Bad Blood: The Tuskegee Syphilis Experiment

Bad Blood: The Tuskegee Syphilis Experiment by James H Jones is topical, given how the government is trying to force everyone to vaccinate, and for some not inconsequential reasons, a rather significant portion is declining. This book would be WHY they are declining.

 So, the Tuskegee Syphilis first hit my radar when HBO did a movie called Miss Evers’ Boys, which was about this very subject matter, so I knew about it that far back, but, as in all things, truth is so much more horrifying than fiction, so I bought the book on the matter.

 In the early 20th century, the only extended medical study to date on the matter of Syphilis had been the Oslo Study. This studied the effects of late stage syphilis in White People because it was Oslo….Norway did not have a surplus of black people.

 Now, the effects were already pretty well known as syphilis had more or less evolved on the European continent and hit everyone from lowest peasant to highest royalty. So it was a known quantity, including the long term effects, for several hundred years prior to this. The Oslo Study just wrote down the long term effects in a scientific paper.

 So syphilis is a sexually transmitted disease (STD) or they may call it sexually transmitted infection (STI) now, either way, you get it through having sex. It presents itself first off as a lesion or sore on your genitals. This is usually easier for men to spot, because in women it may present as a sore on the interior of the vaginal canal, and since the sore doesn’t actually hurt, it can go completely unnoticed in women. 

So the known stages start with lesions on the genitals, which generally heals on it’s own unless you develop a secondary bacterial infection of some sort. The sore is so small you may not even notice it, especially if it heals on its own. So a lot of people don’t bother to seek help because they don’t notice it, or if they do, they might assume it’s an ingrown hair or something.

While the initial infection is healing, secondary syphilis actually starts. Anywhere from six weeks to six months after that initial sore you can go into second stage syphilis. You may develop a rash, your bones and joints may become achy, you may develop heart palpitations, you might actually start losing your hair in patches. Fever, indigestion, headaches…these are all common and known symptoms of second stage syphilis. They are also common to a host of other diseases and sometimes they are just standalone one off of nothing bigger. So just because you have a headache, does not mean you have syphilis. The two are not mutually exclusive. Secondary syphilis will ALSO resolve entirely on it’s own.

At which point it becomes latent, meaning you will have no other symptoms of syphilis for a period of time. This can be anywhere from a few weeks to thirty years of latency. And while it’s sleeping, you think you’re fine because you have no other symptoms. In reality, your body is fighting a losing battle against an internal bacterial infection you don’t even know you have because now you are entirely asymptomatic. This is all known pathology of Syphilis.

So the bacteria is a spirochete, and it’s burrowing into your system, causing horrifying havoc with your body, until it resurfaces following the latent period. Third stage syphilis presents itself as a host of symptoms which can include rubbery tumors all over, your bones might deteriorate. Your nose might literally fall off one day as the bacteria eats the cartilage in your nose. The bacteria can attack your heart, causing the valves to not close properly. Your brain and spinal column might be attacked, effecting your ability to walk, stand, see, speak, hear, and think. Syphilis was a known cause of insanity.

All of this was very well known to Science when the public health services decided they needed to do something about venereal disease in the 1930’s. And while the study was eventually centered in Macon Co, Alabama, the studies authors were well aware that poverty, not race, was a factor in who contracted syphilis. So they could have easily centered this study in one of the five burrows in New York City, but they went with Alabama looking for that new angle….does syphilis have the same course and damage in the black population as it does in white populations. Spoiler alert: It totally does.

Now, when the study started, they were looking to treat people. And treatment, at this time…just before the advent of penicillin as a known cure for syphilis, involved salvarsan and mercury. And this was provided to diagnosed syphilitics, and was sponsored by the Julius Rosenwald Fund and was known as the Syphilis Control Demonstration. And that was the best they could hope for, was to control it. Salvarsan was hit or miss…it might work, or it might cause arsenic poisoning.  It was essentially an early form of chemotherapy. Additionally, salvarsan was most effective on first stage syphilis, and practically useless on second and third stage syphilis. So that first sore, if you ran to a doctor, might be cured. But again, most people don’t know they have it during first stage.

