"Randy hated the idea. It took me almost a week to argue him into it."

May 9, 2014 8:09 AM

To those who have read Randy Shilts' "And the Band Played On", or seen the 1993 movie, French-Canadian airline steward Gaetan Dugas is known as Patient Zero. It has been only in the past few years that the full truth about how the "Patient Zero" narrative was crafted has come out.
posted by roomthreeseventeen (13 comments total)

There are many villains of the HIV/AIDS pandenic. Dugas doesn't crack the top 25.
posted by docgonzo at 8:30 AM on May 9, 2014 [15 favorites]

I remember the early reporting on this mysterious new "gay cancer" and Dugas was not a major figure in it. He was an element, when people wondered how the epidemic started and spread. But as a straight person who read the Shilts book early on, I found the idea that a new syndrome could develop and seemingly strike primarily in one community a much bigger issue.
posted by etaoin at 8:33 AM on May 9, 2014

I'd agree with that, docgonzo.
posted by rmd1023 at 8:34 AM on May 9, 2014

The HIV Plus mag link has this terrific video with footage of Dugas.
posted by roomthreeseventeen at 8:35 AM on May 9, 2014 [6 favorites]

Seconding roomthreeseventeen. Watch that video.
posted by oneironaut at 8:51 AM on May 9, 2014

Favoriting the fuck out of your comment docgonzo.

Blaming the epidemic in North America on Gaetan Dugas is like blaming the recession on Ken Lay. He didn't do it any favors, but he wasn't the cause.

And while finding a villain can be cathartic, as the interviewer for the Canadian mag seems to suggest, the men transmitting HIV in the late 1970's and early 1980's were utterly unaware. Researchers didn't discover the virus until 1983 and wasn't named HIV until 1986. Meanwhile there was mass distrust of the government coming in and regulating/terminating a thriving gay sexual movement.
posted by Sophie1 at 9:59 AM on May 9, 2014 [1 favorite]

Also, for people who are less clear on how HIV works, there tends to be an asymptomatic or mildly symptomatic period of about 7-10 years without any treatment. Therefore, most of the people who died in 1981 were likely infected in the early to mid 70's.
posted by Sophie1 at 10:01 AM on May 9, 2014 [5 favorites]

While reading Band back in 2002, I did some Web searching and first learned about Robert Rayford. His story was first widely disseminated as the book was being published, and indicated that the full narrative was both longer and a lot more complex.
posted by ryanshepard at 10:35 AM on May 9, 2014 [1 favorite]

This is one of my favorite books, I bought in hard cover when it first came out and I didn't put it down until I had ready every page. I lived in San Francisco from 1982 to 1991. So many people that I knew were sick, dying or dead. I can't tell you how awful that time was.

There were a lot of people to blame for dragging their feet, for refusing to fund research, for waffling on the public health issues, for playing politics.

I never once thought of one flight attendant from Canada as the guy who casued AIDS. Poor Gaetan Dugas (may he rest in peace), he was a victim of slut shaming.

Lots of people had lots of sex in the eighties, and you have to remember no one knew HOW the virus was acquired or spread until much later in the game.

This is as it ever was. The reason it was easy to dismiss AIDS as a disease is because it was viewed as something "they brought upon themselves."

Even Shilts (also, rest his soul) bought into that shit.

It took Randy Shilts a few years after the book was published before he divulged that he too was HIV positive. The stigma, the anger, the blame and the shame are all what allow this disease to continue to infect people.

The whole thing is so sad, and maddening.
posted by Ruthless Bunny at 10:45 AM on May 9, 2014 [9 favorites]

I find it curious no one has thought (apparently) to do a social history of the Rayford case, but possibly it's precisely because of what happened to Dugas. One obvious possibility is a sailor connected to the Atlantic shipping trade, but whether that vector would have had a first-order connection to either Rayford himself or to Africa would be interesting to determine from a strictly epidemiological standpoint.

Has any attempt ever been made to statistically "guess" from aggregate medical reports whether there are other Rayfords out there who were not diagnosed so distinctly? Clusters of pneumonia deaths or Kaposi's sarcoma found in, say, New Orleans?
posted by dhartung at 11:13 AM on May 9, 2014

AIDS goes back a lot further than the 80's. In the 50's a guy in England died of an untreatable disease, that was (much) later determined to be HIV.
posted by feckless fecal fear mongering at 9:44 AM on May 10, 2014

David Quammen's Spillover has a terrific section on HIV emergence and is very well documented. It goes to great lengths to refute the Dugas hypothesis and demonstrates a much, much older origin.

Ignore the cover which is a profoundly hyperbolic take on the text. This is a reasoned account by a terrific natural history author.
posted by j_curiouser at 3:11 PM on May 10, 2014

Just this morning, RADIOLAB on NPR is rerunning their "patient zero" episode. They address Dugas, then discuss earlier cases (including a couple from the 1950s and one from even earlier, in 1908) - and mention that the best scholarship now states it may have been a hunter in Cameroon who got it from eating chimp meat, or cutting himself while butchering a chimp. Either that guy, a woman he had sex with, or a man who'd had sex with someone SHE had sex with made their way to the cities that were springing up in that part of Cameroon during German colonization.

Then they go back even further. The virus we got was a mutated chimp virus - and they speculate that the chimp virus was itself mutated from TWO different other monkey viruses, which may have fused somewhere in the body of a chimp sometime within the past million years.
posted by EmpressCallipygos at 3:35 PM on May 10, 2014