Patient Zero and the Making of the AIDS Epidemic

by Richard A. McKay

Now an award-winning documentary feature film

The search for a “patient zero”—popularly understood to be the first person infected in an epidemic—has been key to media coverage of major infectious disease outbreaks for more than three decades. Yet the term itself did not exist before the emergence of the HIV/AIDS epidemic in the 1980s. How did this idea so swiftly come to exert such a strong grip on the scientific, media, and popular consciousness? In  Patient Zero , Richard A. McKay interprets a wealth of archival sources and interviews to demonstrate how this seemingly new concept drew upon centuries-old ideas—and fears—about contagion and social disorder.

McKay presents a carefully documented and sensitively written account of the life of Gaétan Dugas, a gay man whose skin cancer diagnosis in 1980 took on very different meanings as the HIV/AIDS epidemic developed—and who received widespread posthumous infamy when he was incorrectly identified as patient zero of the North American outbreak. McKay shows how investigators from the US Centers for Disease Control inadvertently created the term amid their early research into the emerging health crisis; how an ambitious journalist dramatically amplified the idea in his determination to reframe national debates about AIDS; and how many individuals grappled with the notion of patient zero—adopting, challenging and redirecting its powerful meanings—as they tried to make sense of and respond to the first fifteen years of an unfolding epidemic. With important insights for our interconnected age,  Patient Zero  untangles the complex process by which individuals and groups create meaning and allocate blame when faced with new disease threats. What McKay gives us here is myth-smashing revisionist history at its best.

Genres: Nonfiction, History, Queer, Science, LGBT, Medical, Audiobook

400 pages, Paperback

First published November 22, 2017

Reviews

[Darya Silman · Rating 4 out of 5]

PATIENT ZERO AND THE MAKING OF THE AIDS EPIDEMIC makes things right for Gaëtan Dugas, a Canadian flight attendant accused of being the first carrier and conscious spreader of the HIV/AIDS virus in North America.

To better understand the accusation against Dugas, the reader should familiarize first with the 1987 Randy Shilts's book 'And the Band Played On,' as Randy Shilts was the one spreading the misinformation. The tradition of blaming certain groups for natural disasters, for example, Jews or single women, has persisted long before the AIDS epidemic. The most chronologically close case to Dugas's was Typhoid Mary. Mary Mallon was a poor woman at the beginning of the 20th century, who, being healthy, presumably transmitted typhus to her clients while working as a cook. Though advised to stop working with food, she secretly continued working and infecting her wealthy customers, not out of spite but because she had no other means to earn a living. According to the narrative, created by Shilts, Dugas intentionally spread the disease by visiting public gay bathhouses and hooking up with strangers in bars, while knowing full well he had a fatal HIV/AIDS virus. Shilts based his accusations on the 1984 cluster study by the CDC that unintentionally put Dugas's case number at the cluster's center, identifying it by the numeral 0 (zero). The cluster didn't take into account neither the sequence of cases' appearance nor the duration of a relationship: whether it was a one-night stand or a partnership of many years.

Richard A. McKay debunks the myths around Patient Zero. First, he traces the origins of the numeral O (zero). The Dugas's case initially was number 57 (meaning, he was the 57th person questioned). Then he was identified as O (a letter), an Out-of-California person, connected to 5 cases of infection in California. As the numeral 0 and the letter O look alike in writing, scientists and media slowly yet inevitably mixed the two. The public wanted the answers - and the feeling of ethereal control over the invisible deadly virus - about where the epidemic came from. Shilts took the rumors about gay men viciously spreading the virus as a fact. The gay community was a tight-knit web at the time, and Gaëtan Dugas was a prominent, proud member of it. His flamboyant demeanor and handsome looks also contributed to his villain image: it is not for nothing that an overly beautiful femme fatale has been considered the embodiment of evil.

