It’s an October evening in 1932, in Macon County, Alabama.
A flatbed truck kicks up dust as it bumps along a remote country road. Sitting crowded in the back is a group of African American sharecroppers, weary from a long day picking cotton in the hot sun. Among the passengers is 30-year-old Herman Shaw. Herman sits slumped in the corner of the truck bed, shivering despite the warm weather.
For several days now, Herman’s health has been in rapid decline. He’s been losing weight, his muscles and joints ache, and painful sores have appeared around his groin. Herman fears that he’s become the latest victim of the disease that’s been rampaging through America, a pestilence that the locals around here simply call “bad blood.”
Herman winces in pain as the truck rolls to a stop.
Gingerly, he climbs down from the vehicle and begins walking the rest of the way home.
As Herman limps up the winding dirt path toward his wooden shack, he notices a flier nailed to a fence post. In bold letters, it reads “Do you have bad blood? Free blood tests available at Tuskegee Hospital.”
Herman rips the flier from the fencepost and stuffs it into his pocket. He’s never visited a doctor in his life, and the prospect terrifies him. But he’s desperate, and Tuskegee is just a short bus ride away. This flyer might be bringing good news. Herman continues up the road, feeling optimistic that whatever he’s got, it can be cured – and that his suffering will soon be over.
At Tuskeegee Hospital, sure enough, Herman will test positive for “bad blood,” or as the doctors know it, syphilis – a potentially deadly sexually-transmitted disease without a known cure at the time.
Herman will be one of six-hundred African American men in Macon County chosen to participate in the Tuskegee Syphilis Study, a government-funded research experiment which aims to study the long-term effects of untreated syphilis. The doctors in charge of the study will deceive its participants, telling them that they are receiving real medicine when in fact they are only being given placebos – keeping the patients sick, even after a treatment is discovered so that the doctors can track the full progression of the illness over several decades.
By the time the study is called off in 1972, 128 volunteers will have died as a consequence of their untreated syphilis. It will take decades for many African American citizens to regain their trust in the US public health system – and precisely twenty-five years for the United States government to reckon with its involvement in the ethically reprehensible study, with President Bill Clinton issuing an official apology for the Tuskegee Syphilis Study on May 16th, 1997.
From Noiser and Airship, I’m Lindsay Graham and this is History Daily.
History is made every day. On this podcast—every day—we tell the true stories of the people and events that shaped our world.
Today is May 16th, 1997: President Clinton Apologizes for the Tuskegee Syphilis Experiment.
Act One: Bad Blood
It’s October 1932; 40 years before the Tuskegee Syphilis Study will eventually end.
A young Public Health Service officer gazes through the window of a train heading south through the Alabama countryside. Dr. Raymond Vonderlehr wrinkles his nose in distaste as the cypress swamps and cotton fields streak past the window.
Raymond is the deputy director of the Public Health Service’s Division of Venereal Diseases. He is on his way to Tuskegee, Alabama to launch a medical study on the long-term effects of a disease that has been tearing through the country.
By 1932, one in ten Americans have been infected by syphilis, a highly contagious sexually transmitted disease for which doctors of the day have no cure. The symptoms of syphilis are incredibly painful, with patients experiencing agonizing ulcers around the genitals, as well as chronic fatigue, weight loss, and muscle pain. While these symptoms usually subside after a year or two, late-stage syphilis can lead to permanent organ damage, blindness, and, in some cases, death. The only existing treatments are unreliable and potentially dangerous, as they contain toxic substances like arsenic and mercury.
The question that healthcare professionals face is whether late-stage syphilis is a serious enough disease to warrant the risk of using these existing treatments. To answer that question, the Public Health Service has devised an experiment. They intend to persuade a group of men with syphilis to participate in a study spanning several years. The aim is to observe the long-term effects of untreated syphilis on human body to decide whether existing treatments are worth the risk.
In the early afternoon, Raymond’s train arrives in Tuskegee, Macon County’s largest town. Raymond picks up his briefcase and steps down onto the platform, loosening his tie in the midday heat. On the street outside the station, he is greeted by Dr. Eugene Dibble, the chief physician at the local hospital. After stiffly shaking hands, the two men climb into Dr. Dibble’s car and drive out to the hospital on the edge of town.
