Dr. William Darrow (Session 2)

CHAMBERLAND: This is Dr. Mary Chamberland, and I am here with Dr. William Darrow at the Centers for Disease Control and Prevention in Atlanta, Georgia. The date is November 6, 2017. I am interviewing Dr. Darrow as part of the oral history project The Early Years of AIDS: CDC's Response to a Historic Epidemic. This is the second interview with Dr. Darrow. Dr. Darrow, do I have your permission to interview you and to record the interview?

DARROW: Yes, you do.

CHAMBERLAND: Bill, during our first conversation we ended in the midst of your recounting of what became known as the Los Angeles [LA] Cluster Investigation. To briefly reset the scene, it's March-April 1982, and there's still some uncertainty as to how this new disease is being transmitted. The Los Angeles CDC [Centers for Disease Control and Prevention] EIS [Epidemic Intelligence Officer] Officer, Dr. David Auerbach, had reported to the Task Force in Atlanta that he had become aware of four men in LA with AIDS [acquired immunodeficiency 00:01:00syndrome] who had been sexual partners. You and Dave then set out to assess the social and sexual relationships for as many as possible of the 19 cases of AIDS in gay men that had been reported in Los Angeles at that time. Ultimately, you obtained information through interviews for 13 of the 19, and among the key findings you established sexual links between 9 of those 13 cases.

Four of the men, interestingly, named one man as a sexual partner. He was not from California. He was a Canadian air steward who had been reported out of New York City as an early AIDS case. Because this man appeared to link cases in New York City and Los Angeles, you extended the investigation beyond Los Angeles. Ultimately 40 cases of AIDS in 10 cities were linked to this one individual 00:02:00through sexual transmission. Lots of cases, lots of sexual contact, spread out over lots of cities. In the first interview, you described how you developed a diagram to illustrate all of this. Can you recap for us how you graphically diagrammed these linkages between the men in the cluster? It was a lot of information to try and condense down into something visual that people could take in.

DARROW: Indeed, that was. A major problem was to (decide) how to represent these linkages between men from different parts of the United States, to try to illustrate how they might have become infected, become very seriously ill and later on died. I was very fortunate, because after completing my master's degree (requirements) in sociology at the University of New Hampshire (in 1967), I came 00:03:00back to CDC. I wanted to continue studying the social and behavioral aspects of sexually transmitted diseases. A gift was given to me by [Mr. William C.] Bill Watson, which I think I mentioned in my last interview. Bill came into my office one day and said to me, "We've had a lot of social and behavioral scientists come to CDC as consultants to advise us on how we should proceed with our epidemiologic and other kinds of research, taking advantage of sociology, anthropology, psychology, the other social sciences, but we have found their advice--their suggestions--to be less than satisfactory, because they really don't know CDC and how we have to operate. They don't know the political climate, how we have to adapt. We've decided that instead of getting outside consultants who don't know anything about CDC, we're going to have somebody from 00:04:00CDC go back to school, get a Ph.D. in the social sciences, and then continue on as a staff member. We'd like for you to be that person." He asked me to walk on down the street to Emory University and get enrolled in their sociology program, which I did.

While at that sociology program, I had the good fortune to take a course in social research methods. It was during that methods course that Professor [Martin L.] Marty Levin talked about his work with Dr. James [S.] Coleman at Johns Hopkins University and later at the University of Chicago. Dr. Coleman was a social scientist who wanted to use mathematics, and later he wrote a book on mathematical sociology that Marty Levin, as a graduate student, helped him with. Before that he worked on another study called The Adolescent Society. In The 00:05:00Adolescent Society he came up with this measure of connections between, in this case, high-school students, and he called it the "homophily index." Professor Levin introduced us to the work of Dr. Coleman, Dr. James [S.] Coleman, and told us about the homophily index, how to calculate it, [and that] we might want to use that in our research. He also told us about another book called The Adolescent Society, which he advised us to read in preparation for our comprehensive exam. I got a copy of The Adolescent Society, read it, and I think it was in chapter 6 where associations among high-school students were illustrated with something called "sociograms." This is the way they illustrated it: by showing nodes in a social network -- those were the people -- in circles and then lines of varying distance and various density to show the nature of the 00:06:00connections. I had that information as a graduate student at Emory, getting a Ph.D. in sociology, when I graduated in 1973 and came to work for CDC.

It took, of course, a few years later before I could see how it was relevant to what we were doing in the early 1980's, as you say, in March and April of 1982, when we started collecting information about the relationships between men that included sexual relationships-- some of which occurred in the not-so-distant past and others quite distantly, four or five years in the past. We didn't go beyond that, Mary. We had no idea the length of incubation, how long it was going to be between exposure to an agent -- if indeed an agent was involved -- and the manifestation of symptoms. It took quite a bit of work later on. We 00:07:00guessed, and based on what I knew about sociology and sexual relationships, most people can't remember what they were doing in the past month or the past year, never mind the last ten years. We really didn't explore too much beyond three or four [years]: "Can you remember five years ago?" Those were the kinds of questions we were asking. We were exploring their sociosexual relationships: how many different partners did you have in the last week, in the last month, in the last year? Can you remember in the last five years? That kind of thing, before we got around to the business of, can you remember any of these people, what were they like, where do they live, where did you meet them, and then eventually around to the point of naming names.

Once we started getting these names, which I talked about last time and can talk about some more, we had to illustrate this in some way that we could show our colleagues at CDC, so they could see the patterns that were beginning to emerge. That's when I remembered my work in graduate school with Professor Levin -- the 00:08:00homophily index, mathematical sociology, sociograms, sociosexual networks. With the information that we initially collected in Los Angeles, Dr. Auerbach and myself, and then with colleagues in New York-- and you were working in New York at the time, so you knew many of these people. I tried to illustrate this to my colleagues here at CDC, initially in the form of the sociograms, and they seemed to work quite well. It was quite convincing to some of them. Others, of course, were skeptical. They should be; they're scientists. But some could see, wow, now we begin to see the patterns. It began to make sense to some of my colleagues here.

CHAMBERLAND: A person was depicted as a circle.

DARROW: A circle, right.

CHAMBERLAND: And then lines were drawn to connect them to sexual partners.

DARROW: Right.

CHAMBERLAND: I remember looking at the diagram that was subsequently published, 00:09:00and in some ways, it almost looked like an organic chemistry molecule, if you will. Then I recalled that in the circle you indicated by abbreviations the -- I guess it was the location of their diagnosis?

