The Gay Metropolis (51 page)

The first statewide poll in September 1978 predicted that the measure would pass by a huge margin—sixty-one to thirty-one percent. Because he was a famous conservative, Reagan's surprise announcement made him a crucial recruit for Briggs's opponents. The former governor explained his opposition to the initiative this way: “Whatever else it is, homosexuality is not a contagious disease like measles.” In November, the proposition was defeated by a two-to-one margin.

The Reagans came from a Hollywood milieu that had always embraced discreet homosexuals; that was probably the reason for their occasional displays of enlightenment. Besides Rock Hudson, Nancy Reagan's gay friends included the decorator Ted Graber, who supervised a $1 million renovation of the family quarters at the White House. After Mrs. Reagan's sixtieth birthday celebration, her spokesman confirmed that Graber had spent the night at the White House with his lover, Archie Case. Graber was also a frequent guest at state dinners, as was the ubiquitous Jerry Zipkin, the New York socialite and marathon walker of wealthy women.

By far the most influential gay man in the Reagan inner circle was Robert Gray, an extremely successful Washington public relations man who had been a closeted capital player ever since he had served as Dwight Eisenhower's appointments secretary. In 1980 he was Reagan's deputy campaign director and campaign communications chief; then he became cochairman of the president-elect's inaugural committee. Coded references to Mr. Gray in
The New York Times
included descriptions of him as
a “a trim, precisely groomed man” and a “perennial bachelor noted for his charm and connections.”

In New York, the gay power broker Roy Cohn boasted of his influence within the Reagan White House, and his law partner, Tom Bolan, became head of the screening committee for federal judgeships in New York State. Six autographed pictures of Reagan decorated Cohn's office, including one inscribed, “With Deepest Appreciation for your Love and Support.” On New York op-ed pages, Cohn wrote of Reagan's “generous nature, great warmth and reluctance to inflict personal hurt.” In some ways, Cohn was the ideal gay friend for the Reagans, because he was not only deeply closeted but also publicly self-hating.

Asked about the persistent rumor that his ballet dancer son, Ron Jr., might be gay, the presidential candidate said in 1980, “He's all man—we made sure of that.”

Steve Weisman, who covered Reagan's first term as president for
The New York Times,
thought the “White House wasn't that homophobic because Nancy had friends who were gay. But it was definitely a place where you would hear one staff member call another staff member ‘a fag' behind his back.”

It was also a place where anyone who
was
gay—and not a decorator—was expected to remain firmly within the closet. As a health catastrophe developed at the beginning of this administration, the lack of any openly gay officials in Reagan's entourage would have terrible consequences. In fact, the presence or absence of openly gay people would determine how almost every major American institution reacted to the greatest medical crisis of the decade.

JACK FITZSIMMONS
was a very disciplined, rather laconic, “best-little-boy-in-the-world type,” as Philip Gefter remembered him. In 1981 Fitzsimmons was a thirty-one-year-old associate at Willkie Farr and Gallagher, one of Manhattan's most prestigious law firms. He was also Gefter's lover.

At the beginning of the Reagan presidency, Wilikie Farr loaned Fitzsimmons to the White House counsel's office for three months. His job was to screen new administration employees for the incoming Reagan administration, and he loved it.

“Jack was gay and a Republican,” Gefter remembered. “He was not out. He was in heaven at the White House. This was the pinnacle to him. He had arrived.” Because Gefter was “anything but Republican,” he constantly argued with his lover about his admiration for the new administration.
After three months, Fitzsimmons was bubbling with enthusiasm: he announced that he had accepted a permanent job as an assistant White House counsel. But the next time Fitzsimmons saw Gefter in person, he began to cry.

Through his tears, Fitzsimmons explained that the day after he had accepted the job, he had gone back to White House counsel Fred Fielding to have another discussion with him. “Jack said, in all good conscience, he couldn't take this job without letting Fred Fielding know that he was homosexual,” Gefter recalled. “He said that it was bound to show up on the FBI reports. He knew enough to know that. And Fred Fielding immediately rescinded the offer because Jack was gay.”