As they make their way through Tuskegee, Raymond feels increasingly satisfied with their decision to hold the experiment here in backwoods Alabama, where syphilis rates are among the highest in the country. Most residents of Macon County are impoverished Black farmers and sharecroppers. Raymond is confident that he and his colleagues will be able to convince these vulnerable people to sign up for the experiment in exchange for hot meals and free health checks.
The other reason for holding the experiment here in Macon County is that many government healthcare professionals wrongly believe that syphilis affects Black people and white people differently. This is scientifically inaccurate, but doctors have chosen this predominantly African American region in order to test their theory.
With the help of hospital staff, Raymond gathers a group of 600 local Black sharecroppers to participate in the experiment. 399 of them test positive for syphilis, while 201 uninfected volunteers will act as the control group.
On the first day of testing, Raymond steps out of his office to address the 600 participants. Rather than revealing the true nature of the experiment, he explains that they will be receiving treatment for “bad blood” – the colloquial term for syphilis used by most locals. Raymond doesn’t tell the truth of the matter: that these men will only receive placebos, and that the purpose of the experiment is not to make them better but to monitor the gruesome progression of syphilis in their bodies.
Over the next few years, outrageous abuses will be committed in the name of medical research. The government doctors will perform painful and invasive spinal taps to investigate the infection’s neurological impact. And when a patient dies, the researchers will autopsy the body and learn more about how long-term syphilis attacks the vital organs.
For his role in successfully setting up the experiment, Dr. Raymond Vonderlehr will receive a promotion, becoming president of the Venereal Disease Division of the Public Health Service. And over the course of the next forty years, he and other government officials will continue to monitor the condition of syphilitic men in Macon County, denying them any treatment even as they suffer the worst consequences of the disease.
Even when penicillin is established as an effective cure for syphilis in the 1940s, the participants in the experiment will still be denied medicine, and researchers in Tuskegee will ensure that the men in their study never find out about advances in syphilis treatment. It won’t be until 1972 after a whistle-blower uncovers the details of the study, that the mistreatment of patients in Tuskegee will finally end, and the horrifying details of the experiment will be laid bare for all to see.
Act Two: The Whistleblower
It’s 1966 inside a Public Health Service clinic in San Francisco; thirty-four years after the Tuskegee Syphilis Experiment started.
Medical outreach worker Peter Buxtun sits alone in the corner of the breakroom eating his lunch. The 27-year-old is only a few weeks into his employment here at the clinic, where it’s his job to track and trace outbreaks of syphilis in San Francisco. Every day brings a new set of challenges, but Peter is conscientious, hardworking, and utterly dedicated to containing the spread of this destructive disease.
As Peter unwraps his sandwich, he overhears a snippet of hushed conversation between two colleagues. They’re talking about a doctor in Alabama who was recently reprimanded by officials at the Centers for Disease Control and Prevention, or the CDC – a branch of the Public Health Service responsible for conducting research into infectious diseases. The doctor had apparently given a shot of penicillin to an African-American man with syphilis, prompting CDC officials to complain that he had “ruined their study” and “jogged their statistics.”
The anecdote sticks with Peter. And after lunch, even though he tries to get back to work, he struggles to concentrate. He can’t understand why CDC officials would rebuke a physician for treating a sick person.
So the following day, Peter pursues the issue. He phones the CDC head office and asks what’s going on in Alabama. The Center agrees to send Peter their files on the research conducted so far. And later that week, Peter receives a bulging envelope filled with information regarding the “round-ups” of hundreds of poor, Black sharecroppers with syphilis in Macon County. According to these documents, none of the men received treatment.
Peter is dumbfounded. He works hard bringing penicillin to the poorest parts of San Francisco to treat with syphilis. Meanwhile, in rural Alabama, government physicians are deliberately withholding life-saving medicine. It doesn’t make any sense.
As Peter digs deeper through the documents, he gradually builds a picture of what’s been going on in Tuskegee. Going all the way back to 1932, the documents reveal a large-scale study into untreated syphilis, in which impoverished African-American men in Macon County were used as cheap test subjects by government-funded doctors. Even after penicillin became readily available in the mid-1940s, the patients in the study were only given placebos, as the doctors watched them get sicker and sicker.
To Peter, a Jewish immigrant whose family fled Europe during the rise of Adolf Hitler, the study is grimly reminiscent of the experiments conducted by Nazi doctors on prisoners at Auschwitz concentration camp. He can’t believe that similar horrors are being perpetrated here on American soil.
