September 18, 2025 • 40 mins
As part of our shameful history series, today we dive into the Tuskegee Syphilis Experiments of the 1930s, 40s, 50s, 60s and into the 70s.
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Speaker 1 (00:01):
Welcome to Stuff You Should Know, a production of iHeartRadio.
Speaker 2 (00:11):
Hey, and welcome to the podcast. I'm Josh and there's
Chuck and this is Stuff you should Know about one
of the more shameful chapters in US history and indeed
medical history. I think you could say too.
Speaker 3 (00:24):
Yeah, for sure. And by the way, if you hear
weird noises, my immediate neighborhood is sort of crazy right now.
Speaker 2 (00:32):
What's going on?
Speaker 3 (00:33):
Well, I've got construction next door, I've got a lawn
crew across the street, and they're also shooting a movie
across the street. So it's just pandemonium is happening outside
these sort of quiet doors.
Speaker 2 (00:46):
You know what. I would call that shameful.
Speaker 3 (00:50):
Not like this no episode, for sure.
Speaker 2 (00:52):
That was my attempt at segaway.
Speaker 3 (00:54):
Yeah, nice work.
Speaker 2 (00:55):
I don't know about that, but thanks.
Speaker 3 (00:57):
By the way, this one is a listener recommended and
a teenage listener. This came from Miles Kendrick, a fourteen
year old.
Speaker 2 (01:04):
Nice Miles, great idea.
Speaker 3 (01:05):
Yeah, thanks for that.
Speaker 2 (01:07):
Yeah, we're talking about what's called the Tuskegee Syphilis Experiment
or Tuskegee Syphilis Study, and the actual official name for
it was the Tuskegee Study of Untreated Syphilis in the
Negro Male.
Speaker 3 (01:23):
Yeah, that spells it all out, doesn't it.
Speaker 2 (01:24):
It does. The fact that there's an official title for
this just really kind of goes to show you just
how nefarius the whole thing was. And it was indeed
a nefarious experiment, no matter. It doesn't really matter how
you slice it. You can look at it any number
of ways and it always still washes out stinky.
Speaker 3 (01:44):
Yeah, it does. And this was an experiment. I mean,
I guess we'll go ahead and say what happened generally
is that they recruited black men in Macon County, Alabama
that had syphilis. Kind of one of the misconceptions is
that they were given syphilis as part of this. Not true,
but don't worry. We did that in Guatemala, as we'll
(02:04):
see later on. Yeah, and sign them up for this
study where they would not treat these men of syphilis
just to see how it progressed, basically because they had
this notion and you know, of course just doesn't excuse anything.
But one of the supposed reasons that they had this
notion that syphilis would was different in white men than
black men, and that in black men, it was more
(02:28):
cardiovascular based as far as the symptoms and the results,
and then in white men it was more neurological. And
it was initially supposed to be a six month thing,
but it went on not for four years, not for
fourteen years, but for forty years.
Speaker 2 (02:44):
Yeah. I mean it started out in nineteen thirty two
in the Jim Crow South and it carried right through
the entire Civil Rights era. A number of other historical
things happened during this time that should have given the
researchers pause. From what I saw, the best explanation is
not that these people were inherently evil, although you can
(03:06):
make a case that at least one of the people
who led the study at one point was we'll talk
about him later in Guatemala, But more that they just
came to see these these men, these individuals, these human beings,
there's nothing more than a data set, and that they
stripped them of their humanity so thoroughly that they didn't
even really think that this was there was anything wrong
(03:28):
with what they were doing, even over the course of
forty whole years.
Speaker 3 (03:31):
Yeah. And the reason why they chose Macon County is
a few reasons. One, it's proximity to Tuskegee, which was
you know, key is the place where they carried this
stuff out and others because they they zoned in on
that area because they initially were trying to find out
how many people had syphilis and where so they could
(03:52):
treat these men, right, and they found that Macon County,
Alabama had the highest prevalence of syphilis. And also in
this last art comes from the files that were released
and collected I think in the last decade. Even they
were sharecroppers, there were rural men, and they were poor men.
And the quote that was in these papers that I
found was that they found them immobile and malleable.
Speaker 2 (04:15):
Yeah, they were an extremely vulnerable population. I mean even
among the black population at large in the Jim Crow era,
these were like the most vulnerable people and they had
less rights than even other black people at the time
in America. So yeah, they picked on them very specifically.
(04:35):
And that you kind of hinted at something that I
find as one of the most cynical aspects of this
whole thing, that initially the program that was working down
there was a well funded program that was treating syphilis,
and then the funding ran out of that and they said, well,
we still have all these people that we know have syphilis.
Let's try something different and not treat them. And that
(04:58):
was the beginning of the whole thing.
Speaker 3 (05:00):
Yeah, And it's also key to point out before we
get into the grizzly details, is that these men did
not know they had syphilis, and then they also thought
that they were being treated. They were told they had
quote bad blood, and the whole time they thought they
were getting treatment when they were getting placebos.
Speaker 2 (05:17):
Right. Yeah. And then there were I read a couple
of men who suspected or knew they had syphilis and
wanted to go get it treated, and the people running
the study prevented them from getting it treated, either by
telling them not to go do that or by telling
doctors in the area, do not treat any of these
men because they're part of the study we're carrying out.
(05:38):
Because that's another thing too. I think a lot of
people think that this was some secret government study conducted
in absolute silence. It was not at all. It wasn't
even an open secret. It wasn't a secret at all,
so much so that the people running the study published
thirteen different journal articles over the course of that forty
years and put out annual reports, published annual reports on
(06:02):
the progress of this thing. So it was just right
out there, and people just overlooked it or ignored it
for four decades. Yeah.
Speaker 3 (06:11):
It was a time when you know, the medical community
certainly was aware, but the public at large and the
media didn't really look into you know, medical papers and
stuff like they.
Speaker 1 (06:20):
Do these days.
Speaker 3 (06:21):
Yeah, And we should point out that all of this
was done despite a nineteen twenty seven statute in the
state of Alabama that requires treatment of syphilis, Like it
was a state law that they just rushed aside, basically,
And all of this done for the promise of hot meals,
(06:42):
treatment and burial insurance basically.
Speaker 2 (06:46):
Yeah, for sure. So yeah, I mean, I think that's
a pretty good setup. I think we should kind of
describe what these men were suffering from, yeah, in the
first place, and talk a little bit about syphilis.
Speaker 1 (06:59):
Let's do.
Speaker 3 (07:00):
It was caused by a bacterium called its spiral shaped
and it's called the Treponema palladum bacterium. And they don't
know where it came from, but they know that it
dates at least all the way back to Naples in
fourteen ninety five when mercenaries serving in the French Army
got syphilis and then very quickly spread it far and wide,
(07:21):
because for eight years later it was in India and China.
Speaker 2 (07:26):
That's pretty fast, man.
Speaker 1 (07:28):
Yeah.
Speaker 2 (07:28):
One of the reasons it was so fast is because
these were armies pillaging and raping, and syphilis is primarily
transmitted through sexual contact. It can also be transmitted or
transferred from an infected woman to her fetus, but for
the most part it comes from unprotected sex to this
(07:49):
std Yeah, and there's a there's a hypothesis that it
came back with Columbus and his men, who were again
pillaging and raping, and they had contracted what is considered
a new world disease, syphilis, and brought it back to Europe,
and that's where it spread. Apparently, there's no actual hard
evidence of this or hard proof, but the timing, I
(08:11):
think is what people zero in on. I mean, it
first popped up in fourteen ninety five, and everyone knows
thanks to that child prodigy whose name escapes me right now, Stoner.
I think her last name is Stoner Sackler. The Columbus
sailed the Ocean Blue in fourteen ninety.
Speaker 3 (08:27):
Two, that's right, and if you got syphilis, you were
in for a pretty rough run, including possibly eventually death
in a lot of cases. If you were an infant,
it could be certainly fatal. It could cause blindness and deafness.
It could cause facial differences with teeth and the nose
brain complications. Of course, if you were an adult, you
(08:50):
would get lesions, and then within a few months it
goes into the second stage, where you have lesions basically
all over your body, rashes and pains and headaches, and
finally the disease in the third phase, it dials back
at abates a little bit where it's not transmissible. But
in that latency period, all of a sudden, it can
attack your organs, specifically your liver and cause liver failure
(09:14):
and kill.
Speaker 2 (09:14):
You, and blindness and neurological impacts like dementia and paralysis.
And that's one of the things that makes it so
insidious is after the initial infection symptoms, it just seems
like it went away, and then out of nowhere it
can just come back and kill you. Like you're saying, right,
So this is what these men specifically in this study
were dealing with. I think all of them were in
(09:37):
late latency syphilis where they didn't necessarily have symptoms any longer.
