Listen to Episode

Read Episode Transcript

A listener note. This series is about a shameful chapter in American history. As part of telling a story accurately, we present the point of view of doctors and others from the period who express racist and white supremacist views. Listener discretion is advised. July 1972, San Francisco, California. It's a pleasant summer evening at a pleasant dinner party in a pleasant apartment filled with chitchat and shop talk. An international affairs reporter with the associate press named Edith Leterer breaks away from her conversation to refill her wine glass. Leterer scans the living room. Everyone appears to be having fun. Everyone except the lone man by the window staring out at the city lights. After a minute she recognizes him and acquaintance Peter Bucston. She walks over. Hey 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. But I was born in Czechoslovakia in 37. My father was Jewish, so we ran. I bring this up because I think you should know that something very similar to Nazi science is being practiced here in America. Today, Leterer swallows hard. No more casual sits from her wine glass. She's all ears. What are you talking about? It was just a random morning. I was in the coffee room. This was back when I tracked venereal disease for the U.S. Public Health Service. A couple colleagues were chatting and one mentioned a patient in Alabama. This man had terrible symptoms, he said. He was plainly insane. The family was scared, so they took him to a doctor they knew. And after a brief examination, the diagnosis was made. Ciflus, 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 supposed to. Now wait, I don't understand. The CDC, the Surgeon General, the State Board of Health, they're all in on it. Peter in on what? The experiments. He is for 40 years. PHS has been experimenting on black men and making county Alabama. In the beginning, there were over 600 test subjects. Now, there's less than a hundred. The rest are... Yeah? Dead. We're on account at four. None of them know they have Ciflus. The doctors running the study, they didn't tell them. They just let them die. They want to see what happens when Ciflus goes untreated in a man's body right up until the moment it kills him. They even pay for burial costs. Peter, that can't be true. No one would do that. It isn't possible. I can prove it. I have all the charts, all the 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 of them? Every last one. The study will continue until every last one dies. Lasson does something and he if I've tried, I've tried, but I need your help. This has to be exposed. Leterer's head is spinning. She finds the nearest coffee table in such a glass town. Peter, I want to see everything you have on this. Tonight, right now. Leterer and Bucksden depart that night for Bucksden's home. This there, letter or lease through inter office letters, roundup reports, xray descriptions, autopsy photos. Her eyes widen and phrases like, we are keeping the known positive patients from getting treatment and arrange 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. There are relatively few people in the medical community are aware of it. Even fewer have questioned it. Until now, most people have had no idea it's happening, especially not the test subjects, but the doctors slowly killing them are thrilled with their results. American scandal is sponsored by the new ABC drama Alaska Daily when an indigenous woman goes missing in Alaska. That's where the thrilling new ABC drama Alaska Daily begins and where it's headed will have you on the edge of your seat. Two time Academy Award winner Hillary Swank stars as Eileen, a veteran reporter who joins a team of local journalists working to bring the truth to light. From Academy Award winning screenwriter Tom McCarthy, Alaska Daily premieres Thursday, October 6th on ABC and streams next day on Hulu. If you're into true crime, the Generation Y podcast is essential listening. We started this podcast over 10 years ago to dissect some of the craziest and most notable murders, crimes and conspiracy theories together and we'd love for you to join us. Follow the Generation Y podcast on Amazon Music or wherever you listen to podcasts. From Wondry, I'm Lindsey Graham and this is American 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 unless these conditions are met. The rules were signed into law in 1974 in response to the Tuskegee experiments. Ciflus is a sexually transmitted disease that if left untreated can cause blindness, stroke, heart trouble and sanity and death. In the early 20th century, it was a massive public health concern, poorly understood and until 1945, largely incurable. Beginning in 1932, more than 400 black men were recruited to participate in a study on the effects of ciflus and the coming years another 200 men were recruited as controls. The issue was none of the patients knew that they were part of a study. The infected ones didn't even know they had ciflus. 