing (dragging?) Robert Gallo into AIDS research. Shilts has Curran on that Washington-slept-here list too, noting that he said to Gallo when he was receiving an award at a medical conference in 1982, “You’ve won one award. You should come back when you win another award for working on AIDS.” (ATBPO p. 201) Bringing Gallo into the field was like putting a pair of retrovirus-obsessed eyeglasses over a pair of gay VD-obsessed eyeglasses and expecting to see the epidemic for what it was. Otherwise known as the blind recruiting the blind.
One of the more grimly amusing passages in Shilts’s book concerns Curran’s thought about the fears in the gay community that AIDS would result in gays being put into concentration camps: “Curran thought the train of thought was curious. After all, nobody had suggested or even hinted that gays should be in any way quarantined for AIDS. The right-wing loonies who might propose such a ‘final solution’ were not paying enough attention to the disease to construct the Dachau scenario. Still, it was virtually an article of faith among homosexuals that they should end up in concentration camps.” (ATBPO p. 228) Silly gays. Frankly, who needed concentration camps or “the Dachau scenario” when you had CDC epidemiology. CDC epidemiology saved the country a load of money on barbed wire. And Holocaust I, where gays actually were made to wear pink triangles in real concentration camps—that was so 1940s.
One of the most unfortunate and tragically wrongheaded things about Curran is that, according to Shilts, he held his colleague Donald Francis “in awe, given Francis’s international reputation for smallpox control.” (ATBPO p.262) As one looks back at the circle jerk that also got Holocaust I going, one might hypothesize that all holocausts begin in passionate mutual admirations societies.
Something began to surface during James Curran’s reign over AIDS at the CDC that bears close scrutiny by any enterprising historian interested in identifying the institutional roots of Holocaust II. In 1983, when Susan Steinmetz, an aide to Congressman Ted Weiss, visited the CDC in an oversight capacity, she was prevented from seeing files she automatically should have been able to audit as a representative of a Congressional Committee that had oversight responsibilities on health and the environment. According to Shilts, she was told by the then CDC Director William Foege, “she would not have access to any CDC files, and she could not talk to any CDC researchers without having management personnel in the room to monitor the conversations. The agency also needed a written, detailed list of specific documents and files Steinmetz wanted to see.” (ATBPO p.292) Shilts reported that “Steinmetz was flabbergasted. What did they think oversight committees did? Their work routinely involved poring through government files to determine the truth of what the high-muck-a-mucks denied, and then privately talking to employees who, without the prying eyes of their bosses, could tell the truth. This was understood, she thought.” (ATBPO p.292) What she didn’t realize was that the CDC’s de facto little counterrevolution against science and the ideal of transparency in democratic processes had begun before her unassuming eyes and this would become business as usual at the clandestine CDC for the next three decades. The shroud of secrecy (de rigueur in all abnormal science) that would enable Holocaust II and the cover-up of the CFS, autism and Morgellons epidemics was descending on the CDC in Atlanta.
While Steinmetz was just trying to find memos that would contradict the CDC’s public posture that it had enough money to research the emerging epidemic of AIDS, without realizing it, she had stumbled onto the fact that the CDC had begun acting more like a government intelligence agency with vital national secrets—possibly even embarrassing ones—to keep, than a public health organization that was committed to truthful science and was accountable to the American people. In essence the CDC was showing that it wasn’t above any of the legerdemain that any other part of the government was capable of. It was showing us that it was very much cut from the same cloth as the government gremlins that gave us Watergate and Vietnam.
Steinmetz wanted to see files that pertained to budgets and planning, but she was bizarrely told that she couldn’t see the files because they had patients names in them and that violated patient confidentiality. It strained credulity to argue that patients names were involved in organization budgets and planning. and in retrospect, it was a very lame excuse. This wouldn’t be the first time in Holocaust II that a dishonest explanation with a fake concern and compassion for patients’ welfare would be used by those in authority to stonewall the very people who were actually trying to do something about the welfare of patients. The CDC was already in a paranoid circle-the-wagons mode that characterizes abnormal and totalitarian science. According to Shilts, “The CDC personnel, who struck Steinmetz as peculiarly contentious, wanted to conduct their own review of the files before letting Steinmetz see them . . .” (ATBPO p. 292) And “as another demand, the CDC insisted that before any interviews with CDC staff took place, the agency would screen questions that Susan Steinmetz put to scientists.” (ATBPO p.292) On the eve of the HHV-6 catastrophe and Holocaust II, government science was going into the lockdown of abnormal science. Shilts wrote, “This is getting pretty strange, Steinmetz thought.” (ATBPO p.292) Strangeness was but a puppy at that point.
