Tuskegee Syphilis Study - First, Do No Harm | 1
July nineteen seventy two San Francisco, California. It's a pleasant summary evening at a pleasant dinner party and pleasant apartment filled with chitchat and shop, talk and international affairs reporter with the Associated Press named Edith letter breaks away from her conversation to refill her wine glass letter scans living room. Everyone appears to be having fun. Everyone except the low man by the window staring out of the city lights after a minute. She recognizes him an acquaintance, Peter Buxton. She walks over Peter nice view, right? Yeah. I guess there's a long awkward pause Edith. Do you know how I came to this country? I thought you grew up in Oregon. I did. I was born in Czechoslovakia and thirty seven my father was Jewish. So we ran bring this up because I think you should know that something very similar to Nazi sciences being practice here in America today. Muderer swallows hard. No more casual sits from her wine glass. She's all ears. What, what are you talking about? Mr. random morning. I was in the coffee room. This was back when I tracked the Neal disease for the US public health service. Couple of colleagues were chatting, one mentioned a patient in Alabama. This man had terrible sentence. He said he was plainly insane. Family was scared. So they took him to a doctor. They knew and after a brief examination, the diagnosis was made syphilis tertiary stage, the doctor gave him a shot of penicillin sent him home. But when the higher ups at the PHS found out about the treatment they were angry angry why. Because the doctor treated a man who was not supposed to be treated not suppose now. Wait. I don't understand the CDC a surgeon general, the state of health. They're all in on it. Peter in on what the experiments for forty years, PHS has been experimenting on black men and making county. Alabama in the beginning there over six hundred tests. Now, there's less than one hundred rest are dead, or on accounted for none of them. No, they have syphilis. Doctors running the study, they didn't tell them. They just let them die. They want to see what happens when syphilis goes untreated in a man's body right up until the moment kills him. They even pay for burial costs. Peter. That can't be true. No one, no one would do that. He doesn't possible. I can prove it have all the charts all reports. They're not even trying to hide it. They don't think they're doing anything wrong. The test subjects are all black people all every last one. The study will continue until every last one dies. Musonda does something, and I've tried I've tried, but need your help? This has to be exposed letters head spinning. She finds the nearest coffee table. Such class down. Peter everything you have on this tonight right now. Lederer in Buxton depart that night for Buxton's home once their letter release through interoffice letters round up reports x Ray descriptions, autopsy photos, her eyes, widen at phrases like we are keeping the known positive patients from getting treatment and arranged for autopsy those who die in the future. She takes everything she can carry and starts making copies. The experiment is called the Tuskegee study of untreated syphilis in the negro male. It's the longest running non therapeutic experiment on human beings in the history of medicine, relatively few people in the medical community are aware of it, even fewer have questioned until now most people have had no idea, it's happening, especially not the test subject, but the doctor slowly killing them are thrilled with their results. American scandal is brought to you by chase. So you're thinking about buying a new home at chase? They know you whether it's vacation home condo in the city or new place. Closer to the grand kids. You're not slowing down anytime soon. So you need a lender who can keep up chase will save you money over time by showing you how you can pay off your mortgage faster. That's money, you can spend on a new sports car or on a second home in Scottsdale or taking up goat yoga chase customer. Save more. Learn more at chase dot com slash A S chase, make more of what yours all home lending products are subject to credit in property approval rates program. Terms and conditions are subject to change without notice, not all products, are available in all states or for all amounts. Other restrictions and limitations apply. Owning products offered by AP Morgan. Chase Bank NA an equal housing lender. From wondering, I'm Lindsey Graham. And this is America scandal. Informed consent. Truthful disclosure of diagnosis and test results. These are things we come to expect from our doctors and today in the United States, it's illegal to conduct a medical study involving human participants and less. These conditions are met the rules were signed into law in nineteen seventy four in response to the Tuskegee experiments. Syphilis is a sexually transmitted disease that if left untreated can cause blindness stroke, heart trouble and