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 promised treatment never arrived. Many were allowed to die when they could easily have been cured. The question is why? This is episode 1. First, do no harm. It's April 1929 when Michael Davis steps briskly into the well appointed office of the United States Public Health Service or PHS. The white haired and nearly 50 years old, Davis still has the drive and focus of a young visionary at the start of his career. And today he's got a big vision. He's here to see huge S coming, the PHS surgeon general. Not long ago, Davis joined the Rosenwald Fund, a private charitable organization started by Sears co owner Julius Rosenwald for the well being of mankind. The son of Jewish immigrants, Rosenwald had poured millions into schools, museums and charities and taken a special interest in helping America's black communities. Davis is the funds 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. S企業 still very much the law of the land, but he tells coming, a lot has changed. In the old days, the philosophy was that since blacks lived sinful lifestyles, they got illnesses like venereal disease and deserved what came next, discomfort, physical disfigurement, even death. Luckily, he continues, such medieval thinking is a thing of the past. In lightened 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. Distoring 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 Tuskegee Institute in Alabama, a black university cofounded by Booker T. Washington. With his pitch concluded, Davis sits back, satisfied. After a minute coming nods, says he likes what he's heard. He tells Davis, they'll get started right away. A thousand miles away in Bolivar County, Mississippi, Dr. Oliver Clarence Wenger smiles to himself as another long day at his health clinic draws to a close. It's early September, 1929, and even though it's a Saturday, there's no place he'd rather be. He helps one of the doctors sort the many vials of blood samples collected this afternoon, even more than the day before. And that's good. Looks like he'll be able to complete testing ahead of schedule. Wenger came to Mississippi following his success as director of the PHS, Venerable Disease Clinic in Hot Springs, Arkansas. His clinics cater to local black communities, and Wenger's 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 they need is a little guidance, and it's guidance he's happy to give. He spends his days improving their health, drawing their blood for analysis, and administering injections and appointments to help them feel better. It's satisfying work. Plus these people really are a hoot. Loading the blood into a truck, Wenger chuckles to himself for calling what just happened to Dr. Brevard. Two Negroes approached Brevard and said they felt weak after having their blood drawn the previous day. Specifically, they felt that their sexual powers had been impaired. Dr. Brevard nodded, stroked his chin, then proposed a solution. Would the Negroes like their blood back? Their eyes lit up. Yes, they would. Brevard excused himself, then returned with a one ounce bag of red colored placebo. He solemnly advised the Negroes to take the mixture in teaspoonful doses. They promised they would, and departed with no further complaint. Amazing. Harmless jokes aside though, for years Wenger's believe that medicine is letting black people down, and he wants to do his part to end the neglect. So he was thrilled when the U.S. Public Health Service sent him here to Mississippi. His mission is to oversee syphilis testing for 2,000 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 Wenger 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. Wenger's been running this program too. What he's only a month in, and it's hard work. The days are brutally hot, and the medical facilities are hastily constructed and barely adequate. The infected men can't be cured, right now there is no cure. Wenger's confident there's one right around the corner, but for now, that research process is too expensive and time consuming. So Wenger and his partner do the best they can, with drugs that render the men non infectious. They can at least keep other people from getting the disease. And just as they'd hoped, the program is a success. The PHS does decide to expand it. So Dr. Wenger happily heads to Alabama, launching another large scale anti syphilis effort for the benefit of rural blacks, and they need his help. Even after years of this work, Wenger can't believe how poor they really are. Black sharecroppers and ragged still coated in dirt from the fields. Mee eyes, missing teeth, but still smiling way. How could anyone live like this? It's a mild winter afternoon in February 1930. The rough and dirty men are lined up at the Possum Hollow School in Macon County, Alabama, and by the looks of them, they're lucky to have someone like Wenger to save them from themselves. They even have one of their own, a black doctor named Clyde Foroth from the Rosenwald Fund attending to the men in line. Dr. Foroth's hands a vile of recently collected blood to a nurse. See's Wenger watching him and nods. Wenger walks over as Foroth sends a patient on his way. Now take care of yourself. And don't forget, you know anyone who has been seen by us yet, you'd be sure to tell