Patient Zero

Introduction to patient zero

0:00Rotten eggs, volcanic gas, death and decay. What do all these things have in common? Hey, it's me, Matt Kilty. Join Radiolab on Wednesday, August 26th for a live podcast taping of viscera, gripping tales of the human body, where we will grab a hold of a long overlooked, much maligned chemical element, an element that can be found from the hospital room to outer space. Join us Wednesday, August 26th at 7pm at Caveat in New York City to learn how the smell of death might actually be the surest sign of life. Find out more at caveat.nyc slash Radiolab.

0:30Hey, this is Radiolab. I'm Soren Wheeler. And I have a show for you today that I want to play for a couple of reasons. First of all, it's one of my favorites of all time. And secondly, despite the fact that we produced this story originally back in 2011, it is weirdly and unfortunately perennially relevant, like every year. Like if you're in the U.S. right now, that would be because of the cyclospora situation, which is the explosive diarrhea outbreak. But thinking back to COVID or monkeypox or even the most recent Ebola outbreak, anytime one of these diseases makes its way into us humans, the first question is always, how did it start? Like, where did this come from? Or sometimes like, who did it come from?

1:14And that is what this show that I'm going to play for you today is all about. We produced this one back in 2011. It's got mysterious shadowy figures. It's got a very high stakes story of a man hunting a chimp in Cameroon. And a probably futile attempt to get to the bottom, or rather the beginning of the most famous celebratory gesture in human history. So here it is. Wait, you're listening to Radio Lab. Radio Lab. From WNYC.

1:53Rewind.

1:58So have we said where we are on tape yet? Starting us off today are our producers Lynn Levy and Sean Cole. Very pretty day to be on an abandoned island where victims of contagious disease were quarantined. And one in particular who lived here, died here, never believing that she was in fact sick and dangerous. So this is a story that begins when?

The case of Mary Mallon

2:26Well, it's actually, it starts in 1906. And it doesn't start on the island. It starts in Oyster Bay. Oh, nice neighbor. Very nice. There was this one rich family on vacation there. And their daughter gets sick. She gets sick first. This is Judy Levitt. I am a professor emerita at the University of Wisconsin. And she wrote a book about this story. So basically the girl, the daughter, has a fever. Then her sister comes down with it. And then her mom and a maid. About six out of 11 in the family get sick.

2:58And with this disease, the fever is just the first part of it. Both diarrhea or constipation are reported. So it can go either way, I guess. What is it? Typhoid. And they couldn't figure out what had caused the disease. So they called in this sanitary engineer named George Soper. With the public health department. He was a go-to guy for outbreaks like this. Back then the Department of Public Health was thinking, you know, you'd get sick because of something dirty near you. In the well or in the pipes. Yeah. So he looks into all of that.

3:30Did a whole test on the house and the water and everything. Couldn't find anything. And so he starts talking to the family. And he started quizzing them all. Eventually, he builds up this whole picture of several outbreaks going back years. 1900. Mamaronek. A New York family had a house for the summer. 1902. Dark Harbor, Maine. 1904. Seven cases. Sands Point, New York. Autumn. 1906. Winter. 1907. New York City. All these cases. And they all had one thing in common.

4:02What? Each of these families had employed the same cook. Really? Which is funny because when you cook food, you kill the bacteria in the food. Oh, so it couldn't be the cook then. But this cook. Her most famous dish was peach melba, which is ice cream and fresh peaches. Fresh peaches.

4:28Raw fruit. That was a perfect medium. And the cook's name was Mary Mallon. Mary Mallon. Mary Mallon. Wait a second, Sean Cole. Typhoid. Typhoid Mary is what we're talking about. Oh, so we know this story. No, you don't know this story. What do you mean? Everybody thinks they know this story. I thought I knew this story. And then when I looked into it, I realized I didn't know the first thing about it. And when you look into the details, they tell us some very difficult things about who we were and who we still are in a lot of ways. It's all in the details, all of the juice and problem.

5:00Like the peach juice. Just like the peach juice. We're still dealing with it. Wait. I'm Robert Krillowich. Go ahead. Go ahead. Do your part. I'm Chad Abumrad. This is Radiolab. And in this hour, a series of stories that all hew to that delicious story archetype we call patient zero.

5:20The first cause. We'll try to trace ideas and trends and massive social traumas like pandemics back to that one person. Or one critter. Or the other way you call it is called the but for. If you didn't have this thing, but for this thing, you wouldn't have the rest of the story. I like the but for. The but for. But, meanwhile. Back to the peaches. So, George Soper's like, I've got to find this woman. And when he finds her.

5:52She's in New York City. Working for another family. The laundress had recently been taken to the Presbyterian Hospital with typhoid fever. This is from an article Soper wrote called The Curious Case of Typhoid Mary. And the only child of the family, a lovely daughter, was dying of it. So he goes to the house, walks into the kitchen, sees this woman, five foot six, blonde hair, blue eyes. Had a good figure and might have been called athletic had she not been a little too heavy. Irish immigrant, 36 years old. Not particularly clean. And he says, Mary Mallon, I think you are causing disease in people and I want samples of your urine, feces and blood.

6:31Good afternoon.