While one has to read PATIENT ZERO (12 hours of listening in my case) rather than limit himself/herself/themselves to a Wikipedia article? Though sometimes operating with dry facts, Richard A. McKay crafted a heart-touching story of a single prosecuted (posthumously, I must say) individual, framing it in the overview of the 1980s struggle to comprehend the origins of the HIV/AIDS wave that killed thousands. At the time of the cluster study, it was wrongly believed that the virus's incubation period was 9 months and that the suppression of the immune system by exposure to multiple illnesses caused the decline. Kaposi's sarcoma and pneumocystis pneumonia were the common concomitant diseases, and they were not sexually transmitted ones. Gay men like Gaëtan Dugas, young, handsome, sexually active with multiple partners, traveling extensively, didn't see the point in drastically changing their lifestyles. If Dugas abstained from bathhouses near the end of his life, it was for the facts that a) he was afraid of exposure to illnesses, b) he found a permanent partner.

PATIENT ZERO is a comprehensive, in-depth study of the prejudices against gay men and history of the AIDS in general.

[Cat · Rating 4 out of 5]

In the late 1980s, gay journalist and activist Randy Shilts wrote AND THE BAND PLAYED ON, detailing the early years of the AIDS epidemic and the gay community's various reactions to it. He included in the book a portrayal of a gay French Canadian flight attendant named Gaetan Dugas, whom Shilts identified as a sociopathic "Patient Zero" who intentionally infected hundreds of other men--a term originally used by the CDC to describe the patient who seemed to be at the heart of a specific cluster of Los Angeles AIDS cases but who became, in part through Shilts's damning portrayal, the face of AIDS in North America, blamed single-handedly for its spread through Canada and the US, with deep cultural and legal ramifications for people with AIDS and how the public perceives epidemics/pandemics.

This is a deep academic dive into how scientists, journalists, and the public conceived of epidemics before and after HIV/AIDS, how jargon can get spun wildly out of control when it's released beyond the bounds of the laboratory, how marginalized communities relate to the health establishment in times of crisis, the role of respectability politics in marginalized communities, the pitfalls of the constant search for a "source" to a disease outbreak, and the specific historical and sociological influences on Western society's relationship with disease and scapegoating. It's also an attempt at resurrecting the life of Gaetan Dugas and his reputation, which I found quite affecting--Dugas was no saint, just another flawed human being who was nonetheless done, both intentionally and unintentionally, an abominable turn by Shilts's portrayal, as was, perhaps, our understanding of how we as a society should tackle disease outbreaks. Recommended if you like reading about queer issues/society+medicine and the history of science; McKay is a fairly clear writer even for nonspecialists.

[Fishface · Rating 3 out of 5]

This big, thick trade paperback proved to be quite a short read because so much of every page -- sometimes more than 3/4-- was citations and footnotes. A great deal of it was frankly confusing blathering about epidemiological research methodology that wasn't irrelevant, but could have been a lot shorter and clearer. It wasn't until nearly page 300 that we finally got to what the ad copy told me was the meat of the book: a true biography of Gaetan Dugas, separated out from the layers of hateful nonsense painted over a life cut cruelly short. It was only when we got there that I started to see why the author spent so many pages explaining what Randy Shilts got wrong in his book, where he seemed to get it wrong intentionally in order to promote himself, and what effect his errors had on the public perception of the AIDS epidemic. I came away with a whole new image of Dugas and most of the other people mentioned in here. I'm very glad I read this one.

[Peacegal · Rating 3 out of 5]

This was an interesting book examining the early days of the AIDS crisis in North America, as well as criticizing the notion of a "Patient Zero"--that a single person was responsible for bringing the disease to the US. A decent part of the book was dedicated to examining and refuting parts of the book AND THE BAND PLAYED ON, which I have not read, but now want to. It was good to see a more humanized portrait of the man saddled with the unwanted label of "Patient Zero."

