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The Tuskegee Syphilis Experiment · Stuff You Should Know

0:01
Speaker 1: Welcome to Stuff You Should Know, a production of iHeartRadio.
0:11
Speaker 2: Hey, and welcome to the podcast. I'm Josh and there's
0:13
Speaker 2: Chuck and this is Stuff you should Know about one
0:17
Speaker 2: of the more shameful chapters in US history and indeed
0:21
Speaker 2: medical history. I think you could say too.
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Speaker 3: Yeah, for sure. And by the way, if you hear
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Speaker 3: weird noises, my immediate neighborhood is sort of crazy right now.
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Speaker 2: What's going on?
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Speaker 3: Well, I've got construction next door, I've got a lawn
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Speaker 3: crew across the street, and they're also shooting a movie
0:41
Speaker 3: across the street. So it's just pandemonium is happening outside
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Speaker 3: these sort of quiet doors.
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Speaker 2: You know what. I would call that shameful.
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Speaker 3: Not like this no episode, for sure.
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Speaker 2: That was my attempt at segaway.
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Speaker 3: Yeah, nice work.
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Speaker 2: I don't know about that, but thanks.
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Speaker 3: By the way, this one is a listener recommended and
1:00
Speaker 3: a teenage listener. This came from Miles Kendrick, a fourteen
1:03
Speaker 3: year old.
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Speaker 2: Nice Miles, great idea.
1:05
Speaker 3: Yeah, thanks for that.
1:07
Speaker 2: Yeah, we're talking about what's called the Tuskegee Syphilis Experiment
1:12
Speaker 2: or Tuskegee Syphilis Study, and the actual official name for
1:17
Speaker 2: it was the Tuskegee Study of Untreated Syphilis in the
1:21
Speaker 2: Negro Male.
1:23
Speaker 3: Yeah, that spells it all out, doesn't it.
1:24
Speaker 2: It does. The fact that there's an official title for
1:27
Speaker 2: this just really kind of goes to show you just
1:29
Speaker 2: how nefarius the whole thing was. And it was indeed
1:32
Speaker 2: a nefarious experiment, no matter. It doesn't really matter how
1:37
Speaker 2: you slice it. You can look at it any number
1:40
Speaker 2: of ways and it always still washes out stinky.
1:44
Speaker 3: Yeah, it does. And this was an experiment. I mean,
1:47
Speaker 3: I guess we'll go ahead and say what happened generally
1:50
Speaker 3: is that they recruited black men in Macon County, Alabama
1:55
Speaker 3: that had syphilis. Kind of one of the misconceptions is
1:58
Speaker 3: that they were given syphilis as part of this. Not true,
2:02
Speaker 3: but don't worry. We did that in Guatemala, as we'll
2:04
Speaker 3: see later on. Yeah, and sign them up for this
2:08
Speaker 3: study where they would not treat these men of syphilis
2:11
Speaker 3: just to see how it progressed, basically because they had
2:15
Speaker 3: this notion and you know, of course just doesn't excuse anything.
2:18
Speaker 3: But one of the supposed reasons that they had this
2:21
Speaker 3: notion that syphilis would was different in white men than
2:24
Speaker 3: black men, and that in black men, it was more
2:28
Speaker 3: cardiovascular based as far as the symptoms and the results,
2:32
Speaker 3: and then in white men it was more neurological. And
2:34
Speaker 3: it was initially supposed to be a six month thing,
2:37
Speaker 3: but it went on not for four years, not for
2:41
Speaker 3: fourteen years, but for forty years.
2:44
Speaker 2: Yeah. I mean it started out in nineteen thirty two
2:47
Speaker 2: in the Jim Crow South and it carried right through
2:51
Speaker 2: the entire Civil Rights era. A number of other historical
2:55
Speaker 2: things happened during this time that should have given the
2:58
Speaker 2: researchers pause. From what I saw, the best explanation is
3:02
Speaker 2: not that these people were inherently evil, although you can
3:06
Speaker 2: make a case that at least one of the people
3:07
Speaker 2: who led the study at one point was we'll talk
3:09
Speaker 2: about him later in Guatemala, But more that they just
3:14
Speaker 2: came to see these these men, these individuals, these human beings,
3:17
Speaker 2: there's nothing more than a data set, and that they
3:20
Speaker 2: stripped them of their humanity so thoroughly that they didn't
3:24
Speaker 2: even really think that this was there was anything wrong
3:28
Speaker 2: with what they were doing, even over the course of
3:30
Speaker 2: forty whole years.
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Speaker 3: Yeah. And the reason why they chose Macon County is
3:35
Speaker 3: a few reasons. One, it's proximity to Tuskegee, which was
3:38
Speaker 3: you know, key is the place where they carried this
3:40
Speaker 3: stuff out and others because they they zoned in on
3:45
Speaker 3: that area because they initially were trying to find out
3:49
Speaker 3: how many people had syphilis and where so they could
3:52
Speaker 3: treat these men, right, and they found that Macon County,
3:55
Speaker 3: Alabama had the highest prevalence of syphilis. And also in
3:58
Speaker 3: this last art comes from the files that were released
4:02
Speaker 3: and collected I think in the last decade. Even they
4:06
Speaker 3: were sharecroppers, there were rural men, and they were poor men.
4:09
Speaker 3: And the quote that was in these papers that I
4:11
Speaker 3: found was that they found them immobile and malleable.
4:15
Speaker 2: Yeah, they were an extremely vulnerable population. I mean even
4:18
Speaker 2: among the black population at large in the Jim Crow era,
4:23
Speaker 2: these were like the most vulnerable people and they had
4:27
Speaker 2: less rights than even other black people at the time
4:30
Speaker 2: in America. So yeah, they picked on them very specifically.
4:35
Speaker 2: And that you kind of hinted at something that I
4:38
Speaker 2: find as one of the most cynical aspects of this
4:41
Speaker 2: whole thing, that initially the program that was working down
4:45
Speaker 2: there was a well funded program that was treating syphilis,
4:50
Speaker 2: and then the funding ran out of that and they said, well,
4:52
Speaker 2: we still have all these people that we know have syphilis.
4:55
Speaker 2: Let's try something different and not treat them. And that
4:58
Speaker 2: was the beginning of the whole thing.