sanity and death in the early twentieth century, it was a massive public health concern poorly. Understood and until nineteen Forty-five largely incurable beginning in nineteen thirty two more than four hundred black men were recruited to participate in a study on the effects of syphilis and the coming years. Another two hundred men were recruited as controls the issue was, none of the patients knew that they were part of study the infected ones didn't even know. They had syphilis instead. The sick men were told that they had bad blood and would need regular testing and treatment no more specific diagnosis was ever given. And the promise treatment never arrived. Many were allowed to die when they could easily have been cured. The question is why this episode one, first do no harm. It's April nineteen twenty nine when Michael Davis steps briskly into the well appointed office of the United States, public, health service or PHS the white-haired nearly fifty years old Davis still has the drive and focus of young visionary. The start of his career today, he's got a big vision. He's here to see Hugh s coming the ph s surgeon, general not long ago. Davis joined the Rosen, Walt fund a private charitable organization started by Sears co owner Julius Rosenthal for the being of mankind. The son of Jewish immigrants. Rosenthal had poured millions into schools, museums and charities and taking a special interest in helping America's black communities. Davis is the fund's new director of medical services charged with collaborating with PHS to develop black health programs. This is what he plans to discuss with coming settling into a plush office chair Davis, outlines his agenda. Segregation is still very. Very much the long land. But you tells coming a lot has changed in the old days. The philosophy was that since blacks live sinful, lifestyles, they got illnesses, venereal disease and deserved what came next discomfort physical figuring even death. Luckily, he continues such medieval thinking is a thing of the past enlightened doctors now understand that improving black public health will improve health for everyone. So and now Davis is excited. It's time to get more black people into medicine train these workers to treat the citizens of their community gesturing, as he speaks Davis calls for the hiring of black, nurses, physicians and sanitary. Inspectors? He tells coming, he wants money invested in the construction of black medical facilities. The establishment of scholarships that will promote black public health training. He concludes by saying they'll focus on rural blacks in the south and partnering with the to ski institute, Annella Bama. A black university co founded by Booker T Washington. With his pitch concluded Davis sits back satisfied after minute coming nods says he likes what he's heard. He tells Davis get started right away. thousand miles away in bolivar county Mississippi, Dr Oliver Clarence winger smiles to himself as another long day at his health clinic, draws to a close. It's early September nineteen twenty nine and even though it's a Saturday. There's no place he'd rather be. He helps one of the doctor sort of many vials of blood samples collected this afternoon, even more than the day before, and that's good. Looks like you'll be able to complete testing ahead of schedule when you're came to Mississippi following his success as director of the PHS venereal disease clinic in hot springs, Arkansas his clinics cater to local black communities and wingers, proud of that as a white doctor in the south. He sees himself as something of a shepherd. His patients are like children. He explains to friends all need a little guidance, and it's he's happy to give he spends his days. Improving their health drawing their blood for analysis and administering. Injections knowing wants to help them feel better, it satisfying. Plus, these people really are a hoot loading, the blood into a truck Wang, or chuckles to himself recalling what just happened to Dr Vard to negroes approach provide and said they felt week after having their blood drawn the previous day. Specifically they felt that their sexual powers had been impaired. Dr provide nodded stroked his chin, then propose a solution with the negroes, like their blood back. There is lit up. Yes. They would provide excuse himself, then returned with a one ounce bag of red colored, placebo. He solemnly advised Negros to take the mixture and teaspoonful doses, they promised they would and party with no further complaint. Amazing harmless jokes, aside, though, for years, Wenger's believed that medicine is letting black people down, and he wants to do his part to end the neglect. So he was thrilled when the US public health service sent him here to Mississippi his mission is to oversee syphilis testing for two thousand black locals working for the delta and pine land company, so far he's found that nearly a quarter of the company's black employees carried the disease that revelation has led to what Wang or