REMEMBERING DR. JOYCE WALLACE, EARLY AIDS HERO AND PIONEER OF HEALTH CARE FOR STREETWALKERS
by Lawrence D. Mass
Wallace was a tireless advocate of health care for streetwalkers and the first to tell the gay community, via me, about the epidemic that would later become known as AIDS
At 74, my memory can be spotty. But I have vivid recollections of Dr. Joyce Wallace. It was Joyce who was the first to tell me about a few cases of atypical pneumonia in New York City hospitals in 1981. Unofficially, her call was the first outreach to the gay community about the epidemic that would become known as AIDS.
Joyce was my friend and comrade in community medicine. She was an internist with an eye, ear and heart for outsiders. Worldwide, women probably are still the largest aggregate community of the underserved, alongside racial and other minorities — Blacks, Hispanics, Native Americans, LGBT persons, the poor. Here in New York, it was women who had no community — addicts, prostitutes, the homeless — who became Joyce’s calling.
“Streetwalkers,” which became the preferred term for prostitutes, not only had no designated outreach or resources even in Ob-Gyn practices, but were universally illegal and stigmatized, except in a few progressive countries — e.g., Holland and Germany. Joyce saw early on that streetwalkers, especially in New York City and other urban centers, were a neglected coterie of persons highly vulnerable to STD’s, including the emerging epidemic of HIV, and in desperate need of access to basic and specialized health care. In being on the margins of society and medicine, these women bore many similarities to the sexually active gay men at highest risk for AIDS.
It’s through the early, primitive networks of health care in the gay community and addiction that I got to know Joyce. In 1979 I began writing articles for the gay press on a range of subjects, initially about how reactionary forces in psychiatry were trying to reclassify homosexuality in the wake of the still controversial decision by the American Psychiatric Association to declassify “homosexuality” as a mental disorder in 1973–74. It’s a threat that’s likely to resurface in the current conflagration of social services and consciousness of the Trump administration.
Writing in the New York Native, I found myself reporting ever-worsening spikes of STD’s —syphilis, gonorrhea, amebiasis and hepatitis B — in gay men. Though there were a few notable gay community physicians and a few programs and clinics with outreach to gay men, such as Dr. Dan William and the Gay Men’s Health Project, no physician or other writer had ever provided regular coverage of health issues in the gay press.
Via early community physician networks such as New York Physicians for Human Rights, work in addiction and my articles in the gay press, Joyce became my colleague and friend. One day in the late winter of 1981 I got a concerned call from her. Joyce was eccentric and discursive, traits that endeared her to me because they were my traits as well. That day she seemed notably agitated but also tight-lipped.
The gist of what she had to say was that there were gay men in New York City emergency rooms and intensive care units with an atypical pneumonia. Several had died. The underlying cause(s) had yet to be determined. She added that what she was telling me was strictly confidential. Apparently, she had been asked not to discuss these cases with anyone until more was known. The call with Joyce quickly terminated on this note of hush-hush.
Whatever the confidentiality demands from health care officials, what Joyce understood instinctively and immediately is that the community most affected by what had all the hallmarks of a new epidemic had not yet been informed of what was happening. It’s a narrative that would consistently demarcate Joyce’s commitment to the underserved. And it was a narrative that would play out big time with the media, the public and the gay community as AIDS spread to become one of the greatest pandemics in recorded history.
On the wings of Joyce’s call but without identifying her I contacted the New York City Department of Health and gathered enough scattershot information to write what was the first published news report of the new epidemic (New York Native, 5/18/81).
As AIDS unfolded, Joyce was a singular presence in our physician networks, including the earliest of the AIDS task forces designated by the Centers for Disease Control (CDC) under director Jim Curran. Clearly streetwalkers, with their high rates of injection needle use and STD’s, were at highest risk for acquiring and transmitting what would later be identified as HIV. It was Joyce’s work as well that was among the earliest to counteract the false, pejorative (sexist and homophobic) narrative that heterosexual women were innately less susceptible to infection than gay men.
Joyce’s outreach to streetwalkers was fraught with perils and setbacks at every stage. Chronically underfunded and shunned because of the outlaw status of her clients and the independence of her mission, she persisted against formidable odds. Eventually, her work was recognized and credited with a profile in the New Yorker, “Women on the Edge,” an inspiring account of this remarkable hero of community medicine by Barbara Goldsmith in 1993.
A memory returns to me in efforts to say something personal in Joyce’s honor. One evening I paid her a social visit at her home in Greenwich Village. There, about to leave, was her current boyfriend, who was very handsome. It was mysteriously in that moment of glimpsing the two of them together that I felt her sensuality and kindredness of spirit with those of us regarded as being on the fringes of sexual norms and mores. Like her and with her, we were all sentient and sexual beings, as worthy of dignity, respect and health care as any other coterie of human beings.
Far from being any kind of textualist in matters of humanity, gender, sexuality or medicine, Dr. Joyce Wallace would certainly be with those of us who would vote, if we could, to change the wording of the Declaration of Independence from “All men are created equal” to All people are created equal.
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Lawrence D. Mass, M.D., is a cofounder of Gay Men’s Health Crisis and was the first to write about AIDS for the press. He is the author of We Must Love One Another or Die: The Life and Legacies of Larry Kramer. He is completing On The Future of Wagnerism, a sequel to his memoir, Confessions of a Jewish Wagnerite.
