"Disease Will Accomplish What Man Cannot Do"
How To Kill A Man and Get Away With It: Setting the Stage for What Really Happened At Tuskegee
When the wealthy, powerful founder of Sears, Roebuck, and Company met the famous Booker T. Washington, mutual respect and a connection were forged. Julius Rosenwald made it a point of using his fortune to invest in self-sustaining Black economic initiatives. Before he met Mr. Washington, Mr. Rosenwald had already donated funding to helpful research and economic programs that had been beneficial and empowering to Black southerners.
Booker T. Washington, a giant in his own right, had founded the Tuskegee Institute, a prestigious African American research center in the USA. Both he and Mr. Rosenwald saw it as a respectable place for a potential Black industry that would contribute significantly to society. Both men knew that the economic and political hell that free Black people faced in the South was deeply entrenched by predatory lending practices, a biased and brutal police system, and carefully designed economic slavery.
While technically slavery had been outlawed, free Black people found themselves dumped into a world and legal system that intentionally had not been designed for them. Generations of legal traps had ensured that the majority of the community was barred from education, withheld wages for labor, and unable to build up any kind of economic safety net or own their own land. Former enslavers immediately took advantage of these political and economic weaknesses and exploited them to keep their industries going. This Sharecropping system in the South turned the free Black community into Sharecroppers who worked the land for criminally low wages but were required to buy all their food, supplies, and goods from White owners who intentionally inflated the prices to keep the entire community in perpetual debt. It was illegal to leave the sharecropping system you signed onto and the penalties for organizing or demanding fair wages or even wanting to quit could be fatal. The owners knew they had local police and neighbors who had no issue brutalizing or killing Black sharecroppers who dared to question this American serfdom. This system further disenfranchised and weakened generations of families, as it continually reset the clock and ensured these families could never build up capital, inherit land or homes, take out fair loans, or educate their children. Black children even had to leave school early or not go at all to just help their parents barely eke out an existence to pay back the predatory sharecropping owners. The cycle started young and stayed brutal and exacting until death.
Macon County, where the Tuskegee Study would take place, was 70 years out of slavery but with a population devastated by lives that looked no different from that of their ancestors. The area was a public health failure, with doctors who refused to treat or take Black patients and a small number of Black doctors who could barely charge the economically strapped population. It was an opportunity for all sorts of illnesses to thrive, as poor nutrition, poverty, and backbreaking labor weakened the bodies of the Black residents. Syphilis was one of the major health concerns in Macon County. Because of the lack of the aforementioned public health infrastructure that served Black people and the strain on their bodies, 61 percent of the cases were congenital, passed down from infected parent to child. This cycle of illness desperately needed a cure, but there wasn’t one.
Syphilis is a pretty famous disease whether you have a degree in biology or failed your ninth-grade penile anatomy exam ( Dr. Chisholm, I am sorry). However, it’s a little more complex than the common narrative that’s persisted around it.
1: It’s caused by a bacterial organism and infection occurs in two ways: 1: from an infected mother or 2: from sexual contact.
2: The bacteria is called Spirochaeta Pallida, and it looks a bit like a wiggly worm under the microscope.
3: If contracted by sexual contact, phase one involves a painless sore appearing on the point of entry or genitals. If the disease isn’t treated right away, a long latent phase starts. Then all sorts of sores, growths, bone decay, and heart damage start to wreak havoc on the body. The final, third stage of this disease might erupt decades later, with serious neurological and cardiovascular damage that can cause blindness, mental insanity, paralysis, and then death. Up until the 1940s, the mental illness aspect was considered a separate disease altogether.
Rosenwald set aside a portion of his fortune specifically for Syphilis treatment programs, figuring he could do what public health officials would not. Unfortunately, the stock market crashed in 1929, and with it went much of Rosenwald’s wealth. Both fortune and the incoming treatment programs were gone.
In the seventh and final chapter of Part One of Medical Apartheid, Harriet Washington starts with the story we think we know, about the 1932 U.S. Public Health Service program that promised medical treatment to Black men while secretly providing none of it. That shame and infamy of the Tuskegee Syphilis Study loom large, and it has in its fame falsely become the main source of blame for the current medical establishment’s relationship with people of color. It’s also morphed narratively, as people have tried to distance themselves from the truth of it or failed to lay out the actual vast number of crimes committed.
So what really happened in Macon County? Who knew what, when did they know it, and why does that matter? Tuskegee was supposed to be the site of research and deliverance -potentially for the world- of a disease that had long hurt and killed people. Rosenwald and Washington saw an opportunity in Macon County. But they weren’t the only ones. And this is really where Washington begins to illuminate so clearly what has been lost to history: Where some sought to treat, others like the US Public Health Service, saw an opportunity to experiment with human lives.
The real events of the next forty years, a tragedy in three specific acts, were made possible by pre-existing medical racism, careful plotting, and an ever-growing web of lies that a number of doctors and nurses carefully spun around the lives of the families they tricked. In this Chapter 7 “A Notoriously Syphilis-Soaked Race”, Washington not only reframes the Tuskegee Study in its original context but removed it from the false first place as The Worst and Most Damaging Thing We Did To Black Patients.
The rest of the story that most of us don’t know, is about the ensuing fallout within the Black families, the dramatic race by three White whistleblowers to expose the study to the wider world, and the long-hidden agenda in the writings of both the doctors and the panel that was supposed to review its own sins. Destroyed tapes, missing bodies, and fake medicine In the coming posts, we will learn the names that have conveniently dropped out of this history and look at just how this was pulled off while the system broke many of the ethical standards of the time that they had set themselves.
The doctors of the study are blamed today for not holding any hope. That they did not want anything from this study, and that is their crime. But I would say that their own writings did have hope. As Public Health Service’s own Dr. Thomas Murrell said:
“So the scourge sweeps among them. Those that are treated are only half cured, and the effort to assimilate a complex civilization drives their diseased minds until the results are criminal records. Perhaps here, in conjunction with tuberculosis, will be the end of the negro problem. Disease will accomplish what man cannot do.”