Cold Open

It’s a little after 11 AM, on December 5th, 1980, at Saint Francis Memorial Hospital in San Francisco, California.

Dr. Jim Groundwater presses a button to call in his next patient. Ken Horne is the man’s name - but Dr. Groundwater’s not been looking forward to this appointment. He's seen Ken a lot over the past few months, and every time he’s been stumped by the 37-year-old’s condition.

The door opens and Ken shuffles in. As Dr. Groundwater shakes Ken’s hand, he can see that Ken's been crying. Gently, he asks Ken to remove his shirt and step onto the scales. As Ken fumbles with his buttons and removes his shirt, Dr. Groundwater tries to hide his shock. Ken is gaunt, far more so than his last appointment. It’s almost like he’s wasting away.

The scales confirm Dr. Groundwater’s fears. Ken has lost another seven pounds. And as he steps off the scale, he reels off a list of symptoms that Dr. Groundwater knows all too well by now: fatigue, diarrhea, nausea, and strange purple lesions on his chest.

There’s no doubt that Ken is dangerously ill. But Dr. Groundwater can’t work out what’s causing it. All he can do is keep trying different tests. He explains that he’s going to send Ken for a biopsy of his lymph nodes. That might rule out cancer.

But Dr. Groundwater knows that just eliminating possibilities isn’t good enough. He needs to find out what is causing Ken suffering—and he needs to do it quickly. Because if there’s one thing that is clear to Dr. Groundwater, it’s that Ken is running out of time.

Over the months that follow, Ken Horne’s condition will only grow worse. But when a crop of similar cases emerges across America, a common thread linking all of them will become apparent, and a deadly new disease will be identified. Acquired immune deficiency syndrome, or AIDS, will ravage America and cause more than 40 million deaths around the world, but the fightback will begin when the first scientific report into the outbreak is published on June 5th, 1981.

Introduction

From Noiser and Airship, I’m Lindsay Graham and this is History Daily.

History is made every day. On this podcast—every day—we tell the true stories of the people and events that shaped our world.

Today is June 5th, 1981: The First Scientific Report on the AIDS Epidemic.

Act One

It’s the morning of June 5th, 1981, in Chicago, Illinois, six months after Dr. Jim Groundwater examined a man with a mystery illness in San Francisco.

At his kitchen table, medical researcher Dr. David Ostrow sips from a mug of coffee as he goes through his mail. It’s the usual mix of bills and catalogs. He puts the bills to one side and the catalogs in the trash. But then he comes to a thick envelope with a familiar logo on the outside. He rips it open and slides out a printed booklet, the Morbidity and Mortality Weekly Report from the Centers for Disease Control—an update on the world’s health news that leans heavily into infectious diseases. David glances over the report’s contents. There’s new information about recent measles infections and an article on childhood lead poisoning. But David freezes when he spots the headline “Pneumocystis Pneumonia—Los Angeles.”

Last week, David attended a conference in San Diego, California, where he heard rumors about an outbreak of an unusual pneumonia. David was intrigued by the case since it impacted both his professional and personal life because from what David heard, the outbreak in Los Angeles only affects men who are gay - men like him.

Homosexuality became more openly accepted in some parts of the country, and gay communities coalesced in cities like New York, San Francisco, and Los Angeles. Young men especially began to let loose and enjoy their newfound freedoms. Having multiple sexual partners became the norm.

But this liberation came with consequences. Sexually transmitted diseases were soon rife in the gay community. And for the past three years, David Ostrow’s research has focused on finding a vaccine for Hepatitis B—a virus that’s endemic among gay men and spread through sexual contact. Now, though, a new disease seems to be rearing its head among the same population.

David reads the article in the Morbidity and Mortality Weekly Report several times. It describes how between October 1980 and May 1981, five otherwise healthy gay men in Los Angeles became desperately ill. Two of them eventually died from what was theorized to be a virulent form of pneumonia. But there’s no known link between the five men apart from their geographical proximity and their sexuality. How they caught the disease is a mystery.

