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.'"