And the idea that this was an indefinite open study
that was essentially like this study will end when all
these guys are dead, meant that they were specifically by
not treating them waiting to see how they died, including
(09:58):
from complications of syphilis like you said, that included organ
failure throughout the body.
Speaker 3 (10:05):
Yeah, And they ended up getting three hundred and ninety
nine men that were infected and then two hundred and
one that served as a control. And part of the
recruitment involved a Tuskegee Institute nurse named Eunice Rivers, who
ended up being a very vilified person because she was
a black woman who helped recruit these guys. There was
(10:28):
advertisements by word of mouth and churches and stuff like that,
and she was co authored on two of the thirteen papers.
And you know, of course was vilified for this for
you know, doing this to men from her own race.
But it seems like she knew what was going on,
but she really believed what she was being told by
(10:48):
the Public Health Service that black men it progressed differently
in them than in white men. And that's sort of
the basis of what they were trying to root out.
Speaker 2 (10:56):
I saw that she also reasoned it that at least
these sharecroppers were getting treatment that they otherwise couldn't have afforded,
which was no treatment exactly. And hot meals too, like
that was I mean, this is it started during the depression.
Hot meals were such an incentive that people would submit
to medical experiments for them. So that was a like
(11:18):
it's easy now to look to overlook how important that was,
but that was a big, a big deal sweetener for them.
Speaker 3 (11:25):
Yeah, and penicillin was something that they had been you know,
they'd been searching for something like penicillin for a long time,
especially in Germany. They were looking for they called it
a magic bullet that would, you know, kill the micro organism,
kill the bacteria without harming the cells that it was infecting.
And from nineteen ten on they had some stuff that
kind of worked, something called oh boy, here we go
(11:50):
ares phenamine? Yeah, do you or spinamine?
Speaker 2 (11:54):
That's what I was going to go with nice coorts.
Speaker 3 (11:56):
But in nineteen forty a Scottish position named Alexander Fleming
came along and had proven basically in nineteen twenty eight
that penicillin worked, and in nineteen forty was when it
was finally published in the Lancet. Is like, hey, this
is sort of this miracle magical that we were looking for,
and you know, nineteen forty is kind of squarely in
(12:17):
the middle of this study. Yet they didn't use penicillin
still to heal these guys.
Speaker 2 (12:22):
No, I mean like the fact that a treatment, because
before that treatment was really bad for you. They would
like people have been using mercury to treat it since
about fifteen hundred and then that arsphenamine was a type
of arsenic I think you said so, like it might
not have worked, It took a year, it was very expensive,
(12:44):
and it was not a pleasant thing. When the penicillin
came along, you could get one injection of high dose
penicillin and it could cure syphilis in eight days. It
could even cure late stage latency syphilis that was already
attacking your organs. It could at least cure the it
wouldn't reverse the organ damage. So the fact that they
knew that this existed, I read the Public Health Service
(13:07):
was instrumental in developing penicillin as a treatment for syphilis.
So it's not like the Public Health Service hadn't heard
that that penicillin worked. That is one of the more
damning points, Like there's no defense that they could offer
that would justify withholding penicillin since they knew it worked,
(13:28):
and the study went on for what thirty one more
years after that?
Speaker 3 (13:32):
Yeah, I mean, I don't think anyone ever contended that
it was on the table like, hey, we have a cure,
now it's going to stop, because they that's not what
they were after to begin with.
Speaker 2 (13:40):
No, And in fact, there were quotes from people later
on who were involved and tried to defend it that
was basically like, yeah, we had to we had to
actively make sure that these guys didn't get penicillin from
other doctors who didn't know about the study for things
like colds or whatever, because they would accidentally cure the syphilis.
(14:01):
That's the links that they went to, like the penicillin
was an enemy to this study essentially, is how they
thought of it.
Speaker 3 (14:07):
Well, one more link that they went to before we
take a break was when World War II rolls around,
they purposefully made sure that these study subjects, these men
were exempted from the draft. Because when you go through
the draft process, you get tested for STDs and treated
for STDs, and so they're like, no, no, no, that'll ruin
(14:29):
our study. We got to make sure these guys don't
get drafted. So the takeaway from that is is these
men probably would have been better off like being drafted
and potentially even like storming the beach at Normandy than
being at home in Alabama being quote unquote treated by doctors.
Speaker 2 (14:45):
That's a good point. And the way that they did
it too kind of shows just how complicit a lot
of people in the area where it's not that the
public Health service didn't pull some strings to make this happen.
They went to the director of public health for Macon
County and said, hey, you're friends with the guy running
the Selective Service board. Why don't you, you know, make
(15:06):
sure that this works. And he did. He pulled the
right strings and and he made it happen. But so
this was a there were a lot of people who
came together to make this happen and to prevent these
men from getting their syphilis treated one way or another.
Speaker 3 (15:22):
All right, let's take that break and we'll be right
back right after this.
Speaker 2 (15:55):
Okay, we're back, Chuck and we should probably talk about
how this study began.
Speaker 3 (16:00):
Yeah, it was launched by the director of phs's Venereal
Disease Division, someone named Talia Faroh Clark, and it was
a two arms study again, a control group and an
infected group. And I believe Clark did not suggest giving placebos,
even though that happened. But he also didn't say, Hey,
(16:25):
you know, we're trying to study the difference between how
it progresses in black men and white men. Let's bring
in some white men. They strictly focused on black men.
Speaker 2 (16:32):
Yeah, there was actually a reason for that. There was
a study that was very similar that was conducted in Oslo, Norway,
from eighteen ninety one to nineteen ten, and the results
were published in nineteen twenty nine that did the same
thing but to all white men. So essentially they used
that data from the Oslo study as a comparison, or
(16:52):
they planned to. I guess, yeah, sure right, so you know,
it's all good.
Speaker 3 (17:01):
Tuskegee itself was chosen again I mentioned because of its
proximity to where they were, you know, drawing from for
Macon County, but also because of the government links with
the Tuskegee Institute.
Speaker 2 (17:13):
Booker t.
Speaker 3 (17:14):
Washington had come along and really shaped a critical educational
institution in the United States. They were serving needy black
people of Alabama and it's you know, that's another one
of the just big shames is that it puts such
a black eye on what this you know, kind of
great institution.
Speaker 2 (17:32):
Yeah, I mean, this is the hospital where people would go.
This is I think where nurse Eunice Rivers worked too.
So it was a huge betrayal of that community. And
I mean, even though it's developed by leaps and leaps
and bounds and it's now Tuskegee University, like you said,
it was a black eye. But even worse than that.
Everybody calls this, including us, the Tuskegee Experiment. They don't
(17:55):
call it the Public Health Service Syphilis experiment or the
US government syphlists experiment. So it's an ongoing black guy
on Tuskegee University too.
Speaker 1 (18:05):
Yeah.
Speaker 3 (18:06):
For sure, they were deceived from the beginning, you know,
like we said at Bears repeating that they thought they
were signing up for treatment. In fact, they called it
a quote special free treatment end quote. And you know,
so these guys lined up for it. You know, they
thought they had bad blood and they got placebos in
(18:26):
the name of aspirin, mainly like five thousand pink aspirin
tablets were shipped in nineteen thirty four. Also, these these
tonics that then tinctures they would mix up that you know,
they said, was gonna get their bad blood treated.
Speaker 2 (18:40):
Yes, so you said that tel Afario Clark or Talafaro Clark,
and it conceived of this whole study. I think he
stepped aside pretty early on, and starting in nineteen thirty three.
The next year a guy named Raymond Vanderler picked up
and took over and actually expanded it and now said, Okay,
(19:00):
we're looking for neurological effects. Let's start giving these guys
spinal taps that are really really dangerous, can be really painful,
and can give you horrible headaches afterward too, So let's
just throw that in for you know, just for kicks.
Speaker 3 (19:17):
Yeah. And also in those papers that were released and
collected recently, that same person there was a letter where
he was talking about all the complaints from oh, yes,
so the patients getting spinal taps and how awful it was,
and he was like I'm paraphrasing, but basically like now
I'm the one with the headache.
Speaker 2 (19:35):
Yeah, yeah, he said that. So, yes, this is kind
of like the patronizing, at the very least patronizing tone
that the people running this experiment had toward everybody.
Speaker 1 (19:49):
Yeah.
Speaker 2 (19:49):
So we said also that penicillin came around in the
late nineteen forties or nineteen forties at some point, and
that was one thing that it was like, Okay, you
guys should have stopped everything and giving these guys penicillin.