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Speaker 3: Yeah, And it's also key to point out before we
5:02
Speaker 3: get into the grizzly details, is that these men did
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Speaker 3: not know they had syphilis, and then they also thought
5:09
Speaker 3: that they were being treated. They were told they had
5:11
Speaker 3: quote bad blood, and the whole time they thought they
5:15
Speaker 3: were getting treatment when they were getting placebos.
5:17
Speaker 2: Right. Yeah. And then there were I read a couple
5:21
Speaker 2: of men who suspected or knew they had syphilis and
5:25
Speaker 2: wanted to go get it treated, and the people running
5:27
Speaker 2: the study prevented them from getting it treated, either by
5:31
Speaker 2: telling them not to go do that or by telling
5:33
Speaker 2: doctors in the area, do not treat any of these
5:35
Speaker 2: men because they're part of the study we're carrying out.
5:38
Speaker 2: Because that's another thing too. I think a lot of
5:40
Speaker 2: people think that this was some secret government study conducted
5:43
Speaker 2: in absolute silence. It was not at all. It wasn't
5:47
Speaker 2: even an open secret. It wasn't a secret at all,
5:50
Speaker 2: so much so that the people running the study published
5:53
Speaker 2: thirteen different journal articles over the course of that forty
5:58
Speaker 2: years and put out annual reports, published annual reports on
6:02
Speaker 2: the progress of this thing. So it was just right
6:06
Speaker 2: out there, and people just overlooked it or ignored it
6:09
Speaker 2: for four decades. Yeah.
6:11
Speaker 3: It was a time when you know, the medical community
6:13
Speaker 3: certainly was aware, but the public at large and the
6:16
Speaker 3: media didn't really look into you know, medical papers and
6:19
Speaker 3: stuff like they.
6:20
Speaker 1: Do these days.
6:21
Speaker 3: Yeah, And we should point out that all of this
6:24
Speaker 3: was done despite a nineteen twenty seven statute in the
6:29
Speaker 3: state of Alabama that requires treatment of syphilis, Like it
6:33
Speaker 3: was a state law that they just rushed aside, basically,
6:38
Speaker 3: And all of this done for the promise of hot meals,
6:42
Speaker 3: treatment and burial insurance basically.
6:46
Speaker 2: Yeah, for sure. So yeah, I mean, I think that's
6:51
Speaker 2: a pretty good setup. I think we should kind of
6:53
Speaker 2: describe what these men were suffering from, yeah, in the
6:56
Speaker 2: first place, and talk a little bit about syphilis.
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Speaker 1: Let's do.
7:00
Speaker 3: It was caused by a bacterium called its spiral shaped
7:04
Speaker 3: and it's called the Treponema palladum bacterium. And they don't
7:09
Speaker 3: know where it came from, but they know that it
7:11
Speaker 3: dates at least all the way back to Naples in
7:14
Speaker 3: fourteen ninety five when mercenaries serving in the French Army
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Speaker 3: got syphilis and then very quickly spread it far and wide,
7:21
Speaker 3: because for eight years later it was in India and China.
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Speaker 2: That's pretty fast, man.
7:28
Speaker 1: Yeah.
7:28
Speaker 2: One of the reasons it was so fast is because
7:31
Speaker 2: these were armies pillaging and raping, and syphilis is primarily
7:37
Speaker 2: transmitted through sexual contact. It can also be transmitted or
7:41
Speaker 2: transferred from an infected woman to her fetus, but for
7:46
Speaker 2: the most part it comes from unprotected sex to this
7:49
Speaker 2: std Yeah, and there's a there's a hypothesis that it
7:54
Speaker 2: came back with Columbus and his men, who were again
7:57
Speaker 2: pillaging and raping, and they had contracted what is considered
8:01
Speaker 2: a new world disease, syphilis, and brought it back to Europe,
8:03
Speaker 2: and that's where it spread. Apparently, there's no actual hard
8:07
Speaker 2: evidence of this or hard proof, but the timing, I
8:11
Speaker 2: think is what people zero in on. I mean, it
8:13
Speaker 2: first popped up in fourteen ninety five, and everyone knows
8:17
Speaker 2: thanks to that child prodigy whose name escapes me right now, Stoner.
8:22
Speaker 2: I think her last name is Stoner Sackler. The Columbus
8:25
Speaker 2: sailed the Ocean Blue in fourteen ninety.
8:27
Speaker 3: Two, that's right, and if you got syphilis, you were
8:31
Speaker 3: in for a pretty rough run, including possibly eventually death
8:35
Speaker 3: in a lot of cases. If you were an infant,
8:38
Speaker 3: it could be certainly fatal. It could cause blindness and deafness.
8:42
Speaker 3: It could cause facial differences with teeth and the nose
8:47
Speaker 3: brain complications. Of course, if you were an adult, you
8:50
Speaker 3: would get lesions, and then within a few months it
8:53
Speaker 3: goes into the second stage, where you have lesions basically
8:56
Speaker 3: all over your body, rashes and pains and headaches, and
9:00
Speaker 3: finally the disease in the third phase, it dials back
9:04
Speaker 3: at abates a little bit where it's not transmissible. But
9:07
Speaker 3: in that latency period, all of a sudden, it can
9:10
Speaker 3: attack your organs, specifically your liver and cause liver failure
9:14
Speaker 3: and kill.
9:14
Speaker 2: You, and blindness and neurological impacts like dementia and paralysis.
9:20
Speaker 2: And that's one of the things that makes it so
9:21
Speaker 2: insidious is after the initial infection symptoms, it just seems
9:26
Speaker 2: like it went away, and then out of nowhere it
9:28
Speaker 2: can just come back and kill you. Like you're saying, right,
9:31
Speaker 2: So this is what these men specifically in this study
9:33
Speaker 2: were dealing with. I think all of them were in
9:37
Speaker 2: late latency syphilis where they didn't necessarily have symptoms any longer.
9:42
Speaker 2: And the idea that this was an indefinite open study
9:47
Speaker 2: that was essentially like this study will end when all
9:49
Speaker 2: these guys are dead, meant that they were specifically by
9:53
Speaker 2: not treating them waiting to see how they died, including
9:58
Speaker 2: from complications of syphilis like you said, that included organ
10:02
Speaker 2: failure throughout the body.
