PUBLIC NUISANCE.(gay activist Larry Kramer)(Interview)

A long and vituperative essay appeared on the front page of the March 14, 1983, issue of a weekly newspaper called the New York Native. The Native was the city's only significant gay publication at the time, and anything printed there was guaranteed to attract attention. This piece did considerably more than that. Entitled "1,112 and Counting," it was a five-thousand-word screed that accused nearly everyone connected with health care in America--officials at the Centers for Disease Control, in Atlanta, researchers at the National Institutes of Health, in Washington, doctors at Memorial Sloan-Kettering Cancer Center, in Manhattan, and local politicians (particularly Mayor Ed Koch)--of refusing to acknowledge the implications of the nascent AIDS epidemic. The article's harshest condemnation was directed at those gay men who seemed to think that if they ignored the new disease it would simply go away.

"If this article doesn't scare the shit out of you, we're in real trouble,'' its author, Larry Kramer, began. "If this article doesn't rouse you to anger, fury, rage and action, gay men have no future on this earth. Our continued existence depends on just how angry you can get. . . . Unless we fight for our lives we shall die.'' The piece became perhaps the most widely reprinted article ever published in a gay newspaper. "I am sick of closeted gay doctors who won't come out to help us fight. . . . I am sick of gay men who won't support gay charities. Go give your bucks to straight charities, fellows, while we die." He went on, "Every gay man who is unable to come forward now and fight to save his own life is truly helping to kill the rest of us."

Kramer was also sick of the way he was treated within New York's gay community. For years, the Greenwich Village and Fire Island swells had considered him a nebbishy interloper--a puritan who often wondered in print why gay life had to be defined by sexual promiscuity rather than by fidelity or love. His views were routinely rejected. Gay men had battled hard for sexual freedom, and for many of them the unfettered pursuit of sex was exactly what that freedom was all about; they certainly didn't want to be told what to do with their bodies by a homosexual who seemed chronically unable to enjoy himself. In 1980, not long after Kramer's novel "Faggots" was published, the playwright Robert Chesley wrote, "Read anything by Kramer closely, and I think you'll find the subtext is always: the wages of gay sin are death." That was indeed a central theme of "Faggots," which appeared three years before AIDS, and which lampooned the sexual adventures of upper-middle-class gay New York. "Faggots" turned Kramer into a pariah. The book was removed from the shelves of New York's only gay bookstore, and he even found himself banned from the grocery near his vacation home on Fire Island. "I became a hermit for three years after that book was published,'' Kramer told me not long ago, still surprised by the condemnation he received from people he thought he was going to impress. "The straight world thought I was repulsive, and the gay world treated me like a traitor. People would literally turn their back when I walked by. You know what my real crime was? I put the truth in writing. That's what I do: I have told the fucking truth to everyone I have ever met.''

That is one way to put it. Rodger McFarlane, a former lover, and a comrade in the AIDS wars from the beginning of the epidemic, suggested another: "When it comes to being an asshole, Larry is a virtuoso with no peer. Nobody can alienate people quicker, better, or more completely.'' "Faggots" has been attacked as coarse, prudish, and polemical, but it has sold something like a million copies, which places it high among the best-selling works of gay fiction. "Faggots" has never been out of print. By the end of the book, Kramer had all but predicted the AIDS epidemic, just a few years before it would ruin his world.

At the time, people were too busy enjoying themselves to care. The late seventies and early eighties were a sexual Weimar in New York City. Cocaine and poppers were plentiful and excess was expected--particularly in the West Village. There was also an endless stream of activity in the bathhouses and along the rotting piers from Christopher Street to Chelsea, where gay men congregated by the score for the kind of obsessive and anonymous sex that Kramer warned could someday kill them. "How many of us have to die before you get scared off your ass and into action?" Kramer wrote in the Native piece. "Aren't 195 dead New Yorkers enough?" In his first article on the subject, published two years earlier and less widely read, Kramer noted, "If I had written this a month ago, I would have used the figure '40.' If I had written this last week I would have needed '80.' Today I must tell you that 120 gay men in the United States . . . are suffering from an often lethal form of cancer called Kaposi's sarcoma or from a virulent form of pneumonia that may be associated with it. More than thirty have died."

Twenty years later, with AIDS established as the worst epidemic in human history, with no cure, with as many as fifty million infected, and with people dying every day throughout the world in numbers that cannot easily be absorbed, Kramer's distant cries seem almost meek. Yet the fear that he unleashed helped transform gay life; men who had always insisted that the government stay out of their lives took to the streets by the thousand to demand vigorous federal intervention on their behalf. No longer was it enough to press for the repeal of sodomy laws; homosexuals suddenly wanted benefits and protections that only Washington could provide.

Kramer's actions had even more profound effects: they helped revolutionize the American practice of medicine. Twenty-first-century patients no longer treat their doctors as deities. People demand to know about the treatments they will receive. They scour the Internet, ask for statistics on surgical success rates, and if they don't like what they hear they shop around. The Food and Drug Administration no longer considers approving a new drug until it has consulted representatives of groups who would use it. "In American medicine, there are two eras,'' Dr. Anthony S. Fauci, of the National Institutes of Health, told me. "Before Larry and after Larry.'' Fauci is the director of the N.I.H.'s program on infectious disease, and for twenty years he has been the most prominent voice in federal AIDS research. He has come to regard Kramer as a friend, but for many years he was one of Kramer's most vilified targets. "There is no question in my mind that Larry helped change medicine in this country," Fauci said. "And he helped change ...