So the initially study targeting indigent populations ran for six months. And that was the end of it. And yes, the majority of study participants were black men, as the study was set in the south, initially not just in Alabama, it occurred in Georgia, Mississippi and I believe Arkansas. For those six months.  And it’s all good. Salvarsan was the best possible medicine available and they were treating the men with what they had at the time. They did call it Bad Blood, vs the medical syphilis, because that is what their patients understood. No concerns with it so far.

But then, it wouldn’t be a story if it didn’t get fucked right quick.

And they did limit it to men because they wanted to chart very specifically the progression of the disease, meaning they needed to know when the men first noticed the sores. And since the sores can literally be unnoticed in women, they limited it to men. And they were treated….partially. Why  only partially? Because the occurrence of syphilis in 1930’s south was incredibly high. Like 30% of the population had contracted this. And there just wasn’t enough of the medication around to treat everyone, especially given that it only really worked during that first stage.

The health services did try to get private doctors to assist in what was basically a public health crises; however the public health services could only offer $2 per patient (in 1930’s money), and private doctors charged $5 per person. Now, while people love to scream about all people being racist, the doctors in Alabama typically weren’t. They literally couldn’t be, because the vast majority of the people in Alabama were black. If the doctors refused to treat them, they’d starve for lack of patients, as the white patients didn’t need the plethora of doctors available to them. But the doctors did have their going rate of $5, and they were being asked to take a pay cut to help with this study.

After the six months, one of the doctors, I don’t recall which one, came up with this brain child of turning Tuskegee into another version of the Oslo Study, except studying the course of the untreated disease in the black population.

The five doctors initially involved were Dr. Oliver C. Wanger, Dr. Taliaferro Clark, Dr. Raymond H Vonderlehr, Dr. John R. Heller, and Dr. Eugene Dibbles. So these are the ones that started it. Over the 40 years the study was conducted, there were countless other doctors, medical interns, and other personnel involved, and not a single one voiced an objection to this study. That is well after penicillin was a known cure.

When the Study of Untreated Syphilis in the Negro Male began, their expenses were essentially limited to the cost of Nurse Eunice Rivers….who was Miss Evers in the HBO movie, but her real name was Eunice Rivers. They paid her $1,200 per year for her part in this, or $20,200 in today’s money. Travel expenses for the doctors and the doctors salaries were not included as line items on the budget for the Tuskegee Study. So their budget was $1,200. And Nurse Rivers was expected to pay her own travel expenses from that $1,200. And she was so glad to have the job in 1930’s depression era Alabama that she didn’t argue.

From the beginning the study was extremely flawed, since the stated purpose of the study was to see how syphilis progressed untreated in the negro male, and the study participants had already been treated under the Syphilis Control Demonstration.

All members of the 400 confirmed syphilitics and 200 control group of non-syphilitic subjects were offered free treatment, which consisted of aspirin and tonic. Placebo’s, basically. Which seemed like a miracle because most of them had never had aspirin.

Nowhere in there did they explain to the participants what was actually being studied. They simply said it was bad blood. One of the survivors who testified before Congress said “I ain’t never understood the study.” The people who ran the study are such garbage human beings, there is a special place in hell for them.

Now, the author, Mr. Jones, has nothing but sympathy for Nurse Rivers, she was the human point of contact for the study participants and did everything she could to help these men, visiting them in their rural and poverty stricken homes to ensure they received the care they were promised…that aspirin and tonic, because they were only promised that, not actual treatment. But she did what she could to actually help them. But Nurse Rivers did not trust penicillin. She thought it was dangerous, and trusted the doctors to do what was right. And she’d been told by the doctors that penicillin could kill the men. And so she did not think they should have it.

So this study starts in 1932. Penicillin WAS discovered in 1928, but it was not readily available and recognized as a source of treatment for syphilis until 1943. So from 1932 to 1943, the doctors have a tiny window of grace to get what information they could. I mean, the lack of informed consent is disgusting, but the doctors are morally gray during this window. From 1943, they had a legal, moral, and ethical obligation to provide penicillin to the study participants. But did they do this? One guess.