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Speaker 3: Yeah, And they ended up getting three hundred and ninety
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Speaker 3: nine men that were infected and then two hundred and
10:11
Speaker 3: one that served as a control. And part of the
10:14
Speaker 3: recruitment involved a Tuskegee Institute nurse named Eunice Rivers, who
10:20
Speaker 3: ended up being a very vilified person because she was
10:24
Speaker 3: a black woman who helped recruit these guys. There was
10:28
Speaker 3: advertisements by word of mouth and churches and stuff like that,
10:31
Speaker 3: and she was co authored on two of the thirteen papers.
10:36
Speaker 3: And you know, of course was vilified for this for
10:39
Speaker 3: you know, doing this to men from her own race.
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Speaker 3: But it seems like she knew what was going on,
10:45
Speaker 3: but she really believed what she was being told by
10:48
Speaker 3: the Public Health Service that black men it progressed differently
10:51
Speaker 3: in them than in white men. And that's sort of
10:53
Speaker 3: the basis of what they were trying to root out.
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Speaker 2: I saw that she also reasoned it that at least
11:00
Speaker 2: these sharecroppers were getting treatment that they otherwise couldn't have afforded,
11:06
Speaker 2: which was no treatment exactly. And hot meals too, like
11:10
Speaker 2: that was I mean, this is it started during the depression.
11:13
Speaker 2: Hot meals were such an incentive that people would submit
11:16
Speaker 2: to medical experiments for them. So that was a like
11:18
Speaker 2: it's easy now to look to overlook how important that was,
11:22
Speaker 2: but that was a big, a big deal sweetener for them.
11:25
Speaker 3: Yeah, and penicillin was something that they had been you know,
11:28
Speaker 3: they'd been searching for something like penicillin for a long time,
11:31
Speaker 3: especially in Germany. They were looking for they called it
11:34
Speaker 3: a magic bullet that would, you know, kill the micro organism,
11:38
Speaker 3: kill the bacteria without harming the cells that it was infecting.
11:42
Speaker 3: And from nineteen ten on they had some stuff that
11:45
Speaker 3: kind of worked, something called oh boy, here we go
11:50
Speaker 3: ares phenamine? Yeah, do you or spinamine?
11:54
Speaker 2: That's what I was going to go with nice coorts.
11:56
Speaker 3: But in nineteen forty a Scottish position named Alexander Fleming
12:00
Speaker 3: came along and had proven basically in nineteen twenty eight
12:05
Speaker 3: that penicillin worked, and in nineteen forty was when it
12:09
Speaker 3: was finally published in the Lancet. Is like, hey, this
12:11
Speaker 3: is sort of this miracle magical that we were looking for,
12:15
Speaker 3: and you know, nineteen forty is kind of squarely in
12:17
Speaker 3: the middle of this study. Yet they didn't use penicillin
12:21
Speaker 3: still to heal these guys.
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Speaker 2: No, I mean like the fact that a treatment, because
12:27
Speaker 2: before that treatment was really bad for you. They would
12:30
Speaker 2: like people have been using mercury to treat it since
12:32
Speaker 2: about fifteen hundred and then that arsphenamine was a type
12:38
Speaker 2: of arsenic I think you said so, like it might
12:41
Speaker 2: not have worked, It took a year, it was very expensive,
12:44
Speaker 2: and it was not a pleasant thing. When the penicillin
12:47
Speaker 2: came along, you could get one injection of high dose
12:49
Speaker 2: penicillin and it could cure syphilis in eight days. It
12:53
Speaker 2: could even cure late stage latency syphilis that was already
12:57
Speaker 2: attacking your organs. It could at least cure the it
13:00
Speaker 2: wouldn't reverse the organ damage. So the fact that they
13:03
Speaker 2: knew that this existed, I read the Public Health Service
13:07
Speaker 2: was instrumental in developing penicillin as a treatment for syphilis.
13:11
Speaker 2: So it's not like the Public Health Service hadn't heard
13:14
Speaker 2: that that penicillin worked. That is one of the more
13:19
Speaker 2: damning points, Like there's no defense that they could offer
13:23
Speaker 2: that would justify withholding penicillin since they knew it worked,
13:28
Speaker 2: and the study went on for what thirty one more
13:31
Speaker 2: years after that?
13:32
Speaker 3: Yeah, I mean, I don't think anyone ever contended that
13:35
Speaker 3: it was on the table like, hey, we have a cure,
13:37
Speaker 3: now it's going to stop, because they that's not what
13:39
Speaker 3: they were after to begin with.
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Speaker 2: No, And in fact, there were quotes from people later
13:43
Speaker 2: on who were involved and tried to defend it that
13:46
Speaker 2: was basically like, yeah, we had to we had to
13:49
Speaker 2: actively make sure that these guys didn't get penicillin from
13:52
Speaker 2: other doctors who didn't know about the study for things
13:56
Speaker 2: like colds or whatever, because they would accidentally cure the syphilis.
14:01
Speaker 2: That's the links that they went to, like the penicillin
14:03
Speaker 2: was an enemy to this study essentially, is how they
14:06
Speaker 2: thought of it.
14:07
Speaker 3: Well, one more link that they went to before we
14:10
Speaker 3: take a break was when World War II rolls around,
14:14
Speaker 3: they purposefully made sure that these study subjects, these men
14:18
Speaker 3: were exempted from the draft. Because when you go through
14:22
Speaker 3: the draft process, you get tested for STDs and treated
14:25
Speaker 3: for STDs, and so they're like, no, no, no, that'll ruin
14:29
Speaker 3: our study. We got to make sure these guys don't
14:31
Speaker 3: get drafted. So the takeaway from that is is these
14:35
Speaker 3: men probably would have been better off like being drafted
14:38
Speaker 3: and potentially even like storming the beach at Normandy than
14:42
Speaker 3: being at home in Alabama being quote unquote treated by doctors.
14:45
Speaker 2: That's a good point. And the way that they did
14:48
Speaker 2: it too kind of shows just how complicit a lot
14:50
Speaker 2: of people in the area where it's not that the
14:52
Speaker 2: public Health service didn't pull some strings to make this happen.
