The Clam 

NEW S.T.D. A PUZZLE TO INVESTIGATORS
by Bernard Taylor

TERRE HAUTE--When Ishmael Gradsdovich, 26, found a small bump on 
his penis, he wasn't alarmed. "Bumps happen," he says, in his 
best Forrest Gump. He thought that maybe it was a pimple, or 
an inflamed pubic hair follicle. But when the bump swelled, the 
homeless Gradsdovich went to a free, walk-in health clinic in 
Chicago where venereal warts were diagnosed. 

Case closed, he thought. Although in women they have been linked 
to cervical cancer, venereal warts in males are, although annoying,
embarassing, and sometimes unsightly, a minimal health problem. 


But the case was far from closed, and in fact is a case study in 
an alarming new venereal disease that is worrying investigators. 


The understaffed and undertrained Chicago clinic had misdiagnosed 
Gradsdovich. When the "wart" disappeared, he went back to his sexually 
promiscuous street lifestyle with a passion, so to speak. If anything,
"I was hornier than ever before," he says. 

[I]That bump, misdiagnosed as genital warts, was the only known 
physical symptom of a venereal disease that is so new, and so 
strange, that it doesn't even have an accepted name yet in the 
medical literature. On the street it is known as "the clam" -
- perhaps a reference to the shape of the indicative bump. 

Now that investigators know what to look for and how, it is easy 
for them to make a correct diagnosis. Investigators were reluctant 
to reveal their method--they want people who suspect they have 
a venereal disease to come to professional medical treatment rather 
than trying to treat themselves at home--but the Herald has 
learned that a simple application of vinegar to the bumps is enough 
for a tentative diagnosis. Warts will pale to white when vinegar 
is applied, "the clam" will not. 


Sex Drive Increases


What is alarming about this disease is not the medical consequences 
-- investigators have found no serious health problems associated 
with the disease, and many people may never know they have been 
infected. But this disease, unlike any other, changes the psychology 
of its victims in a very specific, direct way--and a way designed 
to promote the spread of the disease. 

People infected with "the clam," at some point shortly after the 
disappearance of the initial bump, find their sex drive increased 
to levels hardly known outside of the experience of adolescent 
boys. Furthermore, this seems to be accompanied by an increase 
in promiscuity--with the number of sexual partners increasing,
although this may be more a side effect of the constant arousal 
prompted by the infection than a direct effect of the disease. 


"This isn't the first time a disease has prompted behavioral changes 
in order to promote its own spread in a population," says Dr. 
Isabel Rabit, writing in the journal Epidemiology. "Even the 
common cold, which assists its own spread by causing sneezing 
in its host is a pathogen which uses behavioral changes caused 
by its own infection to succeed in its chosen environment." 


But this is the first time a disease in humans has gone beyond phisiological 
reflexes like sneezing and coughing, to change the psychology of 
its victims. Typhoid Mary spread typhoid fever by coughing while 
working in a restaurant. The disease caused the cough, but Typhoid 
Mary caused the epidemic by deciding to go to work. "The clam" 
works differently--"It is as though there had been a strain 
of the disease that had made Typhoid Mary want to go to work," 
Rabit writes. 


Disease has defenders


Because the disease has almost no physical symptoms, and no harm 
has been shown to the human body from being infected, some people 
with the disease aren't too unhappy about it. In fact, a world 
wide web (WWW) site on the internet has a section run by infected 
people, called [I][*]"Aphrodiseaseiac" that contains messages 
with this radical view. 

"We have a disease which makes us more loving, more sexual, and causes 
no harm. Spreading it is more than fun, it is holy. Join the 
sick!" says one of the readouts. 

"It's possible," writes Kenneth MacTerrel in the journal Harmonic 
Dispatch, "that this is not a 'disease,' but an organism destined 
to live symbiotically with our own, encouraging more emotive, 
sensual behavior, and less of the competitive, war-like ethos 
which is causing so much harm in our society today. This 'disease' 
is not actually disrupting anyone's ease, and should be looked 
at instead as the catalyst for a new stage in human evolution." 


