Nobody Gets Out of Here Alive
Patrick Gourley arrives at the Infectious Diseases Clinic on the fifth floor of the old city hospital and walks into his cramped office, which includes both a desk and an examination table.
Gourley, head of nursing at the clinic, pulls a small, clear plastic container out of his purse, sighs and begins his morning ritual.
The container has four compartments, each holding a variety of multi-colored pills. He opens one of the compartments and pours its contents onto the desk. He picks up the three orange capsules containing Sustiva, a non-nucleoside reverse transcriptase, first. He hates this drug the most, because one of the side effects jars his central nervous system, making him feel edgy and wired for two to three hours. He makes a face and quickly downs the pills with a gulp of water.
Next he picks up the rust-colored Zerit capsule, a nucleoside reverse transcript inhibitor, and swallows it. He hasn't noticed any side effects from this pill yet, though long-term he worries that it will poison his mitochondrion, the "engines" that make the cells in the body run. Mitochondrial toxicity can lead to muscle-wasting and nerve damage.
With the first two drugs out of the way, Gourley crunches up the five baby-blue caplets of Viracept, a protease inhibitor, and dumps them into the rest of the water. He prefers this method -- otherwise, the pills practically explode into powder when they come into contact with his saliva, choking him. Viracept is another drug that causes diarrhea in the short-term, though not yet for Gourley.
Worse -- at least for a man who laughs and calls himself "a vain old queen" -- is what the Viracept may be doing to his looks. Although it's unclear whether it's the drug or the HIV that's messing up patients' fat metabolism, doctors currently believe it's the former that's draining fat from its usual places -- in Gourley's case, his face, causing the skin to sag, and his ass, so that his pants have nothing to hang on -- and storing it in unusual places, such as the infamous "buffalo hump" of fatty deposits in the shoulders and neck, or in Gourley's pot belly. With one last sigh, he drains his blue "slurpee."
Having disposed of those nine pills, Gourley turns to the supplements: three capsules containing fish oil and three more pills containing 1,500 mg. of Niacin to lower his cholesterol and triglyceride levels, which have skyrocketed because of the Viracept. He then takes a pill each for calcium and magnesium because the drugs are thought to adversely affect bone density, a vitamin C and a multivitamin for general health, and a "baby aspirin" because, after all, he's 51 and has the high cholesterol and triglyceride levels that may precede a heart attack. He has to repeat the performance twice a day. At night he adds to the supplements with Coenzyme Q and something called NAC to help combat the mitochondrial toxicity.
That's eighteen drug pills and another dozen supplements that he has to take every single day of his life -- without fail. For Gourley, like many other AIDS survivors on the so-called drug cocktails, the cure sometimes seems worse than the disease -- but cruelly, this medicine doesn't even cure. If all goes well, the regimen merely keeps the disease in check. Even then, the drugs are so tough on body and soul that some survivors grow weary and give up the pills and either succumb to the disease or, for reasons doctors don't yet understand, live on.
In Gourley's case, however, the effort and the side effects certainly beat the alternative. A photo on the wall reminds him of that. It's a picture of five men standing in the sun outside a bed-and-breakfast inn at the San Juan Pueblo between Taos and Santa Fe. Two of the men in the photograph, including his lover of fifteen years, have died. Killed by a plague that also strangled a cause.
Patrick Gourley was born in 1949 and raised on a farm outside La Porte, Indiana, a farming community of a few thousand. His parents were Irish-Catholic, his father an even-keeled family man who didn't drink or carouse, his mother an OB/GYN nurse who loved babies, especially the five of her own. Gourley's parents didn't have a lot of money, but they insisted on sending their brood to Catholic schools overseen by an Irish order of Holy Cross nuns. They were Democrats, proud of their heritage and dedicated to the church even in the face of prejudice: Gourley's father recalled that when he was a boy of six in the 1920s, the Ku Klux Klan burned a cross at the end of the lane because his family was Catholic.
Red-haired and green-eyed, Patrick was expected to help with chores such as feeding the pigs before school and breaking ice off the water troughs in the winter. By the time he was eight, however, he realized that he didn't like to do what other little boys liked to do. Somewhere between ages eight and sixteen, he realized that while those other boys were always talking about which girl they'd like to get into bed, he was thinking the same thing about some of them.
He wondered if there was something wrong with him. It was driving him crazy, so at seventeen he decided to go have a man-to-man talk with a school counselor. That afternoon, the man, twenty years his senior, became his lover.
It so happened that Gourley was leaving the next morning on a trip to Mississippi, so he had a lot of time to think about what had just occurred. Gourley's was not the sort of reaction he would later hear about from other gays, who were so "freaked out" by their first experiences with other men that they either retreated into the closet or turned the other guy in. He felt liberated as he headed to a state where a fight for equal rights was being waged.
Many of the nuns at his school were involved in the civil-rights movement and Vietnam War protests, and Gourley was influenced in particular by an intense little nun named Sister Alberta Marie. It was 1967, and Alberta Marie thought it was time these middle-class white kids saw the civil-rights movement up close and personal. So now Gourley and four other students were on their way to observe efforts to register blacks to vote in Mound Bayou, Mississippi.
Mound Bayou was an all-black town set in the middle of cotton fields and surrounded by white towns. Gourley's family didn't have much money, but he was shocked at the poverty he saw. People lived in run-down shacks that seemed hardly fit for livestock, and children stood on dirt streets wearing tattered clothes and no shoes.
The kids were split into different cars with the white civil-rights workers, most of whom were from New York. The whites who lived around Mound Bayou weren't particularly happy with a bunch of Yankees coming to their town to stir up the niggers. They followed the civil-rights workers in trucks with shotguns in the rear-window racks.
The civil-rights workers refused to be intimidated, even though Freedom Riders elsewhere in Mississippi would die at the hands of the Klan. They dealt with their fear and kept on with their work. And Gourley learned a lesson: Nobody was going to give oppressed people their rights -- you had to demand them and be willing to stand up for what you believed.
After he returned home, Gourley and the counselor continued to be lovers on and off for the next two years. He would always consider the relationship a positive experience, which in part helped negate society's messages about being gay -- that it was unnatural, that those who participated would encounter God's wrath. With Sister Alberta Marie's help and his own growing awareness, he learned that the truth about one thing had certain connections to other truths. If society wasn't right about the war in Vietnam, or capitalism, or its treatment of Catholics or blacks or Jews, then maybe it wasn't right about homosexuals, either. Maybe there was nothing wrong with him.
It wasn't as if this all came to him overnight. When he went to the University of Illinois, starting in 1967, he wasn't sure that he wanted to be a homosexual, a queer, a faggot. He joined the National Democratic Socialist Party and became active in the civil-rights and anti-war movements, in part so that he could deflect attention from his sexuality by trying to save the world. He even tried sex with women a couple of times, but as he would later confide to friends, he "just didn't get it." He decided it was time for another chat with a counselor and went to see a university psychologist.
This psychologist was of the mind that homosexuality was a learned behavior, a lifestyle choice, and it could be unlearned. His theory was that by doing manly things in a manly way, Gourley might learn to be a "real man." He began by insisting that Gourley give him a firm handshake.
It was an epiphany, only not the sort the psychologist had hoped for. Gourley realized that no amount of firm handshakes or man-talk or going to bed with women was going to change who he was. He was different, uncomfortable in most heterosexual venues except for one. Only at freewheeling, free-loving and psychedelic Grateful Dead concerts was he likely to see even straight males in skirts dancing with abandon and feel an unquestioning acceptance of who he was: just another Deadhead -- albeit a gay one.
Found my baby down by the river...Knew we'd have to come up soon for air. Even as Gourley was dancing to Dead tunes like "Sugar Magnolia," other events were taking place that would shape his future.
On a sweltering night in June 1969, patrons of the Stonewall Inn, a gay bar in Greenwich Village, fought back against a police raid, and the ensuing riot demonstrated that gays were through being pushed around. The American public was set on its ear. It was a time when powder kegs were going off across the country: Blacks were rioting in ghettos, students were rioting on campuses. And now, Oh, my God, even the drag queens are rioting.
Gourley, however, was oblivious to what had occurred at Stonewall and would not connect its significance to his own internal revolution until years later. In 1972, over a large bottle of tequila and with the Dead on the stereo, Gourley, whose long red hair didn't set him apart from any other male of his generation, and several of his roommates decided to move from Illinois to Colorado. The state seemed exotic, practically on the edge of the frontier -- and they'd heard that the Dead played there often. They all piled into a 1961 blue Dodge Dart, an "invisible car" the cops weren't likely to notice, and arrived in Denver, where they found an apartment in the 600 block of Elati Street.
The apartment was just two blocks from the city hospital, what was then called Denver General Hospital. Not long afterward, Gourley heard that the hospital was hiring attendants for its locked psychiatric ward. He'd never really considered a career in medicine -- in fact, he'd studied to be a teacher -- but he needed a job, and this one was close.
Once again, Gourley found himself in the midst of strong, dynamic women: the nurses of 4West. Worldly and profane, they certainly weren't Holy Cross nuns, but there were many other similarities, including their outspokenness.
Compared to the rest of society, it was easy to be a gay man on 4West. The nurses didn't care. In fact, Gourley found reinforcement for the notion that straight women and gay men make great friends because neither is interested in the other sexually. Nor did he have any problems with the other male attendants. Most were conscientious objectors to the war in Vietnam, and they, too, were ostracized by the larger society.
There were important lessons to be learned on 4West, many of them from the patients. Like homosexuality, mental illness seemed to the general public to be a lifestyle choice: People believed that the mentally ill could do something about their problems if they really wanted to. Patients would arrive with their lives in shambles, though some had been businessmen and housewives, lawyers and teachers. They might have been arrested or beat up on the streets and had often lost everything they had, including family and friends.
On 4West, however, they were treated with dignity and compassion by the nurses and physicians, and Gourley realized the treatment often had as great an effect on them as any of the medications. Thanks in part to his acceptance on 4West, Gourley was encouraged to continue his search to find out who he was. After seeing Denver's first men's "coming out" group advertised in one of the gay newspapers, he attended its initial meeting at the Unitarian Church on 14th Avenue and Lafayette Street. It was the first openly gay "space" that wasn't a bar or a bathhouse, a place where gay men could talk about their experiences and difficulties without the buzz of booze, drugs and naked bodies.
As in other parts of the country, gays in Denver were beginning to realize that nobody was going to hand them their rights; they were going to have to demand them and be willing to fight. In June 1975, a few hundred people, including Gourley, gathered at the urging of two gay organizations, The Tavern Guild and the Imperial Court, at Cheesman Park and staged the first march down Colfax Avenue in commemoration of the 1969 Stonewall riots.
In 1976, a group of gay men, including the leaders of the guild and Imperial Court along with gay Christian organizations Unity and the Metropolitan Community Church, formed the Gay Community Center and hired Phil Nash, a young activist, as its first director. Gourley soon left the coming-out group to volunteer at the center, mostly helping gay men find out where to meet others -- which at the time meant referring them to the gay bars and baths. But there was more to it than that.
It was an exciting time for Gourley. The center was a place to debate politics and make plans for dealing with issues such as police harassing patrons at gay bars and bathhouses. And a lot of the social and political consciousness flowering at the center had to do with the lesbians who were showing up in increasingly greater numbers and demanding their place in the community. Many of them had learned their activism in the feminist movement, only to discover that they did not quite fit in with the heterosexual women there. It was the women, Gourley noted, who raised the issues of racism and sexism in the gay and lesbian community; some of the bars and baths, for instance, did not allow blacks. It was issues such as these, the lesbians pointed out, that made gays hypocritical when they accused straight society of discrimination.
Gourley was continuing to go through his own changes. He decided he was being less than honest telling the world he was gay in Denver, Colorado, where he didn't have to worry about his family finding out, so he wrote a letter to his parents telling them and asking them to understand that he was happy and among good friends. His mother got the letter, read it and held on to it for a couple of days before giving it to her husband. She then called Gourley to say "everything's fine. Your dad wants to write a response, but he needs a few days to think it over."