considers another leap forward, a syphilis treatment program funded by the PHS if it works, you could be replicated in other towns across the country Wang has been running this program to, but he's only a month in and it's hard work the days are brutally hut and the medical facilities are hastily constructed and barely adequate. The infected men can't be cured right now there is no, you're wingers confident, there's one right around the corner. But for now that research processes to expensive and time consuming, so Wayne. During his partner do the best they can with drugs that render the men non infectious. They can at least keep other people from getting disease and Justice, they'd hoped. The program is a success. The PHS does decide to expand so Dr winger heavily heads to Alabama launching another large scale anti-surface effort for the benefit of rural blacks, and they need his help even after years of this work. When you're can't believe how poor they really are lack. Sharecroppers ragged still coated in dirt from the fields roomie is missing teeth, but still smiling way how could anyone live like this? It's a mild winter afternoon in February nineteen thirty the rough and dirty manner lined up at the possum hollow school in making county Alabama. And by the looks of them, they're lucky to have someone like Wang, or to save them from themselves. They even have one of their own a black doctor named CLYDE frost. From the Rosen wolf fund, tending to the men in line. Dr frost, hands of file of recently collected blood to a nurse. Sees winger, watching him, a non when you're walks over his frost sends a patient on his way. Take care of herself. And don't forget, you know, anyone who has been seen by us, yet, be sure to tell them to come by looks like the testing is going smoothly, Dr frost. I'm impressed. Many of these men have never seen a doctor. They're happy to see any medical attention grateful to receive treatment for the first time in their lives. And you're keeping them in the dark. Right. We're here to prove to this country's doctors that the disease can be controlled among rural blacks, what we're sure as hell not here to give these people in education and venereal disease in the facts of life. Yes, sir. It's important, we don't confuse these people with words, they don't know, don't need to know words like syphilis. No one here has said that word myself included. We're sticking to the approved terminology. We just tell them that they have bad blood need medicine, which we provide. Excellent trying to keep us all running smoothly as possible. The fewer needless conversations better frost, can I ask you something, of course, Dr winger? These negroes are extremely trusting almost anything. We ask no whining questions now this seems to be a common trait, amongst negroes. Can you explain it frost takes his time winger can see that he seems to be struggling to find the words? Well, I think that the people here are, are naturally kind and they seem very trusting whites considering how whites treat them down here. That's the prising. Well, Dr Wehner, they've learned to obey authority figures fascinating. Well, I'll let you get back to Dr frost. Keep up the good work. When you're walks away, thinking about that, last exchange, the people here believe in doing what white people tell them to do that has very few questions. He's here to test syphilis and in more ways than one he's found the ideal test subjects looks towards the door as more and more. Black men, enter their this open to suggestion, perhaps, there, other purposes, they might serve, perhaps, they can be driven to make great sacrifices in the name science without even knowing it. American scandal is sponsored by mail chimp. So you wanna grow your business. Now, what growth means new customers and new customers means new marketing male chimps, new, all in one marketing platform is the best way to manage more of your marketing activities from one place, so you can market smarter and grow faster. 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You can expect forgotten oddities of American history, as well as breakdowns of controversial pop culture, events like Tinky Winky outing, when Elvis join Nixon, and the war on drugs, or house, spirit communication, was once full of intersectional, politics, and crossword, puzzles threaten to topple the social order through exhaustive research, and dark, humor American hysteria tries to explain where are weirdest beliefs began how they grew and how much of our past we can find in the present you can bend all of season one right now and season two starts June. Third check out the trailer. And then subscribe, wherever you're listening, now on American hysteria. We cover moral panics stranger danger and satanic ritual, abuse urban legends like poison. Halloween candy and phantom clowns conspiracy theories, like the gay agenda and the aluminum join me Chelsea ever Smith. A former fantastical thinker for a sometimes heartfelt, sometimes Larry