His lover's narrative made Gefter livid. “Didn't you want to blow up the White House?” Gefter asked.

“No,” his lover replied softly.

Fitzsimmons thought “they were right to rescind the offer because he was homosexual,” Gefter recalled. “He thought he was inferior in some way because he was homosexual. So he bought into their view of the world. Jack was someone who had so much self-hatred for being gay. Here was somebody who was a model human being—the best little boy in the world—a graduate of Dartmouth and Harvard Law School. A couple of years later he became a partner in Willkie Farr. … I said, ‘Look at you. Look at who you are. Look where you work. Look where you live—400 East 58th Street. You belong to the New York Athletic Club. Everything about you is unblemished. Even if it
had
shown up on the FBI report, if you had said nothing they would have said nothing.' And he didn't believe that. But there were enough gay people working in the Reagan administration, so if Jack had been complicit in their silence there would not have been a problem.”

IT WAS A
baffling and virulent new disease that would finally make it impossible for Jack Fitzsimmons, Rock Hudson, Roy Cohn, and hundreds of thousands of other gay men to hide who they really were. Acquired Immune Deficiency Syndrome would have a greater impact on the shape of the gay community than all the other events of the previous forty years put together. At a gigantic cost, it would prove the truth of what Edward Sagarin had written thirty years earlier in
The Homosexual in America:
“The inherent tragedy—not the saving grace—of homosexuality is found in the ease of concealment.” It also did more than anything else ever could to further Sagarin's greatest hope for the movement: “If
only all of the inverts, the millions in all lands, could simultaneously rise up in our full strength!”

If you are a sexually active gay man in America, being alive at the beginning of this epidemic feels like standing without a helmet at the front line of a shooting war. Friends are falling all around you but no one even knows where the bullets are coming from. There are no weapons to defend yourself, no medicines for the wounded, and if you want to flee, when you start running you won't know whether your own wounds are fatal—or nonexistent. Three years into this war, the battlefield is just as lethal, but now it feels more like a huge tunnel filled with fire, strewn with bodies and booby traps. If you're still standing—one of the “lucky” ones—you keep running faster and faster, but you can never outpace the inferno.

At the beginning, there was nothing but terror and mystery.

No one knew how this illness was transmitted—or even whether it
could be
transmitted—and no one could cure it. Although there had been a handful of stories about a mysterious new disease in the gay press earlier in 1981, most gay men in Manhattan first learned about what would become known as AIDS at the beginning of the July Fourth weekend of that year—less than six months after Ronald Reagan's inauguration. The story that alerted them was written by Lawrence K. Altman, a physician and the senior medical writer for the
Times.

Doctors in New York and California have diagnosed among homosexual men 41 cases of a rare and often rapidly fatal form of cancer. Eight of the victims died less than 24 months after the diagnosis was made.

The cause of the outbreak is unknown, and there is as yet no evidence of contagion. But the doctors who have made the diagnoses, mostly in New York City and the San Francisco Bay area, are alerting other physicians who treat large numbers of homosexual men to the problem in an effort to help identify more cases and to reduce the delay in offering chemotherapy treatment.

The sudden appearance of the cancer, called Kaposi's Sarcoma, has prompted a medical investigation that experts say could have as much scientific as public health importance because of what it may teach about determining the causes of more common types of cancer.

Doctors have been taught in the past that the cancer usually appeared first in spots on the legs and that the disease took a slow course of up to 10 years. But these recent cases have shown that it appears in one or more
violet-colored spots anywhere on the body. The spots generally do not itch or cause other symptoms, often can be mistaken for bruises, sometimes appear as lumps and can turn brown after a period of time. The cancer often causes swollen lymph glands, and then kills by spreading throughout the body.