David is not the only doctor whose attention is caught by the news of the pneumonia outbreak. It soon becomes clear that the five Los Angeles cases are just the tip of the iceberg. Because over the next few days, the phones at the Centers for Disease Control, or CDC, ring off the hook. Doctors from all over the country call in with their own examples of gay men suffering from the same form of pneumonia.

Among those callers is San Francisco doctor Jim Groundwater—but he has a different malady he wants to report to the CDC. He has a gay patient who seems to be suffering from Kaposi’s Sarcoma, a rare skin cancer that first exhibits itself in purple spots. And Dr. Goldman isn’t alone in reporting a case of this disease. Soon, clusters of Kaposi’s Sarcoma are identified around the country—and they all seem to be isolated to gay communities.

Apart from medical professionals, these cases of pneumonia and Kaposi’s Sarcoma go largely unnoticed at first. Gay newspapers dismiss the CDC report as little more than anti-gay hysteria. The New York Times publishes an article headlined “Rare Cancer Seen In 41 Homosexuals,” but the article is buried in a one-column story on page 20 and contains few facts. The lack of knowledge is hardly surprising—the medical authorities themselves are struggling to identify the diseases that are striking the gay community, and how they may be linked.

Doctors like Jim Groundwater and David Ostrow just want to help stop the mysterious illnesses spreading and keep people alive longer. But the first step to treating this new disease will be identifying it. And, to do that, the medical establishment will need to win the support and trust of a skeptical and increasingly frightened gay community.

Act Two

It’s March 14th, 1982, in Chelsea, an up-and-coming area of New York city, nine months after the Centers for Disease Control’s first report about the new disease stalking America.

In a spacious loft apartment, 39-year-old Dr. Jim Curran rises from his seat, clears his throat and begins addressing his audience. As a specialist in infectious diseases at the CDC, Jim is used to giving talks at conferences. But today’s audience is different. Jim's come to Chelsea to speak with medical professionals who are themselves gay - because he needs their help.

Since the release of the CDC report and the article in the New York Times, Jim’s office has been inundated with reports of similar cases. But the cause for these illnesses still baffles medical professionals. The only headway they’ve made so far is discovering that the immune systems of once-healthy gay men are all been eradicated when they contract this mystery illness. As a result, the disease has been given the name “gay-related immune deficiency,” or GRID for short. And despite the terrifying lack of solid information, it’s Jim’s job as head of the CDC task force to stop this disease spreading further.

In the loft apartment Jim explains to his fellow doctors that he needs to discover as much as he can about this new illness. And for that, he needs their cooperation - and the cooperation of the wider gay community. He needs GRID patients to come forward and be interviewed, despite any shame or embarrassment they may feel. But Jim also lets the audience in on a secret. Although he has no definitive proof yet, Jim suspects that this disease is spread by sexual contact. And if he's right, he thinks GRID will ultimately affect straight and gay patients alike. It might be years before a vaccine or effective treatment is found though. And that’s why it’s so important that Jim speaks with as many people struck with the disease as possible.

But not everyone agrees with Jim’s hypothesis. Fellow doctor Joe Sonnabend runs a sexual health clinic in New York’s Greenwich Village, and he’s seen many cases of GRID among his patients too. Joe is convinced that promiscuity among gay men specifically is the cause of the disease. Joe’s hypothesis is that repeated exposure to different sexually transmitted diseases in the gay community has somehow compromised there immune systems.

And while Joe means well, inadvertently, his immune-overload model only deepens the growing stigma surrounding GRID. Anti-gay campaigners are using the disease as so-called “proof” that homosexuality is wrong, and, as news of the mystery illness spreads, there’s a surge in hate-crime attacks on gay men.

But back at the CDC, Dr. Jim Curran continues to monitor all new cases—and thanks to his outreach efforts, there are more patients for him to interview than ever. By July 1982, Jim has identified 452 cases of this new disease. And when he starts digging into these patients' medical history, he begins to spot some revealing patterns.

