The AIDS Crisis: Episode 1 - Gay Plague

Hey, this is Leon Napok. I'm the host of Fiasco, but you may also know me from the podcasts Slowburn, Think Twice, Michael Jackson, and Backfired the Vaping Wars. I'm excited to be sharing with you the next season of Backfired, titled Attention Deficit, which is now available exclusively on Audible. Backfired is a podcast about the business of unintended consequences.

This is the Gay Life ksam's Public affairs show for gentlemen who prefer gentlemen, for women who prefer women, and for people who prefer people. You don't have to be gay to listen. Good Evening, I'm Randy Alfred Tonight. Our

Campbell was twenty nine years old. About a year earlier, he had gotten sick from an unusual infection and spent four days in the hospital. It turned out there was something wrong with his immune system.

I found that I had a low white blood cell count, which which is the main mechanism the body uses to fight off infection.

Not long after his hospital stay, Campbell went on a hiking trip with his boyfriend on the California coast. Afterwards, he noticed purple spots on the soles of his feet. He figured they were blood blisters from all the walking

My boyfriend he said, oh, well, you know, cop, she does appear on the on the feet and legs. I said, feet and legs.

How did you feel?

It can't be me. I can't have this. It's not this, It's just a bloodlister. It's something else.

Campbell got a biopsy. It showed that he did have Capussi's sarcoma, the disease some had started calling gay cancer.

As a health professional, surely you had read of it.

As a matter of fact, I had not read of it. It's so rare that until nineteen eighty one it was mentioned in medical dermatology textbooks with one paragraph and sort of glossed over onto the next thing.

Campbell wanted to warn other gay men, especially those who didn't share his relatively privileged position.

I really feel very fortunate in some ways, and that I have a lover who cares for me. I have real good health insurance, I can be on medical leave of absence. I have a lot of things going for me, and I'm worried about someone who may develop this disease and yet not have those pluses. So hopefully in my being a blabbermouth in this way has some payoff for

This interview with Bobby Campbell is the earliest recording I've been able to find of someone talking in the first person about having AIDS. Of course, Campbell didn't know that's what it was, yet he just thought he had cancer, not realizing it was a symptom of something even worse. To me, that's what's so extraordinary about hearing him talk about it. He just knows so little about what's coming, and yet he's already certain that it's important and that people need to know about it.

You've never been a closet cancer patient.

No, I've never been a closet cancer patient. I tend to be very disclosing in the things that happened to me, But I just thought that the more I talked about it, the better it would be for me, and the better it would be for other people in my community.

To help spread the word, Campbell took polaroid photos of his feet and put them on a poster. He hung it in the front window of a pharmacy on Castro Street in San Francisco. He also started writing a column in a local gay newspaper and distributed informational leaflets to other gay men while inhabiting a drag persona he called Sister Florence Nightmare, registered nurse.

So I think it's very brave of you to be here publicly discussing a very private and life threatening of situation, and I want to commend you and thank you for that.

If I don't feel brave so much as maybe I show off, I am, but it's I don't know. I feel comfortable in doing it, and as a healthcare professional and an articulate person, I have a story to tell and I'm happy to do it.

It would be another six months before Bobby Campbell's disease was given the name we know it by today. It would be a year before its underlying cause was identified as a virus that destroyed the immune system, and it would be more than a decade before an effective treatment was developed.

Anything you want to add before we close for the evening, Take care of yourselves, brothers and sisters. You're the only one you've got.

This season of Fiasco is about the early years of the AIDS epidemic, when a diagnosis was tantamount to a death sentence.

AID syndrome has spread in epidemic, proportions of the victims have died.

Over the course of eight episodes, you'll hear the story of a scandal unlike any we've covered before. It's a story about denial and misinformation.

People are saying you can catch as from a mosquito bite are in swimming.

Pools, and the politics of a disease that intensified old prejudices and activated new ones.

I believe that God does not judge people.

God judges sin.

It's also a story about what people do in the absence of scientific clarity, when the authorities they depend on an answer to can't or won't figure out what to do. We'll return to Bobby Campbell in a bit. For now, I want to go back to the fall of nineteen eighty when a group of doctors and scientists scattered around the country first became aware that something inexplicable was happening to gay men. I'm Leon Napok from Audible and Prologue projects. This is Fiasco, season five, the AIDS Crisis.