6:35And she says. What are you accusing me of being sick? Playing the role of Mary is Columbia Public Health Professor David Rossner. How dare you? I'm not a sick person. What does she do? She traces him out of the building.

6:46With a fork in her hand. A serving fork. A serving fork. Yeah. I felt rather lucky to escape.

6:54But did she have typhoid? I mean, did she outwardly have typhoid? Well, that's the thing. She never had any symptoms. She felt perfectly healthy. She was actually the first documented case in North America of a healthy carrier, which is to say someone who has the disease and is contagious, but never actually feels the symptoms. The symptoms. So in one weird way, Soper's thrilled. Like he's only read about this. And then here she is in front of him.

7:26But think of how all of this must have sounded to Mary. I mean, some guy from outer space comes into your kitchen and says you're diseased and you're hurting people. I mean, she must have thought. What? I feel fine. I'm living a moral life. I'm not a vagrant. I'm employed. I'm a good, solid citizen. You know, you would be crazed too, wouldn't you, even today? You'd probably grab your knife, yeah. Yeah, you'd grab your knife. Well, does he have any evidence, though, that she is spreading the disease? Not yet. That's why he needs her poop. So he goes back, finds her at a rooming house.

7:56She kicks him out, swears at him. She apparently had quite a temper. And then the health department sends in this female doctor. By the name of S. Josephine Baker, maybe she could ask for blood, feces, and urine a little more gently. I just don't know how you ask for that gently. But she tries. And when it doesn't work, she comes back a little bit later with cops. And they come to the house. And Mary Mallon, when she realizes what's happening, disappears. What do you mean disappears? She just vanishes?

8:27Completely vanishes. They end up searching the entire place. And they can't find her. Finally, I think they're about to leave when one of them spots her skirt at coming outside of a door.

8:43It's a little piece of calico kind of stuck in a doorway. They open the door, and there she is.

8:51And so they drag her out, and she comes out kicking and screaming and... Screaming and kicking. It takes all of them to drag her out. Protesting. And they get her in the ambulance, and Josephine Baker sits on her. As is, according to her, sits on her. And Baker later said... Something like, it was like being in a cage with an angry lion. So they take her down to the hospital. They tested her feces and urine. And they found that, yes, she was, in fact, a carrier of live typhoid bacilli.

9:28It's a weird island, and I spent a while on him.

Quarantine on North Brother Island

9:32So they isolate her, and they ultimately move her... Okay, good. ...from Manhattan to North Brother Island.

9:41Let's have a bit of a haunted vibe. Yeah. And there she is.

9:47Thanks, man. Go, baby. We went there to, just to try to get our heads around what she must have thought. What do you think? What was the island like? Man, everything is completely overgrown. It was really creepy. Creepy because it was in such dissolution? Yeah. Yeah. Just be careful where you step. On one end, there are all of these medical, former medical buildings, including a giant hospital where they isolated tuberculosis patients. So a big brick, stately building. And then on the other side of the island, there's smaller wooden buildings that are crushed.

10:19This may be where her cottage is. Where her cottage would be if it was still standing, but it's not standing anymore. Well, it was one room, one room. It had a kitchen. It had a, I guess, a sleeping area and a sitting area. It probably wasn't so bad if you didn't have to stay there. You know, any places that you're not free to leave becomes like a prison.

10:51So we're marching around, and then Lynn says to me, Hey, look at the view. And holy moly. It's right there. That's when it really hit me. If this is where her cabin was, then one window of it looked exactly onto Manhattan. She could have seen where she used to live.

11:13You can see the traffic on the streets.

11:17This was like the most horrible seaside vacation. Almost the whole time they had her incarcerated, they took feces three times a week, which is, you know, it's not pleasant to have to do that.

11:33And sometimes she was negative and sometimes she was positive. Wait, what? So that's another thing that they were figuring out at the time. So she was probably an intermittent carrier. What does that mean? The disease is always in her. But sometimes she excretes it and sometimes she doesn't. Oh, that must have been confusing for her. When I first came here, I was so nervous and almost prostrated with grief and trouble. My eyes began to twitch. This is from a letter that Mary wrote from the island.

12:03I have, in fact, been a peep show for everybody. But if you keep reading it, and in fact it's addressed to a lawyer, it's clear that she was fighting this. And she had been sending her own feces samples herself to a private lab in Manhattan. And each one of those was negative. Really? The tuberculosis men would say, there she is. The kidnapped woman.

12:27Yeah, that is poison ivy. She sues the city and loses. Still, there are all of these questions as to whether any of this is legal. I mean, even George Soper, the guy who hunted her down, said it was contrary to the Constitution of the United States to hold her under the circumstance. And how long was she on this island for? Three years. Wow. And then what changed was a new health commissioner took over. And so he says it's just not right that we keep a healthy woman locked up like this. She was not dangerous to anybody if she didn't cook.

12:57He lets her go. He lets her go? Yeah. Back to Manhattan. But he makes her promise. She did promise. She signed an affidavit. Saying, she'll never cook again. And she was released. They gave, they set her up with a job as a laundress and they went, here you go, Mary. And then, you know, they kept track of her for a while.

