The word “Tuskegee” in relationship to health care reminds Americans of the “infamous syphilis study” and that horrific medical experiments took place here, and not just in Nazi Germany. Between 1932 and 1972, the United States Public Health Service followed, but did not treat, hundreds of African American men in Alabama who already had late stage syphilis. The men never knew they were being watched as aspirins, iron tonics, and diagnostic spinal taps were explained as “treatment” and scores of them sickened and died.
In my most recent book, I had to explain: why did the doctors do it? Sometimes it is easy to answer this: all the men were black and poor, and almost all the doctors were white. Was this racism pure and simple? Or is this just scientific and governmental bureaucracy run amuck where having the power to do this just lets it go on and on?
Yes, of course, to these answers and then no. No because these public health physicians thought they were answering crucial questions: does race affect disease and do those with late latent syphilis need treatment? Many honestly believed their faulty data that assumed racial differences and ignored contrary evidence. They thought they proved “syphilis wasn’t such a bad disease” and then found that those who had survived into the antibiotic era (when penicillin could have made a difference) often got to other doctors for these drugs despite the study. The doctors allowed medical uncertainty about how to treat syphilis to be explained by racial assumptions and to see individuals as a population.
“Tuskegee” will probably continue to haunt our civic imaginations as a metaphor for malfeasance and hubris in research. The study should remind us both of the dangers of racism and the common practice of wrongly reading race into scientific data.