It's mysterious, it's deadly, and it's baffling medical science.

A new deadly disease that no one understands, not where it comes from, how to treat it, or how to stop it from spreading.

A great medical puzzle. It's known as gay plague.

They are violating the laws of nature, and nature is striking back.

What I was hearing was from patients. My circle of friends are disappearing.

And within just five years, almost everyone I knew was dead or dying.

One night in the fall of nineteen eighty, doctor Jeffrey Green was called into work to see a new patient. It was after midnight and the man needed Green's urgent attention.

I remember everything I remember about this patient because it was probably one of the most poignant moments of my life. It was about one o'clock in the morning, but when I saw him, he was in the intensive care unit and he was being intubated, being put on a breathing machine because he was gasping for breath and very short on oxygen and he needed to be put on the breathing machine for survival. Had a very high fever, and I was confused. I didn't know what was going on.

Green was working in the Infectious disease unit at Bellevue Hospital in Manhattan. Bellevue was one of the biggest public hospitals in the country and an especially interesting place to be an infectious disease specialist because it was cheaper and more accessible than the private hospitals in town. Bellevue served as a safety net for patients from all walks of life, and because it was in New York. Many Bellvue patients were people from abroad carrying diseases that were uncommon in America.

They could be three four, five or even more new patients per day in terms of consultations, and I would go see those patients to give my opinion as to what was going on, to help make diagnoses, and to help in orchestrating the treatment.

The patient Green saw that night in nineteen eighty had the initials HW. He was thirty eight years old. A round of tests confirmed that there was something seriously wrong with his lungs.

Very poor oxygenation.

His chest X ray was almost white, very advanced pneumonia in all five lobes of the lung.

There didn't seem to be anything about HW's medical history that could explain what was happening to him.

Before he was in debated.

I was able to get a medical history, which previous to that admission was pretty benign. He was a guy in his thirties. He was a gay man. He was in the last throes of life. He lived long enough

Each of the five infections HW was fighting was extremely rare on its own. For all five to show up in one young, apparently healthy person was unheard of. Taken together, the infections seemed to suggest some kind of immune suppression. Someone with a healthy immune system could have fought them off without even knowing they had been exposed. HW had other symptoms too, and I.

Remember seeing this very large purple lesion on the patient's nose. But we had bigger fish to fry, you know, with this guy, so we weren't so concerned about his skin lesion.

The only thing that was clear was that HW's immune system had somehow gone haywire.

I realized that this patient had to have come in with severe immune suppression for whatever reason.

We weren't sure, but we felt.

That the only way that he could have had all these things simultaneously would be basically an immune system that

Jeffrey Green was one of the first doctors in the world to notice that a strange and deadly new disease was spreading in the United States. It was not how he thought his career would turn out. Growing up during the nineteen fifties in a sheltered, middle class neighborhood in Queen's Green always imagined that being a doctor would be a job in which he got paid to help sick people get better.

I was birthed by my family's GP. He used to make.

House calls, come give shots in the house, make me feel better.

When I was sick.

You know, he was like part of the family really, and as I was thinking about my future, even as a very young kid, you know, I always thought being a doctor would be a thing that I would like to try.

By the time Green entered medical school in nineteen seventy two, doctors who made house calls were pretty much a thing of the past. Instead, Green went into the field of infectious disease.

Communicable diseases recognize no boundaries, always watchful for epidemics. Practicing physicians constitute the first line of defense.

I liked the idea of finding a problem, diagnosing a problem, and fixing a problem. Infectious diseases was the only one that attracted me. We had tools to actually cure people. I mean, sometimes people didn't make it, but for the most part, patients who got admitted with severe infections got better.

The science of treating infectious diseases had advanced to an almost unthinkable degree during the twentieth century. For much of history, diseases like pneumonia and tuberculosis had routinely proved fatal. By the time Green entered the field, the vast majority of patients seeking treatment for infections could be cured in a matter of days.

