THENEWYORKER,JULY27, 2020 49
Instead of going to the bars, you went
to an ACT UP meeting.” Those meet-
ings became the essential event of the
week in the Village. The numbers of
people attending quickly grew from a
few dozen to a few hundred. “Finally,
we were having a thousand people at
each meeting,’’ Kramer said, “and we
had to move to Cooper Union. The
motto plastered over half the walls in
New York was ‘Silence=Death,’ and we
were ready to start shouting.”
It is difficult to overstate the impact
of ACT UP. The average approval time
for some critical drugs fell from a decade
to a year, and the character of placebo-
controlled trials was altered for good.
The National Institutes of Health even
recognized ACT UP’s role in getting drugs
to more people earlier in the process of
testing; soon changes in the way AIDS
drugs were approved were adopted for
other diseases, ranging from breast can-
cer to Alzheimer’s.
“Before AIDS and before ACT UP, all
experimental medical decisions were
made by physicians,’’ Anthony Fauci said
one afternoon this winter, when I vis-
ited him at the N.I.H. campus. “Larry,
by assuring consumer input to the F.D.A.,
put us on the defensive at the N.I.H.
He put Congress on the defensive over
appropriations. ACT UP put medical treat-
ment in the hands of the patients. And
that is the way it ought to be.’’
ACT UP’s success did nothing to mel-
low Kramer; on the contrary, it seemed
to validate his approach. In speeches, in
public appearances, and in writing, he
put forth two views of the universe: his
own and that of the liars, Nazis, and
murderers who opposed him. (When
Yale refused to accept his papers and a
large donation to create a chair in gay
studies, Kramer accused officials there
of every crime from homophobia to Na-
zism. Not until 1997, when the univer-
sity agreed to accept a million dollars
from Kramer’s brother and establish the
Larry Kramer Initiative for Lesbian and
Gay Studies, did he back off.) Today,
he says that such tactics were always
necessary; others aren’t so sure. “If you
call someone who is not doing enough
in some bureaucracy a murderer, what
do you do when somebody is stabbing
someone in the street?’’ the writer An-
drew Sullivan asks. Sullivan is gay,
H.I.V.-positive, and conservative. “Once
you debase the currency of language,
how do you have somebody take you
seriously? Can everyone be evil all the
time? Is everyone a Nazi?”
There were also problems with the
ACT UP approach to distributing medi-
cine. Easing federal regulations was nec-
essary. But scores of drugs were made
available and used widely before they
had been tested long enough for scien-
tists to know if they would ever work.
(And, if they did work well, it was im-
possible in such a short trial period to
assess the way they interacted with other
medications or how long their benefits
would last.) Nonetheless, the speedy new
timetable changed the course of the ep-
idemic in countries rich enough to sup-
ply those drugs. Sophisticated antiretro-
viral medicines now make AIDS a chronic
but relatively manageable disease for
hundreds of thousands of Americans.
Kramer’s tendency to look for the
dark side prevents him from finding
much value in this. “Kids don’t see the
dangers of AIDS anymore. It’s not that
they don’t care, but they know they are
not going to fall over dead quite as fast
as we fell over dead. I am seen again as
a prude. I always will be.” It is true that
just a few years ago a bathhouse opened
down the street from G.M.H.C.; in
some places, particularly in San Fran-
cisco and Miami, there are even groups—
Sex Panic is the best known among
them—that argue that gay men spend
too much time worrying about public
health and not enough about their sex-
ual rights. It is also true that AIDS is no
longer an absolute death sentence, and
that has, naturally, caused people to relax
their vigilance. These days, once again,
Kramer finds himself attacked more
often by the left—and the gay world—
than by conservatives. “I see the statis-
tics suggesting that drug resistance is
increasing, that young men are getting
infected at higher rates and ignoring
safe sex, and it makes me feel like I
wasted my life. These kids better learn
how to scream, because being sweet
won’t work. That much I know. Honey
doesn’t get you a fucking thing.”L
ast December 21st, a forty-five-year-
old man from Allegheny County,
in Pennsylvania, died of a brain embo-
lism. Within a few hours, Kramer was
in the operating room, ready to receivehis liver. The surgery lasted thirteen
hours, and afterward I heard only dis-
quieting reports from the team at the
University of Pittsburgh. The opera-
tion was more complicated than ex-
pected, Kramer was in critical condi-
tion (which is natural after transplant
surgery), and it would be a while be-
fore anyone could tell how he would
do. Then a headline was sent out by
one of the wire services: “AIDS ACTIV-
IST LARRY KRAMER DIES.”
The story itself, however, stated that
Kramer seemed to be doing fine. The
headline was one of those mistakes you
get to cherish and put on your office wall.
Before it could be retracted, however,
tens of thousands of people got the news
that Kramer had died. In fact, Kramer
was out of intensive care in days and
walking in less than a week, and by New
Year’s Eve he was calling to wish me well.
He will remain in Pittsburgh for at least
another month, while the doctors bal-
ance the complicated mixture of drugs
required to keep his H.I.V. in check with
the drugs needed to keep his body from
rejecting the new liver. (When I told him
I didn’t think I would be back there be-
fore writing this article, he responded
immediately, by e-mail, in capital letters:
“HOW CAN YOU WRITE ABOUT ME IF
YOU HAVEN’T EVEN SEEN MY SCAR?”)
He has bad days, but his recovery
has been rapid. To see that, I have to
only look at my in-box—he can fire off
dozens of e-mails an hour. The doctors
took out his last tube in April. Lately,
he has been working on his novel again
and dreaming of returning home to
New York and, especially, Connecticut.
But, increasingly, he has been talking
about the shortage of organs in the
United States and how “politicians don’t
take it seriously and what an incredible
outrage it is for somebody to die be-
cause they can’t figure out a system in
this country to supply organs.’’ The
tempo of questions has quickened as
his health improved: Did I know how
many goddam organs are just tossed
into the ground each year, killing peo-
ple, killing hope? Did I know that in
many other countries you are presumed
to be a donor unless you opt out? Here
it is the opposite. “Somebody needs to
be fighting about this,’’ Kramer told me
not long ago on the telephone. “Some-
body needs to just get up and explode.”