13:18And then at a certain point they kind of stopped keeping track of her. What happened? Dun, dun, dun. So how many years will go by? Five. Five. What happens next? There's an outbreak of typhoid. Where? Where? At a maternity hospital. Oh, you're kidding. Wow. Josephine Baker, who sat on her in the ambulance before, she says that she goes and pays a visit and walks into the kitchen and she says the first person that she encountered was typhoid Mary Mallon.

13:53George Soper did some legwork on where Mary had been and it turned out she had worked at a restaurant, two hotels, an inn, and a sanatorium, as well as the hospital. Wow. And at least according to his account, two of the people that she made sick during those couple years were children.

14:14She was now a woman who could not claim innocence. She was known willfully and deliberately to have taken desperate chances with human life. She had abused her privilege. She had broken her parole. So then they put her back on North Brother Island, back in her bungalow.

14:29And there she sits. She was a dangerous character and must be treated accordingly. Absolutely. She broke her problem. Yeah, I totally agree. She made a deal and she didn't keep the deal. But the thing is, is that at the time she was sent back to the island, there were hundreds of other healthy carriers identified all over New York and some of them were cooks. What? Really? Mostly men, by the way. And they were cooking? Well, they were barred from cooking, but not all of them always listened. Huh. And yet Mary was the only one who they isolated in this way.

15:03Why? Why only her? I think it was more about making people feel safe than actually making them safe.

15:16Oh, look out for this stair. It's all crumbled. She was what we needed at the time. We're in the hospital where the tuberculosis patients were quarantined. This was towards the end of Lynn and my visit to the island. Yeah, these must be the wards. Definitely. Yeah. So when was she here? This is where they brought her after she had a stroke.

15:46And this is where she was for the last six years of her life. Did she die in here? Yeah. Yeah.

16:01Yeah. Hey, I'm Jad Abumran. I'm Robert Krolwich. This is Radiolab. And today... It's patient zero. That's our subject. Yeah. And this next story...

Tracing the HIV epidemic

16:18It's so huge. It's the ultimate patient zero story, really. Many of us have lived through this. It was... It's as recent an event. It's such a recent event that it still hurts and it still bleeds. Yeah. And in it somewhere is literally the patient that is called zero. So this is... Yeah. A lot of people are going to help us tell the story. But starting us off is science writer, Radiolab regular, Carl Zimmer. So in 1981, doctors for the first time describe...

16:48A mysterious, newly discovered disease... A syndrome... Which affects mostly homosexual men. The young men in Los Angeles... ...are dying. The number of cases has been growing faster and faster. So far, more than 80 Americans have died. 258 people have died. 625 people have died. Of course, this is the part we all know. How, from those first few cases in L.A., AIDS became one of the deadliest pandemics the world has ever seen. More dangerous than the plague of the Middle Ages. But back at the beginning, there was a story.

17:18That I have not been able to shake for the last 30 years. And it's a story that I want to reimagine right now.

17:26Right after news of this syndrome started to break... That's science writer David Quammen, who along with Carl will be one of our guides. Epidemiologists were trying to figure out where... Where did it come from? And they were thinking like, well, maybe it's a sexually transmitted disease. So the CDC launches a study... ...of a group of about 30 patients... Gay men. ...in New York, Los Angeles, and San Francisco... ...to see who had had sexual contact with whom. How do you... Is that just a series of interviews with people? Yeah. Please name all the people that you've slept with.

17:58The CDC eventually releases the results of this survey in the form of a diagram. Like a network drawing. With circles representing patients and then lines representing sexual contact. And each patient, each little circle, was numbered. New York, seven. Los Angeles, twelve. So you didn't know who was who. But you could tell immediately when you look at this thing... ...that of all the 30 or so circles, there was one circle that was special. It had lines coming out in every direction. Seven or eight emanating from him. Like the hub of a wheel.

18:28Except all the spokes on this wheel connected to other wheels. Which then shot out and connected to other wheels, fanning outward. And at the center of it all was that one little circle, numbered... Zero. Number zero. As far as we know, that was the first time that you ever get the term patient zero. Patient zero was a man. A central victim and victimizer. This is from a 60-minute special in 1988. That year, a reporter named Randy Schultz had written a book called And the Band Played On... ...that for the first time revealed the identity of patient zero.

19:01He was a French-Canadian. A very handsome airline steward. Named Gaetan Dugal. Gaetan Dugal. Patient zero. A few minutes later in the report, Schultz comes on to describe a guy... ...who has got unlimited sexual stamina. This sexual athlete who would fly from one hot spot to the next because of his job... ...having sex with literally thousands of men. And as he knew he was dying, at least according to Randy Schultz, he became somewhat sinister and malicious. He would sleep with a male partner at a bathhouse in San Francisco or somewhere else.

19:34And then when the light came up, according to Randy Schultz, he would say, I've got gay cancer. Now you're going to get it too. You talk to him. I talk to him now. This is Dr. Selma Dritz. She was part of that CDC study. I told him that he was getting other people sick with it. And he said, my right to do whatever I want, my civil rights, I do as I please. I've got it. Why shouldn't they have it? They said, you can kill yourself if you want, but you've got no right to take somebody else along with you.