[Leslie · Rating 4 out of 5]

A highly academic book. If your tolerance for academic-style explanations of methodology and careful delineation of how this work fits into current scholarly debates and exactly which theorists supply the foundation for this argument and how those theorists will be used is low, skim the intro and first chapter, which are all about performing that kind of scholarly positioning. The second chapter, about the original cluster study that lay the groundwork for the Patient Zero narrative, is good and important, but the book really starts to pick up in the third chapter, which outlines how and why Randy Shilts approached the story of AIDS in general and the so-called Patient Zero in particular as he did, what sorts of personal, social, practical circumstances shaped the writing and the marketing of the book. McKay then goes on to look at the broader social, journalistic, and cultural uses to which the Patient Zero narrative got put before looking in more detail at the realities of the person behind that mythical scapegoat figure. Overall, an important contribution to our understanding of how AIDS was reported and understood.

[Zoë · Rating 5 out of 5]

het voelt echt gek dat ik dit boek uit heb. overigens was het zeer informatief en ook wel een mooi perspectief over de manier waarop geschiedenis over ziektes (zoals hiv/aids) geschreven wordt niet neutraal is

[Gina Bright · Rating 2 out of 5]

McKay’s book is a much-needed analysis of Gaétan Dugas, a Canadian flight attendant, who unfortunately acquired the title “Patient Zero” in the early 1980s when the CDC drew connections between gay men exposed to what we now know is the virus that causes AIDS.

McKay uses Randy Shilts’ chronicle, And the Band Played On, to show how Dugas was a scapegoat for the disease, and the ramifications this has posed for Dugas, his family, and even Canada. Shilts’ book, he argues, solely blames the flight attendant for spreading the virus, especially when Dugas continued to have unprotected sex after his doctors advised him that his skin cancer (KS) was most likely contagious. But as I argued in Plague-Making and the AIDS Epidemic: A Story of Discrimination (Palgrave Macmillan, 2012), Shilts’ narrative is part of a much larger one, and he constructs Dugas as “the primeval plague carrier” as the disease is made a plague in the USA during this time.

McKay also neglects to stress for his readers that the bulk of Shilts’ book is spent uncovering the Reagan government’s neglect in dealing with this new disease. And McKay’s exposure of Shilts’ private papers, while writing Band, does little to support his claim that Shilts’ portrayal of Dugas stems from Shilts’ own sexual insecurities and a ravenous desire for fame.

McKay should have stuck with exposing the ruthless world of book publication, like he touches upon when discussing Shilts’ editor who thought Band would only make money with the Patient Zero story as its selling point, and not the bigger story of the government’s culpability in the mounting death toll in a community that the hegemonic straight Christian culture wanted to shove back in the closet.

McKay’s book may recover some balance in viewing Dugas as an unfortunate victim who suffered from AIDS and was not the sole perpetrator of its spread across America, but in the process, he maligns Shilts’ character.

In 1987, Shilts’ book was the only megaphone the AIDS community (PWAs and HCPs) had to shatter the silence blanketing all the deaths in the USA. Many of us have never put it down.

Reviewed by Gina M. Bright, Author and Oncology/AIDS Nurse

[Fran Henderson · Rating 5 out of 5]

Vital historical corrective about AIDS misinformation

[Sarah Schulman]

Humane and psychological, but deeply documented and historical.

[Pete Bottiglieri · Rating 3 out of 5]

I have a lot of mixed feelings about this book. The factual information about the AIDS crisis in the 1980's is fantastic, humanizing Gaëtan Dugas was great. The historical facts about how the term patient zero came into the world's lexicon great.
My issue is more when the author starts discussing Randy Shilts. This is where the authors bias truly shows. He does to Shilts what Shilts' book did to Dugas, completely demonizing him. With the use of journal excerpts, he claims that Shilts wanted nothing more than to become rich and famous at any cost. He also asserts that Shilts was basically a sell out and wrote for the heterosexual community. It is easy to look back 30 to 40 years ago and pick apart things and pointing out the wrongs.
I am in no way condoning what Shilts did when outing Dugas as "patient zero", at the same time the book "And the Band Played On" was written during a time when information about AIDS was changing almost daily. The fact that the author claims the Shilts wrote the book for a heterosexual audience is also a point I take issue with, mainly because what would be the point of writing a book on AIDS , that was catered to a homosexual audience, in the mid to late 80's. It would not have brought any more attention to the AIDS than other gay publications at the time. It would have been "preaching to the choir" so to speak.
Overall the book was very informative just biased

