When AIDS Began: San Francisco and the Making of an Epidemic

When AIDS Began: San Francisco and the Making of an Epidemic

When AIDS Began: San Francisco and the Making of an Epidemic

When AIDS Began: San Francisco and the Making of an Epidemic


As the AIDS crisis reaches new heights globally with no cure in the immediate future, the time is ripe to step back and examine the roots of this epidemic. In When AIDS Began , Michelle Cochrane constructs the making of this disease and dispels many of the misconceptions that surround it. By examining the early outbreaks in San Francisco, Cochrane unfolds the "creation" of AIDS in one geographic location and then traces how and why major claims about the transmission of HIV were made, extrapolated and then disseminated to the rest of the world - all important factors in understanding this disease.


John Doe was admitted to the emergency room at San Francisco General Hospital at 10:40 P.M. on July 17, 1994. His "pupils were 7mm dilated, fixed," he had "poor peripheral pulses," blood pressure was falling and near zero.

Upon entry to the operating room 21 minutes later, John Doe was pronounced "DOA" (dead on arrival). He was 38 years old. The Coroner's Property receipt for him listed "no propirty [sic]" other than a wristwatch.

John Doe was the 261,000th American to die from acquired immune deficiency syndrome (AIDS) since surveillance for the epidemic began in 1981.

I was sitting in a San Francisco bar perusing the gay weekly newspapers when I first learned of this man's death one evening in July 1994. I could not have been more shocked to see John Doe in the little gray box bordered in black, as I knew him as a charismatic San Francisco writer and AIDS treatment activist who had lived with a diagnosis of AIDS for almost half his life. He was renown in San Francisco's AIDS community for surviving that life/death sentence. Diagnosed with "gay pneumonia" (Pneumocystis carinii pneumonia; also known as PCP) in the early 1980s and given six months to live, Doe had survived to write a weekly alternative treatment column for a gay newspaper and held frequent community forums on the immune-restorative properties of DNCB, a photochemical applied topically to the skin that is purported to jump-start the immune system of persons with AIDS (PWAs).

I often perused John Doe's weekly treatment column and had last seen him speak at a DNCB forum held at a San Francisco church in the Tenderloin district one summer afternoon in 1993. He was a dynamic and aggressive speaker; the tenor of the treatment forum brought to mind a Southern Baptist revival in Missouri. Doe indicted the establishment of AIDS researchers and clinicians as "doctors of death" who had fashioned professional careers and lucrative salaries from an investment in "our deaths." At the conclusion of his speech, following his scathing attack on the science of AIDS medicine and its orthodox treatments, I half expected more debilitated members of the audience to throw away their crutches and leap dancing into the aisles.

But did John Doe die of AIDS? It all depends on your "social location" in the debates surrounding AIDS pathogenesis and treatment; it depends on who you are, whom you ask, and which questions you pose. For the doctor on duty in the emergency room at SFGH, this "middle-aged man was brought in by paramedics" after apparently falling (30-40 feet) down some stairs. Cause of death: "probable secondary to head/chest injuries. Anatomical findings: severe head trauma, cyanosis with bloody tracheal aspirate."

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