14:56
Speaker 2: They went to the director of public health for Macon
14:59
Speaker 2: County and said, hey, you're friends with the guy running
15:03
Speaker 2: the Selective Service board. Why don't you, you know, make
15:06
Speaker 2: sure that this works. And he did. He pulled the
15:08
Speaker 2: right strings and and he made it happen. But so
15:12
Speaker 2: this was a there were a lot of people who
15:14
Speaker 2: came together to make this happen and to prevent these
15:18
Speaker 2: men from getting their syphilis treated one way or another.
15:22
Speaker 3: All right, let's take that break and we'll be right
15:24
Speaker 3: back right after this.
15:55
Speaker 2: Okay, we're back, Chuck and we should probably talk about
15:58
Speaker 2: how this study began.
16:00
Speaker 3: Yeah, it was launched by the director of phs's Venereal
16:06
Speaker 3: Disease Division, someone named Talia Faroh Clark, and it was
16:10
Speaker 3: a two arms study again, a control group and an
16:15
Speaker 3: infected group. And I believe Clark did not suggest giving placebos,
16:20
Speaker 3: even though that happened. But he also didn't say, Hey,
16:25
Speaker 3: you know, we're trying to study the difference between how
16:27
Speaker 3: it progresses in black men and white men. Let's bring
16:29
Speaker 3: in some white men. They strictly focused on black men.
16:32
Speaker 2: Yeah, there was actually a reason for that. There was
16:34
Speaker 2: a study that was very similar that was conducted in Oslo, Norway,
16:39
Speaker 2: from eighteen ninety one to nineteen ten, and the results
16:42
Speaker 2: were published in nineteen twenty nine that did the same
16:44
Speaker 2: thing but to all white men. So essentially they used
16:48
Speaker 2: that data from the Oslo study as a comparison, or
16:52
Speaker 2: they planned to. I guess, yeah, sure right, so you know,
16:58
Speaker 2: it's all good.
17:01
Speaker 3: Tuskegee itself was chosen again I mentioned because of its
17:04
Speaker 3: proximity to where they were, you know, drawing from for
17:08
Speaker 3: Macon County, but also because of the government links with
17:11
Speaker 3: the Tuskegee Institute.
17:13
Speaker 2: Booker t.
17:14
Speaker 3: Washington had come along and really shaped a critical educational
17:20
Speaker 3: institution in the United States. They were serving needy black
17:23
Speaker 3: people of Alabama and it's you know, that's another one
17:26
Speaker 3: of the just big shames is that it puts such
17:29
Speaker 3: a black eye on what this you know, kind of
17:31
Speaker 3: great institution.
17:32
Speaker 2: Yeah, I mean, this is the hospital where people would go.
17:35
Speaker 2: This is I think where nurse Eunice Rivers worked too.
17:39
Speaker 2: So it was a huge betrayal of that community. And
17:43
Speaker 2: I mean, even though it's developed by leaps and leaps
17:46
Speaker 2: and bounds and it's now Tuskegee University, like you said,
17:49
Speaker 2: it was a black eye. But even worse than that.
17:51
Speaker 2: Everybody calls this, including us, the Tuskegee Experiment. They don't
17:55
Speaker 2: call it the Public Health Service Syphilis experiment or the
17:58
Speaker 2: US government syphlists experiment. So it's an ongoing black guy
18:02
Speaker 2: on Tuskegee University too.
18:05
Speaker 1: Yeah.
18:06
Speaker 3: For sure, they were deceived from the beginning, you know,
18:09
Speaker 3: like we said at Bears repeating that they thought they
18:11
Speaker 3: were signing up for treatment. In fact, they called it
18:14
Speaker 3: a quote special free treatment end quote. And you know,
18:19
Speaker 3: so these guys lined up for it. You know, they
18:22
Speaker 3: thought they had bad blood and they got placebos in
18:26
Speaker 3: the name of aspirin, mainly like five thousand pink aspirin
18:29
Speaker 3: tablets were shipped in nineteen thirty four. Also, these these
18:33
Speaker 3: tonics that then tinctures they would mix up that you know,
18:37
Speaker 3: they said, was gonna get their bad blood treated.
18:40
Speaker 2: Yes, so you said that tel Afario Clark or Talafaro Clark,
18:46
Speaker 2: and it conceived of this whole study. I think he
18:49
Speaker 2: stepped aside pretty early on, and starting in nineteen thirty three.
18:52
Speaker 2: The next year a guy named Raymond Vanderler picked up
18:57
Speaker 2: and took over and actually expanded it and now said, Okay,
19:00
Speaker 2: we're looking for neurological effects. Let's start giving these guys
19:03
Speaker 2: spinal taps that are really really dangerous, can be really painful,
19:07
Speaker 2: and can give you horrible headaches afterward too, So let's
19:13
Speaker 2: just throw that in for you know, just for kicks.
19:17
Speaker 3: Yeah. And also in those papers that were released and
19:20
Speaker 3: collected recently, that same person there was a letter where
19:24
Speaker 3: he was talking about all the complaints from oh, yes,
19:28
Speaker 3: so the patients getting spinal taps and how awful it was,
19:30
Speaker 3: and he was like I'm paraphrasing, but basically like now
19:34
Speaker 3: I'm the one with the headache.
19:35
Speaker 2: Yeah, yeah, he said that. So, yes, this is kind
19:40
Speaker 2: of like the patronizing, at the very least patronizing tone
19:45
Speaker 2: that the people running this experiment had toward everybody.
19:49
Speaker 1: Yeah.
19:49
Speaker 2: So we said also that penicillin came around in the
19:54
Speaker 2: late nineteen forties or nineteen forties at some point, and
19:57
Speaker 2: that was one thing that it was like, Okay, you
19:58
Speaker 2: guys should have stopped everything and giving these guys penicillin.
20:02
Speaker 2: Another thing happened in the nineteen forties that essentially should
20:05
Speaker 2: have put an end to this, and that was the
20:08
Speaker 2: Nuremberg Trials after World War Two, where, among other people,
20:11
Speaker 2: a bunch of Nazi doctors, I think twenty three Nazi
20:14
Speaker 2: doctors were put on trial for war crimes for running horrible,
20:20
Speaker 2: horrific medical experiments on people during World War Two, and
20:25
Speaker 2: I think seven of them were sentenced to death. And
20:27
Speaker 2: yet despite that, the people running this syphilist study were
20:32
Speaker 2: just like, gosh, that, I mean, Nazis suck good thing.