Another thing happened in the nineteen forties that essentially should
have put an end to this, and that was the
Nuremberg Trials after World War Two, where, among other people,
(20:11):
a bunch of Nazi doctors, I think twenty three Nazi
doctors were put on trial for war crimes for running horrible,
horrific medical experiments on people during World War Two, and
I think seven of them were sentenced to death. And
yet despite that, the people running this syphilist study were
(20:32):
just like, gosh, that, I mean, Nazis suck good thing.
We're not Nazis. We're just going to continue on with
this experiment.
Speaker 3 (20:39):
Yeah. In nineteen fifty seven, this is in the twenty
fifth year, the Surgeon General awarded certificates to these patients like,
you know, congratulations on all your work here in this
and participating in this study. And then later on in
nineteen ninety three, one of the researchers, John Charles Cutler,
and we're going to talk about him a bit later
(21:00):
as well, there was a quote where he said it
would be undesirable to go ahead and use large amounts
of penicillin to treat the disease, because you'd interfere with
the study. So you know, they were on record like
time and time again, through countless different changes over these
forty years at Tuskegee, these doctors and nurses, the people
(21:21):
in the public health system, Like it wasn't just like
one like mad scientist running the show all these years.
It was just new people kind of changing hands and
leading this charge like year after a year for forty years.
Speaker 2 (21:32):
Yeah. And one of the things that they clung to,
both internally and externally is this idea that became outdated
when penicillin came along, but they still kept going with
this excuse was that treating late latency, late stage syphilis
could actually cause more harm than good. You could get
(21:53):
this syphilis stirred up again and that could cause that
organ failure, so you're better off not treat And by
the time penicillin came along, by the time Nuremberg came along,
all of these patients would have been in late latency
syphilis were they not already. So that was the thing, Like,
that was what they would push back on, even though
(22:14):
it was not true anymore. I like, once penicillin came along,
it was not dangerous at all, and it really really worked,
and yet they still use that as an excuse whenever
it was challenged. It was very rarely challenged, but it
was challenged by some people, as we'll see.
Speaker 3 (22:30):
Yeah, there was the first person brave enough to even
say anything was named Count Gibson. He was a Richmond
physician heard about the study through a lecture in the
nineteen fifties from Sydney Olanski and wrote a letter saying,
I'm gravely concerned about the ethics of the entire program.
(22:51):
He continued to sort of observe the study after penicillin
came along, and he, you know, Alonski basically came back
and said, I think our work is helping out these
participants overall, and just keep quiet about it.
Speaker 2 (23:08):
Yeah, just all of the thinnest excuses that that was
what they would defend themselves with. I guess Count Gibson
did end up keeping quiet because the medical college that
he worked at in Virginia essentially said you need to
be quiet or else, I would guess, lose your job.
So that was in the fifties, right, Yeah. Next up
was a guy named Bill Jenkins, who was one of
(23:29):
the CDC's first African American professional workers. He was a statistician.
His widow also called him a essentially a radical that
was very involved in the civil rights movement from a
very early time. And he learned about this and the
bald face racism that was just inherent, and it really
(23:49):
obviously stuck in his craw and he tried very hard
to get the New York Times in the Washington Post
to cover it, and they didn't. He later said, we
probably should have a press release and done it differently.
They just sent all this stuff in the New York
Times and WAPO. It's not clear whether they would have
published anything on it anyway, but he gave it a try,
and he eventually was like, I can't do anything else.
(24:13):
I think he also tried internally too to get it
to stop, and it just didn't happen.
Speaker 3 (24:18):
Yeah, so that was sixty and sixty four. There was
a Detroit cardiologist named Irwin J. Shatz, and he was like,
I can't believe what's going on, Like I read this study,
because again, you know, they were putting out these studies
in the medical community was reading them and some people
were like, wait a minute, what is going on down there?
And he said, I suggest that you reevaluate your moral
(24:40):
judgments on this. And there was a co author named
Anne R. Yobs who said it was a co author
of the Syphilist study that said it was the first
letter they got like that and that she planned to
ignore it.
Speaker 2 (24:51):
Yeah. So yeah, they were also pretty arrogant in this
stuff too. Well. They eventually ran head to head with
a guy named Peter Buxton who was working for the
Public Health Service. He was a venereal disease investigator in
the Tenderloin in San Francisco. I think he was twenty
eight in the late sixties or mid sixties, sorry, nineteen
sixty five, and he, I guess heard a colleague talking
(25:16):
about this study and said, which a what? And he
started looking into the reports. He got the Public Health
Service people running this the Venereal Disease Division to send
him all of their reports, and he read through them
and he could not believe what he was reading. And
he went directly to William J. Brown, who was the
head of the Venereal Disease Division at the time, and
(25:38):
he said, like, what are you doing. You stop this.
This is a horribly unethical study. I can't believe you
guys are doing this. And William J. Brown said, well,
it's all good. These guys are getting medical care that
they otherwise wouldn't. And by the way, did we say
it's dangerous to treat people with late stage syphilis? And
I'm sure Peter Buckson said no, it's not. William Brown
(25:59):
said yes it is. And it just went like that
for a while.
Speaker 3 (26:01):
Well, they also responded that, hey, this is political dynamite,
and a nineteen sixty nine review said it was a
hot potato. So like they knew, you know, like full
well at this point that it was morally and ethically
wrong and racist, and that like if this got out,
like this has started when they kind of internally started
talking about, hey, if this got out, this would look
(26:23):
really bad. Before this, I don't even think they even
thought about it but Buckston would end up being a whistleblower.
He would send his files to the AP, and an
AP reporter named Gene Heller wrote a article that ended
up being published in the New York Times, And that
was in nineteen seventy two, seven years after Buxton first
started looking into it. And that's what finally blew it
(26:44):
wide open.
Speaker 2 (26:45):
Yeah, and I saw that despite being aware that this
could look bad for the public Health Service, I think
now the CDC, the people involved in the study were
really surprised and taken aback by the public outrage that
erupted in immediately from this article. I mean, because it
was AP. That meant all of the newspapers across the
(27:05):
country carried it, and a lot of them put it
on their front page. So everyone all of a sudden
knew about this horribly unethical, racist study. And it came
to art screeching, halt.
Speaker 3 (27:17):
Boy, that sounds like a great time for a break. Yes,
you can't throw on the brakes without taking a break,
that's our motto.
Speaker 1 (27:25):
Yep, we'll be right back, all right.
Speaker 3 (27:52):
So Josh threw on the brakes just like the doctors
performing the Tuskegee syphilis experiments, and teen seventy two, it
was a big political scandal Senator Edward M. Kennedy of
Massachusetts called congressional hearings. Buxton testified there, of course, And
in nineteen seventy two, kind of late nineteen seventy two,
(28:14):
an ad hoc advisory panel said, you got to stop
this study. It's pretty clear it's ethically unjustified.
Speaker 1 (28:22):
Was the quote.
Speaker 3 (28:22):
And it results in quote, disproportionately meager compared with known
risks to the human subjects involved.
Speaker 2 (28:29):
Yeah, and I mean when they started to look into it,
they were like, this study is not even particularly scientific.
And one of the big things I saw was in
an episode of a podcast called Distillation by the Science
History Museum, and they were basically saying, some of these
guys did accidentally get treated with penicillin. Other guys in
(28:50):
the control group accidentally contracted syphilis. And so they would
just take one and be like, Okay, you're in the
control group now because you got you got treated accidentally,
you caught accidentally, you're in this untreated group. They would
just shuffle people around. It was not a very well
run study, considering how much time and effort was put
into it.
Speaker 3 (29:10):
Yeah, I mean they never got any like great data
in return for this forty years of you know, I
mean torture basically.
Speaker 2 (29:18):
You know, the data I saw that they did get
was possibly as many as one hundred and twenty eight
of these men died from untreated syphilis. Yeah, like that's
the bottom line here. They would not have otherwise died
because penicillin is so effective. They died specifically because they
(29:38):
were participants in this study. And that is that. There's
no other way to put it.
Speaker 3 (29:45):
Yeah, I mean, if you remember in nineteen ninety seven,
I remember when this happened, President Clinton invited at the time,
there were eight living survivors of the experiments to the
White House to offer, you know, the formal apology and
said it was like a clearly racist, shameful thing that
you endured. And this was after a legal settlement settlement.
(30:06):
There was a ten million dollar legal settlement and benefit
program at the time. I think when it ended, seventy
men who had not received treatment were still alive, and
the survivors got thirty five thousand dollars, their heirs got
fifteen thousand dollars from a class action lawsuit. And then
they started in nineteen seventy three to Tuskegee Health Benefit
(30:29):
Program basically like, hey, we're going to provide medical care
for your survivors, for your families, for widows, for your children,
basically starting in nineteen seventy five.