So over the next few weeks, Peter struggles to shake this troubling discovery. The more he learns about the experiments taking place in Alabama, the more determined he becomes to intervene. He tries to get his colleagues to help, but they’re afraid of getting in trouble with the CDC and losing their jobs. They tell him they have families to think about. But Peter remains undeterred. He writes a scathing letter to the head office of the Public Health Service. And shortly after, he receives a reply, requesting his immediate presence at CDC headquarters in Atlanta.
A few days later, Peter finds himself sitting at the end of a long conference table. Glowering at him from across the room are several high-ranking officials from the CDC and the Health Service. One of the red-faced men proceeds to berate Peter for “meddling” and sputters that he should keep his nose out of government business.
But this does not deter Peter. He returns from Atlanta even more resolute in his mission to shut down this ethically reprehensible study and see justice served. He continues writing strongly-worded letters to senior figures in the Health Department. But time and time again, Peter’s complaints are met with obstinacy and denial.
Years go by without progress. Peter has tried to appeal to the Health Department to change its policies. But finally, having received nothing but excuses and evasions, Peter decides to go public with his information. He leaks the CDC documents to a friend at the Associated Press. And on July 25th, 1972, the New York Times runs a front-page story detailing the use of 600 African-American men as test subjects in a government-led study into untreated syphilis.
The story will create an instant storm of controversy. Soon after the publication, the CDC will terminate the Tuskegee Syphilis Experiment, bringing to an end forty years of unethical research.
In the following months, a lawsuit will be brought against the Health Department by Fred Gray, the lawyer who once represented civil rights activist Rosa Parks. The case will eventually be settled when the government agrees to pay the victims’ families ten million dollars and to provide lifetime medical benefits to all surviving participants from the study. Then, in 1974, Congress will pass the National Research Act, which will be aimed at preventing the exploitation of human subjects by researchers.
But for all these reparations, it will still take another twenty-three years before the US government will fully address its involvement in the Tuskegee Syphilis Study and finally apologize for one of the most shocking examples of medical malpractice in US history.
Act Three: Clinton’s Apology
It’s May 16th, 1997 in Washington D.C.
A televised ceremony is taking place inside the White House. Alongside a lectern decorated with the presidential seal, 95-year-old Herman Shaw stands with several other surviving participants from the Tuskegee Syphilis Experiment.
Today’s ceremony has been arranged at the behest of the Tuskegee Syphilis Study Legacy Committee as an opportunity for President Bill Clinton to offer an official public apology on behalf of the United States government. But before Clinton is scheduled to deliver his long-awaited speech, Herman takes to the podium to say a few words.
The elderly man looks out at the audience, clutching his prepared statement with trembling fingers. He takes a moment to reflect on his own suffering, and the suffering of his fellow test subjects, many of whom did not survive. Then he clears his throat and speaks into the microphone.
"HERMAN: I’m saddened today to think of those who did not survive, and whose families will forever live with the knowledge that their death and suffering was preventable. (audience claps)"
Herman steps down from the lectern, passing President Clinton, who clasps Herman’s hand in a gesture of solidarity and goodwill. Herman smiles at the President, then steps aside and allows Clinton to say his piece.
"CLINTON: What was done cannot be undone, but we can end the silence. We can stop turning our heads away. We can look at you in the eye, and finally say on behalf of the American people, what the United States government did was shameful. And I am sorry. (audience claps)"
Following President Clinton’s apology, the Tuskegee Syphilis Study Legacy Committee will continue to put pressure on federal agencies to address the damages done. They will urge the government to establish the National Center for Bioethics Research and Health Care in Tuskegee, an institution which will officially open in 1999. There, students can explore issues underlying the medical care of marginalized people, so that society can continue to safeguard against abuses of the kind perpetrated during the Tuskegee Experiment, for which President Clinton finally apologized on May 16th, 1997.
Next on History Daily. May 17th, 1974. Four car bombs explode in Ireland, killing thirty-four people and injuring over two hundred.
From Noiser and Airship, this is History Daily, hosted, edited, and executive produced by me, Lindsay Graham.
Audio editing by Muhammad Shahzaib.
Sound design by Mischa Stanton.
Music by Lindsay Graham.
This episode is written and researched by Joe Viner.
Produced by Alexandra Currie-Buckner.
Executive Producers are Steven Walters for Airship, and Pascal Hughes for Noiser.