20:35
Speaker 2: We're not Nazis. We're just going to continue on with
20:38
Speaker 2: this experiment.
20:39
Speaker 3: Yeah. In nineteen fifty seven, this is in the twenty
20:43
Speaker 3: fifth year, the Surgeon General awarded certificates to these patients like,
20:48
Speaker 3: you know, congratulations on all your work here in this
20:53
Speaker 3: and participating in this study. And then later on in
20:55
Speaker 3: nineteen ninety three, one of the researchers, John Charles Cutler,
20:58
Speaker 3: and we're going to talk about him a bit later
21:00
Speaker 3: as well, there was a quote where he said it
21:02
Speaker 3: would be undesirable to go ahead and use large amounts
21:04
Speaker 3: of penicillin to treat the disease, because you'd interfere with
21:07
Speaker 3: the study. So you know, they were on record like
21:12
Speaker 3: time and time again, through countless different changes over these
21:16
Speaker 3: forty years at Tuskegee, these doctors and nurses, the people
21:21
Speaker 3: in the public health system, Like it wasn't just like
21:23
Speaker 3: one like mad scientist running the show all these years.
21:26
Speaker 3: It was just new people kind of changing hands and
21:29
Speaker 3: leading this charge like year after a year for forty years.
21:32
Speaker 2: Yeah. And one of the things that they clung to,
21:34
Speaker 2: both internally and externally is this idea that became outdated
21:39
Speaker 2: when penicillin came along, but they still kept going with
21:42
Speaker 2: this excuse was that treating late latency, late stage syphilis
21:50
Speaker 2: could actually cause more harm than good. You could get
21:53
Speaker 2: this syphilis stirred up again and that could cause that
21:56
Speaker 2: organ failure, so you're better off not treat And by
22:01
Speaker 2: the time penicillin came along, by the time Nuremberg came along,
22:05
Speaker 2: all of these patients would have been in late latency
22:08
Speaker 2: syphilis were they not already. So that was the thing, Like,
22:12
Speaker 2: that was what they would push back on, even though
22:14
Speaker 2: it was not true anymore. I like, once penicillin came along,
22:17
Speaker 2: it was not dangerous at all, and it really really worked,
22:21
Speaker 2: and yet they still use that as an excuse whenever
22:23
Speaker 2: it was challenged. It was very rarely challenged, but it
22:27
Speaker 2: was challenged by some people, as we'll see.
22:30
Speaker 3: Yeah, there was the first person brave enough to even
22:33
Speaker 3: say anything was named Count Gibson. He was a Richmond
22:38
Speaker 3: physician heard about the study through a lecture in the
22:42
Speaker 3: nineteen fifties from Sydney Olanski and wrote a letter saying,
22:48
Speaker 3: I'm gravely concerned about the ethics of the entire program.
22:51
Speaker 3: He continued to sort of observe the study after penicillin
22:57
Speaker 3: came along, and he, you know, Alonski basically came back
23:02
Speaker 3: and said, I think our work is helping out these
23:05
Speaker 3: participants overall, and just keep quiet about it.
23:08
Speaker 2: Yeah, just all of the thinnest excuses that that was
23:11
Speaker 2: what they would defend themselves with. I guess Count Gibson
23:14
Speaker 2: did end up keeping quiet because the medical college that
23:17
Speaker 2: he worked at in Virginia essentially said you need to
23:20
Speaker 2: be quiet or else, I would guess, lose your job.
23:23
Speaker 2: So that was in the fifties, right, Yeah. Next up
23:27
Speaker 2: was a guy named Bill Jenkins, who was one of
23:29
Speaker 2: the CDC's first African American professional workers. He was a statistician.
23:34
Speaker 2: His widow also called him a essentially a radical that
23:39
Speaker 2: was very involved in the civil rights movement from a
23:42
Speaker 2: very early time. And he learned about this and the
23:45
Speaker 2: bald face racism that was just inherent, and it really
23:49
Speaker 2: obviously stuck in his craw and he tried very hard
23:54
Speaker 2: to get the New York Times in the Washington Post
23:56
Speaker 2: to cover it, and they didn't. He later said, we
23:59
Speaker 2: probably should have a press release and done it differently.
24:01
Speaker 2: They just sent all this stuff in the New York
24:03
Speaker 2: Times and WAPO. It's not clear whether they would have
24:06
Speaker 2: published anything on it anyway, but he gave it a try,
24:09
Speaker 2: and he eventually was like, I can't do anything else.
24:13
Speaker 2: I think he also tried internally too to get it
24:16
Speaker 2: to stop, and it just didn't happen.
24:18
Speaker 3: Yeah, so that was sixty and sixty four. There was
24:21
Speaker 3: a Detroit cardiologist named Irwin J. Shatz, and he was like,
24:26
Speaker 3: I can't believe what's going on, Like I read this study,
24:29
Speaker 3: because again, you know, they were putting out these studies
24:31
Speaker 3: in the medical community was reading them and some people
24:34
Speaker 3: were like, wait a minute, what is going on down there?
24:37
Speaker 3: And he said, I suggest that you reevaluate your moral
24:40
Speaker 3: judgments on this. And there was a co author named
24:42
Speaker 3: Anne R. Yobs who said it was a co author
24:46
Speaker 3: of the Syphilist study that said it was the first
24:48
Speaker 3: letter they got like that and that she planned to
24:51
Speaker 3: ignore it.
