the free coffee shop space, and a group of medical students ready to volunteer their time and services, the student group began offering weekly VD testing. Even as the two groups had different, though complementary missions, a mutually beneficial collaboration grew out of Gay Horizons’ desire to expand into a full social service organization and the gay medical students group’s plan to provide VD testing.
Like the early days in Boston’s Fenway Community Health Clinic and the Los Angeles Gay Community Services Center, the coffeehouse “clinic” reflected the needs of the gay male community, the relaxed regulation of community health services, and the entrepreneurialism of gay health activists of the period. One of the medical students group’s most active early members (besides Ostrow) was Kenneth Mayer, a medical student at Northwestern University. In just his second year of school, Mayer jumped at the chance to work with patients and volunteered weekly to do exams and conduct testing. He commented in an interview, “In retrospect this was something we would never allow now … because my training was minimal, I was really early in my medical training and the level of supervision was really minimal but you kind of quick-study. It was a really incredible learning experience.”70 In 1980, after finishing medical school, Mayer moved to Boston, where he became instrumental in transforming the Fenway clinic into a world-class research institution. The casual, make-do approach to staffing permeated nearly every aspect of the clinic, which consisted of “a coffee pot, a portable kitchen table, [and] a room above an old grocery market.”71 Ostrow explained how the ethos translated into the health services:
Wednesday evening once a week … We were mostly medical students and a couple of residents and maybe a couple of actually licensed MDs. So we couldn’t really officially be a treatment site, but we would try to have a doctor there every Wednesday night, and if there was a doctor there he would write a prescription for medication. But if we couldn’t get a doctor there or the patient didn’t have money for the prescription, we would actually pilfer the medications from the stockrooms at our hospitals where we were training.72
Mayer concurred, “There was a lot of begging, borrowing, and stealing,” just as had been the case in Boston.73
Within months of its opening the gay health clinic also began to go by its own name, which reflected the mutual medical and gay liberation roots of group members: the Howard Brown Memorial Clinic. Howard Brown had been the head of the New York City Health Services Administration in the mid-1960s, charged with managing dozens of hospitals and clinics and thousands of employees before he chose to step down rather than be outed by an investigative reporter in 1967. From there he went on to join the faculty at area medical schools before he announced his homosexuality at a lecture at one such school in 1973. His coming out made the front page of the New York Times, and he became the highest profile gay medical professional in an era in which simply being homosexual was cause for medical concern.74 Brown embodied the changing attitude toward homosexuality within medicine that gay health activists around the country worked toward throughout the 1970s.75 In early 1975, shortly after the gay medical students’ clinic began operation, Brown died at the age of fifty of a heart attack. The students named their coffee shop clinic in homage to the greatest gay doctor activist of their time.
The Howard Brown Memorial Clinic grew, moving from its initial space in the Gay Horizons coffee shop above the grocery store in the fall of 1975 to an office in the La Plaza Medical Center that could accommodate increased hours of operation that spilled over into two nights per week.76 Even with its successful diagnosis and treatment of hundreds of cases of venereal diseases, the work of the clinic was reactive in nature. Though gay men came to the clinic because they were, or thought they were, infected with a venereal disease, the majority of the gay community did not frequent the clinic. With his knowledge of social medicine, gained from mentors at the University of Chicago (which included social medicine authority Dr. Quentin Young), Ostrow knew that “if you want to rob, you go to banks because that’s where the money is. So if you want to get people and test them and treat them before they pass on VD, you go to places where they’re congregating … and having sex … you have to go to where the people are rather than wait for them to come to you.”77 In other words, to make health care within the gay community more preventative, rather than reactive, and instill a concern for sexual health among the growing gay social and sexual culture, the Howard Brown Memorial Clinic needed to provide services and build relationships beyond the walls of the new clinic space. Here again, as the clinic sought to start outreach programs with gay bars and businesses to attract new patients and conduct research, the threads of gay liberation and medicine intertwined in Chicago.
Though clearly medical in its focus, the Howard Brown Memorial Clinic relied heavily on the city’s blossoming gay businesses and institutions to bring its services to fruition at first and to expand them. Its initial affiliation with Gay Horizons, along with the personal reputations of clinic activists, gained the clinic access and permission to conduct outreach in local bars and bathhouses. Even as a subsidiary of the larger organization, the clinic was largely autonomous. The medical students scheduled their own volunteers to staff the clinic, managed patient “files,” which consisted of hundreds of four-by-six-inch index cards, and ferried blood samples to city labs.78 As their self-sufficiency grew, with the clinic leaving the coffeehouse venue for a larger, more conducive space that could accommodate increased hours of operation, the priorities of Gay Horizons and the Howard Brown Memorial Clinic diverged from one another. The clinic focused on medical services and research, and it grew exponentially in its first two years in patient numbers, outreach possibilities, and potential for scientific study.79 True to his training as both a medical doctor and a biochemist, Ostrow began conducting medical research, proposing large-scale studies, and, later, publishing his findings to advance knowledge about gay sexual practices, medical needs, and effective treatment methods shortly after the clinic opened.80 Meanwhile, Gay Horizons’ interests lay in building community and providing social services to Chicago gays and lesbians. It began in 1973 by creating a gay helpline and providing meeting spaces like the coffee house that also housed the clinic. Over the course of the next three years, the organization shifted its focus from building social community to also providing social support services like a youth program, peer counseling service, and a drop-in center.81 The inclusion of VD testing in the coffeehouse in 1974 speaks to the organization’s move to provide more support services to the gay community during this period. By 1976, Gay Horizons, in its service offerings, was reminiscent of, though smaller and without a large building of its own, the Los Angeles Gay Community Services Center. By contrast, the Howard Brown Memorial Clinic edged closer to being a medical clinic and research facility. The divergent missions proved grating.
A funding dispute in 1976 allowed the clinic to break away from Gay Horizons and create a clear set of policies and procedures that reflected its allegiance to efficient, high-quality medical care as well as to the gay community. The Howard Brown Memorial Clinic employed a very structured and traditional organizational model with a set board of directors, to which people were nominated, including officer positions of treasurer, secretary, and medical director, among others. The rigid and hierarchical organizational structure chosen by the clinic contrasts dramatically with the Fenway clinic’s original structure in Boston. In fact, also unlike in Los Angeles, there appears to have been very little debate of any other structure or alternative hierarchy for the Chicago clinic, illustrating the strong medical, rather than political, roots of the clinic and its volunteers.
In the place of concern and debate over organizational structures and everyday operations, the medical students and professionals of the Howard Brown Memorial Clinic, with Ostrow at the lead, almost immediately set their sights on medical research and quickly took up the mantle as the most research-focused gay community health clinic in the country. Ostrow and other medical students and young medical professionals like Ken Mayer created an ethos for the new organization that relied on medical training and scientific research to address the medical needs of the gay community. Ostrow and others also made sure that the clinic continued to provide free and sliding-scale services as a gesture to their shared political belief in socialized medicine. This strong set of guiding
