The Exposure and Defense of Tuskegee's Crime

Part 2: In which an immigrant finally brings the whole thing crashing down

Peter Buxtun wasn’t aware that he would be the final blow to the Tuskegee Syphilis Study. When the young Polish immigrant decided to risk his job as a venereal disease interviewer at the Public Health Service, he was most likely unaware of any prior, unsuccessful attempts to stop the medical abuses by a concerned (and “respectably” White) Dr. Irwin J. Schatz. He was simply looking at the same data so many other people had been shown over the decades. And he was going to do something about it.

Buxtun would have discovered in his research that throughout the years the standards of care for syphilis were ignored, that one Nurse Eunice Rivers (more on her later) would have been hired to secretly track the infected men’s movements and deaths, and that the numbers of the control group and the infected group of men had been haphazardly muddied and mixed. This last part was important at that point in time simply because it violated basic scientific experiment processes that were widely agreed on. You can’t as a scientist be moving people between the control group and the studied, infected group when someone contracts the disease midway through. The study was claiming to objectively study and compare the health and decline of the human body between patients with syphilis and those without it. Harriet Washington makes it clear that everyone understood that perfect separation was required for accurate measurements. You can’t have people with undiagnosed syphilis in the control group for months at a time, and then falsify the data to make up for moving them to the infected group!

This ongoing manipulation of the data and disregard to follow through with the intended point of the study is helpful now, as we try to understand aspects of the study that would only be questioned decades after Peter Buxtun bravely wrote to his superiors pressing for answers and an investigation. Dr. Benjamin Roy in 1995 discovered through the PHS’s own records and doctors’ written statements this explicit understanding that the men served as human incubators of syphilis as it could not be cultured on its own. They were not simply men in a lab being observed, they were being used as human laboratories supplying the sera from their blood to make medical progress possible. The men’s blood was very, very useful for developing several highly successful syphilis tests and running tests for a future vaccine. The US government’s contract with the state of Alabama was that anything out of the study was the property of the US government. The study doctors and their actions, as Dr.Roy notices, were constantly doing spinal taps and blood draws on the men. That’s pretty unnecessary for multi-decade monitoring of the decay of the body, but necessary for creating cultures so you can make tests you can sell for lots of money. This aspect of the study, Dr. Roy argues in the Harvard Journal of Minority Public Health, has yet to be thoroughly examined. There was an opportunity for that examination to take place within internal US government structures, but that was a long way off (and an entire controversy of its own).

It would take Peter Buxtun over seven years for his complaints to make any kind of difference, and when they did it was not because his former employer did something about it, but because Buxtun went to a journalist he knew and told her everything he knew. Prior to this time, he had been forced to sit through meetings with PHS physicians, who lectured him on their methods and how the study (against all facts and records) was not only fine but useful. In 1967, he left the agency to attend law school but still wrote to his former employers imploring them to stop the study and asking for answers. By 1969, at least 100 men in the study had died unnecessarily of the disease or complications from it, still believing they were receiving treatment to save them from it. In 1972, Jean Heller broke the story in an explosive piece for the Associated Press. Heller’s reporting shook the nation. Citizens -Black and White- were outraged. This outrage was matched by politicians, doctors, and press media reporters who wanted the US government to explain themselves as well as make the movement to ensure this would never happen again. The officials at PHS were horrified as well because this looked as bad as it was. The response from PHS was that they had no idea of any human rights abuses within. This was followed by quick, nonsensical excuses for why medical treatment was withheld and why the men were lied to, excuses that didn’t make sense to anyone then and don’t make any more sense to anyone now.

Washington points out that there is no utilitarian defense of the study that PHS can hide behind, as their own physicians admitted long before the study ended that it imparted no new clinical knowledge that would allow them to help future patients. It did however give the physicians ample time to beef up their own scientific stature, churn out publications, and create new scientific tools. Another (retroactive) defense that doesn’t make sense is claiming there were no existing national laws. But as Peter Buxtun, Jean Heller, and the physicians themselves would have known, the practices put in place in this study had been illegal or banned since 1929. The ethical norm years before the study did not allow for any part of the deception and fake treatments to be used in a scientific study, let alone one sponsored and run by a government health agency! Another damning realization was that while this study had purported that syphilis affected Black people’s cardiovascular health differently from White people, a mere year into the study the American Heart Association overturned this fiction and concluded there was no real “racial” difference. It was just all in the doctors’ imaginations.

And that’s the thing, isn’t it, about the stories we tell ourselves? They might not be real, they might all be socially constructed, or figments of our imaginations. But these stories always have physical consequences. And that’s why books aren’t just books and history and how it is framed is so hotly contested. To examine the story, testing if it holds true or if it’s an excuse for a certain order of power, money, and resources to be allotted, is scary for people who have a lot to lose. This story was supposed to end with a government-appointed panel to review the Tuskegee Syphilis Study. But that is another drama of betrayal, burned tapes, and hidden histories. For now, we simply end with the public exposure of the longest-running experimental abuse case in known Western History. The journey to right even some of those wrongs, was just beginning.