[Jennifer O · Rating 3 out of 5]

The entire point seemed to be that McKay didn't appreciate Shiltz portrayal of Gaetan Dugas, and it's true that And The Band Played On made Dugas out to be a sociopath. The difference between the 2 authors is vast: Shiltz lived, worked, dated, and died in San Francisco. He was a journalist at ground zero for the AIDS epidemic in the USA. Shiltz died of AIDS-related illness in 1994. McKay was born in 1978 in Canada. The response to the epidemic was vastly different in Canada and 30 years later. He gets 3 stars bc he did humanize Gaetan Dugas, but he regurgitated Shiltz research for 4 chapters. Let Randy Shiltz rest in peace.

[Melinda Borie · Rating 5 out of 5]

This book is amazing and I am upset. I hope You're Wrong About does an episode about this, even though they won't ask me to be on it.

[Iain · Rating 4 out of 5]

"Patient zero"... a grim term in the medical world, actually technically known as the index case is the first documented patient in the onset of an epidemiological investigation. HIV/AIDS began to infect, spread, and make its deadly presence know in the United States in the late 1970s. It was mysterious and baffled the frontline of doctors and nurses who encountered it. Healthy young men, who were gay, began succumbing to opportunistic diseases at an unprecedented rate, namely Kaposi's sarcoma (KS) and pneumonitis - an epidemic had arrived and people were scared.

In the early years of the AIDS epidemic, a "patient zero" transmission scenario was compiled by Dr. William Darrow and colleagues at the U.S. Centers for Disease Control and Prevention (CDC). This epidemiological study showed how "patient zero" had infected multiple partners with HIV, and they, in turn, transmitted it to others and rapidly spread the virus to locations all over the world. The CDC identified Gaëtan Dugas as a carrier of the virus, spreading it to other men he encountered at gay bathhouses. Journalist Randy Shilts subsequently wrote about Patient Zero, based on Darrow's findings, in his 1987 book And the Band Played On, which identified Patient Zero as Gaëtan Dugas. For decades he was seen as one of the most villainous people in medical history, was only patient zero because of a paperwork mistake. But the finding comes long after Mr Dugas’s death, after he passed away from complications related to the disease in 1984. In Darrow's original cluster study Dugas waas labeled as "Patient O" as in the letter and not "Patient 0."

Randy McKay's book, 'Patient Zero and the Making of the AIDS Epidemic' seeks to undo the damage done to Dugas' name as not a villain who spread death to a young man who only a decade into the gay liberation movement was enjoying his life with vigour. When the epidemic began it was a mystery then it way gay cancer and the medical world largely ignored this crisis as it was gay disease. Cancer is not contagious, so why should I stop having sex? Dugas died of AIDS in 1984 when knowledge of the disease and how it is transmitted was in its infancy. The media, prominently Randy Shilts in his seminal book labeled Gaëtan Dugas, a flight attendant from Air Canada as "patient zero." McKay goes to great length to give the patient and not the status a voice, albeit posthumously, to correct the record. Dugas was one of the early victims of AIDS, and not one of its villains.

Randy Shilts' "And The Band Played On" (1987) is the first work to address AIDS and it is a seminal work. That said, its one major flaw is the characterization of Gaëtan Dugas as "patient zero." It does highlight the medical heroes who from the onset were fighting the epidemic.

Richard A. McKay's 'Patient Zero and the Making of the AIDS Epidemic' (2017) seeks to fix that flaw. Recognizing the incredible pressure the CDC was under to find out what was going on and the flawed life of Randy Shilts himself, who in his book needed a villain to personify in the AIDS story - Dugas fit the bill but so did many many other young gay men in the early 1980s.

