In the late 1980s, Dr. Jim Kublin was a medical intern at New York’s St. Vincent’s Hospital, the West Village epicenter of the U.S. AIDS epidemic. The now-closed hospital is the setting for key scenes in Tony Kushner’s award-winning drama about the period, “Angels in America.”
To prepare for an upcoming revival of the play, cast and crew from Seattle’s Intiman Theater recently visited Fred Hutchinson Cancer Research Center to meet with Kublin, now executive director of the Hutch-based HIV Vaccine Trials Network (HVTN). He and others involved in HIV research at the Hutch talked about the pandemic's early days and how things have changed—or not—since that time.
Intiman is partnering with the Hutch in presenting the play Aug. 12-Sept. 21 at Cornish Playhouse at Seattle Center.
“Intiman’s mission is to link what people see onstage to the real world in which we all exist,” said the theater’s producing artistic director, Andrew Russell, who is directing the play. “We want to get it accurate and present the high stakes.”
Kublin, 53, painted a vivid picture of what those dark early days were like: a hospital filled to capacity with dying patients no older than he was at the time—or than many of the young actors before him last week.
“It was devastating,” he said. “It stays with you forever.”
In the mid-1990s, antiretroviral therapy transformed HIV infection into a manageable chronic disease, at least for those who have access to and can tolerate the medications. But before then, being infected with the virus that causes AIDS was essentially a death sentence.
As a young intern, Kublin was training to save lives. He ended up learning other, unexpected lessons.
“By far and away the most meaningful work I did was helping patients—predominately AIDS patients—with their unfinished business before they passed away,” Kublin said. “I helped them communicate with someone or complete a task they wanted to do before they died. It was in many respects the most honorable work I’ve ever done.”
As “Angels in America” makes clear, not everyone responded with such compassion. People with AIDS were much more likely to be shunned out of fear or out of righteousness that the disease was punishment for being gay or using drugs. For that matter, even people who were healthy but openly gay were often treated like second-class citizens. When the play, subtitled “A Gay Fantasia on National Themes,” was first staged in the early ‘90s, a world in which gay marriage was legal in half the United States was unimaginable.
Known for producing socially relevant and challenging plays, Intiman became the first regional theater to produce the two-part, 6 ½-hour epic in 1994, a year after its Broadway debut. Russell expects that half the audience attending the revival next month will be long-time patrons who saw and loved the play 20 years ago. But the other half, he predicted, “[will] have never seen it, and don’t know much about the history, and don’t know much about what’s happening now.”
That’s where the partnership with the Hutch comes in.
The cast itself includes some who lived through that time and some who hadn’t yet been born. Veteran Seattle actor Charles Leggett, who plays closeted gay lawyer and right-wing warrior Roy Cohn, was a college freshman in 1985, the year the play takes place. He recalled the panicked rumors about how the deadly disease could be spread by casual contact.
“I remembered thinking, ‘Do I really want to live in a world where you can’t kiss?’” he said.
Adam Standley, who plays Prior Walter, a desperately ill gay man newly diagnosed with AIDS, was 2 years old in 1985. Standley quizzed Hutch scientists on how his character could have become so ill so quickly. It only seemed fast, he learned, because no one knew then that HIV can take up to 10 years to relentlessly destroy the immune system, leaving a person unable to fight off other infections.
The Hutch’s expertise in infectious diseases grew out of decades of research into treating infections in immune-compromised cancer patients. In 1987, researchers from the Hutch and the University of Washington established the Seattle HIV Vaccine Unit and began conducting one of the first HIV preventive vaccine trials. Today, Seattle is one of more than 30 cities on five continents in the HVTN, the largest publicly funded international collaboration working to develop a vaccine to prevent HIV/AIDS. In addition to its vaccine work, Hutch scientists conduct research on other methods of HIV prevention and on a potential HIV cure.
The stakes remain high. AIDS has claimed 36 million lives worldwide since the first cases were reported in 1981, and today an estimated 35 million are living with HIV, according to the World Health Organization. Sub-Saharan Africa is the hardest-hit region, accounting for 69 percent of infections. Although great strides have been made in getting antiretroviral drugs to low- and middle-income countries, an estimated 19 million people who need them do not have access to them.
At the same time, the very success of antiretroviral treatment has made the ongoing pandemic invisible to many people, at least in the United States, making a preventive vaccine seem less urgent. Yet a vaccine remains the best hope for ending the pandemic, said Jim Maynard, communications and community engagement director for the HVTN.
Maynard described how, before taking the HVTN job, he’d volunteered as a youth group advisor in Boston, training young gay, lesbian and transgender teenagers to teach their fellow high-school students about safe sex. He recalled being devastated when one of the kids he’d trained—a popular 16-year-old who was smart as a whip—became HIV-infected himself.
“He told me, ‘I now have this thing in me, what do I do? I’m 16,’” Maynard, near tears, told the actors and crew members. “Just like clockwork, there’s going to be 50,000 people in the U.S. this year going through that moment, 1,000 a day in South Africa alone. We can’t get medication to them fast enough.”
Volunteers are critical to finding an HIV vaccine. For more information or to find a study visit the VTU.
Mary Engel is a former staff writer at Fred Hutchinson Cancer Research Center. Previously, she covered medicine and health policy for the Los Angeles Times, where she was part of a team that won a Pulitzer Prize for Public Service. She was also a fellow at the Knight Science Journalism Program at MIT. Follow her on Twitter @Engel140.