Speaker 2 (30:41):
Yeah, because that's something that is forgotten. A lot of times,
these men had families, they had wives, They sometimes had
wives that they were still having babies with. So like
their spouses and their newborn children were at tremendous risk
of contracting syphilis because they were in this untreated programs.
So free health care for the life of them, their
(31:03):
spouses and their children seems like the like step one,
the most basic thing that you could do, you know.
Speaker 3 (31:11):
Yeah, and you know, the effects of this were devastating,
certainly to those families and to the men who participated
and died, and even the ones who didn't. But an
ongoing effect has been felt, you know, even today and
since then they've done studies and found data basically that
all but proves that the Tuskegee experiments had a negative
(31:34):
effect on African Americans in the United States, not trusting doctors,
not trusting nurses, not trusting the medical establishment at all,
and not seeking treatment and having negative health effects because
of this, and they've basically proven it because it's even
more localized, Like the closer you get to making county,
(31:54):
the more the data has proven that people did not
trust doctors.
Speaker 2 (31:59):
Yeah, and that's another moniker that I'm sure Tuskegee University
is not happy about. It's called the Tuskegee effect.
Speaker 3 (32:06):
Yeah.
Speaker 2 (32:07):
One of the pieces of datum that I saw that
really kind of caught my eye was that black men
in America seeking out professional medical help dropped by twenty
two percent in the four years following when the news
of this story broke, So it had a pronounced effect.
Speaker 3 (32:29):
And in nineteen ninety seven, nineteen ninety seven, so this
is twenty five years after the study was finished, there
was a study that found that thirty two point one
percent of black women surveyed in a study agreed that
scientists were not trustworthy, compared to four point one percent
of white women at the time.
Speaker 2 (32:46):
Yeah, and there was another thing too, It was the
Tuskegee effect is widely blamed for making containing the AIDS
epidemic in the nineteen eighties and nineties in the black
community so difficult, And a twenty twenty one study found
that twenty seven point seven percent of the people the
(33:06):
Black Americans surveyed found that they believed the governments created
aids to essentially carry out a genocide against Black Americans. Yeah,
that's the level of distrust that came from Tuskegee. But
there's a historian who knows all about this, name Susan Reverbie,
and she was on that Distillation podcast episode and she
(33:28):
essentially said, that's true. But pinning all of this on
the Tuskegee experiment ignores all of the structural racism that
it's still going on.
Speaker 3 (33:39):
Yeah.
Speaker 2 (33:39):
Yeah, that has that it's like current and is keeping
the whole thing fresh in the minds of Black Americans
because it didn't just happen once and they lost trust.
It happens again and again and again every day essentially
to Black Americans when they seek healthcare in the United States.
Speaker 3 (33:55):
Yeah, Tuskegee just kind of put a bow on it,
you know.
Speaker 1 (33:58):
Yeah.
Speaker 3 (34:00):
So, of course things changed in the medical community, and
you know, sort of ethics control after this, after nineteen
seventy two, Congress and the National Institutes of Health change
rules of just you know, humans participating in studies and experiments,
obviously requiring informed consent for stuff like that, peer review
(34:23):
of not the results, but the studies design, Like, before
you can even go out and get into this and
launch a study or an experiment like this, it has
to be peer reviewed and okayed. And then in nineteen
seventy four, the National Research Act was signed into law,
resulting in kind of a laundry list of regulations and
standards in the wake of Tuskegee.
Speaker 2 (34:44):
What's crazy is this is the seventies and it took
the news of this experiment for the United States to
officially adopt informed consent for medical experiments, despite the Nuremberg
Code that basically said if you're running a medical experiment
anywhere in the world, your patients need to be fully
informed and give informed consent in nineteen forty seven. So
(35:06):
I just found that awful that it took so long
for the US to formally adopt that.
Speaker 3 (35:11):
Yeah, I mean, I think this wasn't like the norm
because doctors, you know, most times had ethics when shooing
the experiments and inform consent was a thing. But yeah,
to codify it like that and taking that long is
just you know, outrageous.
Speaker 2 (35:26):
It also, I guess created a subsequent report in nineteen
seventy nine called the Belmont Report that said, there are
three things you need to do if you're carrying out
a medical experiment involving humans. You have to have respect
for the people involved. You have to show beneficence, which
is essentially like you need to go beyond the basic
minimum requirements of making sure these people are protected and
(35:50):
actually exert some sort of kindness even like go way
beyond that. And then justice equality and treatment equality and
including participants equality and distributing the results of the stuff
and the fruits of these studies. So those things got
adopted as well, but not until nineteen ninety five, sixteen
(36:11):
years after the report.
Speaker 3 (36:13):
Yeah. Ninety five was also when President Clinton ordered, you know,
sort of a slew of presidential committees on bioethics and
how things were done. So yeah, a long long time
after it ended, we promised talk of Guatemala because a
very similar and worse thing happened in Guatemala in nineteen
(36:34):
forty six, forty seven, and forty eight when the United
States government funded medical research which did not study untreated
syphilis in Guatemalans, they deliberately exposed and infected Guatemalan soldiers, prisoners,
sex workers, mental patients with syphilis. I feel like we've
talked about this before, it seems at some point, but
(36:56):
it's horrific how they went about this.
Speaker 2 (36:59):
Yeah, three of these patients died. Only seven hundred of
them received even some sort of minimal treatment. And the
guy that I said you could argue is evil who
was involved in the Tuskegee experiment was the guy who
ran this, doctor John Charles Cutler. He ran it from
nineteen forty six to nineteen forty eight. This was not
(37:20):
the first experiment like this. He also would run stuff
like this in prisons as a fresh face student just
out of graduate school. So he and he's also the
one who in nineteen ninety three defended the whole Tuskegee
experiment by saying like, yeah, you couldn't give penasilis people
had ruined the study.
Speaker 3 (37:40):
Yeah, and he gave people syphilis by injecting it, sometimes
into their eyes. He would infect sex workers by infecting
cotton swabs and then inserting them into their you know,
sex organs, and then sometimes ordering them to have sex
with men to see how it you know, how it transferred,
(38:01):
how easily it transferred.
Speaker 2 (38:02):
Yep. So we said that structural racism still exists in healthcare.
And I've got one last stat that kind of drives
us home. There was a twenty twenty study of emergency
rooms in Oregon and they found that even though black
patients who went seeking help to an emergency room had
completed pain scores about at the same rate as the
(38:24):
black patients who went to these same emergency rooms, the
doctors decided that only fourteen percent of these black patients
deserve pain meds compared to twenty percent of white patients.
So it's still going on today, and we still have
a very long way to go. And I feel like
as long as we keep talking about the Tuskegee experiment,
(38:45):
hopefully it'll bring us a little bit closer, a little
bit closer, because here in the United States, we don't
like to do things the right way quickly. It takes
us a very long time sometimes.
Speaker 3 (38:55):
Yeah, And I you know, I'm not getting on a soapbox,
but it's important to tell theselories now because stories like
this are actively being scrubbed from places like the Smithsonian,
and it's not you know, you can't ignore your negative
history as a country and learn anything about your future
(39:15):
as a country.
Speaker 2 (39:16):
For sure, we should put that on a T shirt.
Speaker 3 (39:18):
Chuck, that's a little little wordy.
Speaker 2 (39:21):
Well, Chuck just gave us a great new T shirt
idea everybody, whether he likes it or not. So that
means it's time for a listener mail.
Speaker 3 (39:29):
You know what, let's not do listener mail. We haven't
done this since I feel like the early years. I
feel like we should put out a call to help
grow our show a little bit. We've just kind of
been on coast forever as far as like saying, hey, like,
tell your friends about this, but let's do this, and
you tell me if you approve, and if not, we'll
just erase all this. Okay, But I charge every listener
(39:53):
who loves stuff you should know, tell find your favorite
episode ever, whether it's Ballpoint Pins or The Uppets or
the time the Nazis invaded Florida. dB Cooper, dB Cooper, Like,
whatever your favorite stuff you should know episode is, and
send it to three friends and say, hey, check the
show out. I think you'll I think you'll like it,
(40:14):
and that would help us out. We're always looking to,
you know, grow the show and expand to new audiences
who have never heard of us even after seventeen years,
so it really helps us out and we would really
appreciate it.
Speaker 2 (40:25):
Very nice, Chuck. I think that was great. I don't
object to that at all.
Speaker 3 (40:28):
Fantastic.
Speaker 2 (40:29):
Well, like Chuck said, go forth and spread the gospel
of Stuff you Should Know. And in the meantime, if
you want to send us an email, you can send
it off to Stuff podcast at iHeartRadio dot com.
Speaker 1 (40:43):
Stuff you Should Know is a production of iHeartRadio.