Two days later, his father wrote that in some ways it all now made sense: There had always been something different about his son Patrick, but in a good way. You were always sensitive to the plight of others less fortunate than you, his father wrote, recalling his early interest in the civil-rights movement. As long as Patrick was happy, then he was happy for him. He closed by suggesting that Patrick get in touch with Dignity, a Catholic support group for gays.
The letter made Gourley smile, both for the sentiment and for the thought of his Midwestern-farmer father going to the local priest to find out about Dignity. He laughed, imagining that, for his parents, the only thing worse than having a gay son would be having one who left the church.
Gourley did not have a full-time lover, though he cruised the gay bars and frequented Denver's gay bathhouses looking for sex, which was easy to find. The post-Stonewall '70s had ushered in a new era for gays. Not every homosexual came out of the closet, and many who did preferred to live quietly monogamous lives. But for thousands of young men, the shock troops of the gay-rights movement, it was a time to test the boundaries of their freedom.
Gourley fit the profile of most bathhouse customers: young, white, well-educated, middle- or upper middle-class. Many of the men he met had the money to travel, and the scene often included coast-to-coast bathhouse parties. In Denver there were Empire Tubs on East Colfax and The Zuni in northwest Denver. The biggest of all was The Ballpark on Broadway, with its thirty-foot waterfall pouring into an indoor pool and an abundance of hot tubs and private rooms. A man could have sex anytime of the day or night, often with strangers from opposite sides of the country and all points in between.
But as much as he enjoyed the bathhouse scene and expressing his sexuality, Gourley was beginning to ponder what the lifestyle was saying about gays. Were they to be defined only by the sexual acts they participated in with one another, or was there something more to it? He thought the latter and was supported in this view through his work at the community center. There he'd met many friends, attractive men with whom sex wasn't a part of the relationship -- men like Phil Schroeder, who confessed that he'd literally spent hours driving around the block before parking and then nearly as long walking around before working up the courage to come through the center's doors.
Like he had counseled so many others, Gourley told Schroeder that it was going to be all right. He was home among friends, among brothers. That year, Gourley also met Harry Hay, considered by many to be the father of the modern gay-rights movement and sometimes referred to as "the queer Malcolm X."
Born to an upper-class British family in 1912, Hay, whose father beat him regularly for being a "sissy," had moved with his family to Los Angeles in 1919. As a student at Stanford University in 1930, Hay described himself as "temperamental," a code word for being gay. In the 1940s he argued publicly that gays were born, not created by their environments, and that they should be considered, and consider themselves, a cultural minority, much like Jews. In 1951 he founded the Mattachine Society, the country's first public organization for gay men, but his disappointment that the society seemed to be more of a social club than an organization to lobby for gay rights eventually resulted in his resignation. He was a Marxist and a trade-union organizer whose outspoken involvement in the gay movement during the anti-communist and anti-homosexual hysteria of the Cold War got him summoned to testify before the House Un-American Activities Committee.
After Stonewall, Hay helped form the Los Angeles chapter of the Gay Liberation Front, which shocked America with slogans such as "Kiss a queer" and "Take a lesbian to lunch." However, he and his longtime lover, John Burnside, soon grew tired of the politics and internal bickering in Los Angeles and moved to a small bed-and-breakfast at the San Juan Pueblo in New Mexico.
Gourley knew nothing about Hay or the history of a movement he was now part of when he went to see a documentary film called The Word Is Out in 1976. The movie was a revelation. Hay and Burnside were featured, with Harry in particular talking about gays as a separate, distinct people -- not heterosexuals in which something had gone wrong. The next day Gourley practically ran into the community center raving about the film. His praises were overheard by a huge dyke who usually was given wide berth by almost everyone because she sold pot and carried a gun to protect her business.
"I know Harry," she said, and gave Gourley the address of the San Juan Pueblo.
Gourley wrote, spelling out his disillusionment with what was happening -- or not happening -- with the movement, how it all seemed to be based on sex. A couple of weeks later, to his surprise, Gourley got a letter from Hay. The younger man was echoing some of what he'd been trying to get across for years, and maybe it was time to rev up the machine again. He was coming to Denver to see a few friends and wanted to meet.
In Hay, Gourley found the man who could articulate what he was thinking. Hay talked about the need for gays to see themselves as equal to but different from straight males. And, he said, gays were guilty of defining themselves simply by whom they had sex with. They needed to find out who they were as a people.
In March 1978, the complexion of gay activism in Denver changed when two transvestites were shot and killed by Denver police officers.
Police regularly raided the bars and baths to charge the patrons with public lewdness and threaten the cabaret licenses of the owners. Sometimes the gay community even contributed to the harassment, as it was not above some of the bar owners to call the police on their rivals.
In response, the gay community had done little more than write letters of protest. But with the death of the two transvestites, the leaders at the community center decided it was time to take a more public approach. They organized a march that drew a few dozen participants.
It was Denver's Stonewall, only in some ways more sophisticated. The participants weren't drunk queens busting windows and fighting with the police; they carried their signs peacefully, ignoring the hecklers and the police -- whose ranks included nearly as many officers, some of them taking photographs, as there were participants in the march.
The Denver march had nowhere near the effect of Stonewall, especially on the public, who cared little about the death of two queers in dresses. But it was another step forward for the members of Denver's gay community, proof that they could organize and speak with one voice. Gourley marched along with the others, taking photographs of the police who were photographing the crowd. It was an intoxicating moment of power and pride.
Writing essays and opinion pieces for the gay press and taking to the streets, Gourley was part of a revolution that was sweeping across America as yet another oppressed minority stood up and demanded to be accorded its rights. But revolutions have casualties, like the dead transvestites, and he was learning that he needed courage to face the possibility that he himself could become one. It took writing a letter to the Denver Post about the murder of the transvestites for Gourley to realize that the dangers were real. About 2 a.m. the day after it was printed, he was sleeping at home when the telephone rang. "Hey, faggot, I know where you live," the anonymous caller said and proved it by reciting Gourley's address. "I'm gonna get ya."
Gourley made some inane reply about where the caller could put his threat and hung up. But despite the brave words, he was badly frightened by the incident. Still, he recalled the courage of the civil-rights workers in Mound Bayou, Mississippi, and resolved that he, too, had to deal with his fear and carry on.
Gourley had been attending nursing school; he received his degree in 1978 and went to work in the intensive-care unit at University Hospital.
The only people brought into the unit were those with life-threatening illnesses. Many were older, and there was little to be done except help ease them into death. The saddest were the younger people who died as the result of an accident or some stroke of bad luck.
These deaths seemed so unfair, but again he was under the tutelage of strong women. They told him it was all right, healthy even, to grieve and cry when things did not go as well as they'd hoped.
Things were certainly not going well, health-wise, in the gay community. Gourley's becoming a nurse had to do with the admiration he'd had for the nurses on 4West, not the first hints of concern he was having about the bathhouse lifestyle and its possible links to health problems. He'd considered himself lucky; other than the occasional infestation of crabs and less frequent "nonspecific urinary tract infections," he'd never contracted the "major" sexually transmitted diseases -- gonorrhea, syphilis, venereal warts and hepatitis. After twelve years of Catholic school, he had viewed venereal disease as "punishment from God," but now he believed that the high rates of sexually transmitted diseases among gay males were simply due to frequent sex with multiple partners.
By the mid-'70s, the combination of multiple partners and coast-to-coast mobility had created an epidemic of sexually transmitted diseases among self-proclaimed "fast-lane" gays.
Anal intercourse and "rimming" (oral/anal contact) led to gastrointestinal diseases. Within a given year, sexually active gay men had a 20 percent chance of contracting hepatitis B -- a blood-borne, difficult-to-cure and potentially fatal viral infection easily passed through sexual contact and shared needles. For such men, hepatitis B was a virtual certainty within five years. A survey conducted by Denver public-health officials found that the average bathhouse patron had 2.7 sexual contacts a night and stood a 33 percent chance of leaving the establishment with syphilis or gonorrhea.
Nationally, physicians grew alarmed at the prospect of a truly dangerous disease insinuating itself in the bathhouse crowd, and they issued warnings at conferences in San Francisco and New York. There was a concern that repeated exposure to hepatitis could lead to liver disease or weaken the immune system, allowing some other disease to gain a foothold. The same went for the drugs -- amyl nitrate (to heighten sexual arousal), cocaine, alcohol and methamphetamine -- that were prevalent in the community. The drugs not only damaged organs, but they could also lower the body's ability to stave off infections both viral and bacterial.
Sexual freedom for gays had been hard won, though, and few were ready to listen to the doctors' concerns. Many simply settled into what became the routine for promiscuous members of the gay community: blood tests every three months and a dose of penicillin when needed. Such was the price of freedom.
As part of his nursing-degree program, Gourley had helped with bathhouse STD studies conducted by Dr. Frank Judson, head of the Infectious Diseases division at DGH. The bathhouse managers had cooperated with the studies, even giving Gourley a room -- as long as it wasn't a Saturday night, when there was too much money at stake -- and announcing that STD tests were being conducted.
Judson's study indicating that there were significantly higher rates of gonorrhea and syphilis in the gay population than in the straight was published in the Journal of Sexually Transmitted Diseases and picked up by Denver's daily newspapers.
There was no arguing with the statistics. But for an epidemiology paper he had titled "The Social Significance of the High Rate of V.D. Among Gay Men," Gourley had taken issue with two of Judson's findings. One was that the statistics had been applied to the gay population as a whole. "It is my experience that a majority of gay men do not frequent the baths," he wrote. Gourley also took issue with Judson's conclusion that the high incidence of venereal disease among gay men was due to "the promiscuity of our lifestyle...And that the only way this problem will come under control is when we adopt a monogamous lifestyle characterized by 'true gay love.'"
Gourley's initial reaction was anger that "a straight" was attempting to talk to him about "true gay love." But after cooling off, he had realized that Judson's view was no different from his own. However, he argued, that allegation didn't take into account society's role in forcing gay sex into the bathhouses. Straights had their school dances, their proms; they were encouraged to go on dates and establish monogamous relationships, the prime example being church- and state-sanctioned marriage. Gays had always been shamed and tormented into parking-lot trysts, the cruising scene at gay bars and casual sex in bathhouses. Despite the efforts of the movement, he wrote, at least 90 percent of all gay men were still in the closet to some degree. For these men to go to a clinic and ask for oral and anal gonorrhea tests was to admit their homosexuality. Instead, they stayed quiet and passed on the diseases to others.
"So rather than have health professionals preach to us about such bogus issues as 'true gay love' and 'monogamous relationships,' which are merely opinions reflecting their own hetero-Judeo-Christian mores, it would be much more productive to begin working for a society in which the gay lifestyle is an equally acceptable form of self-actualization," he wrote. "There is a significant correlation between the social, cultural, political and psychological repression of gay men and their inflated rate of venereal disease."
Gourley had received a 100 percent on the paper. And when he tested men for STDs at the bathhouses, he made no attempt to lecture them. Still, he was concerned about the health of his people. It took only a quick look in trash cans of bathhouses and bar restrooms to note the used syringes. Along with repeated bouts of STDs and viral hepatitis, all that drug use simply couldn't be good for them. But it would have been politically incorrect to preach about that to other gay men. Besides, when he wasn't testing, he was an active participant.
In 1979, the name of the center was changed to the Gay and Lesbian Community Center, reflecting the growing role of women in the movement. Soon a woman named Carol Lease was appointed its director.
In June of that year, Gourley brought Hay to Denver to be the grand marshal in that year's march commemorating Stonewall. Instead of hundreds, there were now a few thousand men and women participating. The lesbians wanted to call it a march, the gays a parade -- but the important thing to Gourley was that they were becoming an increasingly political and cohesive community. He thought it was an important step forward that as grand marshal, Hay represented a way of thinking that went beyond sex.