them to come by. Looks like the testing is going smoothly, Dr. Foroth's time impressed. Many of these men have never seen a doctor. They're happy to see any medical attention. We're able 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 is how not here to do is give these people an education and a banary disease in the facts of life. Yes, yes, sir. It's important we don't confuse these people with words they don't know and 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 and need medicine, which we provide. Excellent. We're trying to keep this all running as smoothly as possible. The fewer needless conversations, the better. Foroth's can I ask you something? Of course, Dr. Wenger. These Negroes are extremely trusting. They do almost anything we ask. No whining, no questions. Now this seems to be a common trait amongst Negroes. Can you explain it? Cross takes his time. Wenger can see that he seems to be struggling to find the words. Well, I think that the people here are naturally kind and they seem very trusting with whites, considering how whites treat them down here, that's surprising to me. Well, Dr. Wenger, they've learned to obey authority figures. Fascinating. Well, I'll let you get back to it, Dr. Frost. You've got the good work. Wenger walks away thinking about that last exchange. The people here believe in doing what white people tell them to do. They ask very few questions. He's here to test syphilis, and in more ways than one, he's found the ideal test subjects. He looks towards the door as more and more black men enter. If they are this open to suggestion, perhaps there are other purposes they might serve. Perhaps they can be driven to make great sacrifices in the name of science, without even knowing it. What if your family was the victim of a home invasion, or you woke up in the morgue, or you were seriously injured miles from help? What would you do? This is actually happening. Ask our listeners this very question, while we bring you captivating real life stories of trauma and perseverance. This is actually happening brings listeners extraordinary true stories from the people who lived them. You'll hear stories about conflict, turmoil, or threats that dramatically alter the course of someone's life. Each episode is an exploration of the human spirit, and how survivors manage to overcome hardship and move on with their lives. Even thriving afterward. The new season of this is actually happening is available ad free only with Wengery Plus. And if this new season isn't enough, you can listen to more than 120 exclusive episodes available only to Wengery Plus subscribers. Join Wengery Plus on Apple Podcasts or on the Wengery app. It's March 1930. Dr. Wengery's testing in Macon County has come to an end. Now in a chilly day in the nation's capital, the newly hired Ph.S. advisor to the Rosenwald fund pours over Wengery's results. At his desk, he makes urgent notes in the margins. His name is Dr. Tolliver Clark, and his family roots date back all the way to Colonial Virginia, which is why, as a true southerner, he doesn't find the statistics for Macon County all that shocking. 36% of the black's tested have syphilis. That's nearly 8,000 people. He double checks the data, sees that it must be accurate. He's fascinated by the numbers, energized and intrigued by them, and he has some ideas of his own about how to proceed. Which is why he's invited the Rosenwald funds Michael Davis to his office to discuss the findings. Davis is aware of the data coming out of Alabama, and it worries him. Clark knows that Davis has taken issue with aspects of Wenger's treatment program, not with his methods or its conclusions, but with something else. Clark can sense a certain sentimentality in Davis. He's not a sentimentality he shares, and he knows he'll have to set the director's trait. Please come in. Good afternoon, Dr. Clark. Dr. Davis, thank you for coming to see me. Please sit. Thank you. If I may, Dr. Clark, I'll get right into it. Yes, please. The findings concern me. Well, they concern me too. That's a lot of signegro's down there. That's not exactly what I mean. But obviously there's an ongoing health crisis in Macon County, but I feel we need to be careful with how we reveal this data to the public. Clark, class, there's on the most patient grin he can muster. Here it comes. Please go on, sir. The impression would be given that syphilis in the south is a knee grove problem, rather than one of both races. I fear this really unfortunate emphasis on the knee grove specifically could rouse resentment among knee grove groups in both northern and southern communities. 