Speaker 3 (40:46):
For more podcasts my heart Radio, visit
Speaker 1 (40:48):
The iHeartRadio app, Apple Podcasts, or wherever you listen to
your favorite shows.
Welcome to Stuff You Should Know, a production of iHeartRadio.
Speaker 2 (00:11):
Hey, and welcome to the podcast. I'm Josh and there's
Chuck and this is Stuff you should Know about one
of the more shameful chapters in US history and indeed
medical history. I think you could say too.
Speaker 3 (00:24):
Yeah, for sure. And by the way, if you hear
weird noises, my immediate neighborhood is sort of crazy right now.
Speaker 2 (00:32):
What's going on?
Speaker 3 (00:33):
Well, I've got construction next door, I've got a lawn
crew across the street, and they're also shooting a movie
across the street. So it's just pandemonium is happening outside
these sort of quiet doors.
Speaker 2 (00:46):
You know what. I would call that shameful.
Speaker 3 (00:50):
Not like this no episode, for sure.
Speaker 2 (00:52):
That was my attempt at segaway.
Speaker 3 (00:54):
Yeah, nice work.
Speaker 2 (00:55):
I don't know about that, but thanks.
Speaker 3 (00:57):
By the way, this one is a listener recommended and
a teenage listener. This came from Miles Kendrick, a fourteen
year old.
Speaker 2 (01:04):
Nice Miles, great idea.
Speaker 3 (01:05):
Yeah, thanks for that.
Speaker 2 (01:07):
Yeah, we're talking about what's called the Tuskegee Syphilis Experiment
or Tuskegee Syphilis Study, and the actual official name for
it was the Tuskegee Study of Untreated Syphilis in the
Negro Male.
Speaker 3 (01:23):
Yeah, that spells it all out, doesn't it.
Speaker 2 (01:24):
It does. The fact that there's an official title for
this just really kind of goes to show you just
how nefarius the whole thing was. And it was indeed
a nefarious experiment, no matter. It doesn't really matter how
you slice it. You can look at it any number
of ways and it always still washes out stinky.
Speaker 3 (01:44):
Yeah, it does. And this was an experiment. I mean,
I guess we'll go ahead and say what happened generally
is that they recruited black men in Macon County, Alabama
that had syphilis. Kind of one of the misconceptions is
that they were given syphilis as part of this. Not true,
but don't worry. We did that in Guatemala, as we'll
(02:04):
see later on. Yeah, and sign them up for this
study where they would not treat these men of syphilis
just to see how it progressed, basically because they had
this notion and you know, of course just doesn't excuse anything.
But one of the supposed reasons that they had this
notion that syphilis would was different in white men than
black men, and that in black men, it was more
(02:28):
cardiovascular based as far as the symptoms and the results,
and then in white men it was more neurological. And
it was initially supposed to be a six month thing,
but it went on not for four years, not for
fourteen years, but for forty years.
Speaker 2 (02:44):
Yeah. I mean it started out in nineteen thirty two
in the Jim Crow South and it carried right through
the entire Civil Rights era. A number of other historical
things happened during this time that should have given the
researchers pause. From what I saw, the best explanation is
not that these people were inherently evil, although you can
(03:06):
make a case that at least one of the people
who led the study at one point was we'll talk
about him later in Guatemala, But more that they just
came to see these these men, these individuals, these human beings,
there's nothing more than a data set, and that they
stripped them of their humanity so thoroughly that they didn't
even really think that this was there was anything wrong
(03:28):
with what they were doing, even over the course of
forty whole years.
Speaker 3 (03:31):
Yeah. And the reason why they chose Macon County is
a few reasons. One, it's proximity to Tuskegee, which was
you know, key is the place where they carried this
stuff out and others because they they zoned in on
that area because they initially were trying to find out
how many people had syphilis and where so they could
(03:52):
treat these men, right, and they found that Macon County,
Alabama had the highest prevalence of syphilis. And also in
this last art comes from the files that were released
and collected I think in the last decade. Even they
were sharecroppers, there were rural men, and they were poor men.
And the quote that was in these papers that I
found was that they found them immobile and malleable.
Speaker 2 (04:15):
Yeah, they were an extremely vulnerable population. I mean even
among the black population at large in the Jim Crow era,
these were like the most vulnerable people and they had
less rights than even other black people at the time
in America. So yeah, they picked on them very specifically.
(04:35):
And that you kind of hinted at something that I
find as one of the most cynical aspects of this
whole thing, that initially the program that was working down
there was a well funded program that was treating syphilis,
and then the funding ran out of that and they said, well,
we still have all these people that we know have syphilis.
Let's try something different and not treat them. And that
(04:58):
was the beginning of the whole thing.
Speaker 3 (05:00):
Yeah, And it's also key to point out before we
get into the grizzly details, is that these men did
not know they had syphilis, and then they also thought
that they were being treated. They were told they had
quote bad blood, and the whole time they thought they
were getting treatment when they were getting placebos.
Speaker 2 (05:17):
Right. Yeah. And then there were I read a couple
of men who suspected or knew they had syphilis and
wanted to go get it treated, and the people running
the study prevented them from getting it treated, either by
telling them not to go do that or by telling
doctors in the area, do not treat any of these
men because they're part of the study we're carrying out.
(05:38):
Because that's another thing too. I think a lot of
people think that this was some secret government study conducted
in absolute silence. It was not at all. It wasn't
even an open secret. It wasn't a secret at all,
so much so that the people running the study published
thirteen different journal articles over the course of that forty
years and put out annual reports, published annual reports on
(06:02):
the progress of this thing. So it was just right
out there, and people just overlooked it or ignored it
for four decades. Yeah.
Speaker 3 (06:11):
It was a time when you know, the medical community
certainly was aware, but the public at large and the
media didn't really look into you know, medical papers and
stuff like they.
Speaker 1 (06:20):
Do these days.
Speaker 3 (06:21):
Yeah, And we should point out that all of this
was done despite a nineteen twenty seven statute in the
state of Alabama that requires treatment of syphilis, Like it
was a state law that they just rushed aside, basically,
And all of this done for the promise of hot meals,
(06:42):
treatment and burial insurance basically.
Speaker 2 (06:46):
Yeah, for sure. So yeah, I mean, I think that's
a pretty good setup. I think we should kind of
describe what these men were suffering from, yeah, in the
first place, and talk a little bit about syphilis.
Speaker 1 (06:59):
Let's do.
Speaker 3 (07:00):
It was caused by a bacterium called its spiral shaped
and it's called the Treponema palladum bacterium. And they don't
know where it came from, but they know that it
dates at least all the way back to Naples in
fourteen ninety five when mercenaries serving in the French Army
got syphilis and then very quickly spread it far and wide,
(07:21):
because for eight years later it was in India and China.
Speaker 2 (07:26):
That's pretty fast, man.
Speaker 1 (07:28):
Yeah.
Speaker 2 (07:28):
One of the reasons it was so fast is because
these were armies pillaging and raping, and syphilis is primarily
transmitted through sexual contact. It can also be transmitted or
transferred from an infected woman to her fetus, but for
the most part it comes from unprotected sex to this
(07:49):
std Yeah, and there's a there's a hypothesis that it
came back with Columbus and his men, who were again
pillaging and raping, and they had contracted what is considered
a new world disease, syphilis, and brought it back to Europe,
and that's where it spread. Apparently, there's no actual hard
evidence of this or hard proof, but the timing, I
(08:11):
think is what people zero in on. I mean, it
first popped up in fourteen ninety five, and everyone knows
thanks to that child prodigy whose name escapes me right now, Stoner.
I think her last name is Stoner Sackler. The Columbus
sailed the Ocean Blue in fourteen ninety.
Speaker 3 (08:27):
Two, that's right, and if you got syphilis, you were
in for a pretty rough run, including possibly eventually death
in a lot of cases. If you were an infant,
it could be certainly fatal. It could cause blindness and deafness.
It could cause facial differences with teeth and the nose
brain complications. Of course, if you were an adult, you
(08:50):
would get lesions, and then within a few months it
goes into the second stage, where you have lesions basically
all over your body, rashes and pains and headaches, and
finally the disease in the third phase, it dials back
at abates a little bit where it's not transmissible. But
in that latency period, all of a sudden, it can
attack your organs, specifically your liver and cause liver failure
(09:14):
and kill.
Speaker 2 (09:14):
You, and blindness and neurological impacts like dementia and paralysis.
And that's one of the things that makes it so
insidious is after the initial infection symptoms, it just seems
like it went away, and then out of nowhere it
can just come back and kill you. Like you're saying, right,
So this is what these men specifically in this study
were dealing with. I think all of them were in
(09:37):
late latency syphilis where they didn't necessarily have symptoms any longer.