On to David France's 'How to Survive a Plague' (2016) by David France which looks at the activists and scientists involved in dealing with the AIDS epidemic.

[Randal · Rating 4 out of 5]

Read And the Band Played On by Randy Shilts before reading this book. Patient Zero is an exercise in historical revisionism, and an attempted rehabilitation of the image of Gaëtan Dugas, the man unjustly remembered as "patient zero" responsible for rapidly spreading AIDS through North America, and who was featured so prominently in Shilts' And the Band Played On as a kind of "typhoid Mary of AIDS." McKay rightly destroys the entire notion of a "patient zero" and shows how this misinterpretation grew into a life of its own.

McKay's book is not wholly successful, however, and it is historically likely that Dugas did engage in at least some willful spread of the disease, and the spiteful behavior attributed to him in the press, despite McKay's and many others' attempts to excuse or downplay this behavior. Yet McKay's portrayal of Dugas is important because it humanizes the man, it places him in better historical context, grounds his thought processes in the lines of thinking prevalent in the early 1980s, and ultimately paints a much more sympathetic, real, multifaceted, tragic, and utterly heartbreaking portrait of a man and a community and the broken systems that failed everyone, gay and straight.

The book serves as an interesting historiography of the epidemic (of how histories are written, shaped, molded) and, even with its flaws, the book is an important read in this post-pandemic world.

[Aishuu · Rating 4 out of 5]

A very interesting look at how the game of "telephone" spreads untruths that become accepted fact. I've heard of the "Patient Zero" story, and I never gave it a second thought; this is a reminder to critically evaluate whatever information is provided since the truth is often much more complex than the soundclip and yellow journalism is a thing that exists. Definitely food for thought.

[John Treat · Rating 5 out of 5]

Patient Zero and the Making of the AIDS Epidemic is, without a doubt, the most thoroughly researched book on the AIDS pandemic that I have ever read, and I have read a lot. Stay with it to the end: the final pages are unforgettable.

[Derek Kreider · Rating 4 out of 5]

I enjoyed the perspective of this book and it helped to round out some of my views on the AIDS crisis. The author did a great job of taking a historical look at how views on the disease, particularly in relation to "patient zero."

I will say that my one problem with the book is that I think the author stretches his sympathies here for GD, and criticizes the initial gay community's response too harshly. I'll elaborate.

I understand that GD and others didn't KNOW that the disease was spread sexually, but I mean, it's not too difficult to recognize that it's a real possibility. There were a lot of interviews where people said that they and most of the gay community didn't change their lifestyles as a result of the potential, and that's fine for those who didn't have the disease. But still, there is some level of common sense responsibility here.

Just look at the COVID pandemic and how the left (which includes much of the gay community) responded. We had very limited data as to how severe the pandemic would be, what reduced the spread, how effective certain measures were, etc. Yet there were a lot of those on the left essentially ready to hold those on the right responsible for murder for their careless actions of not wearing a mask and such. OK, fine. But then what does that position mean for holding GD and others in the gay community responsible for their negligence given their limited information? And please note here that I'm only saying the gay community because that's what the book was focused on. Obviously heterosexuals could spread it as well.

I don't think you can have it both ways. Do you want to vindicate GD and the gay community for the spread of AIDS because "who would expect someone to change their lifestyle and restrict their inhibitions and freedoms given limited information?" (even if commonsense makes possibility, or even likelihood clear). But then you're left with an extremely hypocritical response to other things, like COVID. And if you want to keep your demand for the limitation of freedoms and lifestyle based on limited information, then condemn GD and the promiscuous lifestyle of those who spread AIDS, which initially seemed to be happening more so in the gay community.

That's really my big critique here. I loved the book and enjoyed hearing the stories from history and hearing how different people formulated their views. It's tragic, and I appreciate the work the author did to help paint the complexities of the situation and take away some of the demonization of GD. However, in trying to balance the poles it seems like he ends up swinging the conversation too far the other way.