sometimes horrified. Look at how these American freak outs shape, our psychology and culture and make us all into believers one way or another subscribed to American hysteria. Now wherever you get your podcasts. It's March nineteen thirty Dr Wagner's testing and making county has come to an end Nana chilly day in the nation's capital. The newly hire PHS advisor to the Rosenthal fund pores over wingers results at his desk, he makes urgent notes in the margins. His name is Dr taller Clark and his family roots date back, all the way to colonial Virginia, which is why I was a true southerner. He doesn't find the six for making county. All that shocking thirty six percents of the blacks have syphilis us nearly eight thousand people he double checks. The data see that it must be accurate. He's fascinated by the numbers, energized and intrigued by them, some ideas of his own about how to proceed, which is why he's invited the Rosen walled funds. Michael Davis to his office to discuss. The findings Davis is aware of the data coming out of Obama and worrisome. Clark knows that Davis has taken issue with aspects of Wayne's treatment from him. Not with. Methods or its conclusions. But, but something else Clark consensus, certain sentimentality Damus. It's not a sentimentality shares, and he knows you'll have to set the director straight place come in. Afternoon. Dr clark. Dr davis. Thank you, coming to see me. Please we said, thank you. If I may Dr Clark get right into it. Yes. The findings concern me concern me too. That's, that's a lot of sicne goes down there. That's not exactly what I mean. Obviously, there's an ongoing health crisis and making county but a few, we need to be careful with how reveal this data to the public Clark players on the most patient grin, he can muster here comes please. Go on, sir. The impression would be given that syphilis in the south is a negro problem rather than one of both races. I fear this really unfortunate emphasis on the negro specifically could rouse resentment among regroups in both northern and southern communities thirty six percent of negroes in one impoverished county in Alabama. Not reflective the country's negro population as a whole. I have no doubt, the is accurate, but we both know that syphilis isn't just a black disease. The Rosen wall fund wants no part of lending credence to that, stereotype. Sure. Certainly, certainly and don't think I haven't thought of this now I know how concern you in the fun. Dr with nego progress in. It's very forward thinking forward thinking, but. Let me tell you Dr northern Negros. The vast majority of them will not give this mattress I can and as far as the southern black concern. Well, they all love the program. I appreciate that Dr Clark, but still man you're bound ask. Why negroes only why not test southern whites as well. We know they have the disease to if we don't test them, we could be accused of bias biased. I sure you buy has got nothing to do with it. I personally would have loved Weiss being -cluded in the testing tree. But I'll tell you, Dr Davis, I know thing or two about southern whites take it for me. They would not be easy to deal with. Whereas Dr Wang assures me, the negroes down south are most quantitive. Do you take my meaning it's a matter of Quat peration and not of discrimination, that the work is limited in Negros. We'll just learn more this way. And that's the truth. Dr corn that is the truth fact. I've lied. Should give serious consideration to expanding the program. We've got a good thing going. Why slow down? All right. Then I won't keep you Dr Clark Clark smiles, stands, and shakes Davis's hand. Thank you. Dr so appreciate you coming in. Once Davis has gone Clark turns back to the data starts foreing plans for the next stage of the program. He wanted to expand and figures everything will be fine, as long as Davis and his Rosenwasser fund, don't get in the way. The following year Clarkson, his office when he learned that the rose fund has gotten in the way for months, he lobbied, the fun to expand the negro syphilis treatment program. But today he's received a letter from Dr Davis the fund has balked too expensive. Specially during the depression, Kark slams, his fist on the desk and paces takes every ounce of restraint he has not to rip Davis's letter to pieces. He reads, it over and over again, and it's more irritating each time in his mind, here's the words in snivelling voice, the fund has regarded it as a privilege to be able to assist during this preliminary period of study an attack upon this great problem in southern rural areas. That's hogwash, Clark things, the fun could find the money if they really wanted to, but would rather back efforts to educate the negro. They're not really concerned with his health. But Clark is he thinks that the P H S should be building health clinics for black people rather than wasting money on schools? Clark has his own pet name for what? These schools might produce, white collar negroes world doesn't need