Fouratt—well known in the 1980s as the co-founder of Danceteria, which became one of the most popular downtown nightclubs in New York City—who encouraged Richard to move east and for a few months gave him a place to stay. Richard felt that his whole time in San Francisco somehow contributed to his willingness to get involved with Mike—some sense about the wildness and spontaneity of life, about following unexpected impulses, about valuing the inconclusive, the impermanent.
A week after the two met—in late June 1982—Mike was hospitalized with cryptosporidium, formally diagnosed with GRID, and told that he had six months to live. From the time Mike’s T-helper cells had first been tested in 1981, he never had a count of more than 200,and he had consistently high levels of CMV, which was known to be immunosuppressive. Sonnabend immediately put him on two double-strength Bactrim tablets daily to prevent Pneumocystis pneumonia (PCP). It was a crucial decision: Mike would never develop the often-fatal pneumonia. Yet more than thirty thousand would die of the preventable disease in the years to come, simply because the CDC and the medical community failed to prescribe Bactrim as a prophylaxis. Many could have been saved had federal agencies formally announced—as the CDC finally did in 1989—that a daily dose of Bactrim should be the standard of care for patients at risk.
There was no excuse for the seven-year delay: Bactrim was hardly an unknown, recondite, or expensive drug. It was readily available as a cheap generic product in 1981–82 and had been frequently used to prevent PCP in other kinds of immunocompromised hosts—for example, in kidney transplant patients. (Sonnabend, when part of the infectious diseases service at Downstate Medical Center in the 1970s, had had experience in its renal unit.) The CDC and the NIH’s failure to recommend it for GRID/AIDS patients seemed to both Joe and Mike, in Joe’s words, “a glaring example of a discriminatory response—that is, its selective denial to gay people . . . of the brutal indifference of federal health officials.” Many years later, he would express “bewilderment” at “the trust placed in authorities representing institutions that had such an abysmal record regarding concerns for the health of minorities.”
Many AIDS patients, out of understandable panic to do something , would increasingly grasp at a variety of rumored cures. As underground networks and buyers clubs began to spring up to get hold of any drug thought to be effective, the list would grow long: ribavirin (which had been used in Europe and Mexico against various viral diseases); suramin (which produced no rise in CD4 cells but led to unintended and dangerous adrenal insufficiency); HPA-23, acyclovir, imuthiol, and dextran sulfate in various combinations. All were equally ineffective. Other patients underwent chemotherapy and full-body radiation, submitted to bone-marrow transplants and high-dose regimens of interferon, attached themselves to spiritual guides, or swallowed vast quantities of herbal compounds. Mike stuck to Sonnabend’s advice: except for taking Bactrim, which was known to work against PCP, avoid all the touted drugs du jour. 9
During his June 1982 hospitalization, Mike was surprised to get a visit from the undemonstrative, reserved Richard Dworkin, the new drummer in his rock group. The visit meant a great deal to Mike and cemented the two men’s initial attraction to each other. After Mike’s release from the hospital, they began to date and soon became lovers. It was one of those miraculous cases of “hooked atoms.” Richard was as dependable and principled as Mike, but far less histrionic and verbal. Taciturn and forceful, he was Mike’s ideal version of a “top.” As he once put it, “Richard never had the history of self-torture for feeling different that I, early a sissy, always felt.” He would bring a solid strength to Mike’s life, much-needed
A week after the two met—in late June 1982—Mike was hospitalized with cryptosporidium, formally diagnosed with GRID, and told that he had six months to live. From the time Mike’s T-helper cells had first been tested in 1981, he never had a count of more than 200,and he had consistently high levels of CMV, which was known to be immunosuppressive. Sonnabend immediately put him on two double-strength Bactrim tablets daily to prevent Pneumocystis pneumonia (PCP). It was a crucial decision: Mike would never develop the often-fatal pneumonia. Yet more than thirty thousand would die of the preventable disease in the years to come, simply because the CDC and the medical community failed to prescribe Bactrim as a prophylaxis. Many could have been saved had federal agencies formally announced—as the CDC finally did in 1989—that a daily dose of Bactrim should be the standard of care for patients at risk.
There was no excuse for the seven-year delay: Bactrim was hardly an unknown, recondite, or expensive drug. It was readily available as a cheap generic product in 1981–82 and had been frequently used to prevent PCP in other kinds of immunocompromised hosts—for example, in kidney transplant patients. (Sonnabend, when part of the infectious diseases service at Downstate Medical Center in the 1970s, had had experience in its renal unit.) The CDC and the NIH’s failure to recommend it for GRID/AIDS patients seemed to both Joe and Mike, in Joe’s words, “a glaring example of a discriminatory response—that is, its selective denial to gay people . . . of the brutal indifference of federal health officials.” Many years later, he would express “bewilderment” at “the trust placed in authorities representing institutions that had such an abysmal record regarding concerns for the health of minorities.”
Many AIDS patients, out of understandable panic to do something , would increasingly grasp at a variety of rumored cures. As underground networks and buyers clubs began to spring up to get hold of any drug thought to be effective, the list would grow long: ribavirin (which had been used in Europe and Mexico against various viral diseases); suramin (which produced no rise in CD4 cells but led to unintended and dangerous adrenal insufficiency); HPA-23, acyclovir, imuthiol, and dextran sulfate in various combinations. All were equally ineffective. Other patients underwent chemotherapy and full-body radiation, submitted to bone-marrow transplants and high-dose regimens of interferon, attached themselves to spiritual guides, or swallowed vast quantities of herbal compounds. Mike stuck to Sonnabend’s advice: except for taking Bactrim, which was known to work against PCP, avoid all the touted drugs du jour. 9
During his June 1982 hospitalization, Mike was surprised to get a visit from the undemonstrative, reserved Richard Dworkin, the new drummer in his rock group. The visit meant a great deal to Mike and cemented the two men’s initial attraction to each other. After Mike’s release from the hospital, they began to date and soon became lovers. It was one of those miraculous cases of “hooked atoms.” Richard was as dependable and principled as Mike, but far less histrionic and verbal. Taciturn and forceful, he was Mike’s ideal version of a “top.” As he once put it, “Richard never had the history of self-torture for feeling different that I, early a sissy, always felt.” He would bring a solid strength to Mike’s life, much-needed
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