In part because of his conversations with Gourley and other young gay activists, Hay had decided to put in motion something he had been thinking about for some time. He called it A Spiritual Gathering for Radical Fairies, to take place in the desert near Tucson later that summer. It was the chance to examine the spiritual and political side of being gay, Hay said. He had been careful to choose each word for the event carefully: Spiritual, to emphasize that this was to be more than a party in the wilds; Gathering, which seemed to denote a coming together of equals; Radical, which Hay was always reminding Gourley meant "to the root," in that they would be exploring the root of their gayness apart from their sexuality; and Fairies, partly to "reclaim" a word that was derogatory when applied to gays, but also because it evoked images of the elusive, magical creatures of folklore.
The gathering of a couple hundred went off beautifully. Big on ceremony, queens were all over the "mud ritual" of worshiping Mother Earth by smearing their naked bodies with the stuff and dancing around in the warm Arizona air. Hay was so pleased with the outcome that he immediately put Gourley in charge of planning a second gathering for the following summer in the mountains of Colorado.
But danger was on the horizon. Its first warning came to Gourley after the spiritual gathering that fall.
He and his boyfriend at the time, an emergency-room physician, grew hallucinogenic mushrooms. They liked to take them before heading off to the bathhouses, which they viewed as the ultimate playgrounds. One night Gourley ate a new batch of the hallucinogens, more powerful than he was used to dealing with. Inside the bathhouse, he began freaking out and made his way to the outdoor part of the facility, hoping that cool air might help bring him down. But it only got worse.
Demons appeared, looking like gargoyles. They danced toward him, their long purple and pink tongues protruding from grinning mouths and distorted faces, their tentacles and hands reaching, grasping. They were everywhere, whichever way he turned. If they caught him, he thought he would surely die.
Gourley quickly left the bathhouse and rode his bike to the home of his best friend, Don Gorman. Gorman had a technique for bringing friends down from bad trips: He made them sit in a corner and peel an orange. If that didn't work, he made them peel another, until the concentration and isolation brought them back to the world.
The technique worked for Gourley, but he never again used recreational drugs -- not so much as a joint of marijuana. He eventually went back to the bathhouses, but he couldn't shake the idea that in an altered state of consciousness, he had picked up on some negative energy that had invaded the baths, evil spirits or bad karma. Something terrible was happening.
The cops were polite, if somewhat nervous. "We had some reports of nudity," explained one.
Pat Gourley tried not to smile. Three hundred gay men...running around in the forest...dancing to drums...and there was nudity? What a surprise!
The second Spiritual Gathering of Radical Fairies had gone off without a hitch -- or any cops -- until the fifth day of the convocation. Fortunately, most everybody had gone home, and the rest were obviously packing to leave; otherwise, the cops might have gotten an eyeful, and he'd be spending the afternoon bailing a bunch of irate fairies out of jail.
Not that the gathering, at a campsite near Buffalo Park, Colorado, had been one long orgy. Far from it. For a bunch of eccentric queens, they'd gotten down to some serious business.
Gourley had been put in charge of the local organizing team. He'd had to find the site, secure the permit from the forest service and rent two large tents for those who hadn't brought their own. He'd had to make sure that planning and buying breakfast, lunch, dinner and snacks -- all vegetarian to please the widest range of tastes -- for 300 were covered, as well as arrange transportation from Denver (to keep down the car traffic at the site) and for those flying in from the far corners.
As local organizer, he was subjected to all sorts of advice on the agenda from Harry Hay and other movement luminaries such as Mitch Walker, who in the mid-'70s had written Men Loving Men (a gay equivalent of The Joy of Sex) and whose more philosophical book, Visionary Love, had just been released.
Hay had decided that the time was ripe for reviving one of the pet projects he had first envisioned decades earlier. The project, Gourley wrote in the pamphlet announcing the gathering, involved establishing a "permanent Sanctuary, through Community Land Trust, for all of us." Hay's vision was a gay homeland, a rural commune as self-sufficient as possible, almost Amish in austerity, though no one suggested that queens be told they would have to wear black. He wasn't advocating total separation from straight society -- that wasn't practical. Besides, it was his dream that someday straight society would recognize gays and lesbians for their contributions.
For decades Hay had argued that gays and lesbians were distinct peoples -- different genders entirely from their counterparts in the hetero world, a cultural minority that went back as far as time itself. In late-night conversations in Gourley's kitchen, they'd talked about the sanctuary as a place where gay men could withdraw for a time and wrestle with philosophical questions and ideas about presenting what they learned about themselves to the world outside. Maybe it would be in some sort of spiritual way, Hay said, noting that stereotypical or not, gays were often drawn to "helping professions." For example, gays traditionally had been attracted to the clergy and often assumed important roles in Native American religions. When they finally knew what they were about, Hay envisioned gays from the sanctuary offering their services to the rest of the world. Maybe as mediators to resolve issues, he mused.
Gourley liked the idea of going to the sanctuary himself. Maybe it was the old farm kid in him, but he saw himself working in the fields and participating in the great debates to feed both the bodies and the minds of his brothers. He wasn't quite as optimistic as Hay about straight society recognizing gays' attributes and welcoming them with open arms, but it was a nice dream.
For years the idea of a sanctuary had lain dormant in the mind of Hay, who thought the gay community was too absorbed in sexual liberation. But now he thought the second gathering would be the right forum to reveal his plan. Gourley had plenty of help from other activists such as Phil Nash and Tim Offutt, one of the rare "out" members of the gay black community, working out the logistics. His best friend, Don Gorman, who nearly a year earlier had brought him down out of the bad mushroom trip, did the art for the flier -- a mandala with its concentric rings depicting mountains, mushrooms, dancing stick figures and flying fairies tooting horns. For the front of the "tips" flier, he drew a man looking through a kaleidoscope at another mandala, a tribute to Hay and Burnside who, in Los Angeles during the Summer of Love, had owned a factory that made kaleidoscopes to sell to hippies. Of the two, Gourley was the more political and, if not for the balance Gorman brought to their friendship, could have easily tipped into reactionary politics, where everything is black and white and issues are placed over humanity. But Gourley could always count on Gorman's ability to put things into perspective. Oh, Blanche, sit down and do your nails, he'd say when Gourley climbed on his horse. But it was possibly what they didn't do that had the most profound effect on Gourley: Despite their closeness, they were never lovers. It wasn't about sex.
And while Gourley was fond of saying that he got his nursing degree from University Hospital and his "Ph.D. in Queerdom" from Harry Hay, he had a difficult time getting his mentor to discuss his concern about gays' hedonistic sexual behavior. Hay found discussions about sexual behavior counterproductive to his principle theme that being gay was more than "where you put your dick." He was fond of shocking listeners by declaring, with a twist on the old gay adage, "We have nothing in common with straight people except for what we do in bed." In one of the rare times he did discuss sexuality with Gourley, Hay noted that gay men's behavior had changed radically over the years: They now had more anal sex, in part because of the opportunity provided by the bathhouses.
That was one of the reasons Gourley noted on a flier for the gathering that "the fairies planning the gathering ask that there be no drug or alcohol use on the site." They wanted to remove the gathering -- physically and psychologically -- as far as possible from the party scene that defined the liberated gay lifestyle of the '70s.
The campsite permit forced them to limit the number of participants to 300, some of whom arrived in Denver early and headed for Gourley's home in Five Points, where Hay and Walker were soon leading discussions. The other participants arrived, coming from major metropolitan areas and small towns all over the country; there were even a few from Canada. All were taken to the fifteen-acre campsite at the end of a box canyon where Gourley's two tents were set up near a large fire pit.
The evenings were social and spiritual in nature. Taking their cue from the lesbians, who Gourley joked with friends were a "more highly evolved life form than gay men," there were a lot of pagan and wiccan influences in their rituals, a lot of evoking the "Great Mother" and worshiping nature. The weather -- which had been alternately cloudy and rainy -- put a damper on another mud ritual (making Gourley glad that he'd warned participants that at 8,000 feet, even in summer, it was a good idea to bring down coats and rain gear in addition to "your entire wardrobe of flowing non-hetero garb"). A big hit was the drumming and dancing, which reached its peak when Offutt appeared on a hillside one evening dressed from head to toe in a magnificent buckskin outfit, pounding on a large drum. Soon participants were dancing around the fire like wildmen.
The days had their hours for hiking, quiet contemplation and simply building a sense of community by networking with like-minded gay men from all over the country. There were, of course, several "fairy circles," in which the men would gather to discuss issues, some dressed in dresses and skirts or nothing at all. The workshops dealt with more serious matters. The idea of the gay sanctuary was a big hit and, while not everyone agreed on how best to go about it, the consensus was that the gay community needed to move beyond sex as the issue that defined gay culture both to themselves and the straight world. There were also discussions about health concerns and the relationship to the bathhouse scene.
It was during one of these discussions that Gourley first heard the disturbing news brought by participants from San Francisco. They told about a rash of sudden immune-system collapses resulting in the deaths of gay men on the West Coast.
Immune deficiencies and system collapses were not new to medicine: Some people are born with compromised immune systems; others develop problems from poor nutrition or drug use; cancer patients often had to be concerned about lowered immunity to disease because chemotherapy drugs often killed off the parts of the immune system that fight disease.
The men from San Francisco described a different phenomenon, one that seemed limited to the gay population and was killing what had otherwise been relatively young and healthy men. The particularly nasty way they died was also shocking. The victims had developed incredible fungal infections in their throats and literally choked to death.
The stories frightened Gourley. As a nurse, he knew that the fungus they were talking about -- candida -- was present in the mouths of everyone. It sometimes got out of control and caused "thrush," mostly in children, sometimes accompanied by painful sores in the mouth. But it was easily treated and not dangerous. Something was terribly out of balance with an immune system that allowed it to take over to the point where it killed.
He wondered if this new pestilence would, like hepatitis B, eventually be traced back to the bathhouse scene. He couldn't shake an image that stayed with him for the rest of the gathering -- a vision of dark clouds hanging on the horizon.
Still, everyone thought the gathering was a great success. It delighted Hay, who thought that at long last, his ideas might come to fruition. The morning everybody left, they were already talking about the next Spiritual Gathering of Radical Fairies. Even the cops showing up didn't dampen the enthusiasm of those still there, especially when the officers accepted Gourley's promise that they were all leaving anyway and went on their way.
When he arrived home, there was still a considerable number of people, including Hay, hanging out at his house. Gourley was talking with a group of them on the front lawn when someone yelled out of the house that there was a telephone call for him.
It was his mother. His father was in the hospital, dying. Two months earlier, his father had been diagnosed with a terminal brain tumor but the doctors had given him six, maybe seven more months to live; there was supposed to have been time for goodbyes. Now it was too late. By morning, his father was dead. Gourley spent the day in tears. His father was only 63. He'd been a good man, the sort of man who'd do anything to help a neighbor or someone in need, loyal to his friends and absolutely devoted to his church. It wasn't fair.
The men at his home -- Gorman, Walker, Hay, Offutt, Nash and others -- now came to his aid, forming a healing circle around him as he grieved. They talked about their fathers and what they'd meant in their lives, comforting and supporting Gourley. Before too long, some of these men would be gone, too.
The patient on the intensive-care unit at University Hospital was a young Southeast Asian man. He was already so ill that he was largely comatose and breathing only with the aid of a ventilator tube. Language differences reduced what little opportunity there was for Gourley and the other nurses to interact with him in the few days he was on their floor.
The young man was suffering from an unusually overwhelming bout of pneumonia: His immune system had apparently collapsed, allowing the pneumonia to take over. But Gourley didn't connect his patient's difficulties with the immune-system problems he'd heard about at the gathering.
It was apparent that the young man had given up the struggle and was now only waiting for the end. That came quickly one evening.
For those in the medical profession, death was failure. This time, however, there was a strange sort of beauty that followed the young man's demise. He was a Buddhist, adhering to a religion that places a great deal of importance on the moments surrounding the time of death. When he died, his female relatives -- his sisters, his mother and grandmother -- asked permission to observe the time according to their way.
Normally, it fell to nurses to quickly remove all the tubes and needles and get the body down to the morgue to free the bed space and remove the evidence of failure as soon as possible. However, it was a quiet night in the unit and there was no reason to rush, so permission was granted.
