From Outside to Inside and Back Again

Conventional views of science presume a top-down model of knowledge dissemination. True ideas originate within a select community of educated specialists; from there, they percolate "downward"; eventually, in watered-down or distorted form, they penetrate the consciousness of the masses. But as Stephen Hilgartner has argued, this model fails to capture the ways in which "popularized knowledge feeds back into the research process."^[138] Duesberg's views on AIDS are an interesting example. Early in the epidemic, ideas about

"immune overload" diffused from researchers to doctors and patients and were taken up by lay theorists such as Callen and Lauritsen. Many of these same ideas then reemerged in the scientific articles of Duesberg, who cited the lay publications in his footnotes and thanked their authors in his acknowledgments.^[139] As Hilgartner noted, "when one looks carefully for the precise location of the boundary between genuine scientific knowledge and popularized representations, one runs into trouble. …"^[140]

There is still another sense in which the pursuit of scientific credibility by Duesberg reveals the considerable permeability of boundaries between the "inside" and the "outside" of science in the case of AIDS. On one hand, Duesberg's success in promoting his views depended heavily on his status as an "insider." As of 1986, dissenting voices on the causation of AIDS were marginalized, and they might have remained so had someone with the scientific credibility of Peter Duesberg not entered the debate. On the other hand, Duesberg's capacity to sustain his critique then depended heavily on support from "outside." His article in Cancer Research might have gathered dust on library shelves, if not for the active promotion of his views by a group of lay supporters who succeeded in pushing the controversy into the mass media. This publicity led to Duesberg's presentation of his arguments in official forums, such as the AmFAR conference, Science , and PNAS . By extending his credibility from one arena to another—using his scientific credentials to buy him popular support, then using the popular support to push for recognition by his colleagues—Duesberg gained staying power. The next chapter describes how Duesberg sought to continue his battle and how the "AIDS establishment" responded.