20:05And he said, screw you, and walked out. Really a chilling moment. And pretty much from that moment on, Gaten Dugas... He just took on this aura as single-handedly causing an epidemic in the United States. Now, I don't know about you, but I first bumped into this story in the movie version of In the Band Played On. My friend, we're talking about thousands of men whose faces I cannot even remember, and you want names. That's an actor playing Gaten Dugas in the movie.

20:36Now, when I first saw that, AIDS had already infected two and a half million people. And to think that it could all go back to this one guy just seemed unreal. It was a very potent story, there's no doubt.

20:52And he gave HIV to a lot of people. There's no question about that. But what we do know is that he was not patient zero. He was not patient zero. No. He was not the beginning point. He wasn't. Not even close. So here's the question that got me started on this story. Okay, so The Gay Steward, that was the movie stuck in my head. But what's the real movie? What movie can we make about the beginning of the AIDS epidemic? Because when you've got something so vast that, according to some estimates, will have killed 60 million people by the end of the decade,

21:24you need a beginning. You need some way of explaining how this disaster happened. And how it might happen again.

21:35And how exactly do we know that Gaten Dugau wasn't patient zero? Well, there are a couple reasons we know it. So one thing that people started to do, scientists, was to, they started going back and looking at people who had died. People who died mysteriously. AIDS-like things. In the past. Might some of them have been early cases. And they started finding a lot. Robert Rayford had AIDS 12 years before it was recognized in this country in 1984. In 1959, a sailor in Britain died of pneumocystis pneumonia.

22:07And so, for a while, you had all these new patient zeros. In 1961, a nurse in Chicago died of Kaposi's sarcoma. But the real definitive blow to this whole patient zero nonsense came by actually looking at the virus itself. In 1984, same year that Gaten Dugau died, scientists isolate the virus, HIV, which is really just a little string of genetic code that gets into your body and into your cells and uses your cells to make copies of itself. But here's the thing. When it replicates within a single patient, it copies itself imprecisely.

22:42It mutates quickly. It changes a lot. As the virus duplicates itself inside a person, the dupes often have little copying errors in them, little mutations. And it turns out those errors, they happen at a predictable rate. You can kind of almost predict how many you're going to see in a year or five years. And so the amount of changes that you see out there, the diversity, really, of the viruses in the AIDS population, well, that becomes really good information. And so a group of scientists began to look at...

23:13The amount of diversity among HIV patients in the U.S. And other parts of the world. And the more diversity, the longer the virus has been around. Right, right. And they could use that kind of like a clock. If you have a virus here and a virus there... You could measure how different they are, and you would know that it would take a certain amount of time for them to get that different. And to make a long story short... The picture they get... Is... That AIDS entered the United States... Around 1966... At a time when Gaten Dugau was still a virginal adolescent...

23:43From there, scientists were able to trace the virus back to Haiti. And from Haiti, back to Africa. It's been there the longest. It's had the longest time to become diverse, to mutate, to evolve. So if you want to really... If you want to get to the real patients here, as it were, the most interesting stuff actually comes from Africa. So one way to try to figure out its origins there is to go looking for the virus. Yep, and that takes us back to ZR-59 and DRC-60.

24:14Can we talk about them? Sure, what? These are the two earliest known HIV-positive human specimens. And this is where, for me at least, the story gets way bigger than I imagined. Now, the first sample... ZR-59... ...came to light in the late 90s. Somehow, scientists unearthed a very old tube of blood from a hospital in Kinshasa, in the Democratic Republic of Congo. And when they tested it... It had HIV. This had been taken from a Bantu man in 1959.

Finding early samples in Kinshasa

24:431959? Yeah, nobody knows his name. Nobody even knows, I think, what he died of. And that was the only one for a number of years. That was our one glimpse into the kind of deep history of HIV. But then along comes that guy, Michael Warby. He's an evolutionary biologist at the University of Arizona. And a few years ago, Michael went back to Kinshasa and found a second HIV sample. He actually found the virus lurking in a tiny bit of human tissue that was preserved in paraffin wax. It's kind of like Han Solo in the Star Wars movie, when he's kind of frozen in that carbonite or whatever that stuff is.

25:20In this new sample, it was from the same town, Kinshasa is the first, and also, more importantly, from the same time. 1960. And with the two of them, then you can kind of go back in time. Like we described before, you can measure the differences between the samples, calculate how long it would take for those samples to get that different. And in the end, you can use these two samples to wind the clock all the way back to the virus that started it all. And it turned out, the most recent common ancestor of those two specimens goes back to about 1908.

25:571908. That is when it started in human beings. What? 1908? Is that what you said? Roughly. Give or take a margin of error. Early 1900s. Wow. So, around 1908, give or take, something happened. That's right. That moment is the spillover. Spillover. Spillover is the term the scientists use to describe the moment when a virus in one species passes into another species. You know, new diseases in humans tend to pop up from animals.

26:28So, people said, okay, flu comes from birds, where does HIV come from? To get at that answer, you have to look beyond human beings. You have to look at other viruses that are like HIV. So, the search was on. The inability to find a similar disease in research animals. Turns out, right about the time that the HIV virus was discovered. Scientists at the New England Primate Research Center. Some researchers found a virus like it in macaque monkeys. In fact, it was so similar that they called it... SIV. Simian immunodeficiency virus? Yes. And that's where the origin quest started.