white collar negroes. It needs negroes who aren't contagious bitterly Clark realizes. It's time to write his final report on the making county syphilis treatment efforts, he sets Davis led her side his side. He's never going to look at it again. He closes the office door to shut out the noise of the hallway those sheet of paper into his typewriter sits down against a rapidly punch the keys, but after about an hour writing he abruptly stops. How did he not think of this before it was staring him in the face the whole time, right here in the data Macon county has the highest prevalence of syphilis in the south any of those infected received treatment, but many did not because the Rosen wall, thudding dried up before anyone could tend to them. Clark wonders what would happen if the ph decided to focus on the ones who weren't treated, what if they stayed that way could they be useful to understanding more about the disease Clark? Feeling they could now he's not a monster. Would he prefer to treat the CITIC blacks, of course he would? But if the Rosenbaum fund won't pay for it, that means there's no money to treat those people. So it doesn't matter what he'd prefer, if he can't treat them he can do something almost as good he can learn from them, what Clark's imagining is a sweeping experiment unprecedented in its scope. Doctors know that many black people suffer from syphilis. But do they really know the effects of the disease on blacks, specifically, many of theorized that syphilis affects blacks differently than it does whites, but no one's ever actually proved it Clark feels that someone really should conduct that study? Not someone should be him. That's where he'll make his Mark on medical science. Throughout nineteen thirty two Clark makes plans. This is to be a serious study, a disciplined, an absolute commitment to the scientific method will be required. The subject is untreated syphilis in Negros Clark, is pleased to discover that the work is not without precedent just three years earlier in Oslo, Norway, Dr Bruce guard observed hundreds of local test subjects with primary and secondary. Syphilis examination only no treatment, Bruce guard wanted to study the nature of syphilis induced, cardiovascular and neurologic damage has Clark reviews. The details in German scientific journal he nods and satisfaction smile on his face. Obviously, the study was whites, only it was conducted in Oslo Norway, for God's sake. Does it serves the ideal template for Clark's? Counterpoint a colored only rendition Clark wants to do the Oslo scientists one better. They base their conclusions off case histories the didn't conduct ongoing examinations. So Clark will collect his data in real time with his pitcher, Semel cork starts lobbying colleagues at the. HS. He invites them to meet him in his office at his home, in the local restaurants, most popular during lunch hour, he shares his ideas and encouraged by the response all agree that the studies worth will, yes, there are risks to the infected with those risks pale in comparison to the potential, medical insights, one colleague who is fully on board with Clark's plans. Dr Oliver see winger. He happily agrees to collaborate with clock once again with Wang, or support secured Clark knows it's time to get on a train for Alabama upon their arrival. He tells winger he must see the state health officer, Dr J and Baker immediately. It's a pleasant September day. Montgomery went Baker opens, his office door to admit Clark, Rominger Baker, sits down, then gestures for the men to proceed. He's aware that they have ambitious plans to study the negroes in his state when he needs to be certain. These men know what they're talking about the H doctors described their intentions Baker takes it in nods has for clarification, the seemed like intelligent men Clark promises to iron out certain details. Even admits there are still many questions of procedure to be worked out when Clark has done with his pitch Baker waits. A long while before speaking drumming his fingers on the desk, he realizes he's thought of a couple of things they haven't when he finally speaks he agrees but with some conditions. Yes. Clark into his study, but observing blacks without offering any treatment whatsoever isn't going to work to be perfectly clear. Baker explains. It's not that he has a problem with the potential impact on the. Subjects. He's more concerned with their white employers. They may not be happy to learn of a program that isn't doing everything can to keep their workers as healthy and productive as possible. Banker says at the very least clarken operation must take steps to render some of the blacks non infectious and this is non-negotiable. He asked Clark if they have a deal and Clark says they do when the study starts minimal treatment will be provided with that Baker nods and shakes their hands. The visiting doctors move as though they're about to leave, but Baker stops them. He has one more condition. He tells them that if they're going