Now, at last, the hidden enemy could be examined under the probing such light of science. The hunt was on for contagious diseases and their causes, wherever they existed.

Green's patient HW died just eight days after Green started taking care of him. To the doctor, it looked like

It was something nobody had ever seen. Of course, this was a one and only case. This was case one.

Case two walked into Bellevue a few weeks later. Once again, Green noted that the patient was gay and was suffering from a strange infection in his lungs. Not long after, Green was making rounds at the hospital when he overheard a conversation about yet another patient.

While I was doing my note in this little cubicle, the other four or five people were discussing this case, and I was sort of listening peripherally to what was going on. And then I heard them snap an X ray into the X ray box, and I looked over my shoulder at the X ray, and I said, to them, is that patient gay?

The other doctors were shocked. How could Green possibly know such an intimate detail about a patient? He had never met.

The guy who was presenting.

He was standing and holding this blue plastic folder with all the papers of his admission in his hand. He dropped it on the floor and the guy said to me, how.

Did you know that? And I said, I don't know. I don't know how I knew it.

And then later in the day I said, I know how I knew it, because that X ray looks like HW's X ray, the patient number one.

Within several months, Green says he had encountered about a dozen patients who, like HW, were afflicted by rare forms of pneumonia and skin lesions. As you heard Bobby Campbell say in his interview on The Gay Life, those skin lesions were capaces sarcoma, a rare form of cancer typically found in people from sub Saharan Africa and older Mediterranean men.

We had typocarcosis, which is a pigeon fungus that caused the meningitis, you know. We had toxoplasmosis. We had disseminated microbacterial diseases, which is again a typical.

Why these rare infections were suddenly popping up with a

It's a little embarrassing to discuss this because I thought we were looking at a gay disease. The first three or four cases that I saw were in people who were gay, so it wasn't that.

Unusual for me to jump to that conclusion.

It was the only clear connection Green could see between the patients. Soon, his assumption was that anyone suffering from this new affliction had to be gay, even if they refused to admit it.

What happened was on case number four, the guy came in with numasisters pneumonia, and he also passed away, but before he did, he absolutely denied being gay. And I can't tell you how many times I asked the guy. He must have thought I was a freak or something, because I kept asking him, are you sure you're not gay? And after he passed away, I reached out to this woman who I became friendly with while she was visiting, and I said, what's a story?

I mean, was he gay. You know, he's not gay.

And I said, well, so where did he live? He said so he was living in a halfway house for drug addicts.

Intravenous drug users were known to be at high risk for any disease that could be spread through blood, like hepatitis B or C. But when Green went to Harlem to visit the halfway house, he learned something that seemed to confirm his original assumption.

And I talked to people who knew him, and I started asking him the same question, and everyone said, no, he wasn't gay.

But someone said, but he turned gay tricks.

Green wasn't exactly sure what that meant, and asked the person to elaborate, and he.

Said, well, to make money for his habit, he you know, he would go with men.

He would go with women, he would you know.

So, I said, finally I figured it out. It is something to do with gay sex or whatever.

Looking back, it's striking how easy it was to conclude that the new disease was quote unquote gay related. Even when he was faced with someone with a history of intravenous drug use, Green remained and convinced that the patient's sexuality was the key factor. As more cases emerged in

They would take a history and if you had the requisite answers, they would release one patience worth of pentamidine for a treatment course of two to three weeks.

The CDC was established in nineteen forty six primarily to combat malaria.

CDC is one of the task forces of the Public Health Service.

It quickly evolved into an all purpose first response service for various medical emergencies.

Ready to help each state in its fife against communicable diseases.

Anytime there was a major disease outbreak, the CDC was there, doing the investigative legwork and providing assistance to doctors and nurses on the ground. As a result, the CDC had a hand in some of the greatest achievements of the modern era, including the eradication of polio in the United States and smallpox all over the world.

And historic victory over a dread disease. Here scientists usher in a new medical age with the monumental reports that proved the vaccine against crippling polio to be a sensational success.

The CDC had special outposts at major airports where they distributed medications to the doctors who needed them. That was where doctor Green would get his pentamidine.

I would get in.