Another female relative soon arrived carrying a bundle of items Gourley learned were incense, flowers and oils. Gourley removed the tubes. Then the women took over, gently washing the dead man's body, anointing it with strongly scented oils that reminded Gourley of gardenias. When they finished, they sat for a couple of hours, praying in low voices. Finally, they were ready to leave.
Gourley was impressed by the dignity of the whole affair. The experience convinced him that a hospital -- with its sterility and efficiency -- was no place to die. No one could know the time or place, but it would be best at home surrounded by friends and family.
In the fall of 1980, Gourley met and fell in love with David Woodyard, a Methodist minister whose parsonage was a well-known stone church outside of Aspen. They were introduced by a mutual friend during one of Woodyard's trips to Denver, which he said he needed to keep from "losing his mind" as a gay man, even in a supposedly hip town like Aspen.
Woodyard had struck his own small blow for the movement when he danced with another man at an Aspen bar until they'd been asked to stop. He'd also been part of the group that started the community center in Denver and was involved in Unity, a national gay Methodist group that was still trying to fit gays into the existing religious structure.
In December, Gourley spent several weeks in Aspen with Woodyard. He was reluctant to part a few weeks later, when he joined Hay, Burnside, Walker, Don Kilhefner, who had been one of the founders of the L.A.community center, and a young gay anthropologist, writer and pupil of Hay's named Will Roscoe and his lover, Brad Rose, on a trip to Wolf Creek, Oregon. It had been a gay hangout for years, and the visionaries were thinking it might be the right place to establish the sanctuary. Gourley was disillusioned when the trip deteriorated into bickering between Hay and Walker and Kilhefner -- not over grand philosophical issues, but over petty ego trips. Gourley wondered if the sanctuary would ever get off the ground. But he had also been feeling poorly most of the trip and wanted only to get back to Colorado and Woodyard.
Soon after he returned, Woodyard left his parsonage and moved to Denver to live with Gourley. He went to work for the Denver Art Museum in fundraising and development, and the two men settled into life as a couple.
Woodyard loved listening to his new boyfriend's diatribes. But like Gorman, he brought balance to Gourley's politics. They were both able to get him to tone it down, to keep him from being so outrageous that no one would listen. Gourley found his own voice by writing for gay publications in the Denver area. Many of these writings expounded on the idea of gays and lesbians as a cultural minority. With Ronald Reagan coming to power, he noted in a piece that appeared in Out Front, the national gay press was alarmed that the political gains made in the later '70s were "seriously imperiled."
"On one level, we need to realize how fragile our 'rights' are when handed to us by society," Gourley wrote. "Can they as easily be taken back?"
On the other hand, he noted, gays and lesbians were part of the problem as long as they accepted society's definition of what it meant to be gay or lesbian. "It is the 'myth of the homosexual,'" he wrote, borrowing from Walker's treatise in Visionary Love. "Simply stated, this myth implies that the essence of gayness/lesbianism is a sexual act. An indication of how we have swallowed this line is the frequency with which you hear gays and lesbians everywhere screech, 'The only difference between us and straight people is what we do in bed!'
"How sad, and threatening to us as a people, that this is actually a fairly apt description of how most of us view ourselves 11 years after the beginning of this wave of gay liberation."
And while the Reagan administration was certainly unfriendly to gay rights, there were other threats to the movement's progress. The diseases that were getting the most attention by 1981 were the so-called gay cancer and gay pneumonia.
The first was a previously rare form of skin cancer known as Kaposi's Sarcoma. Distinguished by what appeared to be large purple bruises beneath the skin that didn't go away, the disease had in the past been diagnosed almost exclusively in older men of Mediterranean descent. These men usually died of old age long before the cancer could be considered dangerous. Now the cancer was killing young gay men -- and it wasn't limiting itself to the skin. It also appeared in the brain, lungs and bones.
Gay pneumonia, pneumocystis carinii, or PCP, was a formerly slow-moving, easily treated lung infection largely associated with World War II concentration-camp survivors whose immune systems had been depleted by long periods of abysmal living conditions. Now doctors were seeing a version that was very aggressive -- suffocating -- and didn't respond well to treatment. And it was attacking what appeared to be healthy young men -- American men who ate and lived well. Such diseases would not usually have had a chance of gaining a foothold, much less causing death, in someone whose immune system was operating normally.
A big clue that these patients' immune systems were screwed up was the fact that they had low white-cell counts -- counts that should have been elevated to deal with infections. That led doctors to the discovery that the patients had low, or non-existent, T-cell counts (named for their shape, T-cells are considered the "sentinels" in the bloodstream that recognize the presence of a foreign invader and mobilize the rest of the immune system to deal with it). The "opportunistic infections" like Kaposi's and PCP flourished because no sentinels were available to wake up the immune troops.
But what was destroying the T-cells?
Some members of the medical community speculated that rampant drug use in the fast-lane gay community might be suppressing immune systems by destroying T-cells. Others speculated it might be a form of bacteria, like syphilis. Others, including a handful of epidemiology researchers at the Centers for Disease Control, wondered if it might be some new strain of virus. That notion sent a shudder through the medical community.
Ever since the advent of antibiotics, the bacterial infections that had plagued humankind had taken a beating. The discovery of penicillin had saved millions of lives; millions more had been saved by the wide array of antibiotics that had followed. But viruses were another story: They're not really living organisms and are therefore difficult to "kill"; a virus is a parasitic piece of genetic material that takes over the machinery of a cell and can mutate when it makes a "mistake" when replicating itself, producing a new version that may be resistant to drugs.
Whether it was the common cold or genital herpes (which to that point was the most-feared sexually transmitted disease), there were still no cures for many viruses, despite decades of funding and scientific research. But researchers had learned that the best way to defeat a virus was to contain it through the use of vaccines. By 1980, scourges like polio, as well as smallpox, measles and mumps, had all but been eliminated from the United States and other developed countries; the diseases existed only in developing countries and remote areas where vaccines were either unheard of or there was no medical infrastructure to get them delivered.
Denver physician Frank Judson and his team had played a major role in developing a vaccine against hepatitis B in 1979. In this, he was aided by the cooperation of Denver's gay community.
Unlike hepatitis A, which could be transmitted by drinking polluted water or coming into contact with human feces (such as when a restaurant worker doesn't wash his hands), hepatitis B was blood-borne. It was easily transmitted through sexual contact or shared needles -- even something as simple as using someone else's razor to shave -- and hardy enough to live for a period of time outside the human body. It caused cirrhosis and liver cancer and was thought to be responsible for thousands of deaths every year. The hepatitis B epidemic in the gay community made gay people the perfect group to test the effectiveness of the vaccine, and gay men volunteered to participate in the studies.
Now, as new cases of immune-system collapses popped up with increasing frequency, particularly in areas with large gay populations, speculation grew that a virus was the culprit. It seemed to be following the same route of transmission and was affecting the same initial populations -- gays and intravenous drug users -- as hepatitis B. That meant the virus could be in the nation's blood supply and blood products, putting hemophiliacs and people who received blood transfusions at risk. And if, like hepatitis B, it was sexually transmitted, then it would infect women as well.
The first "official" case of the gay plague was recorded in 1981 in New York. Doctors in other parts of the country, especially those involved in infectious diseases and epidemiology, held their breath, waiting to see if the contagion would spread. Those aware of the coast-to-coast bathhouse scene feared the worst.
Among them was a young infectious-diseases doctor named David Cohn, who arrived at DGH in 1981. Cohn had been turned toward infectious diseases as a medical student at the University of Illinois by an instructor named George Jackson. It was Jackson who'd pointed out that throughout history, infectious diseases had killed more people than any other medical ailments.
On the other hand, Jackson added, given time and the right medicine -- especially since the advent of antibiotics -- the infectious-disease specialist often had the satisfaction of actually curing his patients (as opposed to, for example, a cancer specialist who might know from the beginning that death was inevitable and only fought to prolong its coming). In fact, the battle against infectious diseases had been so successful that by that time in the United States, it was something of a backwater specialty compared to oncology. From a medical/scientific standpoint, this new disease offered Cohn and Judson and other infectious-disease specialists and epidemiologists a new medical challenge.
In 1981, Gourley was still deeply immersed in movement politics and writing for local gay publications. Armed with an acerbic wit and confrontational demeanor, he might well have gone over the top with his readers except for Woodyard's influence.
"What you have to say is important," Woodyard cautioned, "but if you scream and yell in somebody's face, they're not going to hear what you're saying."
Some of Gourley's writings took the form of satire about issues he saw causing division within the gay community. One such piece was titled "The Day the Queens Became Men" and poked fun at hyper-masculinity. He submitted the piece, complete with its tongue-in-cheek "Gay Manhood Oath" ("I swear by all that is butch that I will never engage in nelly, silly, swishy or frivolous behavior"), to Out Front. That time editors returned it, telling him that while "entertaining and meaningful...it would be the better part of discretion not to publish it."
Gourley had half-expected the rejection. Gays were no different from straights when it came to not wanting hear about their own foibles, Woodyard reminded him.
Among the other things that Gourley discussed with his lover were his concerns over what was going on at the bathhouses and whether there was a link to immune-deficiency diseases. There had still been no official cases of the disease in Denver, but the plague was hitting close to home. Woodyard was hearing of friends back in New York who were getting sick. Then he learned that his former lover, the man he had been with before Gourley, was ill, too.
It was the summer of 1981 when Gourley wrote his first piece about the plague. By this time, he knew that researchers with the Centers for Disease Control in Atlanta were warning that the disease seemed to be following the same routes of infection as hepatitis B. Gay men who had been infected with hepatitis B (by some estimates as much as 60 percent of the gay-male population) were likely candidates for this new terror. That included Gourley, who had earlier volunteered for Judson's hep B study only to find out he wasn't eligible: He'd already been exposed, and a vaccine wouldn't do him any good.
He and Woodyard finally stopped going to bathhouses, but with the feeling that it was probably too little, too late. However, he didn't panic. No one knew if exposure meant infection and whether infection meant a person would necessarily die.
"Kaposi's Sarcoma. Wow! A cancer all our own," Gourley wrote in a paper published by Out Front titled "Queer Cancer."
"How much energy should we as gay men be giving to this latest malady that is beginning to afflict us? Based on the raw numbers of known cases, it is really quite rare, and if you take a look at all the other health problems faced by gay men, it's pretty insignificant.
"The major health concerns of gay men remain alcohol and tobacco abuse, the various V.D.'s, viral hepatitis, intestinal parasites and queer-bashers."
Gourley noted that a lot of cancers were caused by lifestyle/environmental factors and "therefore we get the same cancers as straight people. See, we really can be just like them -- if we abuse ourselves enough!"
There remained, however, the question of why this particular cancer seemed unique to young gay men. "Is it perhaps a manifestation, a message if you will, from our collective spirit that all is not well in the gay male world as we swirl into the Eighties?
"The straight moralists, of course, have an easy explanation as to why we get certain of these diseases in rates way out of proportion with the general population. 'You fuck too much, you perverts.'"
Society, Gourley said, was in part to blame for gay sexual behavior because it gave "us very limited space to interact with one another -- restrooms, grimy bathhouses, public parks, dingy bars...this environment served to institutionalize quick impersonal sex that did not allow for getting to know the other person on any but a fleeting sexual level." The gay liberation movement had changed some aspects -- bathhouses and bars were no longer grimy or dingy -- but "what hasn't changed is that we still are relating all too frequently to one another as sexual objects."
Moreover, Gourley argued, "While staying up all night and having sex with a half dozen men can be lots of fun and very enhancing of our sexual/spiritual selves, if it's something we are doing with a bottle of poppers screwed into our nose, a quaalude up our ass, several drinks under our belts and a hit of acid on board, several times a month, at the expense of getting adequate rest and nutrition...perhaps we are asking for it." His message that a coast-to-coast lifestyle of sex with multiple strangers was contributing to the rapid spread of the disease was right on. Without knowing what form it would take, physicians working with the gay population had been warning for years about the possibility of a truly deadly disease insinuating itself in the gay community. Now it was happening.