DARROW: No, it was the diagnosis, because even then we didn't know if the cause of Kaposi's sarcoma was the same as the opportunistic infections or CMV [cytomegalovirus]. They had these different manifestations of what we later on called "acquired immune deficiency syndrome." All of this was happening at the same time. One of the questions was, are these cases really connected? Some are developing cancer; some are developing opportunistic infections. At the time, the disease was known as Pneumocystis carinii pneumonia. A lot of patients were developing this, as well as some other very strange diseases. They seemed to be linked by this underlying immunosuppression, but we didn't know. So, I indicated 00:10:00the cases by number -- Los Angeles 1, Los Angeles 2, in terms of sequence of diagnosis, and then by color -- purple if it was Kaposi's sarcoma, yellow if it was CMV or something like that. Both of those things were indicated, you're absolutely right. Then the lines were to show that there had been within the past five years at least one sexual contact that could be confirmed. That is, it wasn't just tale-tell that A would name B. If A would name B, we made every effort we could to talk to B or somebody who knew about B to see if B would rename A, so that we could confirm the link. That [way] it wouldn't just be hearsay evidence, but there was some solid evidence that indeed there was an exposure.

CHAMBERLAND: How did you deal with the individual who had been named by several 00:11:00people as a sexual contact, the man that appeared to link the cases between New York City and Los Angeles? Ultimately 40 cases of AIDS in ten cities linked back to this single individual. You say all of them had named him as a sexual partner, and I presume he named them as a partner based on what you said. How did you designate him in this diagram of relationships?

DARROW: Let me go back a little bit to say that in March 1982, Dr. David [M.] Auerbach called [Dr. James W.] Jim Curran or [Dr.] Harold [W.] Jaffe or somebody on the Task Force and said, "You won't believe this, but one of the men that I talked to recently said there are three different men that he knows very well, all dying of the same constellation of immunosuppressive disorders. All of them are in the same hospital at the same time, and they all have had sexual contact 00:12:00with one another." That was three of the four that you mentioned in your introduction. Dave already knew about those.

Then the response came. "We really need to follow up on this. How about other people in the area? Are they also involved with these three or others?" Dave said, "I haven't gotten that far yet." They said, "You might need some help with this. Is it okay if we ask Bill Darrow to come out and help you?" He said something to the effect of, "Yeah, I can use all the help I can get." I was asked to go join Dave. As you say, there were 19 cases that he knew about in the Southern California area-- 13 were either alive or there was somebody who knew very much about their intimate sexual behavior. We tried to talk to all 13, Dave and I together, so we could hear and help each other out, you know, "You said this," and so forth. All of those interviews were done by the two of us on one day. I think it was April 6, 1982, but I really need to have that confirmed. It 00:13:00was something like April 6, 1982. Dave had set up three interviews, two at the West Hollywood Health Center and a third in Orange County, with three different men who had never met, but all of whom were among these 19 who had been diagnosed.

The first one--I can remember them all--the first one we interviewed was trying to be as cooperative as possible, and then we got to the point, "Can you remember any of the people that you've had sex with-- do you remember their names or something about them?" The first one said, "Yes, one of my former sex partners was this extremely handsome, lovely young man who flew for Air Canada. He was a flight attendant." The second man that we also interviewed in the same facility early in the afternoon was a flight attendant himself. He worked for another airline, and he said, "Yes, I've had sex with other airline stewards, 00:14:00including this extremely handsome French-Canadian guy that flies for Air Canada." Two of them mentioned this person on the same day.

That night -- Dave and I were tired, and this is written up in Randy Shilts' book [And the Band Played On] -- we were tired, and he said, "I'm so tired, and I'm so hungry. Let's stop in Chinatown on our way out to Orange County and get something decent to eat, because it's going to be another late night."We were trying to get all this work done in a week to save the government money, of course. So we did. We had this nice meal in Chinatown. Then we went out there, and we met this fellow who had recently been diagnosed with Kaposi's sarcoma. He was very nice, and we sat at his picnic table -- he had a picnic table inside his house -- and we sat there talking to him. We got around to the point, "Can you remember any of the people that you've had sex with?" He said, "I remember somebody very well because I had sex with him twice. The first time I had sex 00:15:00with him, I'm pretty sure he gave me hepatitis B. The second time I had sex with him, I'm pretty sure he gave me this disease that I've just been diagnosed with." We said, "Okay, can you tell us who he was? Can you tell us anything about him?" "Oh, yes, he's a very handsome guy. You know what, I've got his name and telephone number in my address book. Give me a few minutes; I'll go find it." We're sitting there, Dave and I are talking, and he comes back and he's got this name, and he says, "Here it is." When he tells us the name and tells us about him, I remember I dropped my pencil, and Dave almost fell off his chair. I think he did actually fall off his chair. You'll have to ask him. We looked at each other with our mouths open and said, "How could this be?" The same person is named three times. Later on when I came back [to Atlanta] I looked, and I noticed that [Dr.] Mary [E.] Guinan had interviewed this guy in New York, and he was Patient #57.

CHAMBERLAND: New York City case 57, or CDC case 57?

DARROW: No. AIDS case 57--

CHAMBERLAND: --the national case number.

DARROW: --because we counted them consecutively, so the first case that CDC found out about was patient #1. So, he was the 57th person reported. When I had to write this up, we had 19 cases in Los Angeles, so we called them LA1, LA2, LA3, based on the date of diagnosis. The earliest diagnosed case I changed from whatever it was-- it might have been 335 or something like that, to LA1, LA2. What are we going to do with this guy who's not from LA? I said, " Let's call him the out-of-California case, because we know he's out of California. He appears to be a French-Canadian living in New York. He travels a lot, but let's just call him the out-of-California case. Let's call him Patient "O" for outside of California."

Then we have this "O" that connects two parts of the cluster, which is very 00:17:00important. You say nine patients were connected together, but four were connected together and five were connected together. We couldn't put the four and the five together without this patient who came from outside of California. Initially we called him "Outside of California." I have a document I can show you where I scratched out patient 57 and circled the letter "O" to designate him. Then when I started talking to my colleagues at CDC, I referred to him as "Patient O," the outside-of-California case. Everybody said, "Oh, yes, "Patient Zero." I remember you reporting about this." Very quickly his identification transferred from Patient O to Patient Zero. It happened within a matter of weeks, if not months.

CHAMBERLAND: Oh, really?

DARROW: Yes, everybody on the Task Force was referring to this guy named Patient Zero. I said, "Who are you talking about?" "We're talking about the guy you described." I said, "I described him as the out-of-California case." Then I had 00:18:00to give up. By then he had a nickname, so I started calling him Patient Zero.

CHAMBERLAND: The first, really initial, if you will, transformation of Patient O to Patient Zero happened within conversations, discussions about the LA Cluster Investigation within CDC?