My car and drive to JFK and I think there is a CDC quarantine office and they had the shipment waiting for me, and I get back on the car, drive back to Bellevue and hang the drug.

Soon.

The trip to JFK Airport was part of Green's regular routine, but a CDC technician fielding his requests for pentamidine noticed that Green was not giving a reason for why his patients had numicistus pneumonia. The technician knew that it usually only appeared in patients who had compromised immune systems, like kids with leukemia or people who had received organ transplants. But Green wasn't indicating anything like that on the forms

We started getting phone calls from physicians saying, you know, I have this young man in the intensive care unit and he's dying and I don't know what's wrong with him.

Geynan was a specialist in venereal disease, so when a written report on some kind of outbreak among gay men came into the CDC, she was asked to review it.

Since it wasn't a disease that we knew about, there was no expert in CDC about it, but all of these men also had herpes virus infections, so they asked me to make a comment on it.

The report would turn out to be a foundational document in the history of AIDS. He was co authored by a young doctor in Los Angeles, whom you'll hear more about later in the series. For now, all you need to know is that he was seeing numacistus cases at pretty much the same exact time as Jeffrey Green, and when Mary Gynan had a chance to review his findings,

After I graduated as a chemist, I was living in New York and the New York Times Want Dads was segregated by gender. There was a help wanted male and a help wanted female, and there was never a job listing for a chemist in the help Wanted Female. So I finally found a job at a chewing gum factory.

What's new in the Magic Land of Chicklets.

My job was to make new flavors for chewing gum.

Well great them orange Bradberry.

I was in a laboratory. I had all these different flavors and I would mix them and taste them.

A world of flavor from the Magic Land of Chicklets.

And eventually Gynan decided to go to medical school, where she became interested in smallpox and got accepted into a training program at the CDC. There, she worked on the agency's medical Detective Squad, the Epidemic Intelligence Service.

The Epidemic Intelligence Service is a training program for epidemiologists. The worldwide symbol of a field epidemiologist is the hole in the soul, evidence that we have worn out our shoes tracking down vital clues.

Geynan ended up getting a job in the CDC's Venereal Disease Control Division. By nineteen eighty one, she was an expert on genital herpes infection.

I became doctor Herpes. People call me from all over the world. I had rock stars calling me from Australia. They had genital herpes, and I say, I'm sorry, I can't offer you.

Anything long distance phone calls from rock stars. Aside, being doctor herpes wasn't exactly glamorous. Even within the CED, Venereal disease was considered an unsavory specialty.

Nice people don't talk about VD.

Perhaps that's why America is in the middle of the greatest venereal disease epidemic and its history.

People said, what's a nice girl like you doing a thing like that? It was considered to be people who couldn't get regular jobs took this job.

Venereal disease is almost as prevalent as the common cold. One problem in dealing with VD is the reluctance of many of the infective de seek treatment.

I worked in a venereal disease clinic one day a week, and when I would come back, if I saw some of my colleagues say say to me, oh, my goodness, did you wash your hands.

Guidan's time at the CDC coincided with the rise of a new administration in Washington. Ronald Reagan had run on a pledge to slash the federal budget, and when he got into office, he wasted no time delivering on that promise.

I've already placed a freeze on hiring replacements for those who retire government service. I've ordered a cut in government travel, the number of consultants to the government, and the buying of office equipment and other items.

At the CDC, everything became more difficult, buying new equipment, securing additional research funding, and traveling to investigate outbreaks. For fiscal year nineteen eighty two, the Center for Infectious Diseases faced overall budget cuts of up to fifty nine percent. So that was the state of play. When Gaynan read the report from Los Angeles about a mysterious cluster of numisistus cases in gay men.

I read it and it was like incredible. I knew that something terrible was happening because these are all homosexual men, and two of them had died, and nobody knew why. So I sent it up the hierarchy of approval all the way to the top, and I sent it to my supervisor, who wrote on the paper.

Hot stuff guidance. Supervisor was doctor Jim Currn, a senior researcher in the CDC's Veneurial Diseases Division.

It was circulated to my disc I would say perhaps ten days before it was published. On June fifth, nineteen eighty.