The disease was a gay disease in the United States. It had even been named Gay-Related Immune Deficiency in January 1982. A month later, the CDC reported that 251 Americans had been diagnosed with GRID; 99 had died, more than 90 percent of them gay.
Colorado's first officially diagnosed case of GRID was brought to the intensive-care unit at University Hospital in May 1982. In this case, however, the patient was a hemophiliac -- not gay-identified -- who'd been diagnosed with pneumocystis carinii.
The man was obviously going to die. But what really disturbed Gourley was that he was also suffering from a horrible case of candida in his mouth and throat. It looked as though someone had coated those areas with cottage cheese.
The University Hospital case was one of the first three cases in the country of hemophiliacs contracting GRID. And it changed the course of history.
When CDC researchers warned that the disease might be blood-borne, they had run into resistance from the blood industry, including the American Red Cross, and the Food and Drug Administration, which regulates the blood industry. The naysayers questioned whether the "gay plague" even existed. Even the National Gay Task Force resisted the screening of gay donors because it seemed like another attempt to ostracize gays. The blood-bank industry sided with them: Community-minded gay men had always been big contributors to the nation's blood banks. Now, however, with three hemophiliacs dying from the disease and more infected, evidence was mounting that it was a blood-borne virus. The hemophiliac cases helped "de-gay" the gay plague.
They made it a little harder for the fundamentalists to contend that God was also visiting his wrath on hemophiliacs. They blamed gays, not God, for that.
In July 1982, the disease got a new name to reflect the fact that it was no longer killing just gay men: Acquired Immune Deficiency Syndrome. With the new name, the CDC released its latest statistics: 471 cases and 184 deaths.
At the Denver Gay and Lesbian Community Center, Patrick Gourley was the leading voice pushing for the creation of a special subcommittee to deal with AIDS. There were practically no cases in Denver, but he made it his issue, and director Lease and other leaders at the center listened.
They formed a subcommittee and chose a name -- the Colorado AIDS Project -- and appointed its first director, a former minister named Julian Rush. The idea was for CAP to spearhead AIDS education, fundraising and services for those who came down with the disease. It was important to the gay community to take care of its own. The first three or four people to come down with AIDS in Denver were practically swarmed over by CAP and its volunteers.
Still, it was just one more health issue facing the gay community, as pointed out in Gourley's "Be Well" pamphlet published by the center. One column noted that part of "being well" as a gay or lesbian meant knowing your rights if you were arrested. There was also a column about hepatitis (it noted that the Denver Health Department, which had always had a good working relationship with the gay community, was offering the vaccine for hepatitis B at cost -- about $100 for the series of three inoculations). There was another column devoted to getting enough rest and good nutrition while decreasing stress. It urged readers to examine their drug use. And, Gourley wrote, "Try to decrease the number of different sexual partners you have, especially if you don't know them. You do not need to decrease the amount of sex you are having. Sexual activity itself does not cause disease." Stuck in between a column about "positive gay self-image" and general health tips was one final column devoted to AIDS, noting that 75 percent of all reported cases were in gay or bisexual men.
The pamphlet also promoted another new booklet available at the center on "Guidelines and Recommendations for Healthful Gay Sexual Activity." On the front was "Le Hunk Safe," a drawing of a good-looking man sure to catch attention.
It described what symptoms to look for: swollen lymph nodes in the neck, armpits and groin; pink and purple blotches or bumps; weight loss greater than ten pounds in two months; fever for more than a week; night sweats over a period of several weeks; a persistent, often dry cough not attributable to smoking or the flu; and persistent, unexplained diarrhea.
The cases began to trickle in. The worst for Gourley were those with Kaposi's. The horrifying lesions on the faces of these men could make them appear monstrous. They reminded him of the demons he'd hallucinated at the bathhouse in 1979.
Gourley talked about the vision and what he felt it meant with Gorman. His friend also sensed that something was terribly wrong and dealt with it by leaving for India. He believed that if he dedicated himself to spiritual awakening, he might strengthen himself for the coming battle.
ByMay 1983, hundreds of gay men were getting sick and dying, and more and more cases were coming into Denver hospitals, yet Newsweek magazine had only just run its first story about the disease. It made Gourley angry. "Gay men have been contracting a deadly disease called AIDS for four years," he wrote in Out Front, "with the death toll now over 500 and climbing fast -- and Newsweek just noticed!" At the same time, New York City, with a gay and lesbian population estimated at one million, once again defeated a gay-rights ordinance.
And he had to admit that it wasn't just the straight community that raised his ire. The homosexual community in Denver seemed to be coming apart at the seams. A lot of the money coming into CAP was being raised by the bathhouses and bars, some of which made it clear that they didn't want the money going to the community center's overhead. They weren't going to send the money if it went to pay for a lesbian's salary instead of "for the boys." Sexism was alive and well in the gay community.
A decision was made to split CAP off from the center, and Gourley went with the new organization. He served on CAP's first board of directors, though he regretted the hard feelings caused by the split -- and the unfairness to Carol Lease, who'd done as much as anyone for Denver's gay community.
The center had always been hurting for funding, but CAP was a money magnet. There were other tensions, too, including racism and class distinctions. "What passes for gay and lesbian 'community' here in Denver seems more fragmented than ever as we see individuals and organizations going for each other's throats at the slightest provocation," Gourley wrote. He pleaded with readers to see that they were stronger than ever, if they would just come together.
It was one of his last purely political writings. The gay liberation movement was losing energy, and AIDS was his cause now.
After the trip to Wolf Creek, he'd become disillusioned with the factionalization among some of the key leaders of the movement, including his own mentor, Harry Hay. The old man had tried to revitalize him by asking Gourley and Woodyard, along with Roscoe and Rose, to join him and Burnside at the San Juan Pueblo. He wanted to show them his old stamping grounds, let them make a pilgrimage to the place and time when it seemed like the movement was really starting to fire up.
It was a good trip. Hay was again the teacher more than the politician. They posed in the sun outside the inn, and the old man said he hoped Gourley would get back into the politics of the movement. But Gourley knew his battle was back in Denver -- against a disease that was becoming increasingly personal to him.
That fact hit home when Woodyard's former lover died. David learned of it through mutual friends. It had apparently been a very sad and lonely death, as the man was estranged from his family and had no lover to look out for him.
Gourley and Woodyard started using condoms and made their relationship monogamous. Again, it was with the realization that it was probably too late.
There was no test for AIDS, but Gourley wasn't fooling himself. He had no doubt that he was infected. He hadn't conducted himself any differently from any of the other men who were succumbing to the disease. Woodyard was probably infected, and God only knew how many of his friends and past lovers were as well. Gourley thought about when he might have become infected, recalling his illness after his trip to Aspen in 1980. He didn't blame David -- if it wasn't then, it could have been any one of many other times.
But those concerns seemed of little importance that August when his sister was killed by a drunk driver who plowed head-on into the car she was in. She was only nineteen. For the second time in his life, Gourley had lost someone he loved. It seemed that death was everywhere.
Woodyard had begun the first AIDS support group in the Denver area, holding meetings in their home, calling on his abilities as a minister to help the afflicted realize that they were not alone. Gourley felt the need to reach out in a different way. His writings now concentrated on the disease and its affect on his people.
"It seems that it will be some time yet before the causative agent(s) is found and much longer, perhaps many years, before a 'cure' is available," he wrote in the October 1983 edition of Out Front. "In the meantime, what are we to do to keep from going crazy?
"A first step is to realize that we are not defenseless against AIDS." He argued against those who felt all the money should go to medical research rather than education and self-help programs. "The rationale seems to be that if we just throw enough money at the medical authorities, they will solve the problem for us." He acknowledged that AIDS research was "without a doubt an absolutely necessary component in the overall struggle" and that it had been "very appropriate for us to confront the slow (homophobic) response of federal agencies in allotting monies for AIDS research. The money seems to be flowing a bit more easily today than a year ago, but this has probably been fueled by straight fears that AIDS is crossing over into heterosexual society."
But even if the powers that be were benevolent, not something he expected of the Reagan government, "to leave the task of dealing with AIDS to others would still be a major abdication of responsibility on our part, a move rendering us powerless."
Gays had to look at their own attitudes, at the idea that there was "no need to take responsibility for what you may be doing to your body over the years with unhealthy habits." He knew what kind of reaction that was going to get from the gay community. "Now, before everyone flies off the handle screaming that this business about sexual abstinence and monogamy sounds like homophobic Christian fundamentalist clap trap -- level off!! We need to expand our definition of sexual. We need to continue to be sexual, and I think it is better to be sexual with lots of folks rather than a few. However, take off your strait blinders and begin to explore forms of sexual expression that don't involve the sharing of bodily fluids. Boring, you say, maybe not! ... Touching and cuddling (naked or not) are essential to our well-being. AIDS is not."
Gourley urged his readers to take a hard look at their recreational drug use, to exercise, and to eliminate junk foods "and replace them with healthy diets...I am confident that we can empower ourselves in regard to AIDS. We can heal ourselves. Those of us with AIDS can recover. Those with the early symptoms can reverse them. And those of us at high risk can eliminate or at least greatly reduce that risk."
It was a brave statement. But no one seemed to be recovering from AIDS, no matter how many vegetables they ate or miles they put in on bikes.
In April 1984, the CDC announced that there were now 4,177 cases of AIDS reported in America, 1,807 of them fatal. That same month, Margaret Heckler, secretary of the United States Department of Health and Human Services, made it official: AIDS was caused by a blood-borne virus called HTLV-III, which was later shortened to HIV. The human immuno-deficiency virus.
There was still no test to determine who had been infected, no way of knowing if it was easy to catch or hard -- no one knew if mere exposure to the virus guaranteed infection. Nor could anyone say if some people's immune systems would purge the virus after infections or whether infection would eventually progress to AIDS in every case.
On June 28, 1984, the Colorado AIDS Project presented an educational forum featuring two speakers. One was Dr. Robert Janowski, a primary-care physician with a large gay practice, discussing gay sex techniques to reduce the risk of AIDS infection.
The other was Dr. Cohn, who in 1982 had set up a project in which he became the surveillance officer for the state of Colorado, compiling case studies for every instance of AIDS in the state. The program would eventually be incorporated into the national statistics gathered by the CDC. He'd first met Patrick Gourley when questioning him about the hemophiliac patient who'd died of AIDS in May of that year; it was when he'd asked the nurse about any other unusual, immune-related deaths that Gourley mentioned the Southeast Asian man he felt may have had the disease. Cohn had since found Gourley and Lease to be extremely proactive in requesting educational programs for the gay community.
Such education was necessary to combat what Gourley, in a November 1984 article in Out Front, called "the ostrich syndrome" prevalent among those in the gay community who preferred to know less rather than more. And education, he noted, was going to become even more important with the news that a test had been developed to indicate exposure to HIV.
People in the gay community were troubled by the proposed testing. Would these records fall into the hands of employers and insurance companies and be used to terminate jobs and coverage? More chilling, might they be used to round up homosexuals for quarantine? Gourley recognized these all as legitimate concerns.
However, he wrote, it was important to consider being tested. "The reason being that at this time we must assume that everyone positive for the antibody is potentially contagious to others. Presumably, then, all of us who are positive would then modify our behavior somehow to decrease the risk of infecting others."
Some gay activists were contending that AIDS cases in the heterosexual population showed "it's not just a gay problem."
"True," he wrote, "sort of. I think it is probably pretty certain that lots of straight folks are being exposed to the virus. However, it is still the same risk groups that are getting AIDS."
As of January 31, 1985, there were a total of 79 "persons with AIDS" in Colorado. Of them, 28 were still living; 51 had died. The majority, anywhere from 72 to 92 percent, were identified as homosexual or bisexual; intravenous drug users and hemophiliacs made up another 3 percent each; cases that were transfusion-related or involved heterosexual contact with intravenous drug users made up only 1 percent each. Of the total, 88 percent were white, 9 percent Hispanic and 3 percent black.