24:51
Speaker 2: Yeah. So yeah, they were also pretty arrogant in this
24:55
Speaker 2: stuff too. Well. They eventually ran head to head with
24:58
Speaker 2: a guy named Peter Buxton who was working for the
25:01
Speaker 2: Public Health Service. He was a venereal disease investigator in
25:05
Speaker 2: the Tenderloin in San Francisco. I think he was twenty
25:08
Speaker 2: eight in the late sixties or mid sixties, sorry, nineteen
25:11
Speaker 2: sixty five, and he, I guess heard a colleague talking
25:16
Speaker 2: about this study and said, which a what? And he
25:20
Speaker 2: started looking into the reports. He got the Public Health
25:23
Speaker 2: Service people running this the Venereal Disease Division to send
25:26
Speaker 2: him all of their reports, and he read through them
25:29
Speaker 2: and he could not believe what he was reading. And
25:31
Speaker 2: he went directly to William J. Brown, who was the
25:34
Speaker 2: head of the Venereal Disease Division at the time, and
25:38
Speaker 2: he said, like, what are you doing. You stop this.
25:41
Speaker 2: This is a horribly unethical study. I can't believe you
25:44
Speaker 2: guys are doing this. And William J. Brown said, well,
25:47
Speaker 2: it's all good. These guys are getting medical care that
25:50
Speaker 2: they otherwise wouldn't. And by the way, did we say
25:52
Speaker 2: it's dangerous to treat people with late stage syphilis? And
25:56
Speaker 2: I'm sure Peter Buckson said no, it's not. William Brown
25:59
Speaker 2: said yes it is. And it just went like that
26:01
Speaker 2: for a while.
26:01
Speaker 3: Well, they also responded that, hey, this is political dynamite,
26:05
Speaker 3: and a nineteen sixty nine review said it was a
26:07
Speaker 3: hot potato. So like they knew, you know, like full
26:11
Speaker 3: well at this point that it was morally and ethically
26:15
Speaker 3: wrong and racist, and that like if this got out,
26:18
Speaker 3: like this has started when they kind of internally started
26:21
Speaker 3: talking about, hey, if this got out, this would look
26:23
Speaker 3: really bad. Before this, I don't even think they even
26:25
Speaker 3: thought about it but Buckston would end up being a whistleblower.
26:28
Speaker 3: He would send his files to the AP, and an
26:32
Speaker 3: AP reporter named Gene Heller wrote a article that ended
26:35
Speaker 3: up being published in the New York Times, And that
26:38
Speaker 3: was in nineteen seventy two, seven years after Buxton first
26:41
Speaker 3: started looking into it. And that's what finally blew it
26:44
Speaker 3: wide open.
26:45
Speaker 2: Yeah, and I saw that despite being aware that this
26:48
Speaker 2: could look bad for the public Health Service, I think
26:51
Speaker 2: now the CDC, the people involved in the study were
26:55
Speaker 2: really surprised and taken aback by the public outrage that
26:59
Speaker 2: erupted in immediately from this article. I mean, because it
27:03
Speaker 2: was AP. That meant all of the newspapers across the
27:05
Speaker 2: country carried it, and a lot of them put it
27:09
Speaker 2: on their front page. So everyone all of a sudden
27:11
Speaker 2: knew about this horribly unethical, racist study. And it came
27:14
Speaker 2: to art screeching, halt.
27:17
Speaker 3: Boy, that sounds like a great time for a break. Yes,
27:21
Speaker 3: you can't throw on the brakes without taking a break,
27:24
Speaker 3: that's our motto.
27:25
Speaker 1: Yep, we'll be right back, all right.
27:52
Speaker 3: So Josh threw on the brakes just like the doctors
27:57
Speaker 3: performing the Tuskegee syphilis experiments, and teen seventy two, it
28:01
Speaker 3: was a big political scandal Senator Edward M. Kennedy of
28:06
Speaker 3: Massachusetts called congressional hearings. Buxton testified there, of course, And
28:11
Speaker 3: in nineteen seventy two, kind of late nineteen seventy two,
28:14
Speaker 3: an ad hoc advisory panel said, you got to stop
28:18
Speaker 3: this study. It's pretty clear it's ethically unjustified.
28:22
Speaker 1: Was the quote.
28:22
Speaker 3: And it results in quote, disproportionately meager compared with known
28:26
Speaker 3: risks to the human subjects involved.
28:29
Speaker 2: Yeah, and I mean when they started to look into it,
28:32
Speaker 2: they were like, this study is not even particularly scientific.
28:35
Speaker 2: And one of the big things I saw was in
28:37
Speaker 2: an episode of a podcast called Distillation by the Science
28:41
Speaker 2: History Museum, and they were basically saying, some of these
28:44
Speaker 2: guys did accidentally get treated with penicillin. Other guys in
28:50
Speaker 2: the control group accidentally contracted syphilis. And so they would
28:54
Speaker 2: just take one and be like, Okay, you're in the
28:56
Speaker 2: control group now because you got you got treated accidentally,
28:59
Speaker 2: you caught accidentally, you're in this untreated group. They would
29:02
Speaker 2: just shuffle people around. It was not a very well
29:05
Speaker 2: run study, considering how much time and effort was put
29:09
Speaker 2: into it.
29:10
Speaker 3: Yeah, I mean they never got any like great data
29:13
Speaker 3: in return for this forty years of you know, I
29:17
Speaker 3: mean torture basically.
29:18
Speaker 2: You know, the data I saw that they did get
29:21
Speaker 2: was possibly as many as one hundred and twenty eight
29:24
Speaker 2: of these men died from untreated syphilis. Yeah, like that's
29:31
Speaker 2: the bottom line here. They would not have otherwise died
29:34
Speaker 2: because penicillin is so effective. They died specifically because they
29:38
Speaker 2: were participants in this study. And that is that. There's
29:43
Speaker 2: no other way to put it.
29:45
Speaker 3: Yeah, I mean, if you remember in nineteen ninety seven,
29:49
Speaker 3: I remember when this happened, President Clinton invited at the time,
29:52
Speaker 3: there were eight living survivors of the experiments to the
29:55
Speaker 3: White House to offer, you know, the formal apology and
29:58
Speaker 3: said it was like a clearly racist, shameful thing that
30:01
Speaker 3: you endured. And this was after a legal settlement settlement.
30:06
Speaker 3: There was a ten million dollar legal settlement and benefit
30:09
Speaker 3: program at the time. I think when it ended, seventy
30:14
Speaker 3: men who had not received treatment were still alive, and
30:18
Speaker 3: the survivors got thirty five thousand dollars, their heirs got
30:21
Speaker 3: fifteen thousand dollars from a class action lawsuit. And then
30:26
Speaker 3: they started in nineteen seventy three to Tuskegee Health Benefit
30:29
Speaker 3: Program basically like, hey, we're going to provide medical care
30:34
Speaker 3: for your survivors, for your families, for widows, for your children,
30:38
Speaker 3: basically starting in nineteen seventy five.