One-fifth of GRID sufferers identify as exclusively heterosexual. Jim knows that some of the men might be lying about their sexuality. But even so, the numbers are higher than he expected. But two factors seem to link the patients in this category. Many freely admit that they are or previously were intravenous drug users. And a large proportion of the others are from Haiti.

But one patient stands out to Jim as a specially puzzling: a 62-year-old man who is neither gay, nor a drug user, nor from Haiti. He does suffer from the bleeding disorder hemophilia though. And by a process of elimination, Jim concludes that the man must have contracted GRID through a blood transfusion, a regular treatment he receives for his hemophilia. Jim has stumbled across an important clue: GRID is a blood-borne disease.

Within weeks of this discovery, Jim puts an action of plan to slow the spread of GRID. Blood donations are halted from any person fitting into what’s called the “four H’s”: Haitians, Heroin addicts, Hemophiliacs, and Homosexuals. And to spread awareness of the fact that it’s not just gay men at risk, the name of the disease is also changed. Gay-related immune deficiency is now “Acquired Immune Deficiency Syndrome,” or AIDS.

Jim and his fellow researchers have made a crucial discovery, but their work is only just beginning. Although AIDS has now been identified as a blood-borne disease, effective treatments are still years away. And the myth that the disease only strikes gay men will prove stubbornly persistent. Only when medical breakthroughs are accompanied by a change in society’s attitudes will the AIDS epidemic finally be brought under control.

Act Three

It’s April 20th, 1992, at Wembley Stadium in London, England, more than a decade after the first cluster of AIDS cases was reported in America.

A large temporary stage has been built on one end of the sports arena. The pop star George Michael stands just off-stage with a microphone ready. He looks out over a sea of happy people. Music thumps, lights sweep over the cheering crowd, and then George bounds out into the spotlight.

George is at Wembley alongside a host of other international stars to pay tribute to Freddie Mercury, the iconic lead singer of the British rock band Queen. Freddie died six months ago, and four years after being diagnosed with AIDS.

Now, 72,000 people in Wembley Stadium and millions more watching live all around the world have come together to celebrate Freddie’s life and music - and to raise much-needed funds for research into the disease that killed him.

Six years ago, medical researchers identified and officially named the virus that causes AIDS. Their work revealed that the human immunodeficiency viruses, or HIV, can be spread in both contaminated blood and through sexual activity—with men or women. What was once dismissed as a disease that only affected the gay community is now widely recognized as a threat to everyone. But a cure won’t be found without yet more research, more money and more awareness.

That’s why fundraisers like tonight's tribute concert in London are so important. George Michael’s performance is electric, and his rendition of the Queen hit “Somebody To Love” becomes instantly iconic.

Few watching know the truth behind this emotional performance, though. George is secretly gay, and his boyfriend has been recently diagnosed as HIV positive. The concert may be a heartening sign of changing attitudes toward those suffering from HIV and AIDS, but the fact that George feels he has to keep his relationship a secret shows how far society still has to go.

Throughout the early nineties, more and more money pours in for AIDS research - and soon scientists make some major breakthroughs. Antiretroviral drugs are found to suppress HIV and prevent many of those infected from ever developing AIDS. These treatments come too late for Ken Horne, who died in 1981, George Michael’s boyfriend who died in 1992, and millions of others like them. But thanks to these drugs, countless lives have been saved and even better treatments lie in the future. HIV is no longer a death sentence. And that is the kind of hope that was in short supply when the Centers for Disease Control published the first worrying report about AIDS on June 5th, 1981.

Outro

Next on History Daily. June 6th, 1933. The first bucketful of concrete is poured to begin construction of the Hoover Dam.

From Noiser and Airship, this is History Daily, hosted, edited, and executive produced by me, Lindsay Graham.

Audio editing by Muhammad Shahzaib.

Sound design by Gabriel Gould.

Music by Thrumm.

This episode is written and researched by Owen Paul Nicholls.

Edited by Scott Reeves.

Managing producer Emily Burke.

Executive Producers are William Simpson for Airship, and Pascal Hughes for Noiser.