36% of knee groves in one in Poverse County in Alabama, not reflective of the country's knee grove population as a whole. I have no doubt the data is accurate, but we both know that syphilis isn't just a black disease. The Rosenwald 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 concerned you and the fund are with the knee grove progress and it's very forward thinking. Very forward thinking. But let me tell you, doctor, northern knee groves. The vast majority of them will not give this matter a second thought. And as far as the southern black stroke concerned, well, they all love the program. I appreciate that, doctor Clark, but still. Many are bound to ask why knee groves only? Why not test southern whites as well? We know they have the disease too. If we don't test them, we could be accused of bias. Bias? Well, I assure you, bias has got nothing to do with it. I personally would have loved whites to be included in the testing and treatment. But I'll tell you, doctor Davis, I know a thing or two about southern whites. Take it from me. They would not be easy to deal with. Whereas Dr. Wanger assures me the knee groves down south are most cooperative. Do you take my meaning? It's a matter of cooperation and not of discrimination that the work is limited in knee groves. We'll just learn more this way. And that's the truth, doctor Clark. That is the truth. In fact, I believe we should give serious consideration to expanding the program. We've got a good thing going. Why slow it down? Well, alright then. I won't keep you, doctor Clark. Clark smiles, stands, and shakes Davis's hand. Thank you, doctor. So I appreciate you coming in. Once Davis is gone, Clark turns back to the data and starts foring plans for the next stage of the program. He wants it to expand and figures everything will be fine as long as Davis and his Rosenwald fund don't get in the way. The following year, Clark is in his office when he learns that the Rosenwald fund has gotten in the way. For months, he lobbied the fund to expand the knee grove syphilis treatment program. But today, he's received a letter from Dr. Davis. The fund has balked, too expensive, especially during the depression. Clark slams his fist on the desk and paces. Takes every ounce of his strength 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, he hears the words in a sniveling voice. The fund has regarded it as a privilege to be able to assist during this preliminary period of study and attack upon this great problem in southern rural areas. That's hogwash. Clark thinks the fund could find the money if they really wanted to, but would rather back efforts to educate the knee grove. They're not really concerned with his health, but Clark is. He thinks that the PHS 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 knee grows. The world doesn't need white collar knee grows. It needs knee grows who aren't contagious. Bitterly, Clark realizes it's time to write his final report on the Macon County Sifless Treatment Efforts. He sets Davis's letter aside. He's excited he's never going to look at it again. He closes the office door to shut out the noise of the hallway, loads a sheet of paper into his timewriter, sits down, and begins to rapidly punch the keys. But after about an hour of 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. McConnie County has the highest prevalence of syphilis in the South. Any of those infected received treatment, but many did not, because the Rosenwald funding dried up before anyone could tend to them. Clark wonders what would happen if the PHS 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 has a feeling they could. Now, he's not a monster. And he preferred to treat the syphilitic blacks, of course he would. But if the Rosenwald 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. And 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 the arise 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, and that someone should be him. That's where he'll make his mark on medical science. Throughout 1932, Clark makes plans. This is to be a serious study, a disciplined and absolute commitment to the scientific method will be required. This subject is untreated syphilis in Negroes. Clark is pleased to discover that the work is not without precedent. Just three years earlier, in Oslo, Norway, a doctor, Bruce Gard observed hundreds of local test subjects with primary and secondary syphilis, examination only, no treatment. Bruce Gard wanted to study the nature of syphilis induced cardiovascular and neurologic damage. As Clark reviews the details in a German scientific journal, he nods in satisfaction, a smile on his face. Obviously, the study was whites only, it was conducted in Oslo, Norway, for God's sake. Thus, it serves as the ideal template for Clark's counterpoint, a colored only rendition. But Clark wants to do the Oslo scientists one better. They based their conclusions off case histories. They didn't conduct ongoing examinations, so Clark will collect his data in real time. With his pitch assembled, Clark starts lobbying colleagues at the PHS. He invites them to meet him in his office at his home in the local restaurant's most popular during lunch hour. He shares his ideas and is encouraged by the response. All agreed that the study is worthwhile. Yes, there are risks to the infected, with those risks paling comparison to the potential medical insights. One colleague who is fully on board with Clark's plans is Dr. Oliver C. Wenger. He happily agrees to collaborate with Clark once again. His Wenger supports Accured, Clark knows it's time to get on a train for Alabama. Upon their arrival, he tells Wenger he must see the state health officer Dr. J. N. Baker immediately. It's a pleasant September day in Montgomery when Baker opens his office door to admit Clark and Wenger. 