30:41
Speaker 2: Yeah, because that's something that is forgotten. A lot of times,
30:45
Speaker 2: these men had families, they had wives, They sometimes had
30:49
Speaker 2: wives that they were still having babies with. So like
30:52
Speaker 2: their spouses and their newborn children were at tremendous risk
30:57
Speaker 2: of contracting syphilis because they were in this untreated programs.
31:00
Speaker 2: So free health care for the life of them, their
31:03
Speaker 2: spouses and their children seems like the like step one,
31:08
Speaker 2: the most basic thing that you could do, you know.
31:11
Speaker 3: Yeah, and you know, the effects of this were devastating,
31:15
Speaker 3: certainly to those families and to the men who participated
31:17
Speaker 3: and died, and even the ones who didn't. But an
31:21
Speaker 3: ongoing effect has been felt, you know, even today and
31:24
Speaker 3: since then they've done studies and found data basically that
31:29
Speaker 3: all but proves that the Tuskegee experiments had a negative
31:34
Speaker 3: effect on African Americans in the United States, not trusting doctors,
31:39
Speaker 3: not trusting nurses, not trusting the medical establishment at all,
31:43
Speaker 3: and not seeking treatment and having negative health effects because
31:47
Speaker 3: of this, and they've basically proven it because it's even
31:51
Speaker 3: more localized, Like the closer you get to making county,
31:54
Speaker 3: the more the data has proven that people did not
31:58
Speaker 3: trust doctors.
31:59
Speaker 2: Yeah, and that's another moniker that I'm sure Tuskegee University
32:04
Speaker 2: is not happy about. It's called the Tuskegee effect.
32:06
Speaker 3: Yeah.
32:07
Speaker 2: One of the pieces of datum that I saw that
32:10
Speaker 2: really kind of caught my eye was that black men
32:14
Speaker 2: in America seeking out professional medical help dropped by twenty
32:19
Speaker 2: two percent in the four years following when the news
32:24
Speaker 2: of this story broke, So it had a pronounced effect.
32:29
Speaker 3: And in nineteen ninety seven, nineteen ninety seven, so this
32:31
Speaker 3: is twenty five years after the study was finished, there
32:35
Speaker 3: was a study that found that thirty two point one
32:38
Speaker 3: percent of black women surveyed in a study agreed that
32:42
Speaker 3: scientists were not trustworthy, compared to four point one percent
32:45
Speaker 3: of white women at the time.
32:46
Speaker 2: Yeah, and there was another thing too, It was the
32:48
Speaker 2: Tuskegee effect is widely blamed for making containing the AIDS
32:54
Speaker 2: epidemic in the nineteen eighties and nineties in the black
32:57
Speaker 2: community so difficult, And a twenty twenty one study found
33:03
Speaker 2: that twenty seven point seven percent of the people the
33:06
Speaker 2: Black Americans surveyed found that they believed the governments created
33:12
Speaker 2: aids to essentially carry out a genocide against Black Americans. Yeah,
33:17
Speaker 2: that's the level of distrust that came from Tuskegee. But
33:21
Speaker 2: there's a historian who knows all about this, name Susan Reverbie,
33:25
Speaker 2: and she was on that Distillation podcast episode and she
33:28
Speaker 2: essentially said, that's true. But pinning all of this on
33:32
Speaker 2: the Tuskegee experiment ignores all of the structural racism that
33:37
Speaker 2: it's still going on.
33:39
Speaker 3: Yeah.
33:39
Speaker 2: Yeah, that has that it's like current and is keeping
33:42
Speaker 2: the whole thing fresh in the minds of Black Americans
33:45
Speaker 2: because it didn't just happen once and they lost trust.
33:48
Speaker 2: It happens again and again and again every day essentially
33:52
Speaker 2: to Black Americans when they seek healthcare in the United States.
33:55
Speaker 3: Yeah, Tuskegee just kind of put a bow on it,
33:58
Speaker 3: you know.
33:58
Speaker 1: Yeah.
34:00
Speaker 3: So, of course things changed in the medical community, and
34:04
Speaker 3: you know, sort of ethics control after this, after nineteen
34:08
Speaker 3: seventy two, Congress and the National Institutes of Health change
34:12
Speaker 3: rules of just you know, humans participating in studies and experiments,
34:18
Speaker 3: obviously requiring informed consent for stuff like that, peer review
34:23
Speaker 3: of not the results, but the studies design, Like, before
34:26
Speaker 3: you can even go out and get into this and
34:29
Speaker 3: launch a study or an experiment like this, it has
34:32
Speaker 3: to be peer reviewed and okayed. And then in nineteen
34:35
Speaker 3: seventy four, the National Research Act was signed into law,
34:39
Speaker 3: resulting in kind of a laundry list of regulations and
34:42
Speaker 3: standards in the wake of Tuskegee.
34:44
Speaker 2: What's crazy is this is the seventies and it took
34:46
Speaker 2: the news of this experiment for the United States to
34:49
Speaker 2: officially adopt informed consent for medical experiments, despite the Nuremberg
34:56
Speaker 2: Code that basically said if you're running a medical experiment
34:59
Speaker 2: anywhere in the world, your patients need to be fully
35:02
Speaker 2: informed and give informed consent in nineteen forty seven. So
35:06
Speaker 2: I just found that awful that it took so long
35:08
Speaker 2: for the US to formally adopt that.
35:11
Speaker 3: Yeah, I mean, I think this wasn't like the norm
35:15
Speaker 3: because doctors, you know, most times had ethics when shooing
35:19
Speaker 3: the experiments and inform consent was a thing. But yeah,
35:22
Speaker 3: to codify it like that and taking that long is
35:25
Speaker 3: just you know, outrageous.
