Ed Koch and the AIDS Crisis: His Greatest Failure

Ed Koch Addressing Reporters --- Image by ? Bettmann/CORBIS
Photo: ? Corbis. All Rights Reserved.

And now Ed Koch is dead.

That he took the secrets of his heart to the grave is, historically speaking, meaningless, despite how much speculation has percolated through his obituaries. Gay or straight, bisexual or asexual, Koch simply was who he was (that is, a man taken to shouting “Fuck you!” to anybody who wanted details).

More telling is that he died as he lived — an utterly single man, a “lifelong bachelor.” Yes, he had a tight inner circle of friends for weekly lunches and daily phone calls. And yes, there was that rumor, never corroborated, of an affair with a City Hall aide who was soon relocated to the southwest. But whatever lurked in his heart, Koch never coupled.

As I pored through the hundreds of hours of archival footage for my documentary film How to Survive a Plague, that fact stood out above any other as a probable explanation for why he seemed to lack even the faintest stirrings of empathy when the AIDS crisis came. As has been chronicled repeatedly, Koch stood silent through years of headlines, obituaries, and deaths. He refused meetings with community members, Larry Kramer chief among them. Administratively, he created inter-departmental committees and appointed liaisons, but he gave them neither power nor resources to do anything real. By January 1984, in the epicenter of a ballooning epidemic when tens of thousands of New Yorkers were infected and 864 were already gone, Koch’s New York had spent a total of $24,500 in response.

To be fair, no mayor could have stopped the virus from its diabolical campaigns in the bloodstream. But in the days before cell phones and the Internet, when the New York Times still refused to use the word gay and the hometown gay newspaper sold just 6,000 copies — a time when it was impossible to reach the at-risk community outside of the mainstream — he could have shown leadership. He could have promoted risk reduction and community education. This is what was done in San Francisco, where Dianne Feinstein was mayor. The money and the bully-pulpit worked. The epidemic there, while devastating, was nothing like it became in New York.

Koch’s failure in AIDS should be recalled as the single-most significant aspect of his public life. The memories of all we’ve lost deserve no less.  

And now Ed Koch is dead. Since late last year, he had been in and out of New York-Presbyterian Hospital Columbia. This week his doctors moved him into intensive care. He died at about two on Friday morning of congestive heart failure.

I’m reminded of a story Dr. Gabriel Torres told me about his first visit to intensive care at St. Vincent’s, where he would later become director of AIDS care. He was a medical student on rotation in 1983 or 1984. The disease was still so under-reported that he had not yet heard of it. In the ICU, he found young gay men, intubated for pneumonia, taking up eight of the nine beds. His eyes went cold as he recalled the scene of waling mothers and panicked lovers. “During these days, I mean, the things that went on …”

During those same days, I was a young reporter at the above-referenced gay newspaper. We regularly received phone calls from St. Vincent patients complaining that staff members fearing the disease was airborne refused to bring them food, instead piling their trays outside their doors, or that terrified nurses wouldn’t bandage their wounds or change their soiled linens. It was like something out of a Saramago novel. I personally brought this information to Koch myself, as the first journalist with gay-media credentials to address him in a Blue Room press conference. He responded explosively. “Don’t be ridiculous,” he told me.

Those were the early days. As the epidemic mushroomed, the city’s hospitals simply ran out of space for all of the patients, and again he was silent. Deathly ill people were routinely turned away. At some hospitals, patients were lined up on gurneys along the emergency room hallways for days on end awaiting medical care that never came. When things went south, we all knew there was only one funeral home in the city — the gentle people at Redden’s on 14th Street — where we could bring our friends’ remains.  

I do not recall Koch ever acknowledging these medieval conditions. He surely never took action, nor did he spare an ounce of sympathy for us in the trenches, not in public at least.  

Still, I chose not to interview Koch for How to Survive a Plague. His inaction was simply a fact, nothing I cared to hear him defend. I do not agree with Larry Kramer, who charges Koch with the murder of so many back then. What people died of in Koch’s New York was a viral infection. How they died and how quickly they died — those are the things he might have helped ease. And he didn’t. It is as though he couldn’t empathize with the dying or the rest of us who stood helplessly at their bedsides.

So I was startled when I learned that Koch had seen my film. He wandered into the IFC Center one afternoon in the fall, for the 2 p.m. show. If he got there in time for the opening scenes, he would have seen how much twisted rage had swirled around him by 1987, six years into the plague. A massive protest, which he denounced for using “fascist tactics,” had encircled City Hall with lacerating chants meant to ridicule and cut him cold, including: “New York’s health care is ineffectual /  … Thanks to Koch the ‘heterosexual.’”
What happened to him in that darkened theater remains a mystery. But by the time he was home — and working up a review of the film for the West Side Spirit — he was apparently a changed man. He called the demonstrations against him “necessary to keep the issue on the front burner” and called upon Obama to grant them Presidential Medals of Freedom, the nation’s highest civilian honor. Whether this was the beginning of a mea culpa is not known. But he plainly saw that history — his history — in a different light.

“I urge our Chancellor of Education to show the documentary in our public schools,” he wrote. “It would teach children a lot of lessons, the chief one being the community can, working together, speak truth to power and win.”

And now Ed Koch is dead.

David France is a New York contributing editor and director of the Oscar-nominated How to Survive a Plague.

Koch and the AIDS Crisis: His Greatest Failure