Doctors investigating the outbreak believe that many cases have gone undetected because of the rarity of the condition and the difficulty even dermatologists may have in diagnosing it.

In a letter alerting other physicians to the problem, Dr. Alvin E. Friedman-Kien of New York University Medical Center, one of the investigators, described the appearance of the outbreak as “rather devastating.”

Dr. Friedman-Kien said in an interview yesterday that he knew of 41 cases collated in the last five weeks, with the cases themselves dating to the past 30 months. The Federal Centers for Disease Control in Atlanta is expected to publish the first description of the outbreak in its weekly report today, according to a spokesman, Dr. James Curran. The report notes 26 of the cases—20 in New York and six in California.

There is no national registry of cancer victims, but the nationwide incidence of Kaposi's Sarcoma in the past had been estimated by the Centers for Disease Control to be less than six-one-hundredths of a case per 100,000 people annually, or about two cases in every three million people. However, the disease accounts for up to 9 percent of all cancers in a belt across equatorial Africa, where it commonly affects children and young adults.

In the United States, it has primarily affected men older than 50 years. But in the recent cases, doctors at nine medical centers in New York and seven hospitals in California have been diagnosing the condition among younger men, all of whom said in the course of standard diagnostic interviews that they were homosexual. Although the ages of the patients have ranged from 26 to 51 years, many have been under 40, with the mean at 39.

Nine of the 41 cases known to Dr. Friedman-Kien were diagnosed in California, and several of those victims reported that they had been in New York in the period preceding the diagnosis. Dr. Friedman-Kien said that his colleagues were checking on reports of two victims diagnosed in Copenhagen, one of whom had visited New York.

No one medical investigator has yet interviewed all the victims, Dr. Curran said. According to Dr. Friedmnan-Kien, the reporting doctors said that most cases had involved homosexual men who have had multiple and frequent sexual encounters with different partners, as many as 10 sexual encounters each night up to four times a week.

Many of the patients have also been treated for viral infections such as herpes, cytomegalovirus and hepatitis B as well as parasitic infections
such as amebiasis and giardiasis. Many patients also reported that they had used drugs such as amyl nitrite and LSD to heighten sexual pleasure.

Cancer is not believed to be contagious, but conditions that might precipitate it, such as particular viruses or environmental factors, might account for an outbreak among a single group.

The medical investigators say some indirect evidence actually points away from contagion as a cause. None of the patients knew each other, although the theoretical possibility that some may have had sexual contact with a person with Kaposi's Sarcoma at some point in the past could not be excluded, Dr. Friedman-Kien said.

Dr. Curran said there was no apparent danger to nonhomosexuals from contagion. “The best evidence against contagion,” he said, “is that no cases have been reported to date outside the homosexual community or in women.”

Dr. Friedman-Kien said he had tested nine of the victims and found severe defects in their immunological systems. The patients had serious malfunctions of two types of cells called T and B cell lymphocytes, which have important roles in fighting infections and cancer.

But Dr. Friedman-Kien emphasized that the researchers did not know whether the immunological defects were the underlying problem or had developed secondarily to the infections or drug use.

The research team is testing various hypotheses, one of which is a possible link between past infection with cytomegalovirus and development of Kaposi's Sarcoma.

Altman did a good job of summarizing the state of scientific knowledge at this moment, including all the hypotheses for the causes for these puzzling events. But like everything else people read during the first stage of the epidemic, Altman's article was filled with conflicting signals—enough to make most gay men careen between confidence that they were safe and a conviction that they were surely infected.

The fear grew from the lack of any reliable diagnostic test, and the vagueness of the indicators of possible infection, such as the “violet-colored spots anywhere on the body” which “often can be mistaken for bruises.” For years, this symptom would transform almost every morning for a seemingly healthy gay man into a search for a possible death sentence. Equally alarming were the slightest suggestion of “swollen lymph glands,” a bout of diarrhea, an unfamiliar sore in the mouth, a prolonged flu, or even just a patch of unexplained fatigue.