"This is a ridiculous and dangerous attitude," says Dr. Lucy Axelrod 
of the Centers for Disease Control. "We don't know what this 
disease can do." She notes that AIDS sufferers were infected many 
years before they started showing symptoms of the disease. "In 
1980, would these people have said that HIV was a harmless virus?" 
she asks. Axelrod, and others at the CDC, are worried that other,
more harmful sexually transmitted diseases like AIDS may "piggyback" 
on "the clam," taking advantage of its effects to spread even 
more rapidly. 


Quarantine suggested


And at least one state legislator, Howard Albatros of Florida, has 
suggested that people with the disease should be tested for AIDS 
and if infected, quarantined indefinately. "People with this 
disease are a walking timebomb," he says, "a danger to public 
health worse than anything we've seen in this century." 

Public health officials haven't suggested such approaches, but are 
worried still. "There are medications which subdue the sex drive,
" says Axelrod, "and these have been tried with some success, 
but we can't force people to take them, and many people prefer 
to go untreated. We recommend condoms, although not enough testing 
has been done to ensure that condoms actually prevent the spread 
of the disease." 

Axelrod says that the "female condom," recently made available 
over-the-counter in drug stores, is likely to be the most effective 
way of stopping the spread of the disease, as the "bumps" associated 
with the disease and thought to be indicative of where the disease 
entered the body can occur anywhere in the pubic region, and not 
just in the regions normally protected by a standard condom. 


Estimates as to the number of people infected vary widely, with one 
source guessing that "at least five thousand people are infected,
" and another believing that "as many as one out of every twenty-
two adults in America" have the disease. 


Fashion statement


But nothing has been done which has any hope of slowing the spread 
of the epidemic, and in fact the infection has become sought out 
in some quarters. The Shell service-station hats which have become 
an inner-city fashion statement of late, and which was worn by 
lead singer X.Y. Zee of the group Farrr in their recent MTV hit 
"Storm Widow" are said to be indication that the person wearing 
it has the disease and is willing to "share" it. 

Some have even talked about a phenomenon they're calling "clam diggers,
" in which people, typically young women, seek out partners with 
the disease in order to become infected and thereby increase their 
sex drive. 

Ishmael Gradsdovich has mixed feelings about his own infection, saying 
he's a little scared of a feeling he describes as like being "possessed 
by some sort of alien," but enjoying the revitalization of his 
sexuality. He says he uses a condom, but doesn't want to go on 
medication which would reduce his sexual desire. "I haven't had 
sex this good since I was a teenager," he says. "But then again,
I didn't like having a hard-on all the time when I was a teenager." 


The Herald caught up to Gradsdovich in Terre Haute, where he is 
living as a guest of the Indiana State University Medical Center 
as one of forty people with the disease--mostly homeless people 
like himself who were encouraged to join the study by promises 
of free housing and help getting public assistance. 

Once a week, he is given a physical and given psychological and mental 
tests and is asked about his sexual habits. He told this reporter 
that in the three weeks he has been in Terre Haute, he has had 
five sexual partners, including one on the medical center staff,
and recalls with pride that they all were impressed with his sexual 
vitality and his ability, as he puts it, "to get it up three or 
four times a night." 

He says that he will disclose details about his disease to his partners 
"if they ask," by handing them a flier produced by the ISU Medical 
Center which sketches out the little that is known for sure, or 
suspected, in the medical community. And he claims that none 
of the partners he still communicates with has come down with 
"the clam." 

Dr. Felix Leopard says that Gradsdovich's behavior, as randomly promiscuous 
and of uncertain safety as it is, is better than many. "Some don't 
use condoms at all, some have other S.T.D.s [sexually transmitted 
diseases], and most don't tell their partners anything." As for 
Gradsdovich's uninfected partners, "it's too early to tell. We 
don't know the incubation period of the disease, or much of anything 
about it. We suspect it's a virus, but that's about all we know." 


