Communicative Contacts: Randy Shilts, Gaétan Dugas, and the Construction of the "Patient Zero" Myth

On 9 October, 1987, Le Soleil, a French-language newspaper in Quebec City, reported that Gaétan Dugas’ family was devastated by the unexpected and internationally-broadcast claims that Dugas may have been the man who had introduced HIV to North America before he died in 1984. The flight attendant’s family members were left wondering how his medical confidentiality had been breached, and how Randy Shilts – the journalist advancing these claims – had learned his identity. They almost certainly could not have imagined the scale of the networks of sexual contact and of information-sharing at work in the construction of this persistent origin myth.

My presentation uses archival material from Shilts’ professional papers, gay periodicals, and oral history interviews to reconstruct the journalist’s growing obsession with “patient 0.” In 1982 and 1984, this man had been posited by the Centers for Disease Control as a significant individual in an early “cluster” study that explored the links of sexual contact in a network of gay male AIDS patients. While the medical assumptions supporting the cluster study had become outdated by the time Shilts was researching his book, its story-telling potential had not. I argue that in the course of writing his popular history – and in spite of his stated aim of “humanizing this disease” – Shilts became seduced with discovering and revealing the identity of the man he would call ‘Patient Zero’. I demonstrate that the journalist drew upon an extensive international network of informants and contacts to bypass the barriers of confidentiality erected by public health professionals. Furthermore, I conclude that Shilts’ dark characterization of Dugas drew its intensity from – and indeed combined with – the journalist’s intention to cast the disease itself as a character in his history.