AIDS was focusing the energy gays and lesbians had previously given to their liberation movement. AIDS projects were springing up across the country. Fundraisers were raking in money. In Denver, CAP came up with the idea of a "buddy system" so that no person with AIDS would have to be alone.
In the meantime, the gay community nationwide was beginning to debate the advisability of "de-gaying" AIDS. Gays realized that members of the hetero population weren't going to spend the massive amounts of money that would be needed for research and to care for people with AIDS if they thought gay people were the only ones at risk. It would only happen if they felt it might affect them -- or their sons and daughters. And there were straight politicians, like Colorado's own Senator Bill Armstrong, who publicly wondered whether it would be advisable to quarantine gay males if it looked like the epidemic was spreading rapidly into the heterosexual population.
Gays had some measure of success at de-gaying the disease when the symbol of the cause became a young hemophiliac in Indiana named Ryan White, who had contracted the virus through blood products. His battle against the prejudice he and his family suffered was a cause even the most hard-hearted gay-basher could take up. When government funding was approved to care for people with AIDS, the vast majority of whom were gay, the program was not named for a gay man who had died, but for Ryan White.
Nationwide, health officials wanted the names of gay men who had tested positive for HIV so that they could track the disease as they did other STDs, so they could notify others who might be infected. Many gay men were still afraid of being tested, however. Gourley acknowledged that there was a great deal of controversy over whether testing should be anonymous. But, he wondered, "should we deny ourselves a piece of valuable medical information that can very well be pertinent to our very survival because of our fear of homophobic oppression?...The issue is control over our own health and well being.
"Also, we can only hope to prevent further erosion of our civil liberties around the AIDS issue by developing straight allies...The only effective way to develop these allies is to present ourselves as real human beings, and this cannot be done from the closet. A closeted lifestyle in this very threatening time is indefensible. The first step is to look realistically at how bad things already are, and it will become obvious that no such thing as a 'safe closet' exists for anyone anymore."
Gourley's stance against anonymous testing wasn't winning him many friends in the gay community. He was frequently confronted by angry men. In particular, he found an antagonist in gay activist Tom Witte, who accused him of being an "Uncle Tom" for the health department.
In July 1985, Gourley signed up for the pilot testing program conducted by the Denver Public Health Department. His lover, however, wasn't interested. Woodyard remained faithful to Christianity, believing there was a place for gay Christians and rejecting the fundamentalist idea that AIDS was God's wrath on gays -- but in many ways, he was Gourley's greatest Buddhist teacher. In the West, particularly America, good health was often equated with being good, illness with having done something wrong. But Woodyard argued that illness was just part of life, as was death. The question was how to integrate them into living. There was nothing anybody could do if he was infected, so why test? But Gourley just had to know.
As expected, his test came back positive. He wasted a moment wondering if it was God's punishment for his lifestyle, but quickly dismissed that as left over from his Irish-Catholic upbringing and moved on to a game he called "What ifs?"
What if that affair with an older man when he was sixteen had not been such a positive experience and he had remained in the closet? What if he had gone into the priesthood? What if he hadn't had so much sex in 1979 with so many different partners?
What if he were straight?
The questions, of course, were meaningless. He was gay. He wasn't a priest (not that that would have been any protection). He'd had many lovers. Hell, Blanche, crap happens to everyone, he reminded himself, since Gorman wasn't around to do it for him.
There were bigger things to worry about. It wasn't until 1985, nearly four years after the epidemic began, that President Ronald Reagan first uttered the word "AIDS" in a public forum. That was also the year Rock Hudson died of the disease, putting AIDS and gays in a new perspective for the American public.
And there was soon another incident to put Gourley's own troubles into perspective. August was not a good month. His father and sister had died in August, and in August 1985, Gourley's 33-year-old brother was in a car accident.
His sibling had fallen asleep at the wheel coming home from work and driven into a telephone pole. He was in intensive care for a week, and Gourley was visiting him when the doctors at last unwrapped the bandages from around his face. He would live, but he was blind and disfigured.
Up to that point, Gourley had been toying with the idea of telling his family that he was HIV-positive. But now it seemed insignificant. He knew one thing: I'd rather have HIV than be blind at 33.
If the thunder don't get ya', the lightnin' will...
There was something about that line from the Grateful Dead song "The Wheel" that seemed to sum up the AIDS crisis for Gourley. He used it to lead off an article for Out Front in November 1986.
"It has been over a year now since I had the AIDS virus antibody test and learned that I was positive and therefore infected with the virus that causes AIDS. Though I had anticipated that this would be the case, receiving the news and seeing the pink slip that the results were on came as quite a jolt."
Gourley recalled his game of "what ifs," but noted he played the game much less frequently. "What is proving more difficult to deal with than guilt is the occasional and at times nearly incapacitating rushes of AIDS ANXIETY -- usually initiated by a very innocuous zit, an innocent ache or pain, or the dreaded 'white tongue' following a night of rich food and too much wine."
Gourley admitted that he'd become an "AIDS information junkie." He read everything he could get his hands on, including materials from the ostriches who tried to claim there was no such thing as HIV or, if it did exist, proof that it caused AIDS. He was enough of an epidemiologist to know that if it looks like a duck and walks like a duck and has feathers like a duck, then it's a friggin' duck. But he understood those who were in denial: What was happening was so horrible that it was easy to want not to believe.
In April 1986, Gourley left his job as an intensive-care nurse at University Hospital to work for a program at Denver General that would teach safe-sex practices to gay men and gauge its effectiveness. It was the hospital's first major grant for AIDS research and was administered by Dr. Cohn, who hired Gourley on the spot when he applied. He recognized the benefit of having a gay man, an HIV-positive one at that, run the program. But he also knew that Gourley had a top-notch reputation as an intensive-care nurse.
It wasn't going to be easy to convince gay men to wear condoms. Rubbers were anathema to the gay culture -- they represented heterosexual birth control, not disease prevention. But Gourley prevailed. He had to. His people were dying.
Around this time, Gourley turned to Buddhism. Following his sister's death and brother's accident, he'd been looking for a spiritual base, but going back to Catholicism wasn't an option, and the pagan/wiccan beliefs he'd espoused earlier weren't adequate. Young men -- younger than him -- were dying, and he had the virus that was killing them. He found solace in the Buddhist message that death was inevitable but no one could know the time of it.
"I do find myself appreciating the here and now in a way I never did a couple of years ago," he wrote. "I find myself going out of my way to do things for others and to say that 'thank you' and to be sensitive to the trials and tribulations of those around me...AIDS is also teaching me a deep appreciation for the oneness of all humanity...on a nitty-gritty level, I find I have lots in common with a black, female IV drug user from Manhattan."
He was using this new perspective to continue working on philosophical ideas. "One, 'gay' is not a cross to bear, but a variation on a human theme to be celebrated and explored like all possibilities we are given; two, illness is not punishment but necessity -- health has no meaning or relevance without it.
"What if I didn't have this opportunity to richly focus on the moment?" Gourley asked. "What if I wasn't appreciating the similarities between myself and a nodding junkie with a needle in her arm in a downtown shooting gallery?
"What if my major concern was whether or not I could drive my car around in circles in Cheesman Park?"
Like deaths in a family, AIDS had a way of putting everything into perspective.
Gourley recalled a conversation from the summer of 1986: Only my wife and my father know I have AIDS. Everyone else thinks I have cancer. Can you make sure my death certificate doesn't say AIDS on it? People just don't understand, you know, especially not back in Oklahoma. It bothered him that a man who contracted HIV from his homosexual lover was more concerned with his obituary than with dealing with who he was and what was killing him.
He found himself again hammering on the need to bring AIDS out of the closet before gays were chased back in, undoing all the work that had gone on before the plague. He was proud of the men he saw now with lesions on their faces and beads around their necks, demanding of their government that something be done. He urged others who were HIV-positive to "come out" to their families; then straight society would be forced to deal with gays and AIDS -- not in the abstract, but as it touched the lives of people they loved. He had done so himself and was relieved at the comfort and support his own family had shown.
"We must ourselves realize that AIDS is not a gay disease. We need to understand the fact that AIDS, and its devastating effects on the gay male community in this country, is a historical accident. The coincidental appearance of this virus and the explosion of gay sexual liberation in the Seventies was not divinely orchestrated."
Historically, Gourley believed, "the Seventies gay male liberation movement with its over-emphasis on the 'macho,' consumption-oriented lifestyle of the ghetto will be seen as an adolescent growth phase. The underlying philosophy of the time, i.e., 'the only difference between us and them is where we put our dicks,' will be understood for what it was -- an overly zealous attempt to deal with our own internalized homophobia."
Gourley quoted Judy Grahn's book Another Mother Tongue, in which the author had noted that throughout history, gay people had often been the ones to take risks, especially cultural pioneers like Walt Whitman and Oscar Wilde. For their "differentness," they had at times suffered cruelly -- been despised and attacked -- but they were often the impetus for social change. He said it was time for gays to "honor ourselves." Now, more than ever, gays needed to define themselves and what they stood for. "In order not to view gay as bad," he wrote, "but rather vital and indispensable, we've got to expand on where we were ten years ago.
"We cannot allow ourselves to be defined in straight male terms or we'll never figure out who we are, we'll never feel good about being gay...Our coming out will not be powerful and change creating."
Up until 1987, Gourley had somehow managed to avoid losing someone close to him to AIDS. That changed when he heard that a friend's younger brother and a sometime housemate had died. The young man had been a carefree spirit and an accomplished concert pianist. His battle with the disease had been protracted and gruesome -- medical science was still a couple of years away from good medicines to at least alleviate the worst effects of the opportunistic infections. He had been young and strong, and it had taken a long time to beat him down, but at last he'd died with candida cottage cheese crawling down his throat, suffocating him.
Gourley got the story from Gorman, who was now living in San Francisco. In India he'd hooked up with the leader of a Hindu sect and spent a year "breaking rocks" as he sought enlightenment. When he returned to Denver in 1983, he'd at first approached AIDS as though he could chant it away. But then he'd taken off for San Francisco, where he'd thrown himself into the AIDS activism in the East Bay.
Gorman had tested positive for HIV. But he was convinced he could beat the disease through his meditation and healthy living.
Everyone had his own way of dealing with the pressure, and there even seemed to be progress on the medical front. A drug known as AZT, or Retrovir, had been shown to slow AIDS by destroying key enzymes in helper T-cells that the virus needed to reproduce. Patients showed improvement, but the results didn't last. The virus kept reproducing, if more slowly, including mutations that proved more resistant to the drug.
On the political front, Gourley was still arguing with Witte and others that confidentiality in testing was counterproductive. In the spring of 1988, Gourley wrote a piece in opposition to gay activists who were fighting HB 1177 in the Colorado Legislature, a bill requiring that medical records be kept for those who tested positive. "One of the major concerns is that records kept by the health department on infection with the virus may someday be used to discriminate against gay men. This concern is not inappropriate," he wrote. "However, everyone must realize that such records already exist for other sexually transmitted diseases (syphilis, hepatitis B). These diseases are also markers for sexual preference and for the most part already in the medical records."
He acknowledged that gay men's skepticism and mistrust of health departments "and most societal institutions, in general, is historically appropriate." However, he wrote, gays were buying into "society's attitudes about us and actually reinforce them in our insistence that infection with this virus be treated anonymously. By wanting this disease treated differently from others, we reinforce the idea that AIDS is bad and so are the people who get it."
Again, his was not a popular opinion in the gay community. But Gourley was concerned about a growing polarization between some segments of the gay community and health departments. A group called The Coalition for Political Responsibility was even advocating that gay men give false information as to what "risk group" they fell into, which would make it appear as though the epidemic were moving more rapidly into the heterosexual community and result in more money and effort going into AIDS research.
But Gourley warned that such tactics could backfire. "What has kept truly repressive quarantine measures -- a la Bill Armstrong -- at bay to date is the epidemiology of the disease: that it is impossible to transmit this virus through casual contact."