DARROW: Yes.

CHAMBERLAND: I didn't appreciate that, because I thought it originated outside of CDC.

DARROW: No, it happened inside CDC over the ensuing months. By the time we wrote it up and published it in 1984 --let me go back. There was an MMWR [Morbidity and Mortality Weekly Report] article that came out shortly thereafter.

CHAMBERLAND: June '82.

DARROW: Exactly right, but that was just the LA cases. The next step was to develop a protocol and instruments and get clearances and permission from the New York City Health Department to follow up on this lead, because this out-of-California case was not living in California, obviously, no longer living 00:19:00in Canada. He was living in New York at the time. We wanted to follow up, and we learned very quickly that he was a patient of Dr. [Alvin E.] Friedman-Kien's, and he was being followed for Kaposi's sarcoma there. As I told you yesterday, he was initially diagnosed in Canada, and he had lymphadenopathy. He was diagnosed with lymphadenopathy as early as 1979. When I looked at the medical records that Dr. Guinan had gathered, he was complaining of swollen glands as early as 1976. I don't know if that was connected with hepatitis or some other illness, but on his medical records he had a long history of having health problems.

CHAMBERLAND: The MMWR did not contain a diagram in it. It was just text. That initial diagram that was put out in the public domain was in the American Journal of Medicine article that appeared in 1984, I think it was.

DARROW: Right, 1984, yes.

CHAMBERLAND: That did have a diagram, and in that diagram the node that represents the Canadian air steward who's linking the two coasts, if you will, in terms of cases via sexual contact, his code is not an "O" for patient outside-of-California.

DARROW: It is a zero.

CHAMBERLAND: Do you know how that transformation occurred?

DARROW: I don't.

CHAMBERLAND: You have to look carefully, because the fonts are such that, I mean I literally pulled out a magnifying glass when I re-looked at that paper, to convince myself that I was reading the number zero and not capital --

DARROW: I probably had an "O," because I tried to use the "O" as long as possible.

CHAMBERLAND: You formally referred to him in documents or presentations as "O," Patient O?

DARROW: As the out-of-California case, right, because LA1, LA2, "O" makes sense. I mean, they're letters.

CHAMBERLAND: Right, exactly, right.

DARROW: To me, it made sense to me. There was this baseball player named Lawrence Berra. Everybody knew him as Yogi. After a while you don't call him Lawrence, you call him Yogi, and that kind of thing happened with this Patient Zero story. After a while I gave up. You want to call him Patient Zero? Fine with me. We'll call him Patient Zero.

CHAMBERLAND: Right, OK.

DARROW: It was never meant to mean that he was the origin of the epidemic, that he was the first case. We never intended that. We just wanted to show that there were connections among these men based on sexual exposures, suggesting that this might be a sexually transmitted disease. We didn't even want to suggest that one infected the other, because we had no data to prove that. We couldn't; it was all retrospective. We didn't want to push the envelope more than we should have. We tried to be very honest and very straightforward, but look, this data was so 00:22:00convincing to some of us that you had to begin to think that it wasn't nitrite inhalants that was causing the problem. It wasn't a genetic defect. It really looked like an infectious agent.

CHAMBERLAND: Transmitted sexually--

DARROW: Yes, if it looks like an infectious agent, hey, let's pursue that angle. Let's stop following paths that are not going to lead us anywhere. I think that was generally the way the thinking went after the LA Cluster Investigation and the illustrations of these connections.

CHAMBERLAND: Indeed, in the American Journal of Medicine article particularly, and somewhat in the MMWR, you do have text in there that states what you just did: that this is not to imply that we have identified this central node in our 00:23:00diagram as being the origin of [or] even the source of infection for people in this cluster, let alone nationwide. That was described. However, perceptions about this man and his role in the epidemic certainly took on a life of their own, if you will, because the moniker, Patient Zero, that you and your colleagues used when discussing him, as you said in-house at CDC, began to be used in the more popular media and press, and particularly, in the book that Randy Shilts, this gay San Francisco journalist, wrote in 1987. In "And the Band Played On," he also refers to this case as Patient Zero. There was a subsequent HBO [Home Box Office] movie based on the book, and Patient Zero is a central 00:24:00figure in this. When Randy was writing his book, did he contact you and others at CDC for information? Not just about the Cluster, but certainly that would have been an area he was interested in. Did you all talk with him?

DARROW: Yes, we did. He called here quite a bit. He was working for the San Francisco Chronicle at the time. He was an investigative reporter, and his beat was AIDS. As far as I know, he was the first person who was assigned to look at all the aspects of the AIDS epidemic. I think his assignment went back to 1982. It was very early in the sequence. He started calling people, including me and other members of the Task Force from 1982 on. He also came to CDC. He made a visit, and he arranged that visit with the Office of Public Affairs, I believe 00:25:00it was called at the time. [Mr. Donald A.] Don Berreth was the main contact at CDC, as far as I was concerned, our head information officer.

CHAMBERLAND: Right. He was the head of that office.

DARROW: Don Berreth talked to those of us who had been working on the Task Force and said, "Look, this investigative journalist, Randy Shilts, is coming. He wants to speak with you, and I want you to speak with him. He wants to have private one-on-one interviews. He may ask you to tape them. I hope you'll consent, and I hope you'll be extremely truthful and honest with him. Don't hold anything back." I very much admired that position that he took, because at the time there was a lot of controversy in the press and in the public forum and even in Congress about what was going on, this gay disease, all kinds of stigmatizing comments and so forth. But he wanted us to be very open and 00:26:00transparent. Yes, many of us spoke with Randy when he came to collect information for his book. I spoke with him in private, one-on-one, during that period of time.

CHAMBERLAND: You did.

DARROW: I did. He said, "Do you mind if I record this?" I said, "Quite frankly, I'd rather that you not. What I would prefer is that you take notes, and that before you quote me directly you give me the privilege of at least reviewing your notes before it becomes public record. Will you do that?" He said "Yes," and he kept his promise. He sent me segments of his book before it went to publication, and I had a chance to comment. He changed some things; other things he didn't change. I remember one of my major recommendations was, "Randy, I don't think you should be naming all of these people."

CHAMBERLAND: He used real names.

DARROW: He used real names. I said, "You can name me, and you can name other members of the government. You know, we're fair game. You can quote us if you've 00:27:00got the quotes, but you shouldn't talk about people that you met in bars and bath houses as part of your public life in San Francisco. I don't think that's appropriate. I think you should use pseudonyms." He said, "I can't do it. I can't do it. This has to be all-truthful. I'm going to take my role as an investigative journalist, and I'm going to do it." I said, "Okay, but that's your decision. My suggestion to you is that you not do it." I didn't like that. I didn't think it would be appropriate.