27:00This is Beatrice Hahn. I'm a professor of medicine and microbiology at the University of Pennsylvania. And so, after they found it in macaques, what happened? Um, it took a couple years. But eventually, she says, they found SIV. And still another primate species, the Sudimangabe. And then in a few more. The African green monkeys, mandrills. Pretty soon, it was all over the place. There are now, I think, 40 different species of African monkeys known to have their own version of SIV. So then the question was, which one of these monkeys, or primates, passed it to us? Then, unexpectedly... A researcher named Martine...

27:32Martine Peters... ...at this center in Gabon... ...Gabon... ...decided to test her chimps... ...two orphan chimpanzees... ...and bingo, she found a very, very close match. A virus that was the closest relative of HIV-1. So?

Chimpanzees and the cut hunter

27:46Everybody said, well, you know... It was a chimp. It was a chimp. Okay. Yeah, it came from a chimp. Yes. But then the question was, well, which chimps? Or rather, where? Where exactly?

27:58So... Beatrice Hahn and her colleagues started looking at chimps that came from different parts of Western Central Africa. Now, getting blood samples from chimps in the wild is pretty much... It just isn't feasible. You know, because in the wild, they hide the moment they see us. So, you get stuck with fecal samples. It's poop. Huh. Yes. Poop. There's lots of DNA in there. And viruses. So, they would just go to where the chimpanzees would sleep at night, and they would just, you know, collect some poop. Bring it back to the lab, and Beatrice would analyze all the viruses.

28:29Over 90 different wild communities... ...from every part of Central Africa. Over 7,000 different fecal samples. And slowly, they were able to piece together... ...which communities were infected, and which ones had the closest to HIV-1. That's when it hit us for the first time. What exactly hit you? The geographic origin of these chimps. In 2006, her and her colleagues published that the human AIDS virus comes from a group of chimps, a very specific group that live in a very specific place.

29:00This little corner of southeastern Cameroon. Between the Boomba River, the Ngoka River, and the Sanga River. These chimps were essentially penned in between these three rivers. It's an area probably only of 100 square miles. Not much more than that. Wow. So, when we're looking at what humans have, and we're looking at what all of those chimps in Africa have, the most perfect match is this little territory up there in Cameroon. Yeah. There is no other virus that is any closer.

29:31So, that's that. So, can you reconstruct the spillover and the who that it spilled over into as best as we understand it? You can hypothesize. And the best hypothesis is the cut hunter hypothesis. The cut hunter? The C-U-T hunter? That's right. A hunter who gets cut. And what can we say about this guy? I mean, what do we know about him? If we had to guess, if we had to guess, that human was probably a Bantu man living very near the forest or in the forest in southeastern Cameroon.

30:06He was hunting. Maybe he had a bow and arrow. Maybe he had a spear. And he kills a chimpanzee.

30:17Bingo. Here's a big pile of meat. And he starts to butcher it. He's cutting open the chest cavity. He's pulling out organs. And he cuts himself. And he gets blood-to-blood contact. Chimpanzee blood against his blood.

30:35What happens is that the virus in the chimpanzee blood found itself in an environment that was unexpected, that was alien to it, but was not too much different from the biochemical environment it had been in, chimpanzee blood. It could function. And that's the moment. That's the moment it begins. That human is patient zero. But why then? Why 1908? I mean, presumably, people have been hunting chimps for a really long time.

31:08Why wouldn't this guy be patient seven million? That's another of the big questions. People certainly in Central Africa have been eating monkeys for thousands of years. I mean, David says there's really no way to know, but this could have just been the right virus. Maybe this particular virus evolved in a way that made it more transmissible in humans. Or maybe it just got lucky to come along at precisely the right time. What you're looking at, this is Carl again, is a time when this part of Africa was being heavily colonized.

31:41The French and the Belgians were building train systems. The populations were on the move. Kinshasa, which was then Leopoldville, it was exploding. It was huge. The cities were attracting people from the boonies in those days. So by 1908, all the virus has to do is get from that tiny village where the Cut Hunter lived to one of the new cities. That happens almost certainly by river.

32:08I was stirred by the work of Beatrice Hahn and Mike Warby to see what this scenario looked like on the ground. So I went to Southeastern Cameron and I chartered a little boat, about a 30-foot wooden boat with an outboard motor. And he traced the path of the virus. We went down the Ngoko River and we stopped at a few villages. There are a couple little villages there, one of which has a market where you can buy monkey meat and crocodile meat. And he says it wasn't hard to imagine how it all might have went down.

32:40Perhaps the Cut Hunter gave the virus to a woman who then passed it on to a fisherman. A fellow that I call the Voyager. Who then got in a boat, as David did, and carried it down the river. The Sangha River, which is the, the Ngoko is the tributary of the Sangha. Sangha becomes a bigger river, 200 meters wide, which then flows to the Congo River, the big river. And into the city. And I imagine him sliding into Brazzaville around 1920, the first HIV positive man to arrive in an urban center.

33:16Where there's a much greater density of humans, where there are prostitutes. A greater fluidity of social and sexual interactions. And that seems to have been the place from which the disease went global. So that's how it happened.

