Reporting and Reactions From Forty Years Ago: Part III

This third and final excerpt brings the narrative back to San Francisco, where in late 1981 only a few gay journalists were trying to keep “gay cancer” in the headlines. Despite Randy Shilts’ later efforts, he had not yet made the disease part of his beat, although the San Francisco Chronicle’s science writerswere providing regular medical updates. His friend and rival Randy Alfred, however, had gotten ahead of most other local gay journalists by showcasing the disease both on his weekly radio show and in the San Francisco Sentinel, where he’d recently become editor.

Excerpt #3: A Determination to Live

Meanwhile in San Francisco, dermatologist Marcus Conant and oncologist Paul Volberding, both with UCSF Medical Center, had become two of the leading members of a new city task force devoted to combating gay cancer. In future years, to even get 30 minutes of their time would be something of a coup; but when the two physicians approached journalist Randy Alfred with a request to appear in-studio on his KSAN radio program, The Gay Life, listeners had an early opportunity to hear a measured, point-by-point examination of everything known so far – including a response to the rampant speculation buzzing around what gay cancer may or may not actually be.

To start, Alfred pressed, was it accurate to even call this outbreak a disease, let alone a gay disease? Volberding acknowledged that Kaposi’s sarcoma had only recently become prominent in gay men, while Conant pointed out that because there are no known physiological differences between gays and heterosexuals, any new disease would be just that: a human ailment, rather than a peculiarity of homosexuality. They were aware, he added, of cases recently identified by CDC among heterosexual men and women. “So I would believe that probably we’re seeing this outbreak in a very sexually active group in the population, namely the gay community, and that we will see this disease in the heterosexual community as well in the next few months in greater numbers.”

Among those heterosexual cases, Conant noted, heavy drug use seemed to be common, especially of the intravenous nature. For those who were insisting that cancer in and of itself was not contagious, Volberding stressed, an “underlying defect” was probably responsible for both illnesses, “that something is causing the immune system to be compromised in that the deficiency in the immune system allows these persons to be infected by organisms that otherwise are only seen in people who are debilitated, and also to develop a malignancy that otherwise is very rare.”

To offer a modicum of hope for persons developing symptoms, Alfred brought up the issue of treatment; the best his guests could offer, however, was guarded speculation. “Obviously, the ideal treatment would be to correct the defect that is causing the problem. Unhappily, at the present time, we are unaware of what that defect is,” Conant told him.

A number of alternate hypotheses were already swirling around the community, which Alfred found ways to raise throughout the conversation. What about heavy drug use, or immune systems burned out by repeated VD treatments? It was true that many of the patients so far had lengthy histories of smoking pot and using poppers, they acknowledged, and medical researchers had taken notice of treatment resistance in cases where patients had repeated bouts of common sexual ailments like gonorrhea. But, Volberding countered, some of the persons with KS or PCP were relatively young, with far less experience compared to men who’d enjoyed an active gay lifestyle for some years now. In fact, a few of the patients had little to no prior history of sexually-transmitted infections, and their popper use was variable as well.

Perhaps it’s a silver lining, Alfred mused, that this entire experience would eventually produce a great deal more knowledge about cancers and the human immune system. But, he admitted, “The question is that a lot of us don’t like being in an experimental group by virtue of our lifestyle.” With so little data, Conant advised, any answers to these questions would have to be “broad and speculative.” Already, however, the evidence was pointing to a viral agent spread through sexual activity. “If the suggestion that it may have come from a point source and be something that is transmissible is correct, then individuals should reduce the number of sexual contacts they have.”

By the end of 1981, both Time and Newsweek had joined the mainstream papers in publishing cursory stories on the epidemic, but much of the credit for keeping gay cancer in the headlines lay with a small handful in the gay media who, often against the wishes of their publishers and advertisers, insisted on keeping it there. In his dual roles as radio host and editor of the Sentinel, Alfred was generating more than his fair share of that coverage, which in the year ahead would continue to swell in both frequency and volume. “So I was following the procedure of, anybody that I ever talked to on any of the stories, I added to my beat checklist,” he recalled. “And [the Sentinel] came out every two weeks, and I phoned them every two weeks to find out what was new. That is, I didn’t wait for them to tell me. I called all my sources every two weeks.” 

In contrast to the Bay Area Reporter, where updates at the time remained sparse and far removed from the front pages, he invited registered nurse Bobbi Campbell, whose KS diagnosis came soon after the first news stories had appeared, to begin writing about his experiences in a regular column. The soft-spoken 29-year-old would emerge as a self-appointed “poster boy” for gay cancer victims, a role his stories would amplify. Winsome, earnest, and congenitally optimistic, Campbell gamely stepped into the spotlight, albeit one within the narrow confines of gay media, offering a much-needed human element to a story that remained clouded by scientific uncertainty, clashing opinions on what (if anything) to do, and – for some gays – wholesale avoidance of the subject matter. If writing about his experiences could shine a light for someone – an anonymous gay “brother” on Castro or Christopher Street, who either was afraid or unaware of what those strange purple lesions signified – then Campbell hoped his efforts could prevent at least one more death. “I’ve taken to wearing a button with the title of Gloria Gaynor’s 1979 hit song, ‘I Will Survive,’” Bobbi Campbell declared. “It seemed an appropriate title for this column. I’m writing because I have a determination to live. You do, too– don’t you?”

By the end of 1981, more than 230 known patients were reported to have died from the still-unnamed medical condition, and for physicians on the frontline, nothing would be quite as frightening as the onslaught on patients’ bodies they were already witnessing. “It’s like it did things that a virus, a  smart virus, shouldn’t do,” Paul Volberding later remembered. “Because viruses aren’t supposed to kill 100% of people – you know?”

Source Notes

Information and direct quotes from the January 10, 1982 episode of The Gay Life were transcribed from The GLBT Historical Society’s Online Audio Holdings.

Information and direct quotes from the December 10, 1981, San Francisco Sentinel were retrieved through Inter-Library Loan from the University of Michigan Library’s Microfilm Services.

Reflections by Dr. Paul Volberding come directly from our in-person interview at the University of California-San Franciscoon March 21, 2016.