to study untreated syphilis, and making county blacks, they better, find some local sponsors. He can't have the PHS running about Alabama and experimenting on the locals without the support of a trusted, medical institution, preferably, one that already employs, a number of black doctors, nurses Clark, nods rapidly agreement Baker can see the man filling in the blanks. There's really only one place in the country that meets those conditions and luckily for Clark and winger it happens to be just fifteen minutes away from the heart of making county. From Gumri clarken winger hit the road on their way to the illustrious to ski institute co founded by Booker T Washington. The institute has stood since eighteen eighty one, one of the most significant bastions of black education in the country. A place where blacks can truly receive a world class education, both medical and industrial arts. They're planning to meet with Dr Eugene h dill to skis medical director and they're nervous. They're about to tell this black doctor that the intend to oversee an experiment on local syphilitic blacks. They will not tell the black test subjects that they have syphilis and will observe the disease as it runs. Its course almost totally unimpeded by medical intervention. The experiment will be presented to test subjects as an extension of the Rosenwasser fund treatment program, but it isn't conversations minefield. They'll have to be cautious nuance. And how they go about securing Dr Dibble support because to ski is the only place there. Perriman can be carried out. Dr Eugene, doodle, make sure he's standing straight, when Clark and Wang, your pull up. He hopes he'll be suitably impressed with John a Andrew Memorial Hospital. And with him the hospital is a beautiful brick building with white trim and four magnificent columns at center Dillsworth hard, these past seven years to ensure that it stands monument to black chievements and prosperity, every aspect of the institute, reinforces that serious and legitimate work is done here. Demel recognizes that he must do all he can to propel ski into the future. It's nearly nineteen thirty three and black people to progress in this country must not nicely. He's anticipating this meeting as much, if not more than the white doctors from the us just now stepping out of their core. Low doctor Clark, Dr winger I'm Eugene Dibble notices Clark shoots Wenger, quick look before taking the lead, whether it is certainly an honor to meet you. Dr Phil, we have much. Discussing preferably in private. Can you show us your office? Of course. Once the three doctors sit down. Dr Clark does most of the talking Dibble is contented to most of the listening, he can tell Clark is leading details out, perhaps intentionally perhaps, not this is all to be expected. However, Dibble reminds himself to maintain focus on one thing, the good of the institute. This is a wonderful facility, you have here. We want help you make the most nothing will do that, like you committing to help your government facilitate scientific progress Wang jumps in bat, that in Washington, they'll never forget your valuable service to your country, and your people, Dr till the word we'll do here with your help. If you let us will truly improve public health on a national scale for generations Dibble remain silent for several moments processing, the information he sees Clark and winger. Look at each other almost nervously he realizes that they need him, just as much as he needs them. Dibble is not used to this kind of power, but he likes it. Of course, he was always going to say, yes, the prestige and association with a PHS will bring to ski is immeasurable, but they don't need to know that Dibble puts on his best thoughtful expression, and breaks the silence. I believe I understand you want the institute to provide you with the interns, nurses, you'd like to use our offices and examination rooms, and you will be providing some measure of treatment to making county blacks with syphilis though, some, the details are still being worked up the program will ask the better part of the year, and he'd made sign off on all of this, or the program will not be able to go forward. Yes. That is correct. Well, you have my support. I think the study will be wonderful for the ski institute, our young nurses struggle to secure meaningful employment after we train them out in the world. Why people will rarely agreed a higher black nurse. So if you're telling me, you'll employed by nurses. And black physicians for your study. And I think that's a good thing. That's, that's the most important thing deal notice Clark, suppressive grin. Oh, I agree. Dr and you won't regret this. Now, if you Dr winger is time to work out the protocol, for our study turn with plans together. Propel this finance itution of yours to a level of respect of prestige. It's never seen. Following a brief tour to skis hospital. Dibble's clarken Wang, or to their car smiling waves. Goodbyes drive off cloud of dust and their