CHAMBERLAND: He questioned you about the LA Cluster?

DARROW: In great depth.

CHAMBERLAND: In great detail.

DARROW: Yes. I can remember it, because David Auerbach said, "Oh, you're going to talk to Randy? I've already talked to him, and he knows everything." Then David said after a brief pause, "Everything."

CHAMBERLAND: Ah, ah. Yes, he had the names.

DARROW: He had already gotten it from some other place.

CHAMBERLAND: He had gotten it from some other source. Can you recall if at the 00:28:00time he was referring to this Patient Zero or--?

DARROW: No. I don't think he did. I think he referred to this French-Canadian airline steward. "I understand you met him and talked with him." I said, "Yes, in New York, not in Los Angeles." He knew a great deal about this. It wasn't so much, I think, because we had been talking to reporters and the public. It was the in-house communication and also with our colleagues in the Los Angeles County Health Department and San Francisco and New York. You worked in New York. I mean, those of us working for CDC were communicating constantly, as you may recall. We tried to be very circumspect, and we tried not to use names. We tried to protect the confidence of the information that we had. But sometimes in order to expedite the investigation, we did use names-- had to, in our conversations. 00:29:00Or we used the patient numbers, you know, Patient 57, it would have been. It wouldn't have been LA1 or Patient Zero or Patient O. I don't remember talking to him about Patient Zero, but I do remember talking to him about the LA Cluster and the follow-up work that I did in New York until I was assigned to do other things.

CHAMBERLAND: Do you think Randy's book "And the Band Played On" contributed to this wider dissemination of this individual being known as Patient Zero?

DARROW: Oh, definitely, because he names him, and he describes him throughout the book.

CHAMBERLAND: Right, and he calls him Patient Zero--

DARROW: Then he gives his name, the name that he had, so that everybody knows this person now by his name, not by -- Do you know, there was a book that was published by [Ann Giudici] Fettner and [William A.] Check in 1984, called "The 00:30:00Truth About AIDS." In there, there's a discussion of this French-Canadian airline steward who had many different sex partners. They say, "Let's call him Eric." They used a pseudonym in 1984, three years before Randy published his book. Then they go on to tell the story of Friedman-Kien being in San Francisco talking with Dr. Marcus [A.] Conant, and Dr. Marcus Conant telling Friedman-Kien on the telephone, or I guess it was in person at the time, "Oh, yes, I met this guy, and he's got a date with one of our doctors here." In the book by Fettner and Check, Friedman-Kien allegedly called his colleague, [Dr.] Linda [J.] Laubenstein, in New York at NYU [New York University] Hospital and said, "I found our 'Typhoid Mary.'" But [it] calls him Eric. It doesn't call him Patient 00:31:00Zero, doesn't call him the out-of-California case, doesn't call him Patient 57. Calls him Eric. A pseudonym.

CHAMBERLAND: Again, just trying as best we can to look back and see how Patient Out-of-California becomes Patient Zero. To recap, within CDC in-house discussions, the moniker Patient Zero was used, but in official publications that tag was never used. He was never referred to as Patient Zero in any of the documents that you published --

DARROW: Not before 1984. In '84, it looks like Patient Zero but it's not spelled out z-e-r-o. It was never spelled out z-e-r-o.

CHAMBERLAND: I was going to say that. In the American Journal of Medicine 00:32:00article that...

DARROW: --there is this circle--

CHAMBERLAND: --in the diagram he's called, it says Patient --

DARROW: -- oh or zero.

CHAMBERLAND: -- oh or zero. There's a key. You have a key where you explain the abbreviations: LA equals Los Angeles, SF equals San Francisco. I think the number zero is identified as "index patient, index patient."

DARROW: Yes. Let me explain that, because it didn't mean that he was the first case. What it meant was, it would have been impossible to connect cases between the West Coast and the East Coast without the information that he provided. That's the other thing. He was more generous than anybody else in providing information to me and to other members of the Task Force. He was very open. I think I recounted last time about how, after I met him and interviewed him in person in Dr. Friedman-Kien's office, he told me that he had an address book 00:33:00with all the names in it. I said, "Oh, I would like very much to see that. May I go back to your apartment?" He said, "Oh, no, no, no, I've got other things to do. I've got errands to run, but I'll call you and I'll tell you the information that's in there." I said, "Okay, fine, when are you going to call me?" He said, "I don't know." I said, "Can I call you?" He said, "Yes, but you can only call me between 6:00 and 6:30", and I said, "Okay, fine, I'll call you around 6:00, and then you'll give me this information?" He said, "I'll be glad to. I'll be at my apartment then. I've got to go out tonight, but we can do it then." I called him from Grand Central Station while I was waiting for a limousine to take me to the airport to return to Atlanta, to CDC. I was able finally to get one of those pay phones and to speak with him. I actually wrote down all the information that he gave me at that time while waiting for the limo. Then he said, "6:30 is here. I've got to go." I got the names of I think it was 73 different people, or I got 00:34:00some information about phone number, a nickname, something. I could see that they were from all over the country. They were from Texas, they were from Georgia. They weren't just from California or New York, although most of them were from California. He had recently updated his book, and if he hadn't done that, I might have gotten 100, 200, 300 different names. Nobody else had provided such extensive information.

CHAMBERLAND: I was going to ask you about that, because after the release of the book and perhaps other media, public press, Patient Zero was portrayed as a real villain, a scapegoat, someone who was knowingly spreading disease to his partners. I wanted to ask you about, in terms of your interactions with him, did 00:35:00he come across as someone like that? It sounds very different.

DARROW: No, not at all. He came across as a person who was very much concerned about his own health, about the health of others, because he knew many other people who were very sick and some who had already died. I think the last thing he wanted to do was to spread the disease to others. I said to him, "You know, we don't know for sure what's causing this, but it's increasingly looking like an infectious agent, a pathogen, a germ, something that's being spread from one person to another through unprotected sexual activities." He said, "Whoa, what are you talking about? I've got cancer. There's no cancer that spreads by sexual contact. What are you talking about? This is not gonorrhea, this is not syphilis." Now, he wasn't using those terms, but that was what was going through 00:36:00his head. I said, "Just because we haven't found any link up to this point doesn't mean it's not possible. We now have to consider the hypothesis that this is a sexually transmitted disease. You could have gotten it from somebody else; you could give it to somebody else." He says, "Oh, my God, if that's true, that's awful, but I don't think it's true. It can't be true because, you know, you're going too far now essentially." He was very skeptical of that. I was unable to convince him that he should change his sexual behavior. That wasn't part of our interview. We talked for an hour and a half or so, and then we had to end. At the time, he wasn't convinced that it was sexually transmitted. From what I understand, other people did confront him directly, including some medical officers in public health, and said, "Look, this is sexually transmitted. You've got to stop." And he said, "I'm not convinced. I don't think 00:37:00so," from what I've heard. But that didn't happen in our conversations, and I did speak to him a number of times after that on the phone. I never met him again face-to-face, not even when he came to CDC.