This new emerging opposite world of public health and scientific duplicity and defensiveness didn’t make sense to Steinmetz’s colleagues back in D.C.: “On the phone, other oversight committee staffers in Washington confided that they had never heard of an agency so recalcitrant to Congress . . .” (ATBPO p.292) It got even worse for Steinmetz at the CDC in Atlanta when, on the second day of her oversight visit, she was told by the CDC manager who was handling her visit that her “presence would no longer be permitted in the CDC building and that no agency personnel would be allowed to speak to her.” (ATBPO p. 293) The stonewalling and the lockdown were not confined to the CDC in Atlanta. Shilts reported that Steinmetz also faced new obstacles in her path when “The National Cancer Institute officials issued a memo demanding that all interviews with researchers be monitored by the agency’s congressional liaison. At first the National Institutes for Allergy and Infectious Disease was cooperative, but then, in an apparent NIH-wide clampdown, information became difficult to excavate there as well.” (ATBPO p.293) Science and public health in America were about to play the same kinds of political games that are played in totalitarian countries. Public health information was about to be totally controlled by the government.
Curran can himself take a great deal of personal credit for the HIV mistake. Shilts writes that “During the summer of 1983, Dr. James Curran had grown fond of citing the ‘Willie Sutton Law’ as evidence that AIDS was caused by a retrovirus. The notorious bank bandit Willie Sutton was asked once why he robbed banks, to which he replied, “Because that’s where the money is.” Curran, according to Shilts, would ask “’Where should we [at the CDC] put our money? . . . ‘Where would Willie Sutton go? He would go with retroviruses, I think right now.’” (ATBPO p. 331) There is a revealing amount of cockiness and arrogance in Curran that remind one that pride goeth before a fall. But one Willie Suttonish thing was certainly true: retroviruses turned out to be exactly where the big money was for a number of dishonest and incompetent retrovirologists
It is fascinating to see Shilts catching Curran red-handed as he lies about the inadequate funding for AIDS. Publicly Curran would say “we have everything we need,” (ARBPO p.331) but Shilts was able to use the Freedom of Information Act to locate documents that “revealed that things were not so rosy at the CDC, and Curran knew it. Even while he reassured gay doctors in San Francisco, he was writing memos to his superiors begging for more money.” (ATBPO p. 331) For anymore cognizant of the overwhelming mendacity that characterized just about everything concerning Holocaust II, it is especially disturbing to read Shilts’s account of Curran’s excuse: “‘It’s hard to explain to people outside the system,’ he said. ‘It’s two different things to work within the system for a goal and talking to the people outside the system for that goal,’ he said.” (ATBPO p. 332) Curran was basically making the anti-transparency excuses people inside of the government always make for talking out of both sides of their mouths. It’s too bad Shilts didn’t consider the possibility that this character trait was also reflected in the basic science and epidemiology of AIDS that was being churned out by the CDC. It would turn out over the next few decades that indeed government science spoke out of both sides of its mouth.
Curran got the venereal HIV/AIDS paradigm he and his colleagues wanted, the one that could be expected to materialize given his background. It wasn’t surprising then, that he said in 1984, according to Shilts, “Gay men need to know that if they’re going to have promiscuous sex, they’ll have the life expectancies of people in the developing world.” (ATBPO p.416) Actually, given the crazy treatments some gay men were going to be medically assaulted with, he was a true visionary.
As could be predicted, according to Shilts, “Jim Curran also viewed testing as essential to any long term strategy in fighting AIDS.” And so the Pink Triangle medical apartheid agenda of testing and stigmatizing gays as HIV positive (or as an HIV risk group) began in earnest. And the gay community got specially tailored forms of communication from Curran. According to Shilts, “Curran was always cautious when he talked to newspaper reporters, fearful that his observations on the future of the AIDS epidemic might be fashioned into the stuff of sensational headlines, but he felt no inhibition with the gay community. Instead he felt his mission was to constantly stress the gravity of the unfolding epidemic.” (ATBPO p.483) Of course, while he was giving the gay community the tough love, behind his epidemiological back was the looming HHV-6 spectrum catastrophe, a situation which was exponentially worse than anything his little team of clap doctors and pseudo-epidemiologists could possibly have imagined. Given that it was the CDC’s AIDS paradigm that in essence scapegoated the gay community for what would turn out to be everyone’s HHV-6 problem, it is the epitome of irony that according to Shilts, Curran thought that “the question was not if there would be a backlash against gays, but when. It might come soon. ‘You should get ready for it,’ he said.” (ATBPO p.484) How does one prepare for a backlash against gays? Buy extra canned goods? Bake an extra quiche? It was certainly nice of him to give the gay community a heads up, but in truth, the pseudoscience, the incompetent fact-gathering implicit in ignoring the DuBois 1980 Atlanta cases, and the homodemiology of the CDC, constituted a kind of epidemiological backlash before the backlash. Curran and his team needed only look in the mirror to see the kind of anti-gay values that could do far more mischief to the gay community than an army of right wing loons.