Insisting on confidentiality could also affect the possibility of getting treatment. People with HIV could be sure that they would not be treated anonymously with antiviral drugs currently being developed. The researchers would have to be able track the drugs' effectiveness and make sure that patients were following the treatment program. He felt that medical confidentiality would be maintained as it was for other patient-doctor relationships.
Gourley urged that gay men "boldly assault the barricades of HIV discrimination by being open and public with their positive antibody status."
After two and a half years of dealing with government bureaucracy, Gourley was ready to leave the safe-sex program. He told Cohn that he wanted to get back into real nursing, where he could work with patients.
He could leave the political issues to others, such as ACT UP (the AIDS Coalition to Unleash Power), which had been formed in the mid-'80s by playwright Larry Kramer, who had been dissatisfied with what he felt was a lack of assertiveness by others in the Gay Men's Health Crisis organization. Kramer had organized ACT UP to agitate for more government resources for AIDS research and the care of people with AIDS. In 1989, 4,500 members of ACT UP and abortion-rights activists held an angry demonstration at St. Patrick's Cathedral in New York City, disrupting mass by throwing condoms in the air, lying down in the aisles and chaining themselves to pews to protest the church's opposition to safe sex and abortion.
But for Gourley, acquaintances and friends were dying or disappearing. Several of his lovers from the '70s were getting sick. Black activist Tim Offutt, who'd worn the buckskin outfit and banged his drum with so much energy nine years earlier, was horribly ill when he left for Chicago to be closer to his family. Gourley heard that he'd been involved in AIDS activism up there, but then there was no word, and he feared the worst.
Phil Schroeder, the friend who'd driven around and around the community center trying to work up the nerve to "come out," was ill. As was Don Gorman in San Francisco, his healthy living and meditation notwithstanding.
And now David Woodyard. David had a heart attack, but they didn't know if it was AIDS-related. There'd also been a series of battles with bacterial infections. He was better at the moment, but there was a feeling of the inevitable.
Gourley wanted to do what he could for his loved ones. Cohn practically begged him not to leave and had an offer in mind. He and Judson were in the process of trying to get a larger clinic to deal with the onslaught of AIDS patients, and Cohn thought Gourley was the logical choice to be the head nurse.
It was clear that the epidemic could not be dealt with as other epidemics had been. Polio and tuberculosis, for example, affected people in specific ways that could be addressed by a primary physician or specialist. AIDS attacked on a variety of fronts and required the specialized skills of different members of the medical community all working in conjunction. In the course of a week, an AIDS patient might need to see a pulmonary specialist for pneumonia, an oncologist for Kaposi's, an internist for cytomegalovirus and a psychiatrist for stress or AIDS-related dementia.
The new clinic was set up on the fifth floor of the old hospital building. Cohn felt that hiring Gourley was once again a no-brainer: He was an excellent nurse who was probably as well-educated about AIDS as any of the doctors. He was already HIV-positive, so he wasn't afraid of drawing blood or setting up intravenous drug feeders. And he was gay, so he was familiar with what the majority of the clinic's patients were dealing with socially as well as medically.
The clinic was the only one of its kind in the area. A patient's primary care contact was a nurse, of which there might be a half-dozen on a given day, with only one doctor in attendance. Cohn managed most of the infectious-disease cases -- such as for PCP and thrush. Dr. Adam Myers, the chief of oncology at DGH who had been treating AIDS patients since 1981, conducted an oncology clinic twice a week for patients with Kaposi's and lymphoma. The doctors might see patients only a couple of times a week, while the nurses were there day after day and saw it all ("Buying Time," November 9, 1994).
Ninety percent of the patients were gay, most of them white, most in their thirties to early forties. The patients reminded Gourley of those he'd seen as an attendant on 4West. Their lives were in shambles. Often the disease had cost them their jobs, their homes and, in some cases, their friends and families. The world looked on them as pariahs, as people who had brought this plague on themselves.
Taking their cue from Gourley, who still remembered the beauty surrounding the Southeast Asian man's death, the staff urged families and lovers of patients who were approaching that final moment to bring them home. Or at least get them out of the hospital and into hospice care.
And patients were dying sometimes at the rate of twenty or thirty a month. The staff at the clinic often relied on their patients' campy sense of humor to keep from going crazy over the losses. In the midst of terror, it was often the patients who worked hardest at keeping everybody's spirits up. Or as Gourley put it, "If you danced in as a queen, you might as well dance out as a queen."
But Patrick Gourley stood little chance of escaping the grim reality himself. Even antagonists like Witte, who asked that Gourley be his caregiver when he came to the clinic, were dying. Gourley's own HIV-related problems had been minimal -- sores in his mouth and skin problems. He'd taken Gorman's route and changed his lifestyle, taking vitamin supplements and riding miles on his bicycle. But when he wasn't dealing with AIDS patients in the clinic, he was taking care of Woodyard at home.
Woodyard hadn't let the occasional bout with an infection slow him down much. He was a stained-glass artist and continued to work in his studio. He'd been working for Children's Hospital since 1989 in fundraising and development and volunteering as a chaplain there. Still, there was no denying that his immune system was failing.
Gourley took care of him and dealt with the reality of what was coming by reverting to his childhood days and working in a backyard garden: It was so life-affirming to coach plants to grow. But there was no getting away from AIDS for long.
Gorman had also been getting progressively worse out in San Francisco. Gourley went out to visit his friend several times. Even sick, Don was the same man he had loved. He now carried a small purse filled with quarters so he would always have "change for the changeless." To him, there was always someone worse off than he was. And then there wasn't.
In 1991, Gorman died in the hospital, but he was surrounded by friends, including his lover, Cornelius, who had cared tenderly for him through it all. There was one thing about AIDS: It rarely snuck up on anybody, and there had been time for Gourley to tell Don that he loved him and would miss him.
Still, it was a low point for Gourley. Don Gorman had loved life as much as anyone he had ever met. He'd done everything he could to stave off the disease, and it hadn't worked.
After Gourley got the phone call, the only thing he could think of was a line from a Studs Terkel book: Nobody's going to get out of here alive.
Gourley quit writing for publications. He just didn't have the heart for politics -- not for the movement, not for AIDS -- anymore. He felt numb. And he was realizing that this disease might wipe out his generation of gay men along with their hopes and dreams of winning a place for themselves in the world
There would be survivors like Harry Hay and John Burnside, who had been too old to hit the worst years of infection and had been in a monogamous relationship anyway. Important work was still being done by younger men like Will Roscoe, who, stimulated by his conversations with Hay, had published Zuni Man-Woman, a book regarding "third gender" people -- homosexuals -- in Native American culture. And there would be another generation of gay men. But AIDS had sapped this one's energy for trying to answer questions like "Who are we?" and "Does gay stand for something more than sexual preference?"
He tried writing to Hay about how the disease had drained him. But Harry and John were in their 80s, with health problems of their own. He could never get Hay to engage him on the subject.
In 1993, the clinic staff started keeping track of patients who had died by dedicating a wall to them back in the small room where they looked at X-rays, filled out the mounds of paperwork required by drug companies and government agencies and escaped, if only for a few minutes, from the desperation outside the room.
They or loved ones of the deceased wrote the names of the victims and the dates of their deaths on the wall. Some names were accompanied by newspaper obituaries; others were surrounded by colorful stickers of flowers, balloons and flags placed there by friends, families and lovers. More than a few were circled with a heart. By August 1994 the wall had more than 120 names on it. Most were men, but there were a few females, too: a 44-year-old homemaker who left a husband, two sons and a daughter; a young woman in her twenties whose boyfriend hung with her until the bitter end, signed her name to the wall and disappeared.
Gourley had written that it would be necessary for gays to rely on an alliance with people of good intentions in the straight world to combat this disease. Some of that had been evidenced by straight society's pressure on the government to fund research and programs to help people living with AIDS cope with food, housing and medical assistance. But Gourley saw it on a more intimate scale with doctors like Cohn and Myers.
The doctors at the ID clinic were all more gay-friendly than most, and seemingly more human in both their approach and their emotions. Gourley worked most closely with Cohn, the medical director of the clinic. They had their rows, and it seemed that at times he'd had to talk to the doctor endlessly about understanding gay men. Cohn could be very intense, even short-tempered, and Gourley would be angry with him -- until he saw the time and care the doctor would spend with a patient, often far beyond what was medically necessary.
Some things had gotten better. There were better medicines for coping with the worst effects of opportunistic infections, making patients more comfortable. The doctors were beginning to get a handle on PCP and Kaposi's. But there were always other infections popping up to pick at the patients like ravens at roadkill until death won by default.
In the "library" -- a quiet corner of the hospital where medical students once caught up on their studies -- patients were hooked up to intravenous bags of chemotherapy drugs to combat Kaposi's or other infections, or for blood transfusions, as they sat forlorn in overstuffed chairs. Other patients quietly waited their turns out in the hallways or tiny examination rooms. Some, still in the early stages of the disease, seemed perfectly healthy except for telltale bruises on their faces or a dry, hacking cough. Many others, though, looked like concentration-camp survivors -- gaunt, haunted, hopeless. Some sat in wheelchairs next to portable oxygen tanks. Others had to be led like the blind because their faces were so swollen with edema they couldn't see. Many wore scarves or hats to hide the fact that chemotherapy had robbed them of their hair.
Patrick Gourley saw the faces of AIDS every day at the clinic and then again when he went home. If there was a silver lining, it was his amazement at the loyalty these men showed one another. Though some ran from the disease, more often than not they stuck it out.
Woodyard put up with his infections and went about his life. He acted as though AIDS were nothing more than a pesky fly interrupting more important things in his life. When it got too difficult to stay on his feet to work on his stained glass, he resorted to knitting. In 1995, as it became more apparent that he wouldn't last much longer, Woodyard started making sure Gourley wouldn't go off the deep end after he was gone. He teased that it was a good thing that Jerry Garcia of the Grateful Dead had recently died; otherwise his lover, who sometimes saw as many as fifteen concerts a year, might have become a full-time groupie. On a more serious note, he contacted an accountant, a dear friend of theirs, and made sure to set up his estate so that Gourley, never one for fiscal responsibility, didn't give it all away.
Woodyard was prepared spiritually. Death, he reminded the Buddhist in the relationship, was just another facet of life. But he didn't just lie down. Instead, he hosted a fundraising committee meeting for Children's in their backyard even as pain was beginning to grip him as it hadn't before. The next day he was in terrible agony, and not even the liquid morphine Gourley gave him helped.
Then, and only then, did David Woodyard weaken. Like Christ on the cross, he cried out, nearly delirious, "What did I do to deserve this?"
It stunned Gourley and caused him to despair. How could he bring his lover back from that state of hopelessness? David had done nothing to deserve this, but he was beyond hearing any such reassurances.
They had always planned for David to die at home, resting in the arms of his lover, surrounded by his many friends. But the pain was uncontrollable, and he was taken to Rose Hospital, where they were able to bring it to a manageable level.
In fact, when Gourley called him that night, he sounded almost giddy on the drugs. He said he was feeling better and would see Patrick in the morning, in time for Robert Schuller's Crystal Cathedral televangelism program. There was an old queen who played the organ for Schuller, and David loved organ music.
But at five that morning, Gourley woke in a cold sweat. He knew that something was wrong and rushed to the hospital. When he arrived, they were trying to call him at home. David was semi-comatose and unresponsive.
Woodyard might have been ready for the trip, but he was in no rush to go home. There was, perhaps, one last earthly pleasure he was waiting for. At 9 a.m., Gourley turned on the Crystal Cathedral. Ten minutes later, while the old queen played, David died.
"Sometime back I got into the habit of saying to myself 'Well, it's chemotherapy, stupid!' This would usually occur at 5 a.m. when I had crawled out of bed to pee and take my four ddI tablets.
"Choking those suckers down first thing in the morning is a particularly unpleasant way to begin the day...I was frequently filled with righteous indignation at having to do it at all and wondered why this AIDS treatment business couldn't be a bit more pleasant...being very aware, of course, that the 'full-blown out of control version' has a tendency to ruin every day."