CHAMBERLAND: He came to CDC for what reason?

DARROW: He was called back to donate specimens. I think it was Dr. Harry [W.] Haverkos who was instrumental in getting him to come to CDC to collect all kinds of specimens. At the time we thought that he might be a transmitter, and it might be something biological that we could find that might suggest why he was transmitting. I don't know exactly when that happened. I don't think it happened before 1985, when we were pretty sure what the agent was. As early as '83 it was looking like there might be a virus involved, from the work that was being done at the Pasteur Institute.

CHAMBERLAND: That was very prescient, if you will, for Harry Haverkos to have 00:38:00him come to CDC and donate blood.

DARROW: And other specimens, too.

CHAMBERLAND: And other specimens. The myth of Patient Zero persisted for years, decades. I went back and was looking at excerpts from Randy Shilt's book, "And the Band Played On," and I came across this quote. He writes, "Whether he [Patient Zero] actually was the person who brought AIDS to North America remains a question of debate, and it's ultimately unanswerable." [It]turns out it was possible to answer that question. New research that was published in the journal Nature, in October of 2016, so about a year ago, using advanced molecular genetic analyses, going back to the out-of-California case specimen and other 00:39:00specimens from early AIDS patients that were available, using these techniques, definitely established that so-called Patient Zero was far from the first or even a very early case of HIV [human immunodeficiency virus] infection in the United States. It turns out, and you obviously know this, Bill, HIV had been silently circulating and infecting people in the United States for more than a decade before cases were first recognized in 1981. What was your reaction to the study's findings in this major article that combined epidemiology and these genetic analyses?

DARROW: As a scientist, I was grateful to see them, but there had been some earlier reports that had been published based on specimens from patients seen at the University of Miami, mostly Haitian patients, and then there was another 00:40:00follow-up study. Actually, studies of this kind had been going on for at least 15 years. I think Dr. [Michael] Worobey was part of these studies. Of course, the techniques improved over time, and so more definitive results were forthcoming. I was very happy to see this, because, as I said earlier, we never cared about the first case. I do care about when the virus first came to the United States, and the evidence that's available now suggests it was probably around 1968, maybe give or take a year or two, and [it] probably came from Haiti to New York City. It was in New York City for some time. Some of the anecdotal information that we have from studies of injection drug users and other populations seems to support that, that it arrived in New York around 1968 or so 00:41:00and infected a few people but probably didn't get into the gay population until a little bit later than that-- how soon we don't know.

One of the things that I found when I was looking through my materials was a very interesting letter from somebody who had seen that Candy Darling died in 1973. Candy Darling was part of the Andy Warhol group that was here in New York at the time and was in some of his films. Candy Darling died in 1973 and had cancer and some mysterious infections, apparently, according to this obituary that was clipped out and sent to CDC and that I have in my files. The question is, could Candy Darling have been one of those early cases? You know, that's 00:42:00kind of interesting. It might have been, but there might have been lots of others. All of that is now seemingly possible, but we don't have specimens. I mean, how are we ever going to prove this or disprove it? We can't.

But it is interesting to speculate. About the French-Canadian steward, it didn't seem possible for him to be the early case, because he was 21 years old and working at a hair salon when he decided to become a flight attendant. I think it was in Quebec, he was still in Quebec, where he was born and raised, in 21-- at the age of 21, and this was 1973. Then he decided to go to Vancouver to learn English a little bit better so that he can apply and become an airline steward. I don't believe he started flying until 1974. He could have been infected in Quebec City, but it's much more likely he didn't until he moved to Vancouver. He 00:43:00was one of the first cases ever found in Vancouver or connected with Vancouver, but more likely even in '74. He was diagnosed with lymphadenopathy five years later and Kaposi's sarcoma six years. Now people say, that's not impossible because the average [incubation] time is 8-10 years. Back then there were some cases who developed very early on, as you may recall. There was even a case from Australia where the exposure date and the onset of AIDS was about a month. There were some very unusual cases like that, but it just didn't seem to fit that he would be the first case. It never seemed that way to me. I was very happy to see all of this additional evidence discounting that. I think it's just a shame that his family has had to suffer the stigmatization that seemed to come with it-- with people casting aspersions and pointing blame at this person who, if he 00:44:00hadn't cooperated with us and hadn't done some of the things that he had done, we might still be trying to find out answers to questions. It's regrettable.

CHAMBERLAND: This Nature October 2016 publication generated a tremendous amount of media interest -- television, print, lots of headlines about "Patient Zero myth debunked," whatever. You, I know, were interviewed several times about this. Were you surprised that this was such a splash?

DARROW: I was. I was surprised, but I think Donald [G.] McNeil, Jr.'s article in the New York Times gives a clue as to why. In his article about the ethics of finding Patient Zero, he raises the question, "Why are we so curious about the first case? Why do we want to know who's responsible for these epidemics?" That 00:45:00seems to go back-- well, Typhoid Mary, of course, didn't start the typhoid epidemic. At the time she was diagnosed, there were about 500 other cases. Why is everybody so concerned about Mary Mallon, this horrible person who was spreading typhoid, when other people had typhoid and were spreading it around? There's a long history of trying to cast blame on some person or some event or some thing and say, if that hadn't happened, then we wouldn't have these problems. I think Donald McNeil, Jr.'s article in the New York Times does a wonderful job of describing that. He talks about influenza epidemics, he talks about the Ebola epidemic, and how each of these has been traced back to a certain place, a certain person and so forth. A book recently was published on The Great Influenza epidemic, the Spanish Flu, of 1918 and 1919, and where did that begin? It began in the Midwest--Kansas, of all places, but nobody got 00:46:00blamed for that except the Spaniards. The Spaniards got blamed for it because they didn't have many cases. It's ironic.

CHAMBERLAND: It is ironic.

DARROW: I was very much surprised, but I think Donald McNeil's article goes a long way toward explaining it. Whenever there's a disease, somebody wants to say, okay, who's at fault.

CHAMBERLAND: Fascinating, Bill. I'd like to move on and ask you -- because I know you had many other projects. Unless you have any closing comments about the LA Investigation, I wanted to ask you about some of the other work that you did at CDC. You did work about AIDS research that extended beyond studies of the disease in gay populations. I wondered if you could tell us a little bit about some of those studies and the work that you did.