Journalist David Black caught some of the underlying psychological problems at the CDC in his book The Plague Years. He wrote, “In fact the CDC, like many physicians and scientists, seemed embarrassed by the gayness of the disease.” (TPY p.57) We now know only too well in retrospect is that the best science and epidemiology can not be conducted in an atmosphere of gay-sex-related embarrassment. Black quoted one CDC researcher as saying to a visiting gay activist, “This never would have happened if you guys had gotten married.” (TPY p.57) When the activist asked if the researcher meant to each other, the researcher said, “To women.” (TPY p.58) The CDC researchers conducted their epidemiology and science in an awkward atmosphere of antipathy to gays, surely not a fertile field for objectivity. According to Black, when he asked Curran to explain exactly what he means by “‘intimate contact’ [between men] the phrase researchers kept using to describe the conditions under which the syndrome spread, he seemed uncomfortable, squeamish. He stammered and glanced anxiously around the room.” (TPY p.58) If some of Jim Curran’s best friends were gay, they had clearly done very little to make him comfortable with their sex lives. One suspects that most of Jim Curran’s best friends were not gay.
One absolutely show-stopping moment in Black’s rich little book is a criticism that was leveled at Curran: “He started making up these ‘facts’ from the data as he interpreted it,’ said one unnamed gay critic of Curran.” Who was that astute gay critic? Please stand up now, take your bow.
How Mary Guinan Helped Corrupt the Hard Drive of AIDS Research
Historians who want to trace the series of missteps that led to the HHV-6 pandemic and Holocaust II may benefit from taking a close look at a little known researcher at the CDC who played a curious role in both of the supposedly separate AIDS and chronic fatigue syndrome epidemics. Her surprising inability to see an obvious link between the two syndromes may be one of the important seeds of the whole HHV-6 disaster. She is mentioned in both the Shilts history of the early AIDS epidemic and Hillary Johnson’s journalistic account of the CDC’s bungling of the epidemic of facetiously-labeled chronic fatigue syndrome.
According to Shilts, Mary Guinan worked for James Curran in the CDC’s venereal disease division. She was the person who sent James Curran the first ill-fated report on the first cases of what would eventually be called “AIDS” in “homosexuals.” With fellow VD chasers Harrold Jaffee and Curran, she shared the CDC AIDS Task Force’s preoccupation with venereal diseases epidemiology. She helped impose the CDC heterosexist venereal groupthink on the emerging data of what would eventually be gayified epidemiologically into “Gay Related Immunodeficiency (GRID).”
Ironically, considering what turned out to be the role of HHV-6 in AIDS, Shilts reported that in 1981, “on a hunch, Guinan called a drug company that manufactured medicine for severe herpes infections. They told her about a New York City doctor who had been seeing . . . dreadful herpes infections in gay men.” (ATBPO p.72) Shilts wrote that “Guinan was shaken by her investigation. She was accustomed to dealing with venereal diseases, ailments for which you receive an injection and are cured. This was different. She couldn’t get the idea out of her head: There’s something out there that’s killing people. That was when Mary Guinan hoped against hope that they would find something environmental to link these cases together. God help us, she thought, if there’s a new contagion spreading such death.” (ATBPO p.72) One way that God certainly wasn’t helping was by having a VD-obsessed doctor and her colleagues trying to comprehend a pandemic that wasn’t, strictly speaking, venereal.