33:57Let me add another parenthesis. There are essentially 12 major groups of the HIV virus. What David means is that 12 different kinds of HIV viruses have spilled over 12 different times. Eight of them came from monkeys, three of them came from chimps, and one came from gorillas. Wow. And of those 12, only one of them is responsible for the global pandemic. Wow, there are 12 kinds. 12 times that we know about. It's probably happened dozens and dozens more times that we don't know about.

34:29So the spillover is not a highly improbable event. In most cases, those spillovers have not resulted in extended chains of disease in humans, let alone global pandemic. In a few cases, they've resulted in localized disease. And in one case, the sweepstakes winning strain, HIV-1 group M, has infected 60 million humans around the world and killed 30 million. A lot of people to thank for this segment.

35:18Thanks to David Quammen, who's got a book called Spillover, which is all about diseases crossing over from animals to us. Also, thank you to Carl Zimmer, whose book on viruses is called A Planet of Viruses. And thank you also to him and to Michael Warby. Their interview was recorded on a podcast from Meet the Scientist and also to Beatrice Hahn of the University of Pennsylvania. And to Katie Slocum from the University of York for letting us use her recordings of chimpanzees. Hey, you want to know about one of my proudest moments of being a dad?

36:05Yeah. Happened this morning. Yeah. So you know how Emil's a little bit of an introvert, right? We're sort of worried whether he socializes enough. Well, we were taking him to daycare and he's taking his shoes off. And there's this little boy who's only there two days a week and he's not adjusting well. And every time his mother drops him off, she has to literally pry him off her. And he's wailing. And so Emil sits down on this little seat to take his shoes off. The mother of this kid puts this little boy next to Emil and he is just crying.

36:37He's distraught. So then what happens is Emil turns to this little boy, looks at him, sticks out his hand and says, High five.

36:51High five. Out of nowhere. That is amazing. Yeah. Because it's like they're out in their own society, you know? Yeah, totally. Yeah. Okay. So let's do the introductions. I'm Jad. I'm Robert. This is Radiolab. We're calling this show. Patient Zero. Yeah. And for this next segment, no more patients.

The origin of the high five

37:09No more diseases.

The origin of the high five

37:10Exactly. Let's focus instead on invention, on the people who bring new ideas into the world. Yeah. The zero is behind the ideas. That doesn't quite sound right. You know what I mean. Yeah. And that guy you just heard? Hi, my name is John Mowallam. I'm a contributing writer at the New York Times Magazine. He's got his own high five story to tell, though it's not about his daughter. We have, I think we have kids around the same age. Or her first high five. It's actually about the first high five ever. Yeah. Ever? Yeah. See, one morning a few years ago. 2007 or 2008.

37:41John turned on his computer, opened up his email, and found... A press release about the true, undisputed inventor of the high five coming, you know, out finally. Who was the press release from? National High Five Day, which is a kind of a joke holiday that was invented by a group of high school friends, I think. And they told the story? They told the story of Lamont Sleets. He was a college basketball player at Murray State in Kentucky. And the story in the press release went something like this. Sleets' father fought in Vietnam as part of the 1st Battalion, 5th Infantry, which was

38:13nicknamed the Five. And they used to greet each other by holding up their hand and saying, Five, as a kind of prideful thing. And when Lamont was younger, they would all sort of hang out at the house in Kentucky, and he couldn't keep all their names straight. So when they'd walk in the door and go, Five, he would just sort of smack their hand. And they'd go, Hi, Five. Oh, like, Hi, like, Hello, Five. Hello, Five, yeah. Hi, comma, Five. You know, he has small hands. He likes to put them up against the big hands of the five guys. And it was years later that he started playing college basketball at Murray State and started

38:43high-fiving all his teammates. He really never stopped high-fiving. It was just something he did. But when he went around playing away games, other teams picked it up and it sort of spread out. So he was sort of both the inventor of the high-five and the kind of Johnny Appleseed did a high-five at the same time. And within a few weeks of John getting this press release... The story was everywhere. ...went kind of viral. It wound up sort of all over the internet. There were some local newspapers who, you know, picked it up. You know, Murray State suddenly became very proud of the fact that they were the home of the high-five. It became sort of part of the institutional lore in the athletic department there.

39:13And then you read this and you thought what? I thought, how sad.

39:20How sad? Why how sad? Because I knew the story of Glenn Burke.

39:27Turns out John had already been poking around into this question of who invented the high-five and he had stumbled on this photograph. You know what? Maybe I don't have it, but... Black and white picture. Oh, yeah. Here we go. Two baseball players facing each other. Afros. Huge smiles. And their hands are in the air right about to connect. Which one of these is Glenn Burke? Burke's the guy in the warm-up jacket. I think he's even got his hat on backwards. Glenn Burke was a center fielder for the L.A. Dodgers in the 70s. Big guy. He says he had 17-inch biceps, so I'll take his word for that.

39:57The other guy in the picture is Dusty Baker. He's an outfielder. But you can tell in the picture, just from the way that Glenn is sort of throwing his whole body forward, that he's the one initiating the gesture. I mean, this is a guy who was, you know, the soul of the Dodgers clubhouse. He just had that type of charisma. This is Luther Burke Davis, Glenn's sister. With Glenn, it was like, like he'd always be on the stage. Often said he should have been a comedian. He was always dancing around in the clubhouse. He used to do Richard Pryor stand-up routines, just from memory. He just genuinely loved people.