DARROW: Starting with the case-control study, (AIDS Project #1), CDC kept count 00:47:00of the studies that involved the collection of specimens. I didn't collect data as part of CDC AIDS Project #1, but I was assisting with the development of the protocol, the questionnaire, pretesting the questionnaire, and training the interviewers. I even wrote an article about the interviewers and their success and published it in Archives of Sexual Behavior to show people who thought that women couldn't interview gay men about these kinds of things and so forth. That was all dispelled by [Dr. Pauline A.] Polly Thomas and other people who worked on this. I wanted to show that different young medical officers, it didn't matter what their gender was or anything, they could be trained, and they could do a very good job of collecting highly sensitive information. I did do that as part of AIDS Project #1. I worked a little bit on #2, which was AIDS cases 00:48:00outside of the four major areas where we did the case-control study. That would be New York, Atlanta, San Francisco and Los Angeles. Then the Cluster Study was called CDC AIDS Project #6.

CHAMBERLAND: Oh, that was #6.

DARROW: That was #6, and we collected specimens. I didn't-- David Auerbach and other medical officers that I was working with collected specimens there and in New York City, because what we were interested in doing in New York City -- or what I was interested in doing in New York City, and I got permission from the health department to do that for a while -- was to talk to all the people who had not been reported as having AIDS that were on that list of 73 people, to see about them and their health, to see if they had any indications that they might be sick and had not yet been reported. That turned out to be very fruitful, 00:49:00because I can remember talking to some of those contacts that had been named by Patient Zero or the Out-of-California case, and at the time they were perfectly all right. Then I checked back later on, and they were diagnosed. They came down with AIDS, which gave further credence to the hypothesis that it's a sexually transmitted agent. That was AIDS Project #6.

The next big project that I got involved with shortly after the Cluster Investigation wound up in 1982 was the follow-up of the hepatitis B cohort. From 1976 until 1981 there was a series of studies done by CDC on the prevalence, incidence, and the effectiveness and safety of a vaccine for hepatitis B. [Dr. Donald P.] Don Francis was very much a part of that, as were other colleagues working in venereal disease [VD] control, which later on became STD or sexually 00:50:00transmitted disease control. I was involved in that from 1976 -- the planning of that in 1975 actually and 1976 -- and I would do various things in conjunction with that. Even though I wasn't a lead author, I assisted with that.

In 1983, because Paul [M.] O'Malley, who worked on the hepatitis study, called me up one day and said, "You won't believe this, but of the first ten cases of AIDS here in San Francisco, six were part of the hepatitis study. Do you think there's any possibility that there's something in the hepatitis vaccine that's making them sick?" He actually said that over the phone. I said, "Paul, I didn't know that. We need to follow up." From that day forward --that must have been in 1981 -- from that day forward we were interested in that cohort in San Francisco as well as the others.

Then Don Francis, when he came here-- he wasn't here initially in '81, he came later, when the hepatitis lab moved from Phoenix here. Don came, and Don said, 00:51:00"We really ought to take a look at those guys. We have over 6,000 specimens saved from those guys in San Francisco. If some of them are coming down with AIDS, that's really important. We've saved their blood that we collected in '78, '79 and '80, and here it is 1983. Why don't we contact some of those guys and ask them if they'll give us more specimens, so we can compare what's in their blood today with what was in their blood back then? Bill Darrow, wouldn't you like to do this work, because you don't have anything else to do?" And Bill Darrow said, "Sure, I'd be glad to do it. I always liked to go to San Francisco, and I've always had good relationships with my colleagues out there." I started working on that, and that was CDC AIDS Project #24.

CHAMBERLAND: Refresh our memory as to who Paul O'Malley was.

DARROW: Paul O'Malley was a public health worker who joined the San Francisco 00:52:00Health Department after serving as a medic during the Vietnam War. I don't think he ever was sent to Vietnam, but he had training as a medic. Then after he left the Army -- I'm pretty sure he was in the Army -- he went to San Francisco to get a job with the health department to continue that kind of work, and he ended up in VD (STD) Control. When the hepatitis study came along, he was asked to head up that study, and he did, and he did a wonderful job. What a great guy. That's one of the real advantages of working in public health and at CDC-- you get to meet the most wonderful people. Paul and I knew each other from the earliest meetings on hepatitis B in '75. We stayed in touch, and then in '83 I got a chance to work with Paul O'Malley again. That was great, because he really 00:53:00cared for all those men who were in that hepatitis study. He was a real treat to work with. So that's Paul. Paul was interviewed by [Dr.] Sally Smith Hughes as part of that oral history project they did at the University of California.

CHAMBERLAND: The study ultimately was reassuring in that it didn't indicate that the hepatitis B vaccine was the source of infection. It did provide information about the increasing prevalence of HIV infection in this cohort of gay men, because you had sequential specimens over time.

DARROW: That's correct. We showed that the prevalence of HIV in the [hepatitis B virus] HBV cohort was very low, less than 5%, as I recall, in 1978. and When we started getting permission to test the bloods in '83 and '84, two-thirds of 00:54:00these men had antibody to HIV. We couldn't do anything about it because the blood test wasn't really available until '85, so it was all retrospective. When it came out, I can remember presenting these data at a conference at NIH [National Institutes of Health]. You could have heard a pin drop when I showed the curve of the prevalence of HIV antibody in this cohort. People were really frightened.

CHAMBERLAND: Did you do any studies in heterosexual populations?

DARROW: I did, and that followed. That's CDC AIDS Project #72. Harold [Jaffe] and Jim [Curran] called me in one day and said, "Okay Bill, you've helped us understand the epidemiology of HIV among homosexual and bisexual men. Can you help us understand the epidemiology of HIV in heterosexuals, and particularly heterosexual women? We know that women are infected, so let's focus on a group 00:55:00that has a large number of partners and uses drugs and so forth and see what the prevalence is. If we can get at the incidence, okay. Let's look at the risk factors, and let's look at ways of preventing transmission. Why don't you design a study of female sex workers." I said, "Okay, if that's what you want me to do, I'll do it." Project #72 was a study of female prostitutes in the United States, and we did it in eight different places. We called for-- there was an RFA [Request for Applications]-- and we made awards to as many places as we could. We even got a few places to agree to do it with very minimal or no funding. One of them was Colorado Springs, and that's where I did a lot of my subsequent work for CDC AIDS Project #90. That's where we really did some good social network 00:56:00research. That was through the auspices of [Dr. Richard] Rich Rothenberg.