So for the first 11 years, there’s no known treatment, the participants are all well into tertiary stage syphilis when penicillin become readily available. And really, the information the doctors wanted won’t be available until they perform the autopsy, because the heart damage, the damage to break and spinal canals, those aren’t immediately visible. The effects may be, but the actual physical damage is not available until after death. And here’s the really whacky part: While the disease itself can be stopped in its tracks by penicillin, preventing further damage, the damage that is ALREADY DONE does not heal.

But rather than change the focus of the study to The Study of Untreated Syphilis in the Negro Male from 1932 to 1943….they just kept it going. Waiting for them to die. Then claiming the bodies for autopsy purposes. Morbid little fuckers.

For her part, Nurse Rivers had remarkable success getting the surviving family members to agree to the autopsy.  Out of 143 men that they knew and were able to corral into a hospital at the time of their death, there was exactly 1 who declined to the autopsy. Of course, part of the cooperation was the Milbank Memorial Fund, a philanthropic fund that provided $500 per year for the duration of the study to pay burial costs. With increases as costs rose. So by agreeing to the autopsy, the family could get the burial paid for. Still grim as fuck. This allowed for $50 per person for burial funds.  It was $500 per year, so split that over who they expected to die in a given year based on the known progression of the disease. And if…BIG IF…the person AND their family agreed to the autopsy. No autopsy, no burial money.

So the autopsy’s were performed on the men, one by one, as they died of a completely treatable disease.

If they’d been honest from the get go, gotten consent from everyone, and treated as soon as medicine became available, tracking the men’s overall health until they died, then performed the autopsy…this would be literally nothing. It could even be called good Science, as it would confirm that we are all, in fact, human, and this disease treats us all the same. They’d have still gotten medically relevant data AND been on the right side of history.

Instead, they randomly decided that NOONE should be treated, because SOME people had been known to have allergic reactions to penicillin. Want to know where’s a really good place to have an allergic reaction to something? A hospital.

Instead, they let this virulent bacteria to ravage a population, leaving men insane, blind, and unable to walk. For Science. Isn’t that beautiful?

The Public Health Services reach is such that when World War II started, and a significant portion of the subjects of the study were eligible for enlistment, they overrode the US Army on giving them treatment. Nope, those guys don’t get treatment. We need them for Science.

They literally had lists out to all the health clinics in Alabama saying do not treat X, he’s part of an important study for Science.

World War II….we went to fight Nazi’s who were engaging in similar behavior in fucking Europe. This is not a shining moment for liberty in America.

In 1965…so 33 years into the study, the first rumblings of WTF start in the medical community, when Dr. Irwin J Schatz of Henry Ford Hospital in Detroit, MI became the first member of the medical community to object to the Tuskegee Experiment. He had read an article about this by one of those visiting doctors in a medical journal, and what Dr. Schatz wrote to that doctor was:

“I am utterly astounded by the fact that physicians allow patients with patients with potentially fatal disease to remain untreated when effective therapy is available. I assume you feel that the information which is extracted from observation of this untreated group is worth their sacrifice. If this is the case, then I suggest that the units of the United States Public Health Service and those physicians associated with it need to reevaluate their moral judgment in this regard.”

He was ignored.

Not so easily ignored was Peter Buxton, who was a USPHS interviewer and investigator in San Francisco. And in 1966, Buxton he heard some co-workers talking Tuskegee, and he didn’t quite believe what he was hearing, he thought, there’s no way this is real. Part of his job as interviewer and investigator was to write a short paper on venereal disease or epidemiology every couple of months. So in 1966, he decided to write a paper on Tuskegee. He got all the information from Public Health Services archives and the Centers for Disease Control who were all helpful and cooperative, meaning no one thought there was anything wrong with any of this. Talk about moral compass gone askew.

And as Buxton was reading through the literature, he realized that none of the test subjects had any idea they were being studied. Now, Buxton was in America because his Father was Jewish from Czechoslovakia and a war refugee. So he had a family sensitivity to unethical medical experiments.

So Buxton gets all this information, realizes no one is aware they are being studied, and this struck him as highly amoral. Because he was a decent human being. The lack of informed consent was top of his concerns, followed closely by the lack of treatment. So in November of 1966, he reaches out to the current director of the division for venereal diseases for Public Health Services, which was a Dr. William J. Brown and expressed concerns about the morality of the study.