35:26
Speaker 2: It also, I guess created a subsequent report in nineteen
35:30
Speaker 2: seventy nine called the Belmont Report that said, there are
35:34
Speaker 2: three things you need to do if you're carrying out
35:36
Speaker 2: a medical experiment involving humans. You have to have respect
35:39
Speaker 2: for the people involved. You have to show beneficence, which
35:43
Speaker 2: is essentially like you need to go beyond the basic
35:46
Speaker 2: minimum requirements of making sure these people are protected and
35:50
Speaker 2: actually exert some sort of kindness even like go way
35:54
Speaker 2: beyond that. And then justice equality and treatment equality and
35:58
Speaker 2: including participants equality and distributing the results of the stuff
36:04
Speaker 2: and the fruits of these studies. So those things got
36:08
Speaker 2: adopted as well, but not until nineteen ninety five, sixteen
36:11
Speaker 2: years after the report.
36:13
Speaker 3: Yeah. Ninety five was also when President Clinton ordered, you know,
36:18
Speaker 3: sort of a slew of presidential committees on bioethics and
36:21
Speaker 3: how things were done. So yeah, a long long time
36:25
Speaker 3: after it ended, we promised talk of Guatemala because a
36:29
Speaker 3: very similar and worse thing happened in Guatemala in nineteen
36:34
Speaker 3: forty six, forty seven, and forty eight when the United
36:37
Speaker 3: States government funded medical research which did not study untreated
36:42
Speaker 3: syphilis in Guatemalans, they deliberately exposed and infected Guatemalan soldiers, prisoners,
36:49
Speaker 3: sex workers, mental patients with syphilis. I feel like we've
36:53
Speaker 3: talked about this before, it seems at some point, but
36:56
Speaker 3: it's horrific how they went about this.
36:59
Speaker 2: Yeah, three of these patients died. Only seven hundred of
37:03
Speaker 2: them received even some sort of minimal treatment. And the
37:07
Speaker 2: guy that I said you could argue is evil who
37:10
Speaker 2: was involved in the Tuskegee experiment was the guy who
37:13
Speaker 2: ran this, doctor John Charles Cutler. He ran it from
37:17
Speaker 2: nineteen forty six to nineteen forty eight. This was not
37:20
Speaker 2: the first experiment like this. He also would run stuff
37:23
Speaker 2: like this in prisons as a fresh face student just
37:26
Speaker 2: out of graduate school. So he and he's also the
37:30
Speaker 2: one who in nineteen ninety three defended the whole Tuskegee
37:35
Speaker 2: experiment by saying like, yeah, you couldn't give penasilis people
37:38
Speaker 2: had ruined the study.
37:40
Speaker 3: Yeah, and he gave people syphilis by injecting it, sometimes
37:44
Speaker 3: into their eyes. He would infect sex workers by infecting
37:49
Speaker 3: cotton swabs and then inserting them into their you know,
37:53
Speaker 3: sex organs, and then sometimes ordering them to have sex
37:57
Speaker 3: with men to see how it you know, how it transferred,
38:01
Speaker 3: how easily it transferred.
38:02
Speaker 2: Yep. So we said that structural racism still exists in healthcare.
38:07
Speaker 2: And I've got one last stat that kind of drives
38:09
Speaker 2: us home. There was a twenty twenty study of emergency
38:13
Speaker 2: rooms in Oregon and they found that even though black
38:16
Speaker 2: patients who went seeking help to an emergency room had
38:20
Speaker 2: completed pain scores about at the same rate as the
38:24
Speaker 2: black patients who went to these same emergency rooms, the
38:27
Speaker 2: doctors decided that only fourteen percent of these black patients
38:32
Speaker 2: deserve pain meds compared to twenty percent of white patients.
38:37
Speaker 2: So it's still going on today, and we still have
38:39
Speaker 2: a very long way to go. And I feel like
38:41
Speaker 2: as long as we keep talking about the Tuskegee experiment,
38:45
Speaker 2: hopefully it'll bring us a little bit closer, a little
38:47
Speaker 2: bit closer, because here in the United States, we don't
38:50
Speaker 2: like to do things the right way quickly. It takes
38:53
Speaker 2: us a very long time sometimes.
38:55
Speaker 3: Yeah, And I you know, I'm not getting on a soapbox,
38:58
Speaker 3: but it's important to tell theselories now because stories like
39:02
Speaker 3: this are actively being scrubbed from places like the Smithsonian,
39:07
Speaker 3: and it's not you know, you can't ignore your negative
39:11
Speaker 3: history as a country and learn anything about your future
39:15
Speaker 3: as a country.
39:16
Speaker 2: For sure, we should put that on a T shirt.
39:18
Speaker 3: Chuck, that's a little little wordy.
39:21
Speaker 2: Well, Chuck just gave us a great new T shirt
39:23
Speaker 2: idea everybody, whether he likes it or not. So that
39:25
Speaker 2: means it's time for a listener mail.
39:29
Speaker 3: You know what, let's not do listener mail. We haven't
39:31
Speaker 3: done this since I feel like the early years. I
39:35
Speaker 3: feel like we should put out a call to help
39:38
Speaker 3: grow our show a little bit. We've just kind of
39:40
Speaker 3: been on coast forever as far as like saying, hey, like,
39:43
Speaker 3: tell your friends about this, but let's do this, and
39:47
Speaker 3: you tell me if you approve, and if not, we'll
39:49
Speaker 3: just erase all this. Okay, But I charge every listener
39:53
Speaker 3: who loves stuff you should know, tell find your favorite
39:56
Speaker 3: episode ever, whether it's Ballpoint Pins or The Uppets or
40:01
Speaker 3: the time the Nazis invaded Florida. dB Cooper, dB Cooper, Like,
40:05
Speaker 3: whatever your favorite stuff you should know episode is, and
40:08
Speaker 3: send it to three friends and say, hey, check the
40:11
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40:14
Speaker 3: and that would help us out. We're always looking to,
40:16
Speaker 3: you know, grow the show and expand to new audiences
40:19
Speaker 3: who have never heard of us even after seventeen years,
40:22
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40:24
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40:25
Speaker 2: Very nice, Chuck. I think that was great. I don't
40:27
Speaker 2: object to that at all.
40:28
Speaker 3: Fantastic.
40:29
Speaker 2: Well, like Chuck said, go forth and spread the gospel
40:32
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40:34
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40:43
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