40:29So much so, she says, that in the year that picture was taken, the Dodgers made him the sort of public face of the team. He was their ambassador of goodwill. He's the guy they'd sit down to all the press events. You know, like meet the youngsters or people, you know. That sort of thing.

Glenn Burke and the Dodgers

40:41Here's the story about this picture. What was the date? October 5th, poetically enough, 1977. It's the playoffs, Dodgers versus the Phillies, game four, bases are loaded. Dusty Baker. Steps to the plate. And.

40:58Grand slam. Crowd goes nuts. Baker does his victory lap. In just disease. You know, round and third coming to the plate. Burke comes racing out of the dugout. And he's got his arm really high up. And Baker. Sees him instinctively raises his arm. And before you know it. Burke and Baker. Smack hands. Bam. There it was. The sportscasters that were, you know, announcing the game said they had never seen that done in sports before. And from there on the Dodgers started high-fiving and everyone else started high-fiving. The high-five. Became a thing. Mm-hmm. And it all began with that one moment.

41:35The platonic high-five right there. Unfortunately, that moment? That was actually both the beginning and also almost the end of Burke's career. It's not that he wasn't good. He was actually really good, even in his rookie season. He was being talked about as the next Willie Mays by the Dodgers organization. But? He was gay.

41:56And he tried to keep that a secret while he was playing. Dusty Baker actually had kept trying to set him up with his wife's cousins. And Burke never liked any of them. And Baker was completely confused because he knew these were really good-looking women, apparently. So there were rumors circulating. And the rumors reached the front office of the L.A. Dodgers. And one day, Burke was called in by management. And they offered him $75,000 to get married. What? $75,000? To get married? Huh. What is this, like the mob or something?

42:26Well, exactly. I mean, no, they didn't regularly offer their players money to get married. And Burke's response, apparently, was he said, I suppose you mean to a woman. And shortly after that, the Dodgers traded him to the Oakland A's for a player who everyone acknowledged was completely inferior. That was confusing for us. And I know it had to be confusing for him. It was shocking to everyone. No one understood why he was traded. And you think it was because he was gay? Yeah. Yeah. You know, baseball is all American sport. Yeah. But, you know, at least he was still going to be able to play ball.

43:00Or at least he thought. He ends up in Oakland. Doesn't get very much playing time. And when he did get on the field, it wasn't very pleasant. He used to get heckled a lot, you know, from people in the bleachers. And even worse, according to a couple of different people, his coach. Billy Martin. Would often introduce Glenn Burke this way. This is Glenn Burke the faggot. Really? Yeah. And so Glenn Burke retires. Wow. And he was only like 26 or something, right? Yes, he was young. Within a year of his rookie season. Just walks away. God, that's like an aborted career.

43:32Exactly. From there, he ends up in the Castro District in San Francisco, which is the big gay neighborhood. And things go okay for a while. But then one day when he's crossing the street. Three teenage girls in their mother's car. Come barreling down the road. And they hit him. And broke his leg in three places. Oh, man. And that kind of ended everything when that happened. He starts taking painkillers. One thing leads to another. He gets hooked on crack. Can't hold a job. He goes broke. Ends up living. On the streets.

44:02And in 1994, Burke is diagnosed with HIV or AIDS. I guess AIDS at that point. He ended up coming to live with me.

44:13A lot of times he didn't sleep well at night. And we would sit up and talk.

44:18Put on music and I'd dance and he'd move his arms around because he was in the bed. He was bedridden.

44:28And so you took care of him until he died? Yeah.

44:32Glenn Burke died in 1995. But what he's left with at this point is he's left with the original high five, right? That's his claim. Yes. Yes. That defined him. To some people, at least, at the end. And he believed it. A reporter had asked him, you know, if it was true about the high five. And he said, yeah, think about the feeling you get when you give someone the high five. I had that feeling before everybody else did.

44:58Huh. So what did you do when you got this press release? So I called National High Five Day because I wanted to talk to Lamont Sleets. Even though I was sad, it seemed like, okay, here's another person's prideful accomplishment. Let's get his story. Hello.

Unraveling the viral prank

45:15Hello. Eventually. Hey, there we go. He gets this guy on the phone. My name is Greg Harrell-Ledge. Greg is one of the founders and he and John get to talking. And John asks him the sensible first question. Is the Lamont Sleets story true? He figured it was, but, you know, he thought he should at least ask. He's a reporter. And there was a pause and he said, no. Frankly, we've been waiting for someone to ask. We thought no one would ever ask. It's not true. This is something that we had made up. We wanted to see if the media would run with it. They made the whole thing up. They made the whole thing up and then they just went to go cast their protagonist.

45:46Yeah. So we sat down, we picked Murray State. That's just kind of a great sounding school. It pops up in the NCAA tournament every few years. And they came across this guy, Lamont Sleets. Why him? Well, it was pretty close to random. They then told me they had received an email from Lamont Sleets' wife. Absolutely. His wife emailed us and said, some of the details that you have are flat out wrong. That implies that some of the things you've said are right, though. But Lamont thinks he probably did invent the high five. Wait, wait, wait, wait. What about Glenn? I was kind of like, hmm, kind of a bit blown away, you know?