One, Kerran happened to be going to a conference on sexually transmitted diseases, and he asked some of his fellow attendees if they'd seen anything like what was being described in the report.

We talked to the doctors who were working with people in the gay community and gay physicians themselves, and they told us that they too were seeing cases that were very unusual. And there were some doctors in New York who were also calling us about this rare cancer kapasci sarcoma that was being seen in New York.

One month after the new Massisus report was published, the CDC followed up with a second one documenting the cases of capasi sarcoma. The New York Times covered it that same day on page twenty under the headline rare cancer in forty one homosexuals. The article cited Kerran in saying there was no apparent danger to non homosexuals from contagion. That same week, Kerran traveled to New York for his first in person meeting with a patient suffering from the new disease.

And we went to see one individual patient and as we talked about our past, we said, you know, we are exactly the same age.

The patient was an actor, and as he and Kerran started chatting, they found they had a lot more in common than just their age. They were both from Detroit, and they were both raised Catholic. In fact, they even went to rival Catholic prep schools. Both had left Michigan for college, one to Notre Dame, the other to Yale. And now one was a doctor trying to diagnose the other.

And then he had these skin lesions on his face. His question to me, of course a doctor expert from CDC, will these go away? I be able to get rid of him so I can continue my acting career. And of course I'd never seen a patient in my life with Kappa she sarcoma, so I didn't know.

Kurran kept tabs on the patient as his condition worsened over the following months.

He had went from a tall, handsome actor to having lost almost half his body weight, all of his hair. And I will always think how similar our background was on how he died. This inexplicable death. What made us different. I guess it was because he was a gay man and I was straight. That he went to New York and was exposed in the epicenter of this horrible disease to something neither one of us knew what at that point, and he died and I was living there to study it.

Not long after the CDC published its report on Numisistus pneumonia, the agency created a centralized task force to investigate the situation. Jim curn was put in charge.

So at the time they asked me to share it, and I was assigned disease detectives from a variety of areas. Virology because perhaps this was a virus cancer assigned somebody to us, and we had some laboratory people assigned to us, and a statistician assigned to us, and we thought it could well be sexually transmitted, so std people were actually assigned from my own group.

Before the task force did anything else, they set out to confirm that what they were seeing was in fact a new phenomenon. To that end, they reviewed hospital records in the eighteen largest cities in the country to see how many previous cases of pneumaicistus or other rare infections there had been.

What we found was virtually there were no cases before nineteen seventy eight, and there were none outside New York

Different people on the task force had different ideas about what was making people sick, but a central animating question was why the disease seemed to be disproportionately affecting gay men.

Some people thought it was related to allogenetic semen, that if you were exposed to hundreds of different semen, you could become allergic to it, and that allergy would cause the reaction to damage your immune system. Some people thought it was an environmental cause, since many people who have sex with each other go to the same places, maybe there was some kind of contaminant.

The so called environmental theories posited that maybe something about the environments where gay men congregated was causing them to get sick. A leading early hypothesis was that the disease was caused by poppers, the inhalable muscle relaxings that many gay men were using in clubs to get high and

Poppers were available all over the place, so one of the things that I wanted to do was to see what they contained.

Guidan heard she could find poppers at adult bookstores around Manhattan, so she went to New York in search of samples.

They would actually have a place to have sex inside the bookstore, and they sold poppers. It was a bookstore in Greenwich Village.

I think Geynan brought the poppers back to CDC headquarters in Atlanta to be tested, and I brought them in.

We sent them over to various people within CDC to see if they were but it was There wasn't any real connection.

The poppers theory endured long after it fell out of favor with scientists. There are a few reasons why. For one thing, it made it possible to blame the new disease on a substance specifically associated with gay nightlife and vice, but also more generally, it held out the promise of a simple smoking gun. If the illness really was caused by some kind of environmental factor, and solving the problem could be as straightforward as isolating it and getting rid

Freezer.