Patrick Gourley is writing again. This time for Resolute, the Denver newsletter for people with AIDS. For two years after Woodyard's death, Gourley suffered through what was probably clinical depression. He'd started taking the antiviral drugs in 1996, only to encounter one unanticipated side effect: guilt. If only David could have held on a little longer. Then again, if only they all could have held on a little longer. But he was needed at the clinic, and gradually the call of his patients and his growing reliance on Buddhism, as well as a new boyfriend, brought him back to life.
Now Gourley is swimming right back into the fray. The battle against AIDS in the United States and at the ID clinic of what is now called Denver Health Medical Center began to turn in 1996. Most, like Gourley, credit the advent of the antiviral drugs, which, when used in combination, attack the virus's "lifecycle" by destroying enzymes HIV needs to gain a foothold or to replicate. The medical effort was soon aided by a new test to measure "viral load," which measures the amount of virus in the bloodstream. The more virus, the faster the progress of the disease (as well as easier transmission from one person to the next). The test, which the ID clinic began using in the fall of 1996, helped give the staff a better idea of when to jump in with the drugs, although that remained a matter of debate: In some cases, patients were "pulled back from the brink," but in other cases, the drugs were too much for already weakened bodies.
Still, the pills have prolonged lives. Sometimes they even improve the quality of life -- the infections don't come, or they don't come nearly as often -- but the side effects are more than a little unpleasant. And at this time, the antiviral therapy is for life. If Gourley stops taking the drug cocktails, the virus may begin to multiply rapidly. And that means mutations that may be resistant to the drugs if he tried to start up again.
Some people go off the drugs and their viral load stays low and T-cell counts remain high. No one knows why. One theory is that the antiviral drugs kick-start some immune systems, which then function on their own. But Gourley has also seen such people remain healthy for a while and then get sick again -- except that then the drugs don't work anymore.
Gourley doesn't waste his time with activists like Stephen Allen and Marty Freyer of the Denver branch of HEAL, an organization that claims that HIV either doesn't exist or isn't the cause of what (they contend) are a variety of unrelated diseases that were lumped under the category of AIDS. They charge that doctors such as Cohn, Judson and Myers (doctors they tell Westword are "pieces of shit") and, by default, nurses like Gourley, participated in a terrible conspiracy to conceal that AIDS is a "myth" -- created to get money, especially from drug companies. What's more, they claim, those in the AIDS medical "industry" are all participants in a plot to kill homosexuals and minorities -- not with a virus, but with the new antiviral drugs.
In a recent interview with Westword, Gourley says the members of HEAL are merely latching onto old paranoias, the same type of thinking that found favor with those gay men in the '80s who spread rumors that their killer was a "bug" planted by the CIA or FBI in the New York subway system. It is they who are trying to argue that the earth is flat, because they cannot understand what they cannot see.
HEAL also claims that gay men's falling death rates due to what they refuse to call AIDS are a reflection of that population simply dying off. Gourley, however, points out that -- as potentially unhealthy as it may be -- the bathhouse scene has been revived, and drug use, including the use of amyl nitrate (which HEAL claims may have been the cause of the immune-system breakdowns) is still prevalent among young gay men. And yet they're not dying from AIDS in the same sort of numbers as before the advent of antiviral drugs.
In fact, the number of people with AIDS in the United States has continued to climb -- from an estimated 174,633 in 1993 to 297,136 in 1998. When the antivirals came into use, people with AIDS started living longer. In 1993, according to the CDC, an estimated 44,991 people in the United States died of AIDS. That figure continued to climb, hitting a 1995 peak of 49,895. The next year, however, there were 37,221 estimated deaths, a downward trend that continued in 1997 (21,445) and 1998 (17,171), the last year available. The CDC attributes the fall to "the widespread beneficial effects of new treatment regimens," as well as prevention strategies and education.
In Colorado, the year-by-year statistics mirrored both the growth and demise of the plague, as well as the consequences for those infected in the early years. Colorado Department of Public Health and Environment figures show that there were 79 reported AIDS cases in 1983 through 84; of that number, none are living. Of 95 cases reported in 1985, one is still alive; of 183 cases in 1986, two survive. And of the 3,752 people diagnosed with AIDS between 1987 and 1993 -- the year in which the single most AIDS cases (732) were reported -- there are only 730 still living. But from 1995, the percentage of people with AIDS still living compared to the number of reported cases begins to jump dramatically.
In August, 1998, San Francisco's largest gay newspaper ran a banner headline proclaiming, "No Obits!" For the first time in seventeen years, there were no AIDS-related obituaries in the paper. The headline caused debate, with some people arguing that it would mislead readers into thinking the danger had passed (when it was just moving into poorer communities, where such deaths would not be reported to a gay newspaper) and that it might further erode funding for service organizations (to which contributions had been declining since antiviral drugs had turned AIDS into a "manageable," not-always-fatal disease).
This past December, the Vatican held a conference on AIDS and reaffirmed the church's opposition to condoms as a way to fight the disease. The announcement sparked a tenth-year anniversary protest by ACT UP at St. Patrick's Cathedral, though only thirty protestors showed up.
Unless it's World AIDS Day or there's a juicy scandal (such as the recent revelation that hundreds of Catholic priests have died of the disease), reporters pay little attention. Like many of those in the medical community, the media is turning its focus to Africa, the current epicenter of the disease.
As horrible as the plague was, the United States has a much better medical infrastructure than the African nations, as well as considerably more resources for dealing with an epidemic. Experts like Cohn, who has been to Africa on sabbatical to work for the World Health Organization, are warning that the death toll in the United States will pale compared to the millions who will die in Africa, Asia and Russia.
Only a month ago, Newsweek, which had originally taken nearly four years to recognize the plague in the United States, reported that as much as 30 percent of an entire generation has been infected in Africa. Those numbers are expected to be similar in Asia and Russia -- meaning tens of millions of deaths and, because AIDS in the rest of the world is a heterosexual problem, leaving many more millions of orphans.
Almost twenty years after the first AIDS cases began showing up in Denver, the face of the disease has changed at the clinic. Where once more than 90 percent of the patients were gay males -- almost all of them white, well-educated, middle- and upper middle-class -- now more of the faces are brown and female. Eighty percent of the patients are still gay men, but an ever greater percentage of them are minorities, and those who are white are poorer and less educated. Ten percent are women, almost all of them having contracted the disease through intravenous drug use -- their own or that of their sexual partners.
In January of this year, only two patients at the ID clinic died, and one of them was a suicide. But with 850 patients compared to 550 five years ago, the clinic is actually following more patients now simply because they are living longer.
It's not all good news. Patients still die from AIDS. The drugs don't always work or they work for a while and then lose their efficacy. There are instances where the drugs themselves have done the killing. But instead of battling to beat back each opportunistic disease, the effort now is to keep patients on their "meds."
Instead of struggling to buy a few more months, weeks or even days of life and then easing the inevitable meeting with death, doctors and nurses can actually tell their patients that they are not necessarily going to die anytime in the next few years or even decades.
Now Gourley's more concerned that some of the lessons learned through thousands of deaths are already being forgotten. He hears young gay men talking about getting HIV as if it's no big deal -- just pop a few pills and they'll be all right, an idea on which the drug industry is capitalizing. "Despite the ads appearing in the gay press, advertising various antivirals accompanied by photos of half-naked hot studs engaging in some vigorous outdoor activity, displaying buns of steel, they are very difficult drugs to take, with significant side effects," Gourley writes. "Hey, buckos, it was/is the glorification of that sort of shallow flesh worship that got many of us in this pickle in the first place."
To avoid a repeat of the '80s, Gourley believes that it is time for the "re-gaying" of AIDS. In another statement guaranteed to cause controversy, Gourley says that the pool of virus in the heterosexual community is so small in Denver that "unless you have sex with people who are using IV drugs, or have sex with men, you are not going to get AIDS here."
He believes that the de-gaying of AIDS -- necessary at one point -- has now become a hindrance. Outside of the gay community, he thinks mainstream society believes that gays have gotten the message so that monies used for prevention and education are being redirected. Inside the community, organizations like CAP have "given us an excuse to quit dealing with it ourselves." CAP and the other AIDS agencies still serve a useful purpose, he adds quickly. But it's time once again for gays to start taking care of their own. And some of what got them into trouble in the '70s -- the bathhouse scene and drug use -- are nearly as prevalent today.
Many of the issues the gay community faced before AIDS are still pressing. Some -- like reaching out to gay men of color and poor whites -- mean the community will once again have to look in the mirror regarding matters of race and class. In the 1970s, the coming-out phenomenon was largely composed of upper- and middle-class white men who moved from their home communities to the "gay ghettos" of major metropolitan areas. Today, men of color, as well as poor whites, tend to remain in their home communities -- among families and friends -- where it is more difficult to be out. It is even more difficult for them to be out and have AIDS, which Gourley believes is causing the "re-closeting" of the disease. The reason AIDS research has gotten as far as it has is because of political activists demanding that something be done. The new victims are not as vocal and have no one to speak for them, Gourley contends.
At the same time, he believes, AIDS should no longer be the health issue. "There are more lesbians and gay men dying of heart disease and alcoholism than AIDS." But it still irritates him that newspapers don't list AIDS as a cause of death in obituaries.
In his tiny office outside the ID clinic, Gourley muses that it's past time for gay men to revive the liberation movement. "It's been the lesbians, bless their hearts, who have carried the torch for the past ten years," he says. "It's about time we started doing our fair share again."
Sometimes he wonders where the movement would be now if AIDS hadn't drained its energy and killed many of its leaders. Heck, the Stonewall Inn is being added to the U.S. Register of Historic Places. He's shy about trumpeting his own role in the movement or battle against AIDS (it took several requests over a period of years and Cohn's assistance to get him to agree to an interview for this story). Two years ago he declined to attend a dinner put on by CAP to honor him and Cohn for their work. He appreciated the thought, but he believed there were others more deserving. But history should be important to the next generation of gays, he says.
Just as young gay men already seem to be forgetting the terror of AIDS, most seem to know little about the movement, the Mattachine Society, Stonewall or Harry Hay. At the same time, he's been hearing from Hay, who's telling him it's time for him to get up off his ass and get active again. He opens a copy of Hay's book, Radically Gay. The old man signed it when he was visiting last fall on a book tour: "To Patrick, whose seminal contributions to Denver's Gay Liberation achievements in the 1970s sparked many ideas developed in this book.
"My love and gratitude, Harry Hay."
Gourley notes that conservatives in the state legislature last week won their battle to ban gay marriages in Colorado, an issue on which Gourley isn't sure where he stands. In some respects, he worries that anything so hetero-imitative may cause gays to lose their edge. On the other hand, anything that upsets the Christian right so terribly can't be all bad. And the mere fact that the Republicans had to struggle to ban gay marriages would have never occurred thirty years ago.
Still, there is much work to be done. That was clear to Gourley on New Year's Eve, when he and his lover were leaving a party downtown and encountered six obviously intoxicated young men. "Hey, faggots," one of them yelled, his friends laughing. The comment caught Gourley off guard. He and his lover weren't holding hands or swishing down the sidewalk. After all he had seen -- all the death and suffering faced with courage by "faggots" -- it seemed unfair for the term to be used in so derogatory a fashion. Gourley's boyfriend, who is ten years younger, was upset and wanted to confront them. Even Gourley, for just a moment before prudence overcame the better part of valor, thought about yelling back, "That's Mister Faggot to you!"
Looking at the photograph of the smiling men in front of the San Juan Pueblo bed-and-breakfast, Gourley notes that AIDS taught a lot of valuable lessons. Most important, it answered the question about how they would prove to the world that being gay was more than a sexual act. How many hundreds of times had he seen a man stick by his lover, clean up vomit and diarrhea, spoon-feed an invalid for months, even years, long after there was any sort of sexual relationship?
He had been there himself. It wasn't about sex. It was about love. Maybe at last the world had seen the meaning of true gay love. All it took was a few hundred thousand lives.
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