In Shilts’s account of Guinan, seeing the epidemic through gay-obsessed lenses was a given. He wrote about one of her days in 1981: “It had been another typical day of gay cancer studies for Mary Guinan. She had wakened at 6 a.m to breakfast with gay doctors and community leaders and asked again and again, ‘What’s new in the community?’ What new element might have sparked this catastrophe.” (ATBPO p.82) It was just gay, gay, gay—24/7—for the AIDS Task Force. They simply couldn’t wash the gay out of their hair. It was one of those times when every gay person should have checked to see whether they still had their wallets. Someone was about to sell them a gay epidemiological bridge.
As Shilts sympathetically presents Guinan, he inadvertently nails the whole CDC psychological and sociological bias problem: “Guinan felt helpless and frightened. This was the meanest disease she had ever encountered. She strained to consider every possible nuance of these peoples’ lives.” (ATBPO p.83) What she really meant was gay nuances of gay lives. It is supremely ironic that Shilts wrote, “The CDC, she knew, needed to work every hypothesis imaginable into the case-control study.” (ATBPO p.83) Every hypothesis imaginable? Not by a long shot. How about the hypothesis that these cases were just extreme versions of the DuBois 1980 Atlanta cases that the CDC had been informed about? The un-gay cases.
The process of identifying the emergence of the epidemic in nongay drug users, as described in Shilts’s book, makes it clear how gaycentric the thinking of the pioneers of the AIDS epidemiological paradigm was: “At the CDC there was a reluctance to believe that intravenous drug users might be wrapped into the epidemic, and the New York physicians also seemed obsessed with the gay angle, Guinan thought. ‘He’s said he’s not homosexual but he must be,’ doctors would confide in her.” (ATBPO p.83) Everybody was becoming an expert on gayness in those days. Given the reluctance to even see connections in those cases of nongay drug-using outcasts, it should come as no surprise when years later anyone saw the obvious connections between the epidemics of AIDS and chronic fatigue syndrome they were treated like they were strictly out to lunch. The AIDS paradigm was fatefully and messily intertwined with all the psychological baggage of sexual titillation and repulsion. If the CDC was unprepared psychologically to see drug users “wrapped into the epidemic,” how about all the good clean living white heterosexuals with the AIDS-like permutations of the immune system that characterize chronic fatigue syndrome?
Guinan’s San Francisco trip with Harold Jaffe to interview AIDS patients and heterosexual controls also revealed the CDC mindset: “The CDC staffers could tell gay from straight controls by the way they reacted to the questions about every aspect of their intimate sexual lives. Heterosexuals seemed offended at queries about the preferred sexual techniques, while gay interviewees chatted endlessly about them.” (ATBPO p.96) Oh those gays! A herd of chatty Cathies if ever there was one. Given the bias-laden epidemiology that this chattiness was about to imprison the gay community in, one is tempted to say that loose gay lips sank a proverbial legion of gay ships. If one were watching this on a screen in a movie theater, one would want to scream out to the clueless gay interviewees for their own sake, “For Heaven’s sake, shut up!”
Guinan was one of the CDC researchers credited by Shilts with recognizing that hemophiliacs and blood transfusion recipients might ultimately also become victims of “gay pneumonia.” She also was one of the first to worry about the AIDS infection possibilities of “semen depositors.” (ATBPO p.132) Guinan cast a wide net: “No sooner had she convinced the CDC that intravenous drug users were indeed a category of GRID cases separate from gay men, then her field of investigations discovered the first reported GRID cases among prisoners and prostitutes.” (ATBPO p.132) Unfortunately epidemiological net wasn’t wide enough to catch the 1980 DuBois Atlanta Cases of immune dysfunction. Also unfortunately for her, she helped create the very consequential epidemiological urban myth of Patient Zero. She was the first person to come in contact with Gaetan Dugas the so-called gay Typhoid Mary who the CDC would turn into the “Patient Zero” or more appropriately, “Scapegoat Zero,” of the epidemic depending on your point of view. He would become an icon for all the venereal gaycentric thinking down at the CDC.
In one of those amazing moments in Holocaust II in which a scientist comes so face-to-face with the truth but fails to see what is right before their eyes, Shilts reports that when Guinan was studying drug users, “blood sampling of the intravenous drug users also revealed that, although many were infected with cytomegalovirus, the viral strains were all different. This was strong evidence that the herpes virus had not developed some new virulent strain. No single strain emerged, lending further weight to Don Francis’s hypothesis that a new virus, not CMV was a work.” (ATBPO p.133) The CDC, in retrospect, was most likely eyeballing strains of an undiscovered virus that would be called HBLV when Gallo’s scientists supposedly “discovered” it in 1986. It was subsequently named HHV-6. In retrospect it is pretty obvious that the CDC was looking at HHV-6 but thinking it was only CMV. (And those who wanted to see a retrovirus would have been especially predisposed not to see a new DNA virus like HBLV/HHV-6.)