And the idea that this was an indefinite open study
that was essentially like this study will end when all
these guys are dead, meant that they were specifically by
not treating them waiting to see how they died, including
(09:58):
from complications of syphilis like you said, that included organ
failure throughout the body.
Speaker 3 (10:05):
Yeah, And they ended up getting three hundred and ninety
nine men that were infected and then two hundred and
one that served as a control. And part of the
recruitment involved a Tuskegee Institute nurse named Eunice Rivers, who
ended up being a very vilified person because she was
a black woman who helped recruit these guys. There was
(10:28):
advertisements by word of mouth and churches and stuff like that,
and she was co authored on two of the thirteen papers.
And you know, of course was vilified for this for
you know, doing this to men from her own race.
But it seems like she knew what was going on,
but she really believed what she was being told by
(10:48):
the Public Health Service that black men it progressed differently
in them than in white men. And that's sort of
the basis of what they were trying to root out.
Speaker 2 (10:56):
I saw that she also reasoned it that at least
these sharecroppers were getting treatment that they otherwise couldn't have afforded,
which was no treatment exactly. And hot meals too, like
that was I mean, this is it started during the depression.
Hot meals were such an incentive that people would submit
to medical experiments for them. So that was a like
(11:18):
it's easy now to look to overlook how important that was,
but that was a big, a big deal sweetener for them.
Speaker 3 (11:25):
Yeah, and penicillin was something that they had been you know,
they'd been searching for something like penicillin for a long time,
especially in Germany. They were looking for they called it
a magic bullet that would, you know, kill the micro organism,
kill the bacteria without harming the cells that it was infecting.
And from nineteen ten on they had some stuff that
kind of worked, something called oh boy, here we go
(11:50):
ares phenamine? Yeah, do you or spinamine?
Speaker 2 (11:54):
That's what I was going to go with nice coorts.
Speaker 3 (11:56):
But in nineteen forty a Scottish position named Alexander Fleming
came along and had proven basically in nineteen twenty eight
that penicillin worked, and in nineteen forty was when it
was finally published in the Lancet. Is like, hey, this
is sort of this miracle magical that we were looking for,
and you know, nineteen forty is kind of squarely in
(12:17):
the middle of this study. Yet they didn't use penicillin
still to heal these guys.
Speaker 2 (12:22):
No, I mean like the fact that a treatment, because
before that treatment was really bad for you. They would
like people have been using mercury to treat it since
about fifteen hundred and then that arsphenamine was a type
of arsenic I think you said so, like it might
not have worked, It took a year, it was very expensive,
(12:44):
and it was not a pleasant thing. When the penicillin
came along, you could get one injection of high dose
penicillin and it could cure syphilis in eight days. It
could even cure late stage latency syphilis that was already
attacking your organs. It could at least cure the it
wouldn't reverse the organ damage. So the fact that they
knew that this existed, I read the Public Health Service
(13:07):
was instrumental in developing penicillin as a treatment for syphilis.
So it's not like the Public Health Service hadn't heard
that that penicillin worked. That is one of the more
damning points, Like there's no defense that they could offer
that would justify withholding penicillin since they knew it worked,
(13:28):
and the study went on for what thirty one more
years after that?
Speaker 3 (13:32):
Yeah, I mean, I don't think anyone ever contended that
it was on the table like, hey, we have a cure,
now it's going to stop, because they that's not what
they were after to begin with.
Speaker 2 (13:40):
No, And in fact, there were quotes from people later
on who were involved and tried to defend it that
was basically like, yeah, we had to we had to
actively make sure that these guys didn't get penicillin from
other doctors who didn't know about the study for things
like colds or whatever, because they would accidentally cure the syphilis.
(14:01):
That's the links that they went to, like the penicillin
was an enemy to this study essentially, is how they
thought of it.
Speaker 3 (14:07):
Well, one more link that they went to before we
take a break was when World War II rolls around,
they purposefully made sure that these study subjects, these men
were exempted from the draft. Because when you go through
the draft process, you get tested for STDs and treated
for STDs, and so they're like, no, no, no, that'll ruin
(14:29):
our study. We got to make sure these guys don't
get drafted. So the takeaway from that is is these
men probably would have been better off like being drafted
and potentially even like storming the beach at Normandy than
being at home in Alabama being quote unquote treated by doctors.
Speaker 2 (14:45):
That's a good point. And the way that they did
it too kind of shows just how complicit a lot
of people in the area where it's not that the
public Health service didn't pull some strings to make this happen.
They went to the director of public health for Macon
County and said, hey, you're friends with the guy running
the Selective Service board. Why don't you, you know, make
(15:06):
sure that this works. And he did. He pulled the
right strings and and he made it happen. But so
this was a there were a lot of people who
came together to make this happen and to prevent these
men from getting their syphilis treated one way or another.
Speaker 3 (15:22):
All right, let's take that break and we'll be right
back right after this.
Speaker 2 (15:55):
Okay, we're back, Chuck and we should probably talk about
how this study began.
Speaker 3 (16:00):
Yeah, it was launched by the director of phs's Venereal
Disease Division, someone named Talia Faroh Clark, and it was
a two arms study again, a control group and an
infected group. And I believe Clark did not suggest giving placebos,
even though that happened. But he also didn't say, Hey,
(16:25):
you know, we're trying to study the difference between how
it progresses in black men and white men. Let's bring
in some white men. They strictly focused on black men.
Speaker 2 (16:32):
Yeah, there was actually a reason for that. There was
a study that was very similar that was conducted in Oslo, Norway,
from eighteen ninety one to nineteen ten, and the results
were published in nineteen twenty nine that did the same
thing but to all white men. So essentially they used
that data from the Oslo study as a comparison, or
(16:52):
they planned to. I guess, yeah, sure right, so you know,
it's all good.
Speaker 3 (17:01):
Tuskegee itself was chosen again I mentioned because of its
proximity to where they were, you know, drawing from for
Macon County, but also because of the government links with
the Tuskegee Institute.
Speaker 2 (17:13):
Booker t.
Speaker 3 (17:14):
Washington had come along and really shaped a critical educational
institution in the United States. They were serving needy black
people of Alabama and it's you know, that's another one
of the just big shames is that it puts such
a black eye on what this you know, kind of
great institution.
Speaker 2 (17:32):
Yeah, I mean, this is the hospital where people would go.
This is I think where nurse Eunice Rivers worked too.
So it was a huge betrayal of that community. And
I mean, even though it's developed by leaps and leaps
and bounds and it's now Tuskegee University, like you said,
it was a black eye. But even worse than that.
Everybody calls this, including us, the Tuskegee Experiment. They don't
(17:55):
call it the Public Health Service Syphilis experiment or the
US government syphlists experiment. So it's an ongoing black guy
on Tuskegee University too.
Speaker 1 (18:05):
Yeah.
Speaker 3 (18:06):
For sure, they were deceived from the beginning, you know,
like we said at Bears repeating that they thought they
were signing up for treatment. In fact, they called it
a quote special free treatment end quote. And you know,
so these guys lined up for it. You know, they
thought they had bad blood and they got placebos in
(18:26):
the name of aspirin, mainly like five thousand pink aspirin
tablets were shipped in nineteen thirty four. Also, these these
tonics that then tinctures they would mix up that you know,
they said, was gonna get their bad blood treated.
Speaker 2 (18:40):
Yes, so you said that tel Afario Clark or Talafaro Clark,
and it conceived of this whole study. I think he
stepped aside pretty early on, and starting in nineteen thirty three.
The next year a guy named Raymond Vanderler picked up
and took over and actually expanded it and now said, Okay,
(19:00):
we're looking for neurological effects. Let's start giving these guys
spinal taps that are really really dangerous, can be really painful,
and can give you horrible headaches afterward too, So let's
just throw that in for you know, just for kicks.
Speaker 3 (19:17):
Yeah. And also in those papers that were released and
collected recently, that same person there was a letter where
he was talking about all the complaints from oh, yes,
so the patients getting spinal taps and how awful it was,
and he was like I'm paraphrasing, but basically like now
I'm the one with the headache.
Speaker 2 (19:35):
Yeah, yeah, he said that. So, yes, this is kind
of like the patronizing, at the very least patronizing tone
that the people running this experiment had toward everybody.
Speaker 1 (19:49):
Yeah.
Speaker 2 (19:49):
So we said also that penicillin came around in the
late nineteen forties or nineteen forties at some point, and
that was one thing that it was like, Okay, you
guys should have stopped everything and giving these guys penicillin.
Another thing happened in the nineteen forties that essentially should
have put an end to this, and that was the
Nuremberg Trials after World War Two, where, among other people,
(20:11):
a bunch of Nazi doctors, I think twenty three Nazi
doctors were put on trial for war crimes for running horrible,
horrific medical experiments on people during World War Two, and
I think seven of them were sentenced to death. And
yet despite that, the people running this syphilist study were
(20:32):
just like, gosh, that, I mean, Nazis suck good thing.