Why aren't the medical center researchers isolating the subjects,
protecting the public from this epidemic? "We feel that it's 
in the public's long-term interest to have an honest picture of 
the actual progress of the disease and its effects on an individual,
rather than to hysterically quarantine the victims of the disease 
in the absence of any evidence that such actions are warranted." 


Citizens angry


This infuriated some Terre Haute residents, including the Rev. Tad 
Apron, who showed up with parishioners and other angry members 
of the community at a city council meeting last week to angrily 
vent their worries. "This isn't some sort of benign form of measles 
we're talking about here," the fiery and flamboyant Apron said,
"this is a sex disease, threatening to turn you and your children 
into heat-seeking love missiles of death. We don't know how this 
disease kills, or how it spreads. Who knows but that these people 
may be infecting the workers at your day-care center, your local 
McDonalds, or your next-door neighbor? Who knows but that you could 
get this disease from a mosquito or a tick?" 

Apron's rhetoric, and the pleas of the other citizens who spoke at 
the meeting moved the council to pass a resolution urging the 
medical center to "ensure that epidemic diseases are kept out 
of innocent communities." But because the center is outside of 
city limits, there was little non-symbolic action that the council 
could take. Apron vows to take the issue before [sic.] county 
board of supervisors in two weeks. 

Medical center spokespersons, though, insist that while studies have 
not been completed yet, there is no evidence that the disease 
can be spread through casual contact, insect bites, or food-handling. 
It is not even certain that the disease can be transmitted through 
the blood (although the CDC is eager to come up with a way to 
test the nation's blood supply for the disease), and the one known 
case of an infant contracting the disease from an infected mother 
has been complicated by a dispute over whether sexual molestation 
may have been the real mode of transmission. 


Immorality encouraged?


Which raises another issue. While no hard figures are available,
there have been whispers among researchers that people with the 
disease are more likely to commit crimes such as rape and sexual 
molestation. 

"This is one angle we are looking at," admits Axelrod, although "there 
isn't enough evidence one way or another yet, and even if it is 
shown that there is a correlation, this doesn't tell us much. 
It may be that the acts of molestation or rape are, because of 
the physical trauma they cause, more likely to spread the disease 
so that people who are prone to this sort of violent behavior 
are more likely to be infected. It is certainly premature to 
even begin to suggest that this disease causes violent sexual 
behavior." 

Doria Gherkin, author of Men in Hate with Woman isn't buying it. 
"It's an open secret among researchers that men with this disease 
go on to commit date rape at astounding rates. It's a challenge 
to the feminist argument that rape is about violence, not sex. 
An increase in the male sex drive leads to an increase in rape 
-- the male sex drive is essentially a rape drive that goes wild 
in these cases. As I wrote, in Men in Hate, in male culture slow 
murder is the heart of eros. Men find violence sexy, and when 
they become sexually driven, they become compelled to violence." 


"If it does turn out that this disease encourages rape or molestation,
" Axelrod says, "then it becomes a public health problem in a 
way that we're not used to." 


Support groups formed


In San Francisco, a support group, called "The City Chowder Club,
" formed to discuss the problems associated with the disease. 
Starting as a discussion and education group, with speakers coming 
from the medical community to discuss options and current research,
it quickly degenerated into a sex club. "The meetings are essentially 
fast-forward singles bars," one member told a writer for Epidemiology. 


Ironically, others are suggesting just this approach to stop the 
disease-- channeling the expanded sex drive of the infected individuals 
into avenues which allow them to gratify their desires without 
spreading the disease to uninfected people. One scholar even 
suggested that an all-out effort be supported with public funds 
to design durable, inexpensive and effective masturbatory aids 
and that communities or subcultures of infected people be set 
up so that those with "atypical sexual needs" are able to pair off 
with each other. 

With no consensus in sight, even such far out approaches as these 
have been reviewed with respect in the New England Journal of 
Medicine. And, until researchers like those at the University 
of Indiana give us real data on the mechanisms of the disease,
this sort of guesswork and wishful thinking is all we have to 
work on.