CHAMBERLAND: Who was out in the Colorado Health Department?

DARROW: --in Colorado -- I don't think he was still in Colorado at the time. Through the Venereal Disease Control Strategic Planning System, which went back to the 1970's, Rich was in Colorado and established a very good working relationship with the El Paso County Health Department -- in Colorado Springs, Dr. John Muth, and a guy named John [J.] Potterat, who was a former venereal disease investigator, public health advisor, in Los Angeles. John was very much interested in the dynamics of gonorrhea transmission at the time when we were really interested in gonorrhea. When HIV came along or when AIDS came along, he was very much interested in this in our communities, [in] what populations. When 00:57:00I approached John about possibly doing a social network study, I said, "It's going to be a lot of work." He said, "Yes, I'm all game, because I want to find out what's happening here."

CHAMBERLAND: When did your study of U.S. female prostitutes reveal?

DARROW: Okay, so that would have been from 1985 to 1987, something like that.

CHAMBERLAND: So, early.

DARROW: It was a cross-sectional study. Then we were going to follow it up with a longitudinal study to try to get at incidence and prevention. That was the idea for Project #90. We first did the cross-sectional [study], and we found that the main risk factor was not number of partners for the women; it was use of injection drugs. Unfortunately, prostitutes that injected drugs were much more likely to be infected than those that never did. Secondly was sexual contact with non-professional contacts. In other words, with their lovers, their 00:58:00boyfriends, their pimps. That was much riskier than exposures to clients, where there was a much more likelihood of a condom being used or some kind of screening happening. But with their boyfriends, uh-uh, there was no condom, there was no screening, and sometimes the boyfriends used drugs. That was the riskiest factor for infection among female prostitutes in the cross-sectional study.

CHAMBERLAND: I'm curious, because your work on these very early aspects of CDC's response to the AIDS epidemic was happening at a time when it was a very conservative political climate in the United States -- at the time of the rise of the New Right, the Moral Majority. Did the politics of the day in any way affect your ability to do your job or get you in hot water?

DARROW: Oh, I got into a lot of trouble, yes. I have to admit that. Let's take 00:59:00the prostitute study, for example. Okay, I'm a social scientist, and I'm trained that if you're going to study a population, a marginalized population like prostitutes, you can't do it without having their input. It's only fair, it's ethical, it's the right thing to do. Of course, with a very conservative government, to even suggest that you might invite a prostitute to serve as an advisor-- Not only that, but to have the meeting here at CDC on government property and to have a prostitute in the meeting making decisions among scientists.

CHAMBERLAND: This is a planning meeting, if you will, for the study when you invite in experts, external experts.

DARROW: Oh, it was a planning meeting for the study, yes. As I said, we had eight different centers involved. We wanted to call them all in to talk about a common protocol that we would all be willing to follow and a common questionnaire so that we could pool the data, so we could compare data from 01:00:00Atlantic City, New Jersey, with Los Angeles, California. How are you going to do that if you've got different protocols and different instruments? It's a cooperative agreement, right? They can essentially do what they want. You can twist their arms, [but] you can't force them, so it all has to be negotiated. Are we going to do this just with public health people? To me, it didn't make any sense. We had to have some prostitutes or former prostitutes who knew what was happening out there, just like, why would you do a study of gay men and exclude gay men? To me it made sense. I invited a former prostitute, we'll say, that was recommended to me by Dr. [Jacqueline] Jackie Boles, Professor of Sociology at Georgia State University, whose field was the sociology of work. One of the professions she was interested in was prostitution. To her it was a 01:01:00job, so she wanted to see how they managed their lives and so forth. She said, "There's this woman -- I can name her because she didn't mind -- Dolores French, who just published a book called, Working [My Life as a Prostitute.] Why don't you go to Dolores and ask her if she'd be willing to come and provide advice, become a member of the team?" So, I did.

CHAMBERLAND: An expert advisor.

DARROW: An expert advisor. I can tell you, when we had our meeting, I've never seen so many CDC (employees) interested in a scientific meeting as we did that day. Everybody wanted to see this woman of the night that we had called upon to advise us. Of course, I got called into the second-floor office. That's where the --

CHAMBERLAND: Office of the Director --

DARROW: "Darrow, what the hell are you doing now?" It's a miracle I was not fired. I had a number of occasions where things like that happened.

CHAMBERLAND: One thing I wanted to ask you about is, in the time that you were working at CDC, again, in these early days in the '80s, did you have any peer 01:02:00group in terms of other Ph.D. sociologists? If not, what did it feel like? Certainly on the Task Force you were the sole sociologist amongst all these biomedical types. What was that like?

DARROW: I had a great time, actually. I very much enjoyed it, because I had very good colleagues who for the most part were empathetic. Some were not. Some were extremely skeptical initially of the anecdotal data that we social scientists seem to thrive upon. They wanted to have more rigorous research, and so would I, if I had the money and the support. But you're absolutely right. I think the reason that I was selected to join the Task Force was because there was nobody else available. They couldn't pick anybody else; they couldn't be choosy. I was asked to join the Task Force in August of 1981 to help out while I continued to 01:03:00do all the other things that I was supposed to do. It was because at the time, there might have been one or two other social or behavioral scientists around. I think [Dr.] Sevgi [O.] Aral was on the staff, and she was trained in sociology as I was. In fact, she was a classmate of mine at Emory when I was there. She called me up one day, and she said -- she was a native of Turkey -- she said, "We're back here in Atlanta, and Mustafa is working at Georgia Tech and I can't find a job--

CHAMBERLAND: Her husband.

DARROW: --are there any jobs at CDC?" I said, "Yes, I think maybe there's a project that's being done. You need to come and talk with [Dr.] Paul [J.] Wiesner and [Dr. Ronald K.] Ron St. John--

CHAMBERLAND: This is the STD group.

DARROW: --I think they could use somebody like you on that project." They were working at some health center. [Dr.] Stuart Brown was part of that. I think you know Stuart Brown.

CHAMBERLAND: Yes, indeed.

DARROW: I said, "You need to talk with Stuart Brown." So, they hired her. When I 01:04:00was asked to help the Task Force, she was going to help with all the other STDs.

CHAMBERLAND: Non-AIDS things?

DARROW: Yes, but if there were any other social scientists with Ph.D.s, I can't remember who they were at the time. There might have been a few.

CHAMBERLAND: It's interesting, because you comment on the stereotype of the sociologists producing soft data, but I recall from our first interview that you talked about [how] you actually knew your way around statistical methods and computer printouts and data analyses. There wasn't -- that's not soft.