46:21Yeah. You know, here was this guy who was proud of this and these guys just kind of stripped it away from him. Do you feel a little guilty? Did I mean like, okay, it's a high five. It's kind of a silly thing. On the other hand, this guy's life, the way he died. Do you feel like you robbed him? We do feel, we do feel we wish that we had done things slightly differently and putting together this sort of collegiate prank. But we didn't really know of Glenn Burke at that time. Greg says they hadn't heard of the Glenn Burke story when they pulled this prank. And now that they know it, they really feel bad.

46:53In fact, they're now organizing a charity event they're calling. The National High Five-A-Thon. Which will raise money for charity, including one chosen by Glenn Burke's sister, Lutha. I'm very proud. Anytime I see somebody do a high five, it just really makes me happy. And that seemed like a good end to the story. But, uh, no. Because then John told us that. If you really honestly want to get to the bottom of who invented the high five, I mean, we didn't think we wanted to, but now that we're in it, what the hell? Well, you've got to go beyond Glenn Burke's story. I've wanted you to believe that he was the hero at this point, right?

47:25So maybe I should tell you a little bit about Derek Smith, right? Even though Glenn Burke died believing that the high five was his legacy, at more or less the same moment that he invented it, a guy named Derek Smith, a basketball player for the Louisville Cardinals, was at practice. And a guy named Wiley Brown went up to Derek Smith and was going to give him just an ordinary low five, and Derek Smith looked him in the eye. This is what Wiley Brown told me. Derek Smith looked him in the eye and said, no, up high.

47:55That year's Louisville team, they were known as the Doctors of Dunk. You know, they're a high-flying team. They played above the rim. And John says when Louisville played in the 1980 NCAA Finals. Wiley Brown. I haven't seen it, but apparently the broadcaster referred actually to the high-five handshake. Give him the high-five handshake. High-five. He felt compelled to explain it to America. Wow. And did the moment that Derek Smith did it, did an asteroid fall on his head or something? Well, in 1996, I believe, in the 90s, he had an undiagnosed heart condition.

48:25And he just died all of a sudden on a cruise ship. What? Yes. And he said explicitly to Wiley Brown, this is something I'm going to be remembered for. You know, our kids and our grandkids are going to talk about this. And in fact, our kids and grandkids do talk about it. And they're probably very proud. But. It was Kathy. Then we ran into this one. You're not fire away. This is Kathy Gregory. She coached women's volleyball in the 1960s, years before Glenn Burke and Derek Smith. And she says with her girls. Everyone did it. All the time. So I do believe that it was volleyball that first started it.

48:58And interestingly, she says they would high five more when a player screwed up. Yes. No, no. It isn't just about celebration. Because really, when do you need a high five? Of course, it's more when you're down. Yeah. It makes people so happy. So women's volleyball. There you go. Because then our producer Lynn Levy also discovered that in the movie Breathless in 1955, and exactly one hour, 18 minutes into the film, you will see two Frenchmen do a very distinct haute 5 right there.

49:30Isn't this all like an indication to you that it's maybe, it's one of those things that probably was there, the dawn of man? Because it like gives pleasure? Yeah. It's just like a... Like from an evolutionary point of view? No, I don't think so. I think this has the feeling of something that was born. I mean, who in this room wants Glenn Burke to be the original guy? Just raise your hand. Yeah. Me. Me. Yeah. It's the better story, frankly. So look at what's happening here. Every time we look for the original of anything, be it a disease, a contagion, a gesture, we

50:05find more than one. So what do you do in this situation? I think, you know, what you do is you just choose. You say, which one is the better story? Let's just go with the best high five. Forget the first, the best. And I think we can do that. Let's just call it Glenn Burke. Glenn Burke invented the high five. Done. All right. High five. High five. High five. High five. High five. High five. High five. High five. High five. High five.

Staff credits and closing

50:27High five. High five. High five.

Staff credits and closing

50:28Hi, I'm Josh, and I'm from Plainfield, New Jersey, and here are the staff credits. Radiolab is hosted by Lulu Miller and Latif Nasser. Soren Wheeler is our executive editor. Sarah Sandback is our executive director. Our managing editor is Pat Walters. Dylan Keefe is our director of sound design. Our staff includes Jeremy Bloom, W. Harry Fortuna, David Gable, Maria Paz Gutierrez, Sindu Nyanantzambandam, Matt Kielty, Mona McGaulker, Annie McEwen, Alex Neeson, Sarah Kari, Natalia Ramirez, Joanna Strogatz, Anissa Vitsa, Arianne Wack, Molly Webster, and Jessica Young.

51:15With help from Gabby Santas and Maya Appleby Malamed. Our fact checkers are Nora Belblidia, Hilary Elkins, Rachel Gross, Diane Kelly, Emily Krieger, Natalie Middleton, and Sophie Samain. Hi, I'm Maddie, and I'm from Frederick, Maryland. Leadership support for Radiolab's science programming is provided by the Simmons Foundation and the John Templeton Foundation.

51:49Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation. Here's an official