[Alexandra · Rating 5 out of 5]

Outstanding work. Great information, well-organized, and (I think) easy to follow even if you have little background on the subject. Gaetan Dugas deserves this kind and compassionate vindication of his humanity, and McKay's attention to detail on the subject is laudable. I also appreciated how he was able to be highly critical of Randy Shilts' representation of Dugas, while at the same time not simply flipping the script and utterly demonizing Shilts' - McKay's nuance in exploring why "Patient Zero" became what it did possesses all the grace with which Shilts himself explored all aspects of the unfolding AIDS epidemic except Dugas' story.

Particularly, I think it was interesting that McKay used "Typhoid Mary" Mallon and Gaetan Dugas to illustrate recurring issues in public health; specifically when he discussed how Dugas' reaction to his diagnosis was compounded or possibly confused by the rapidly changing scientific information and shift in norms about infectious disease beliefs - juxtaposing this with how Mary Mallon reacted when told she was told she, an asymptomatic, well person, was making others sick, underscores how changes in conventional wisdom coinciding with catastrophic new illnesses can severely complicate responses. This is particularly true when the heavily affected group (or in Mary's case, the carrier) is part of a marginalized people (gay, Irish, which at the time was demonized).

Also useful here is an intrinsic examination of the Canadian response to the AIDS epidemic, which one doesn't see focused on very often.

McKay's determination to accurately investigate what went wrong with the harmful "Patient Zero" mistake and to right the cruelties inflicted on Gaetan Dugas results in a heartfelt but critically informed book that fleshes out complex issues and gives censure where censure is due without falling into the same trap Shilts did - black-and-white demonization. Fantastic read.

[T’Layne Jones · Rating 4 out of 5]

*4.5 stars. An interesting and moving counterbalance to Randy Shilts’ famous book, And The Band Played On.
I’m so glad this was written. I was struck, on rereading Shilts’ book a couple years ago, by the apparent internalised homophobia behind so much of the perspectives. This book attempts to re-examine the same history, of the emergence of AIDS in North America and how that impacted the queer community, with a less prejudiced lens. McKay particularly takes care to research and uncover the reality behind the (vitriolic) legend of Gaëtan Dugas, one of the first recorded patients to present with Kaposi Sarcoma in North America, and who was declared to be ‘Patient Zero’ - publicly blamed for bringing AIDS to North America. This travesty has been proved to be a lie, and this book provides a nuanced picture of the emergence of AIDS, of Gaëtan Dugas, and of Randy Shilts. Recommended

[Jeff · Rating 2 out of 5]

I love the investigative disease histories by Richard Preston, John Barry, Bill Wasik and other authors. This is not those. This is a repudiation of Shilts' "And the Band Played On" and an attempt to revive Gaetan Dugas from infamy as "patient zero." This is a pop and social history about labeling someone as "patient zero" and the effects of scapegoating a specific demographic, so don't expect any hard-hitting scientific sleuthing. Don't expect an actual history of the AIDS disease, but rather the screw-ups that led to the "patient zero" label. My expectations aside, it was slow-paced, boring, and entirely too long.

[Katie · Rating 5 out of 5]

In "Patient Zero", Richard McKay deconstructs popular (and medical) perceptions regarding "patient zero" in epidemics and disease history. Using the life story of Gaetan Dugas, who was widely regarded (and condemned) as "patient zero" of the AIDS epidemic, McKay traces how scientific labeling and understanding shifted Dugas from "Patient O" (meaning outside of California) to "Patient 0" and then, finally, to "Patient Zero." In tracing this process, McKay debunks our understanding of contact tracing and limitation of epidemiological methods when it comes to tracking disease. In the last chapter, McKay provides are far more nuanced and caring portrait of Dugas, demonstrating that Dugas was not, in fact, a careless or sociopathic individual who purposely spread AIDS, but rather he was man full of life and joy who adjusted his behaviour according to his understanding of health and disease and who participated actively in AIDS organizations before his death at the age of 32. Detailed, thorough, and filled with empathy, McKay's book serves as an excellent examination of the AIDS epidemic and the narratives that have been built around it.