We're not Nazis. We're just going to continue on with
this experiment.
Speaker 3 (20:39):
Yeah. In nineteen fifty seven, this is in the twenty
fifth year, the Surgeon General awarded certificates to these patients like,
you know, congratulations on all your work here in this
and participating in this study. And then later on in
nineteen ninety three, one of the researchers, John Charles Cutler,
and we're going to talk about him a bit later
(21:00):
as well, there was a quote where he said it
would be undesirable to go ahead and use large amounts
of penicillin to treat the disease, because you'd interfere with
the study. So you know, they were on record like
time and time again, through countless different changes over these
forty years at Tuskegee, these doctors and nurses, the people
(21:21):
in the public health system, Like it wasn't just like
one like mad scientist running the show all these years.
It was just new people kind of changing hands and
leading this charge like year after a year for forty years.
Speaker 2 (21:32):
Yeah. And one of the things that they clung to,
both internally and externally is this idea that became outdated
when penicillin came along, but they still kept going with
this excuse was that treating late latency, late stage syphilis
could actually cause more harm than good. You could get
(21:53):
this syphilis stirred up again and that could cause that
organ failure, so you're better off not treat And by
the time penicillin came along, by the time Nuremberg came along,
all of these patients would have been in late latency
syphilis were they not already. So that was the thing, Like,
that was what they would push back on, even though
(22:14):
it was not true anymore. I like, once penicillin came along,
it was not dangerous at all, and it really really worked,
and yet they still use that as an excuse whenever
it was challenged. It was very rarely challenged, but it
was challenged by some people, as we'll see.
Speaker 3 (22:30):
Yeah, there was the first person brave enough to even
say anything was named Count Gibson. He was a Richmond
physician heard about the study through a lecture in the
nineteen fifties from Sydney Olanski and wrote a letter saying,
I'm gravely concerned about the ethics of the entire program.
(22:51):
He continued to sort of observe the study after penicillin
came along, and he, you know, Alonski basically came back
and said, I think our work is helping out these
participants overall, and just keep quiet about it.
Speaker 2 (23:08):
Yeah, just all of the thinnest excuses that that was
what they would defend themselves with. I guess Count Gibson
did end up keeping quiet because the medical college that
he worked at in Virginia essentially said you need to
be quiet or else, I would guess, lose your job.
So that was in the fifties, right, Yeah. Next up
was a guy named Bill Jenkins, who was one of
(23:29):
the CDC's first African American professional workers. He was a statistician.
His widow also called him a essentially a radical that
was very involved in the civil rights movement from a
very early time. And he learned about this and the
bald face racism that was just inherent, and it really
(23:49):
obviously stuck in his craw and he tried very hard
to get the New York Times in the Washington Post
to cover it, and they didn't. He later said, we
probably should have a press release and done it differently.
They just sent all this stuff in the New York
Times and WAPO. It's not clear whether they would have
published anything on it anyway, but he gave it a try,
and he eventually was like, I can't do anything else.
(24:13):
I think he also tried internally too to get it
to stop, and it just didn't happen.
Speaker 3 (24:18):
Yeah, so that was sixty and sixty four. There was
a Detroit cardiologist named Irwin J. Shatz, and he was like,
I can't believe what's going on, Like I read this study,
because again, you know, they were putting out these studies
in the medical community was reading them and some people
were like, wait a minute, what is going on down there?
And he said, I suggest that you reevaluate your moral
(24:40):
judgments on this. And there was a co author named
Anne R. Yobs who said it was a co author
of the Syphilist study that said it was the first
letter they got like that and that she planned to
ignore it.
Speaker 2 (24:51):
Yeah. So yeah, they were also pretty arrogant in this
stuff too. Well. They eventually ran head to head with
a guy named Peter Buxton who was working for the
Public Health Service. He was a venereal disease investigator in
the Tenderloin in San Francisco. I think he was twenty
eight in the late sixties or mid sixties, sorry, nineteen
sixty five, and he, I guess heard a colleague talking
(25:16):
about this study and said, which a what? And he
started looking into the reports. He got the Public Health
Service people running this the Venereal Disease Division to send
him all of their reports, and he read through them
and he could not believe what he was reading. And
he went directly to William J. Brown, who was the
head of the Venereal Disease Division at the time, and
(25:38):
he said, like, what are you doing. You stop this.
This is a horribly unethical study. I can't believe you
guys are doing this. And William J. Brown said, well,
it's all good. These guys are getting medical care that
they otherwise wouldn't. And by the way, did we say
it's dangerous to treat people with late stage syphilis? And
I'm sure Peter Buckson said no, it's not. William Brown
(25:59):
said yes it is. And it just went like that
for a while.
Speaker 3 (26:01):
Well, they also responded that, hey, this is political dynamite,
and a nineteen sixty nine review said it was a
hot potato. So like they knew, you know, like full
well at this point that it was morally and ethically
wrong and racist, and that like if this got out,
like this has started when they kind of internally started
talking about, hey, if this got out, this would look
(26:23):
really bad. Before this, I don't even think they even
thought about it but Buckston would end up being a whistleblower.
He would send his files to the AP, and an
AP reporter named Gene Heller wrote a article that ended
up being published in the New York Times, And that
was in nineteen seventy two, seven years after Buxton first
started looking into it. And that's what finally blew it
(26:44):
wide open.
Speaker 2 (26:45):
Yeah, and I saw that despite being aware that this
could look bad for the public Health Service, I think
now the CDC, the people involved in the study were
really surprised and taken aback by the public outrage that
erupted in immediately from this article. I mean, because it
was AP. That meant all of the newspapers across the
(27:05):
country carried it, and a lot of them put it
on their front page. So everyone all of a sudden
knew about this horribly unethical, racist study. And it came
to art screeching, halt.
Speaker 3 (27:17):
Boy, that sounds like a great time for a break. Yes,
you can't throw on the brakes without taking a break,
that's our motto.
Speaker 1 (27:25):
Yep, we'll be right back, all right.
Speaker 3 (27:52):
So Josh threw on the brakes just like the doctors
performing the Tuskegee syphilis experiments, and teen seventy two, it
was a big political scandal Senator Edward M. Kennedy of
Massachusetts called congressional hearings. Buxton testified there, of course, And
in nineteen seventy two, kind of late nineteen seventy two,
(28:14):
an ad hoc advisory panel said, you got to stop
this study. It's pretty clear it's ethically unjustified.
Speaker 1 (28:22):
Was the quote.
Speaker 3 (28:22):
And it results in quote, disproportionately meager compared with known
risks to the human subjects involved.
Speaker 2 (28:29):
Yeah, and I mean when they started to look into it,
they were like, this study is not even particularly scientific.
And one of the big things I saw was in
an episode of a podcast called Distillation by the Science
History Museum, and they were basically saying, some of these
guys did accidentally get treated with penicillin. Other guys in
(28:50):
the control group accidentally contracted syphilis. And so they would
just take one and be like, Okay, you're in the
control group now because you got you got treated accidentally,
you caught accidentally, you're in this untreated group. They would
just shuffle people around. It was not a very well
run study, considering how much time and effort was put
into it.
Speaker 3 (29:10):
Yeah, I mean they never got any like great data
in return for this forty years of you know, I
mean torture basically.
Speaker 2 (29:18):
You know, the data I saw that they did get
was possibly as many as one hundred and twenty eight
of these men died from untreated syphilis. Yeah, like that's
the bottom line here. They would not have otherwise died
because penicillin is so effective. They died specifically because they
(29:38):
were participants in this study. And that is that. There's
no other way to put it.
Speaker 3 (29:45):
Yeah, I mean, if you remember in nineteen ninety seven,
I remember when this happened, President Clinton invited at the time,
there were eight living survivors of the experiments to the
White House to offer, you know, the formal apology and
said it was like a clearly racist, shameful thing that
you endured. And this was after a legal settlement settlement.
(30:06):
There was a ten million dollar legal settlement and benefit
program at the time. I think when it ended, seventy
men who had not received treatment were still alive, and
the survivors got thirty five thousand dollars, their heirs got
fifteen thousand dollars from a class action lawsuit. And then
they started in nineteen seventy three to Tuskegee Health Benefit
(30:29):
Program basically like, hey, we're going to provide medical care
for your survivors, for your families, for widows, for your children,
basically starting in nineteen seventy five.
Speaker 2 (30:41):
Yeah, because that's something that is forgotten. A lot of times,
these men had families, they had wives, They sometimes had
wives that they were still having babies with. So like
their spouses and their newborn children were at tremendous risk
of contracting syphilis because they were in this untreated programs.