And a few months after that, he is invited to the CDC headquarters, where he is basically harassed and berated for having doubts. Cause he’s not a doctor, you see, he should just Trust the Science. And how dare he question the Medical Science.

After this, he wrote another letter to Public Health Services saying hey, why did you berate and harass me, what is going on here. And he received no response. And went dormant himself for a little bit. No shame or blame, it still bugged him, but he did have his own life to pursue at this point. And he took this time to go to law school. I wish I could say he came back and sued them, but he was not the lawyer to pursue the Tuskegee Case.

But Buxton’s second letter, while it was ignored and he never received a response, did elicit a reaction at Public Health Services. The wagon’s were circled, and the doctor’s reconvened, and they determined if treatment should now be administered. And they determined No. Anyone surprised by this?

It actually revitalized the study, if you can believe that. Of all the doctors involved in this meeting, only one, Dr. Jean Stollerman, who was the chairman of the department of medicine at the University of Tennessee, he was the only doctor to have no prior knowledge of Tuskegee, and he was like….This is not right. We need to treat these people. There is no reason NOT to treat them at this point. Everyone else on the panel seemed to think they needed to ride it out til all study members were dead and autopsied. For Science.

So 1968, the study starts gearing up again, as they try to run down participants who had moved or they had lost contact with following Nurse Rivers’s retirement in 1965. So their tracing the missing men, trying to corral them for autopsies, and this goes on for another four years until 1972, when Peter Buxton mentions the story to a friend of his who is a journalist for the Associated Press.  And being a GOOD journalist, she asks if he has documentation to back up his story. And he provides her with file after file of solid proof of chicanery on the part of the US Public Health Services.

She takes it to her bosses at the AP and they say well, you aren’t really an experienced enough journalist for a story of this magnitude, can we hand this off to someone else, and she said yes of course, and shipped it all to Jean Heller. Who received the entire story, gift wrapped with a shiny red bow. Including supporting documentation. And the story broke. Big.

Lawsuits happened, I believe it was Fred Gray as the attorney for the plaintiffs….you might know him as the attorney who defended Rosa Parks.

The survivors were granted $37,500 each in 1974, which adjusted for inflation is about $214,000. For 40 years of medical abuse, not even a quarter of a million dollars. The descendants of the deceased syphilitics were granted $15,000 or approximately $86,000 in todays dollars.

The control group also received payments, because they were also not informed of their participation in the study to give consent, they were awarded $16,000, which is about $91,000, with $5,000 for their heirs, which is about $28,000.

The book was initially written and released in 1981, with a new final chapter in 1993, which is the version I have, with a chapter on how Tuskegee is having long lasting impacts on the black communities, specifically in regards to the HIV/AIDS epidemic. See, right behind the gay community and intravenous drug uses, the black community was the hardest hit during the AIDS epidemic. And for some not at all surprising reasons, the black community doesn’t trust the doctors to treat them. So that was 20 years after Tuskegee ended, and hear we are 50 years after, and the impact is still felt as black communities decline in record numbers to vaccinate in the current climate.

And because racists are gonna race hate, racists don’t seem to understand why black people don’t just suck it up for the good of us all.

And they don’t see how “vaccine passports” fuel racism and hatred for disenfranchised and minority populations who have ample reason to hate, fear, and mistrust the CDC, the PHS, and government in general.

This book was excellent. James H. Jones was man on the ground when the story broke, and his own research was instrumental in the subsequent lawsuits against the CDC and PHS. It is a horrifying sign of the times and the shitshow that’s bound to come next in the 21st century, that no doctor was ever cited for malpractice, fined, or lost his license as a result of their participation in this study. The government paid out the fines, but no one was ever punished.

That says a lot. And for some bizarre reason, doctors are still considered sacrosanct. Even when what they are engaged in is wholly evil. He goes into not just the study itself, but describes in heartbreaking detail the grinding poverty of the deep south and the effects of poverty on health in general. Which helps explain the willingness of study participants to participate. They had NEVER seen a doctor before this. Because they couldn’t afford it. And now they were being offered free healthcare. Remember…if it’s free, you’re the product.

This book was initially reviewed on YouTube on February 20, 2022, but is now available on Rumble and PodBean.