Edit to add: I'm sick of reviews on this site complaining that books from academic presses are "very academic" in nature. No shit, it's on the publisher's label! Stop complaining that you picked up a book not catered for the layperson and that you have to think harder (or at all) to read it. Some of us want to read academic books aimed at scholars and not shitty pop history texts.

[cow boy · Rating 4 out of 5]

this was an interesting look at the HIV/AIDS epidemic and how one man was made the scapegoat of virus and was blamed for the spread of it. it delved into his life and how there were conflicting stories about him.

it also discussed how humans always search for someone to blame. living through a year of the covid pandemic already (with no end in sight) it made me reflect about how the world has treated the people of wuhan and how they became the scapegoat.

how can we blame people for not acting sooner when people have no idea how the viruses spread and there is little information?

[Mary · Rating 3 out of 5]

It was well-researched, but, holy smokes, this was this dry. It was as though he took his doctoral thesis and just published that rather than editing it for a broader audience.

He also mentions in the afterward that he has never read And the Band Played On. He references that book often throughout, so I feel like he is making a counterargument to something he is only vaguely familiar with.

Ultimately I am glad I read it because the information is important and corrects a lot of misinformation that is still prevalent about the early AIDS epidemic.

[Joe · Rating 4 out of 5]

Fascinating examination of, and follow-up to, Randy Shilts’ seminole AIDS document AND THE BAND PLAYED ON, focusing almost exclusively on Shilts’ “villain,” alleged “patient zero,” Gaëtan Dugas. McKay’s arguments are extremely convincing and call into question all that went into Shilts’ choices where Dugas is concerned. Though BAND is an excellent piece of writing and undeniably influential (and passionate), this is a necessary companion piece where truth and ethics are concerned.

[anya · Rating 4 out of 5]

while sometimes this book pulls a grammarly in being grammatically correct but wordy and hard to read, WOW is it an important read! bringing very much needed justice to gaëtan dugas, the victim behind the patient zero story that features in "and the band played on", one of THE most influential pieces of literature in the queer community. this book is definitely a must when learning about queer history, brilliant job mckay!

[Jan · Rating 5 out of 5]

An excellent analysis of one of the major tropes in accounts of HIV-AIDS in North America, grounded in meticulous historical research. McKay fully unpacks his subject, giving a fascinating account of how the patient zero myth was launched jointly by researchers and Randy Shilts, then picked up everyone else in the world, ultimately usurping Typhoid Mary as the origin image for any crisis. This book is additionally valuable for portraying the Canadian history of HIV-AIDS.

[Stephanie · Rating 3 out of 5]

Fairly interesting corrections of all the misinformation created by And the Band Played On. Gaetan Dugas was certainly not the originator of Aids. But he did a lot of spreading even after he knew he was sick, but I definitely take issue with Randy Shilts exposing the flight attendants name after his death. This book goes in the opposite direction, though. It excuses any misbehavior on Gaetan's part that brought him to the attention of people in the first place.

[Trent · Rating 4 out of 5]

A fascinating look at how the media got the story all wrong back in the 1980s, and how urban myth became history. Thankfully, Richard McKay is here to discredit the myths and write the history once more in a better way.
A finalist for the Publishing Triangle's 2017 Randy Shilts Award for Gay Nonfiction.

[Karen (Living Unabridged) · Rating 2 out of 5]

Not a book I would usually choose. Now that I've finished it, I'm still not exactly sure who the intended audience is. It's academic and heavily footnoted but manages to gloss over details the author doesn't want to explore. I suppose it's mostly a corrective for Randy Shilts' "The Band Played On" which I haven't read.

[Rachel Hewett · Rating 5 out of 5]

This in-depth analysis of the misconception of "Patient Zero" was eye-opening and incredibly educational. It goes to show just how easy it is to crucify someone who was completely innocent just because it was convenient for the narrative. It's even easier when the person is already dead. Rest in peace, Gaetan Dugas.