It is interesting and perhaps revealing that Guinan and her colleagues could deal with the fact that the disease or syndrome manifested itself differently in gay men and drug users—presumably for reasons that would ultimately be figured out. But God forbid that anyone would subsequently suggest that even though there were differences in the manifestations of chronic fatigue syndrome and AIDS that they were essentially manifestations of the same agent and the same pandemic. Distinctions were not turned into differences where drug users and gays were concerned, but where the gays with AIDS and the middle-class straights with chronic fatigue syndrome were concerned, every distinction,—even the teeny-tiniest or most irrelevant kind—was immediately considered a dramatic how-dare-you-compare-these-apples-and-oranges difference. Such bogus thinking would be at the heart of the “chronic fatigue syndrome is not AIDS” paradigm which would guide public health through the next three decades.
For all her good work Guinan was eventually rewarded with the position of assistant CDC director. Unfortunately for all the victims of HHV-6, what she did do at the CDC didn’t have as much impact on the well being of the world as what she did not do. It was Guinan in 1985 who got a call from Dan Peterson, a former colleague and one of the two doctors who are credited with recognizing an outbreak of the absurdly named “chronic fatigue syndrome” in their Lake Tahoe practice. According to Hillary Johnson, “The two had become friends during a shared stint at the at the University of Utah hospital in Salt lake City in 1976.” (OW p.31) Also, according to Johnson, “Peterson had frequently sought her counsel on different infectious disease cases; he had also struck her as a gifted diagnostician.’ (OW. P.31)
Johnson reported that “Guinan listened as her former colleague described his Tahoe patients, her curiosity aroused by the possibility that this ailment, which three recent medical papers had described, was occurring in epidemic form. Previously, researchers had described it as a sporadic illness. She remembered too, that Atlanta clinician Richard DuBois had made a presentation to agency staff on the malady early in 1983, even proposing that the new mono-like syndrome might be a second epidemic of immune dysfunction rising concurrently with AIDS.” (OW p.31)
Did this lead Guinan serendipitously into a more complicated epidemiological vision of a variable epidemic that included both what was called “AIDS” and “chronic fatigue syndrome”? Not on your life. These first CFS patients were not gay and not drug users. They were from medical practices that could be described as being devoted to folks who ride in the middle and front part of society’s bus. Such stark social differences would make it of no consequence or interest that study after study would show one immunological and neurological similarity after another between AIDS and chronic fatigue syndrome. Guinan had helped build a paradigm that was so gay, gay, gay and so socially radioactive that the links between AIDS and CFS would be willfully ignored, buried alive by denial, and through a kind of determined public health radio silence, for all intents and purposes, be covered-up big time.
Ignoring the obvious, Guinan sent the future “CFS” patients of America on one of the greatest medical wild goose chases in history. According to Johnson, she passed the Peterson cases on to Larry Shonberger, chief of the CDC’s epidemiology within the Division of Viral and Ricketsial Diseases. Not surprisingly, Johnson reports that “Schonberger and his staff of epidemiologists had a mandate to monitor and occasionally investigate outbreaks of viral diseases, with the exception of AIDS, which by 1985 had been awarded a separate division and staff and more than half of the federal agency’s entire annual research budget.” (OW p.32) And so, because of Guinan’s phone call and her very questionable judgment, CFS research headed down exactly the wrong road
Had Guinan wisely directed the Lake Tahoe cases in the direction of the CDC’s AIDS division back in 1985, there was still a chance that the political and medical apartheid of the “chronic fatigue syndrome is not AIDS’ paradigm and Holocaust II might not have been able to fully materialize. But AIDS had been so gayified and turned into such a sexual bogeyman and scarlet letter syndrome, that Guinan and everyone else at the CDC couldn’t for the life of them admit that average (i.e. heterosexual) Americans were coming down with any similar or related form of acquired immunodeficiency. Instead those people were given the whitewash of a diagnosis of chronic fatigue syndrome. Those good country people, to borrow a term from Flannery O’Connor, couldn’t in a million years be suffering from something that had at one time or another been called Gay Cancer, Gay Pneumonia, and Gay Related Immunodeficiency. After all, they weren’t gay.