Patient Zero and the Making of the AIDS Epidemic: Review

Patient Zero and the Making of the AIDS Epidemic
by Richard A. McKay
University of Chicago Press

Reviewed by Alina Oswald

Three decades and counting after the release of Randy Shilts’ And the Band Played On, maybe it’s time to take a brand new look at the story defining the first years of the AIDS epidemic, and to tell that story from another perspective—that of Gaétan Dugas, the so-called and mistakenly identified “Patient Zero” of the AIDS epidemic. That’s what Richard A. McKay, a Wellcome Trust Research Fellow in the Department of History and Philosophy of Science at the University of Cambridge, attempts to do in his debut book Patient Zero and the Making of the AIDS Epidemic.

Thoroughly researched, McKay’s Patient Zero sheds more light on who Gaétan Dugas was and explains the confusion that led to the words “Patient Zero” to be attributed to Dugas—that is, interpreting the letter ‘o’ for the digit ‘0’ and, hence Patient O (Out-of-California) for Patient 0 (Zero). Yet, readers who might pick up the book expecting to read Dugas’ story (like a biography of sorts) might not really get what they’re looking for. That’s because, while the Patient Zero book focuses, in part, on capturing a more intimate portrait of Gaétan Dugas—the man, the AIDS patient and, in the end, the AIDS activist—most of the book focuses on methodically deconstructing Randy Shilts’ And the Band Played On, in particular Shilts’ portrayal of Dugas.

That said, Dugas’ story needed to be told from Dugas’ perspective or from the perspective of those who knew him well, in order to right a wrong and help us revisit and reflect on the history of the early AIDS epidemic in North America; in particular to shed light on the confusion surrounding “patient zero” and its long-term implications and effect on how others have treated the epidemic as well as those living with the virus.

“The AIDS epidemic is far from over,” Peter Piot, founding executive director of UNAIDS and author of No Time to Lose [A&U, November 2012] comments on Patient Zero in an online blurb. “It is crucial that we understand both the history and the myths of AIDS.”

Alina Oswald, Arts Editor, is a writer, photographer and the author of Journeys Through Darkness: A Biography. Visit her online at