There is absolutely no evidence whatsoever linking alcohol, nitrites or any other nitrites with Carposi sacoma, the so called gay cancer. The CDC was asked by the press whether poppers had been eliminated as a factor. CDC replied, and quite properly, that nothing has as yet been eliminated. That response has

Well, Jim Curran wanted the answer to be poppers too, but he and his colleagues at the CDC were fairly convinced from the start that what they were seeing was most likely a virus. Their suspicion was that the new disease might be similar to hepatitis B, which was transmissible through blood and other bodily fluids, and could be spread through sex and intravenous drug use. If that was how the new disease worked too. That would mean it didn't

It was all sorts of questions, first about drug use and about sexual behavior. And we all had to ask the same questions, what kinds of sex, what kind of drugs? How many sex partners have you had in the past year. And I was just amazed at how cooperative these people were. They would be counting the number of sex partners they had. They'd say I had two or three thousand partners in their lifetime. And so people afterwards said to me, oh, they were just bragging about Let's see, they were not

After administering the questionnaire, Guynan collected patient samples.

The patient would sit on the barstool of the kitchenette and I would take blood from them. And I had to pack up all the specimens in these boxes with dry ice in it to keep them cold, and they had to be there at CDC within twenty four hours. I then had to get those specimens to the post office before the post office closed.

Gyan was working fourteen hour days during her trip to San Francisco, conducting interviews and drawing blood samples herself. It didn't always go smoothly.

This one young man came in who was very tall and built like a football player, and as I was putting the needle into his arm, he fainted and fell on top of me. We both fell on the floor, and I tried to pull the tourniquet from his arm because it was bleeding. All the blood was coming out and I couldn't get it. And I finally pulled the needle out, and when I pulled it out, I stuck it into the palm of my left hand.

Geynan didn't know whether she had just given herself the disease. Sitting in the hotel room covered in someone else's blood. She improvised, I.

Tried to squeeze my palm of my hand to get any blood in it that might have gone in there. I was not sure what I was going to do here. I was in San Francisco with all sorts of needles on the counter and a man unconscious in my room with blood all over him and me.

Finally, the man woke up and apologized.

He said he always faced at the sight of blood. So I asked him if he would stay on the floor while I got the specimens, because I needed to get those specimens, and I did.

The incident would haunt Geyan for several years, especially when she developed a lesion on her arm that looked like it could be Capasi sarcoma. Her secretary at the time was so afraid of catching it that she quit. It was not until nineteen eighty five that a blood test

Than the control group.

The finding seemed to bolster the hypothesis that members of the task force had held from the beginning that the new disease was a virus that was transmissible through sex and could therefore infect anyone, not just gay men. According to Kerrn, that was the reason the CDC never adopted

Doctors have even coined a new word for these conditions, GRIDS, gay related infectious diseases.

For the most part, though there was no early media coverage. Jim Curran again, there was virtually no coverage in the mainstream media in the first year or so. The people who did good coverage were people with the New York Native the gay publications, but there was essentially nothing in

I remember having lunch with him at Uncle Ty's Hunan Juan, and we talked for hours, and he wrote this very long story in the Wall Street Journal and they wouldn't publish. So he called me back and he said, they think this is just a story about gay men, and this is the first time I've ever had a story turned down.

Current pushed back, noting that the disease almost certainly didn't just affect gay men, and I.

Said, well, there is heterosexual transmission two very likely couldn't totally prove it, but we're having good examples of it. So they published a very short article that said heterosexuals get aids two.

The Wall Street Journal article was published on February twenty fifth, nineteen eighty two, under the headline new often fatal illness and homosexuals turns up in women coma heterosexual males. Over the course of the coming year, as the article's central thesis became increasingly evident, more media outlets began to pay attention.

Federal health officials consider it an epidemic, yet you rarely hear a thing about it.

In August, CBS ran its first ever nightly news report on the epidemic.

It's a disease first detected in the gay community that has now spread beyond that, a disease experts are now calling a national epidemic. There is a one in five chance a victim will die within the first year of the illness.

The report included an interview with Bobby Campbell, conducted seven months after his appearance on the Gay Life radio show.

It was devastating, you know, at that time, I was twenty nine years old.

For Bobby Campbell, it is a race against time. How long before he and others who have this disease finally have answers, finally have the hope of a cure.

The CBS report noted that while most of the known cases have been found in gay men, other groups were starting to get sick too.