So free health care for the life of them, their
(31:03):
spouses and their children seems like the like step one,
the most basic thing that you could do, you know.
Speaker 3 (31:11):
Yeah, and you know, the effects of this were devastating,
certainly to those families and to the men who participated
and died, and even the ones who didn't. But an
ongoing effect has been felt, you know, even today and
since then they've done studies and found data basically that
all but proves that the Tuskegee experiments had a negative
(31:34):
effect on African Americans in the United States, not trusting doctors,
not trusting nurses, not trusting the medical establishment at all,
and not seeking treatment and having negative health effects because
of this, and they've basically proven it because it's even
more localized, Like the closer you get to making county,
(31:54):
the more the data has proven that people did not
trust doctors.
Speaker 2 (31:59):
Yeah, and that's another moniker that I'm sure Tuskegee University
is not happy about. It's called the Tuskegee effect.
Speaker 3 (32:06):
Yeah.
Speaker 2 (32:07):
One of the pieces of datum that I saw that
really kind of caught my eye was that black men
in America seeking out professional medical help dropped by twenty
two percent in the four years following when the news
of this story broke, So it had a pronounced effect.
Speaker 3 (32:29):
And in nineteen ninety seven, nineteen ninety seven, so this
is twenty five years after the study was finished, there
was a study that found that thirty two point one
percent of black women surveyed in a study agreed that
scientists were not trustworthy, compared to four point one percent
of white women at the time.
Speaker 2 (32:46):
Yeah, and there was another thing too, It was the
Tuskegee effect is widely blamed for making containing the AIDS
epidemic in the nineteen eighties and nineties in the black
community so difficult, And a twenty twenty one study found
that twenty seven point seven percent of the people the
(33:06):
Black Americans surveyed found that they believed the governments created
aids to essentially carry out a genocide against Black Americans. Yeah,
that's the level of distrust that came from Tuskegee. But
there's a historian who knows all about this, name Susan Reverbie,
and she was on that Distillation podcast episode and she
(33:28):
essentially said, that's true. But pinning all of this on
the Tuskegee experiment ignores all of the structural racism that
it's still going on.
Speaker 3 (33:39):
Yeah.
Speaker 2 (33:39):
Yeah, that has that it's like current and is keeping
the whole thing fresh in the minds of Black Americans
because it didn't just happen once and they lost trust.
It happens again and again and again every day essentially
to Black Americans when they seek healthcare in the United States.
Speaker 3 (33:55):
Yeah, Tuskegee just kind of put a bow on it,
you know.
Speaker 1 (33:58):
Yeah.
Speaker 3 (34:00):
So, of course things changed in the medical community, and
you know, sort of ethics control after this, after nineteen
seventy two, Congress and the National Institutes of Health change
rules of just you know, humans participating in studies and experiments,
obviously requiring informed consent for stuff like that, peer review
(34:23):
of not the results, but the studies design, Like, before
you can even go out and get into this and
launch a study or an experiment like this, it has
to be peer reviewed and okayed. And then in nineteen
seventy four, the National Research Act was signed into law,
resulting in kind of a laundry list of regulations and
standards in the wake of Tuskegee.
Speaker 2 (34:44):
What's crazy is this is the seventies and it took
the news of this experiment for the United States to
officially adopt informed consent for medical experiments, despite the Nuremberg
Code that basically said if you're running a medical experiment
anywhere in the world, your patients need to be fully
informed and give informed consent in nineteen forty seven. So
(35:06):
I just found that awful that it took so long
for the US to formally adopt that.
Speaker 3 (35:11):
Yeah, I mean, I think this wasn't like the norm
because doctors, you know, most times had ethics when shooing
the experiments and inform consent was a thing. But yeah,
to codify it like that and taking that long is
just you know, outrageous.
Speaker 2 (35:26):
It also, I guess created a subsequent report in nineteen
seventy nine called the Belmont Report that said, there are
three things you need to do if you're carrying out
a medical experiment involving humans. You have to have respect
for the people involved. You have to show beneficence, which
is essentially like you need to go beyond the basic
minimum requirements of making sure these people are protected and
(35:50):
actually exert some sort of kindness even like go way
beyond that. And then justice equality and treatment equality and
including participants equality and distributing the results of the stuff
and the fruits of these studies. So those things got
adopted as well, but not until nineteen ninety five, sixteen
(36:11):
years after the report.
Speaker 3 (36:13):
Yeah. Ninety five was also when President Clinton ordered, you know,
sort of a slew of presidential committees on bioethics and
how things were done. So yeah, a long long time
after it ended, we promised talk of Guatemala because a
very similar and worse thing happened in Guatemala in nineteen
(36:34):
forty six, forty seven, and forty eight when the United
States government funded medical research which did not study untreated
syphilis in Guatemalans, they deliberately exposed and infected Guatemalan soldiers, prisoners,
sex workers, mental patients with syphilis. I feel like we've
talked about this before, it seems at some point, but
(36:56):
it's horrific how they went about this.
Speaker 2 (36:59):
Yeah, three of these patients died. Only seven hundred of
them received even some sort of minimal treatment. And the
guy that I said you could argue is evil who
was involved in the Tuskegee experiment was the guy who
ran this, doctor John Charles Cutler. He ran it from
nineteen forty six to nineteen forty eight. This was not
(37:20):
the first experiment like this. He also would run stuff
like this in prisons as a fresh face student just
out of graduate school. So he and he's also the
one who in nineteen ninety three defended the whole Tuskegee
experiment by saying like, yeah, you couldn't give penasilis people
had ruined the study.
Speaker 3 (37:40):
Yeah, and he gave people syphilis by injecting it, sometimes
into their eyes. He would infect sex workers by infecting
cotton swabs and then inserting them into their you know,
sex organs, and then sometimes ordering them to have sex
with men to see how it you know, how it transferred,
(38:01):
how easily it transferred.
Speaker 2 (38:02):
Yep. So we said that structural racism still exists in healthcare.
And I've got one last stat that kind of drives
us home. There was a twenty twenty study of emergency
rooms in Oregon and they found that even though black
patients who went seeking help to an emergency room had
completed pain scores about at the same rate as the
(38:24):
black patients who went to these same emergency rooms, the
doctors decided that only fourteen percent of these black patients
deserve pain meds compared to twenty percent of white patients.
So it's still going on today, and we still have
a very long way to go. And I feel like
as long as we keep talking about the Tuskegee experiment,
(38:45):
hopefully it'll bring us a little bit closer, a little
bit closer, because here in the United States, we don't
like to do things the right way quickly. It takes
us a very long time sometimes.
Speaker 3 (38:55):
Yeah, And I you know, I'm not getting on a soapbox,
but it's important to tell theselories now because stories like
this are actively being scrubbed from places like the Smithsonian,
and it's not you know, you can't ignore your negative
history as a country and learn anything about your future
(39:15):
as a country.
Speaker 2 (39:16):
For sure, we should put that on a T shirt.
Speaker 3 (39:18):
Chuck, that's a little little wordy.
Speaker 2 (39:21):
Well, Chuck just gave us a great new T shirt
idea everybody, whether he likes it or not. So that
means it's time for a listener mail.
Speaker 3 (39:29):
You know what, let's not do listener mail. We haven't
done this since I feel like the early years. I
feel like we should put out a call to help
grow our show a little bit. We've just kind of
been on coast forever as far as like saying, hey, like,
tell your friends about this, but let's do this, and
you tell me if you approve, and if not, we'll
just erase all this. Okay, But I charge every listener
(39:53):
who loves stuff you should know, tell find your favorite
episode ever, whether it's Ballpoint Pins or The Uppets or
the time the Nazis invaded Florida. dB Cooper, dB Cooper, Like,
whatever your favorite stuff you should know episode is, and
send it to three friends and say, hey, check the
show out. I think you'll I think you'll like it,
(40:14):
and that would help us out. We're always looking to,
you know, grow the show and expand to new audiences
who have never heard of us even after seventeen years,
so it really helps us out and we would really
appreciate it.
Speaker 2 (40:25):
Very nice, Chuck. I think that was great. I don't
object to that at all.
Speaker 3 (40:28):
Fantastic.
Speaker 2 (40:29):
Well, like Chuck said, go forth and spread the gospel
of Stuff you Should Know. And in the meantime, if
you want to send us an email, you can send
it off to Stuff podcast at iHeartRadio dot com.
Speaker 1 (40:43):
Stuff you Should Know is a production of iHeartRadio.
Speaker 3 (40:46):
For more podcasts my heart Radio, visit
Speaker 1 (40:48):
The iHeartRadio app, Apple Podcasts, or wherever you listen to
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