"Bad Blood": The Tuskegee Syphilis Experiment
content warning: anti-Blackness, racist medical rhetoric
(Image: Wikipedia)
THE STUDY
The Tuskegee Syphilis Experiment (aka the case of Miss Evers’ Boys) is rarely taught in history classes. If it is, it’s often framed as a regrettable anomaly in the history of the American medical establishment, a dismaying spot on the record of exceptional American medical innovation. The disturbing truth is that most medical knowledge about syphilis that we have today results directly from the systematic abuse of Black patients over a 40 year period. The state (government, committees, laws) and the medical establishment (doctors, research, industry) collaborated on a study that compromised the health of hundreds of Black men, harming them in the name of scientific inquiry and national health.
In 1932, the Tuskegee Institute and the U.S. Public Health Service worked together to recruit 400 Black men into a study titled the “Tuskegee Study of Untreated Syphilis in the Negro Male.” As the name of the study suggests, doctors wanted to examine how syphilis affected the human body when left untreated. They conducted a study involving direct observation and minor experimental procedures over four decades that exploited patient trust, autonomy, and health. The progression of the experiment was predicated on the medical establishment’s view of the Black body as a pathologized and dispensable site of clinical experimentation.
The Public Health Service supervised and directed the study from Washington D.C., though the research primarily occurred at the Tuskegee Institute in Macon County. Booker T. Washington originally founded the Tuskegee Institute in 1881 and it was a well respected Black institution in Alabama. White doctors leading the study strategically employed Black medical professionals, including the now relatively infamous Nurse Evers, in an effort to promote the narrative that the study was in the interest of the local Black community and in the service of Black health nationwide. The study paraded the deeply patronizing and anti-Black defense that the Black patients in the study were better off remaining ignorant of their diagnosis and the study’s purpose. Thus, though Black medical professionals were a part of the study, Tuskegee was the result of the anti-Blackness of white doctors and bureaucrats who collaborated to establish, legitimate, and sustain the study, undetected, for decades.
THE PATIENTS
When the study began in the early 1930s, there was not yet a cure for syphilis however treatment could stop the spread of the disease. The study was initiated after doctors traveled to rural Alabama in order to administer treatments to render the disease non-transmittable in local residents. Doctors and researchers discovered a large population of syphilis-infected Black sharecroppers in Macon County who were working for the Delta and Pine Land Company and were, largely, uneducated. As these first doctors treated Macon County residents, they told the Black men that they had “bad blood,” rather than identifying the venereal disease. By keeping the patients ignorant about their own health, the doctors cultivated the group they would soon after observe in the official Tuskegee study.
(Image: History.com)
The Tuskegee Syphilis Study operated by guaranteeing that syphilis-positive Black men in Macon County would check in frequently with doctors/researchers in order to treat their “bad blood,” the false diagnosis they had been given. The study operated by strategically withholding sexual health education from the Black patients. Medical professionals kept a close eye on how the men faired with the venereal disease, even conducting autopsies when patients died of syphilis. The study was justified as a government-funded project to benefit Black health, but only Black men were subjected to the study’s violence while white patients nationwide were properly treated for the same disease.
While the ethical concerns of the study were at first only limited to keeping health information from Black patients, the discovery of penicillin as a cure for syphilis in 1943 led to a whole new level of violence in the study. White doctors and bureaucrats insisted that the Black men in the study not receive the curative treatment so that the study of syphilis’ prolonged effect on the body could continue. In short, doctors and US state officials observed as oblivious Black patients died of a curable disease. Empiricism, objectivity, and scientific inquiry were valued above the well being of hundreds of Black men.
THE AFTERMATH
The “Tuskegee Study of Untreated Syphilis in the Negro Male” finally came to a dramatic end in 1972 after a doctor associated with the study leaked the details of the experiment to a journalist with the Associated Press. By 1972, the study’s initial anti-Black justifications were not accepted by the public, including white doctors and bureaucrats. Thus, once the study became a matter of public attention, it was immediately shut down and even investigated in a Congressional hearing.
As the American public grappled with the study’s anti-Blackness, duration, and violence, new patient protections and study regulations were passed including the National Research Act in 1974 and the research regulation that all studies must gain the voluntary, informed consent of study patients. The Tuskegee experiment redefined public perception around the power of the medical establishment. Yet, Tuskegee was framed as -- and continues to be remembered as -- an aberration in the otherwise positive track record of American medical experimentation. Black feminists, such as Angela Davis, have extensively documented the opposite: the U.S. has used Black bodies as the staging ground for medical innovation for centuries. The medical establishment has committed forced sterilization, studied cancer cells, and tested dangerous contraceptive devices on Black people (and women in particular) across the entire country for generations.
(Image: The New York Times)
THE LEGACY
In total, 28 study patients died of syphilis, 100 study patients died of related complications, and 40 relatives of study patients were infected with the disease. However, another devastating consequence of the Tuskegee Syphilis study is the narrative that the medical establishment’s anti-Blackness started and ended with Tuskegee. Rather, from medical knowledge created during enslavement to eugenics-era science to forced sterilization to Black maternal mortality rates today, Black people have always been violently recruited as the raw material of American medical experimentation. The historicized narrative of Tuskegee as an extraordinary circumstance has led to its erasure in conversations about purpose, mechanism, and logic of the medical establishment. Instead, Tuskegee is a story about the disposability of Black life in the service of scientific knowledge production.
(Image: McGill University)