Now It's been detected in Haitian refugees and in some people with hemophilia, a disease that prevents blood clotting so the patient needs frequent blood transfusions.

Soon, these high risk groups were nicknamed the four HS. Homosexuals heroin users, haitians, and people with hemophilia. All of a sudden, gay related immune deficiency no longer seemed like an accurate descriptor. In September of nineteen eighty two, the CDC gave the disease its permanent name.

Acquired immune deficiency syndrome. It's mysterious, its deadly, and its baffling medical science. Once thought to affect only promiscuous homosexual males, AIDS is now spreading in epidemic proportions to other segments of the population.

With that, AIDS was officially not just a gay disease, at least as far as most doctors and scientists were concerned. In practice, though, the wider world remained largely indifferent, and what little public discussion there was of AIDS often continued to place the blame on gay men.

Gays are being called all the dangerous and violent group that corrupts children and infects the community with AIDS.

It's probably obvious why I wanted to make this podcast, Living through COVID nineteen. I wanted to know what it was like the last time American society was transformed by a deadly virus. I wasn't expecting easy parallels. I just wanted to know how it felt to live through it, the early years in particular, and what it had to tell us about the thing we've all been living through lately. As you'll hear over the course of our series, there

It's well documented from the time of the Black Death in thirteen forty eight. With almost every epidemic, people respond to the epidemic in exactly the same predictable ways. The first thing they do is they deny that it's even occurred. You know, it's not happening, and then they want to blame someone for having caused it, as if that will make it not have happened and go away.

Still, the AIDS crisis was and continues to be a singular disaster. This is in large part because of who got sick and died first, but it's also because of who responded and who didn't. I feel compelled to say that our series will not offer a comprehensive picture of everything that went wrong or everyone who was affected. Our goal is just to be specific, to try to understand why this particular epidemic unfolded the way it did, and why has been allowed to kill more than thirty million

And I began talking to some of the oncologists at the hospital.

I said, how do you guys do this?

I mean, patients dying, you know, in seven months, eight months, a year, two years. I'd give him, you know, and then I feel like I've succeeded with two years' survival. And they said, well, you just add up all the years that you've kept people alive, and that's the way you have to think about it. And they pulled me back. My colleagues pulled me back.

Green still has dreams about some of the people with AIDS he has treated over the years. In one of those dreams, he's running from one waiting room to another, all of them filled with dying men.

So recurring nightmare that I have is running in an office that has fifteen different rooms and not being able to keep up, and I'm running from room to room, and I feel that type of in the dream, that panic attack reoccurring.

Green is haunted by another image too. As part of his work treating people with AIDS, he started doing what his family doctor had done all those years ago. He made house calls. To this day, Green thinks about something he saw while visiting a patient in a brownstone in Manhattan.

And I went to see him because he was dying and he was too weak to come to the office. And he had set up a cot like a hospital bed, I guess, in the middle of his aviary, which was his living room. And there were these exotic birds that you know, very large Brazilian colorful cockatoos and other kinds of fancy birds.

And when I walked in the door, his partner lit me in.

What I saw was a skeleton on the bed on his back, looking at the ceiling. There was a white, gorgeous bird, maybe a foot tall, on his chest, and it looked like.

A bird of prey.

Or a scavenger bird that was gonna wait till he died to eat him. It was I'd wake up at night once or twice a month with that image in my head.

Still they fall around, they are fall and round, they are fallund me the strong GUYSI.

Masie.

On the next episode of Fiasco, the revolutionary first stirrings of AIDS activism in New York City.

People who were sick were organizing and taking care of each other. We really weren't even looking that much to the healthcare establishment because they didn't want to deal with us. It was a whole different kind of of activism.

Fiasco is presented by Audible Originals and Prologue Projects. The show is produced by Andrew Parsons, Sam Graham Felsen, Madeline kaplan Ula Coppa, and me Leon Nafock. Editorial support by Nola Wawas and Jessica Miller. Our researcher is Francis Carr. Archival research by Michelle Sullivan. This season's music is composed by Edith Mudge additional music by Nick Sylvester of God Mode, Joel Saint, Julian and Dan English, Noah Hect and Joe Valley.

Say Masson.

V sure to let me

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