DARROW: That's a very good point. I think that's why I was respected, more than the fact that I was a social scientist. When I went to Emory, they used SPSS, the Statistical Package for the Social Sciences, in one of its earliest forms. I even remember the way you had to set things up. You couldn't have anything in the first 16 columns unless it dealt with this, and then you put everything else 01:05:00from 16 to 80. They gave me good training in statistics and in research methods. A lot of people were just beginning to use computers and didn't know -- I remember working with Grady Waters, the name just came back, yes! Grady Waters, and he had an assistant, and that was about it for the computer staff here at the time. I had taken a course in Fortran, so I knew a little bit about programming. I knew about SPSS. I had some good training in statistics that was beneficial, particularly for epidemiologists. I could do those kinds of things, and so I was called upon to do that as much as I was to consult on sociological type things.

CHAMBERLAND: The early days of CDC's response to AIDS happened at a time that there were lots of challenges on many fronts. This interview and your earlier 01:06:00one certainly highlighted some of those. When you look back, do you think there are any aspects of the response where CDC fell short or could have done a better job?

DARROW: I think CDC did a marvelous job under the circumstances. It was like trying to fight Muhammad Ali with both hands tied behind your back. We were really at a disadvantage. We had to be very careful with what we did, because we would have been open for criticism. On the other hand, there was a terrible problem going on. People were dying, and we couldn't get any support, so we had to be very careful about that. But all of my colleagues were really devoted to the mission. The mission was given to us: we've got to find out what's going on 01:07:00in order to save lives. We're not going to get much support. If we don't do it, we don't think anybody else is, so we've got to do it, and so we did. I never heard anybody complain about coming to work early and staying late, about traveling here, traveling there. It was mission-oriented research, and I think that's when public health is at its best, when you've got a mission. You've got to try to figure out what's killing people, so you can stop it. That's what we all tried to do, and it didn't make any difference at the time if you were a microbiologist or an immunologist or even a sociologist. If you had something that you could contribute, you should do it, and that's what we did.

CHAMBERLAND: CDC's AIDS response has relevance even today in the public health 01:08:00challenges that still arrive. There are lessons to be learned?

DARROW: There certainly are. There certainly are, and I would say in some ways, at least for me to do research on HIV/AIDS is more difficult today. We didn't have any money for anything back then. Now there's money for certain things, but it's pretty much going into the biomedical side. People are still interested in developing vaccines; they're still interested in developing better treatments. We talked to Tara [Smith] earlier. She's doing research on better diagnostic tests.

CHAMBERLAND: This [is] a current CDC -- a very young, junior staff who's working--

DARROW: Yes, spending all of her time trying to develop better diagnostic tests. Where's the really good behavioral research? Where's the really good sociological research? I'm in a Department of Health Promotion and Disease Prevention, and there's virtually no good research being done now on educating 01:09:00people about infectious or chronic diseases, other public health problems. It's just thought, what else is there to learn? There is so much more to learn, particularly in this age, the digital age of information technology. We don't really know how to use all of the things that are available to us today like the biomedical scientists do, and it's because there's an absence of support for that kind of research.

CHAMBERLAND: Interesting. Interesting. Bill, you were part of something that changed history and the course of public health. How has that affected you personally and professionally?

DARROW: Personally, I can remember all the men who died, including some who died in my own house. That's a sad thing. There have been periods of my time where I 01:10:00just didn't want to do this anymore. And then I remember them. Wonderful people. It's had a tremendous impact on me, because here I am now with 55 years of experience in public health and, as you know, it's hard for me to leave. It's in my blood now. I've got the antibodies. I can't seem to stop. Personally, I feel as though I have to continue in their memory. Professionally, there have been good times and bad times. There has been a lot of interest in some of the things that I have been party to at certain times, but it's as hard for me today as it ever was to try to get grants to support this kind of research. There doesn't 01:11:00seem to be much interest in the kinds of things that I'm interested in and have always been interested in. I still get papers rejected when I send them off for publication. Some things never change.

CHAMBERLAND: You left CDC in 1994 and went to Miami to Florida International University. It's 2017, so you've had nearly another 25-year career, you're knocking on the door of another 25-year career. You are like the Energizer Bunny.

DARROW: That's an interesting story, too, because I saw what [Dr.] Eugene [J.] Gangarosa and [Dr. Philip S.] Phil Brachman, Sr., and others were able to do here at CDC by offering courses on global epidemiology. At the time there was a nascent program in public health at Emory University. Now we have the Rollins 01:12:00School of Public Health, and the Dean is, of all people, James Curran, my former boss. Many of my former colleagues are faculty members there, and I saw that happen. I saw that go from a core of about four or five people to a faculty of something like 400 or 500 today. When I was invited to join the faculty at Florida International University, I was the sixth person to join that faculty that formed in 1985. We haven't grown like the Rollins School of Public Health, but now we have- I have 130 colleagues and a dean with six different departments and a program that offers a Ph.D. as well as an M.P.H. in public health, and we're expanding with undergraduate education and online education. I've had an opportunity to contribute to academic public health as well as to public health 01:13:00research. That's given me a great deal of satisfaction as well, to see us at least follow part of the way along the path that I saw pioneers from CDC help do with our neighbors down the street.

CHAMBERLAND: Bill, it has been an absolute pleasure to have this conversation with you, two conversations in fact, and I have to commend you for your memory of events. It's just absolutely amazing to me. Thank you very much.

Any closing thoughts? I'll leave the last word to you.

DARROW: Thank you for doing this. I think it's wonderful that CDC has taken an interest in the history of public health. When I started my work in venereal disease control in 1961, I was exposed to the history of syphilis, and I found 01:14:00it fascinating. Of course, some things happened along the way that have been troubling and still interest me, like the Tuskegee Study of Untreated Syphilis in the Negro Male, as it was originally called. But our history is very rich. I now teach a course on the history and foundations of public health, where we recount many of the experiences, the investigations of [Dr.] Joseph Goldberger on pellagra and discovering that the cause was not an infectious agent, but a vitamin deficiency. I mentioned the influenza outbreak and John [M.] Barry's wonderful book about the Great Influenza and all of the historical things that have happened. Now to see CDC focusing on its very rich history, all of its contributions to smallpox eradication, to the recent investigations of Ebola 01:15:00virus. You're also talking about the toxic shock history, and here we are talking about AIDS. CDC has been involved in so many things. Polio. You say we're revisiting the polio scare, and I remember all of that. I had a cousin who developed polio at a very early age. All that CDC has done. I think it's just wonderful that you and other people are recording all this information for posterity, so that everybody will be aware of all the contributions that CDC has made.

CHAMBERLAND: Thank you, Bill. I think we'll close.

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