weight as it settles. He pictures the years ahead all the success to come great new chapter in the history of the institute is about to begin and Dibble is proud of his role in it. It is at this instant, however that who smile fades, if he's being honest with himself. He's not so sure that Booker T Washington, where he's still alive would be so proud divulge shakes the feeling off returns to his office Booker T Washington, isn't here. This is a different time. American scandal is sponsored by calm yesterday with no warning. The sky, collapsed, Dallas rain hail, and Howard's or wins thrashed the city, cutting our power and flooding the living room. So I didn't sleep too. Well, in humid, hot box with no AC. Wondering how much all the food, I'm going to have a throwaway cost. And hoping I can dry out the rug before Milou sets in, but you don't need a minor disaster to keep you up at night. The stress of everyday life is enough, except sleep deficiency does damage to both your brain and your body. But with calm, you'll discover a whole library of programs designed to help you get the sleep your brain and body needs, like sounds gapes and over one hundred sleep stories, narrated by soothing voices like Jerome Flynn from game of thrones and Stephen Fry. So if you want to seize the day, sleep the night with health of calm right now. American scandal listeners can get twenty five percent off a calm premium. Mm subscription at calm dot com slash a s that C A L M dot com slash A. S forty million people have downloaded com. Find out why calm dot com slash A s. It's timber nineteen thirty two. Dr taller Clark is in Baltimore, Maryland. John Hopkins University. He senators speak with Dr Joseph Earl more Dr Albert KAI del venereal disease clinic. He's feeling somewhat desperate for their expertise. Clark knows he wants to study untreated syphilis in Alabama blacks, he's got all the official by and he needs. But when it comes down to the finer points of actual scientific protocol, he still has a lot to sort out, which syphilis blacks will be observed he obviously can include all of making counties infected thirty six percent. How many tests subjects does he need in which one should they be? He's hoping more and kinda will contribute suggestions to flesh out the ticky study so we can begin in earnest as the doctors walked across the schools expansive campus on a Chris fall after noon Clark. It's all the suggestions. He could hope for and more of the two Johns Hopkins. Doctors Moore's the more talkative, he warns Clark pitfalls to avoid, I the study can't be. About black people at doesn't mean examine people by the racist. He says it means examined black men, only Clark writes down a wants to know wine more replies that since female genitals are primarily inside the body. It's much harder to get reliable information as to the date of the syphilis infection for woman early syphilis symptoms can easily be mistaken for something else that make sense to Clark. He asked if there's anything else and more says there is ideally, no men under thirty the younger, the test subject, the more difficult, it will be to observe the late stage manifestations of the illness, next more suggests that the men be brought in batches to the ski clinic and asked to provide a full and accurate, medical history only men who can identify exactly when they're infection took place should be allowed to participate in the study as this will make Clark's job much easier. Additionally Clarke should seek total two hundred to three hundred patients given making counties, infection rates it shouldn't be hard to find. Enough men who meet these criteria. Finally more reminds Clark is something very important. Something Clark already feels. He knows but to him, it's worth remembering more tells him not to forget that syphilis in the negro is in many respects almost different disease from syphilis in the white by Clark Moore's eager to see how the data derived from the blacks and making compare with data obtained from the whites and Oslin Clark and more believe that whites blacks are simply fundamentally biologically different like many American doctors. They cling to the theory that syphilis is likely to damage the neural systems, more and whites. The cardiovascular system more and blacks far copes that his study with it's real time examination of subjects will prove this once and for all. For the past eight months, Eunice rivers has been the supervisor of nightnurses in Andhra hospital at the ski institute as usual, she's feeling beat. It will probably take another eight months before she's used to working all night, not able to head home until sunrise. But you'll get used to it for as long as she can remember, she strive to make her father, proud Albert rivers was a man, so alliterate he could barely write his own name. Eunice can never forget, how determined he was for his eldest daughter, not to be like him. He pushed her to pursue a rigorous education, sent her to a different town, where his sister live near decent school where children could really. Learn something Eunice came to appreciate the fact that her father would always quiz, her on what she'd learned the second, she returned home after a full day of class when she was college age. He enrolled, her at the Skegness toot with what little money had. She took handicrafts, but her father put a stop to that he told her she had potential and could be. Great nurse Eunice proved father. Right. She excelled which is why Dr Dibble promoted her tonight manager. But when doctor Dibble requested a meeting with her today. She got nervous. She's tired all the time. Now. She walks down the long stretch of hallway that ends at Dibble's office and wonders. I make mistake they mix up the x Ray charts something else. She knows she should have double checked, now she's probably about to get fired and right in the middle of what people are calling a great depression. Man. You want to see me, Dr till, yes, nurse rigors, please sit down. Dr Dibble seems happy, so nurse rivers relaxes. Maybe she was wrong. She relaxes more stable begins to talk. He says he's always been admirers hers respects her work ethic, her medical background, her way, with patients, he mentions a doctor Clark, with the public health service, then he comes to the point. So all that said, I have good news nurseries. The P is going to study and his picked to ski to facilitate. That's so exciting doctor, I'm happy to hear that. And I want you to help with the study rivers taken aback for how can I help while the study's going to examine men in our local community? Black men, specifically studies examine the effects of untreated syphilis in the negro male, you've solid background in public health project. So I'd like you to be the special scientific assistant for the study doing well. Yes, of course. But, but what? Well, I don't think I know civil Allah g in enough detail to be useful. It's really not enough to be anyone special scientific assistant. You can do whatever they want done. I don't have to worry about that river smiles, if the medical director believes in her, she completed herself, she allows herself laugh. Well, now what's Finers rivers? Well aft to be honest with you. Dr I would have done almost anything to be off nights has I can assure you this is much better than night duty. I can't wait for you to meet Dr Clark. He's a good man. I think we can trust him. At that moment in nineteen thirty two Dr tala for Clark is in his office, quite pleased. With the latest developments his diligent work has helped him secure the backing of the Alabama state or have health, the Macon county board of health and the to ski institute with all its black personnel, and disposal, the to ski study of untreated syphilis in the negro male will last around six to eight months, and beginning October, which is just a few short weeks away Clark source through his mail, and his Glancy a letter from his colleague, Dr winger he opens the letter up and beams as he reads in, when you're expresses his eagerness to begin an eagerness Clark shares winger. Ends his letter with I'm confident the results of this study. If anywhere near our expectation will attract worldwide attention you will either cover us with mud or glory, when completed. Couldn't agree more. Next on American scandal, the to ski study of untreated syphilis in the negro male officially begins and quickly becomes something darker far from Borys after the selection of the test subject. Dr Clark reveals what he's truly after but the black medical professionals to ski find their into deep to turn back from wondering this American scandal. I hope you enjoyed this episode if you did. Subscribe now on apple podcasts Spotify, Google podcast wondering dot com or wherever you're listening to this right now. If you're listening on a smartphone swipe over the cover on gas fund the episode notes, including some details may miss, you also find some offers from our sponsors, supporting them you help us offer this show to you for free. And if you do like the show, we'd love you to give us a five star rating and leave a review I always love to know your thoughts and reviews are the best way for others to find the show. Tell your friends and family showed them, how to subscribe, you. Can also find us and me on Twitter. Search for hashtag American scandal or follow me at Lindsey Graham, we use many sources when researching are stories but we highly recommend the books bad blood, the to ski syphilis experiment by James, h Jones and the to ski syphilis study, my Fred Degray, just a quick note about our reenactments. We can't always know exactly what was said. But everything in our show is based on historical research. American scandal is hosted edited, and executive produced by me, Lindsey Graham for airship. Sounds I by Derek Barents. This episode is written by Hannibal DS, editing by Casey minor, an EMMY Cortlandt executive producers are Stephanie jen's Jenny lower Beckmann and her non Lopez for wondering.