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, but he needs to be certain these men know what they're talking about. The Ph.S. doctors describe their intentions. Baker takes it in, nods, asks for clarification. They seem like intelligent men. Clark promises to iron out certain details and even admits there are still many questions of procedure to be worked down. When Clark is done with his pitch, Baker waits a long while before speaking. Drumbing 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 can do 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 test subjects. He's more concerned with their white employers. They may not be happy to learn of a program that isn't doing everything I can to keep their workers as healthy and productive as possible. Baker says at the very least, Clark and Wenger's operation must take steps to render some of the blacks noninfectious and this is nonnegotiable. He asks 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 in Macon County blacks, they better find some of 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 and nurses. Clark nods rapidly in agreement. Baker can see the man filling in the blacks. There's really only one place in the country that meets those conditions and luckily for Clark and Wenger, it happens to be just 15 minutes away from the heart of Macon County. From Montgomery, Clark and Wenger hit the road on their way to the illustrious Tuskegee Institute. Cofounded by Booker T. Washington, the Institute has stood since 1881 as one of the most significant bastions of black education in the country, a place where blacks can truly receive a world class education in both the medical and industrial arts. They're planning to meet with Dr. Eugene H. Dibble to ski geese medical director and they're nervous. They're about to tell this black doctor that they 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 ununpeated by medical intervention. The experiment will be presented to test subjects as an extension of the Rosenwald fund treatment program, but it isn't. Conversations in Mindfield, they'll have to be cautious and nuanced in how they go about securing Dr. Dibble's support, because Tuskegee is the only place their experiment can be carried out. Dr. Eugene Dibble makes sure he's standing straight when Clark and Wenger pull up. He hopes they'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 its center, and Dibble's worked hard these past seven years to ensure that it stands as a monument to black achievement and prosperity. Every aspect of the institute reinforces that serious and legitimate work is done here. Dibble recognizes that he must do all he can to propel Tuskegee into the future, it's nearly 1933, and if black people are to progress in this country, it must not remain isolated. He's anticipating this meeting as much, if not more than the white doctors from the PHS, just now stepping out of their car. Hello, Dr. Clark, Dr. Wenger. I'm Eugene. Dibble notices his Clark shoots Wenger a quick look before taking the lead. Well, it is certainly an honor to meet you, Dr. Dibble. We have much to discuss and preferably in private. Can you show us to your office? Of course. Once the three doctors sit down, Dr. Clark does most of the talking. Dibble is content to do 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, and we want to help you make the most of it. Nothing will do that like you committing to help your government facilitate scientific progress. Wenger jumps in. You can bet that in Washington, you'll never forget your valuable service to your country and your people. Dr. Dibble, the work will do here with your help if you let us. We'll truly improve public health on a national scale for generations. Dibble remains silent for several moments, processing the information. He sees Clark and Wenger 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 the PHS will bring to Tuskegee 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 and 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 of the details are still being worked out. The program will last a better part of the year, and you need me to sign off on all of this, or the program will not be able to go forward? Yes, Dr. Dibble. That is correct. Well, Drs. You have my support. I think this study will be wonderful for the Tuskegee Institute. Our young nurses struggle to secure a meaningful employment after we train them. Out in the world, white people will rarely read a higher black nurse. So if you're telling me you'll employ black nurses and black physicians for your study, and I think that's a good thing. That's the most important thing. Dibble notices Clark's impressive grin. Oh, I agree, Dr. and you won't regret this. Now, if you allow Dr. Wenger and I some time to work out the protocol for our study, we'll return with some plans. Together, we'll propel this fine institution of yours to a level of respect and prestige it's never seen. Following a brief tour of Tuskegee's hospital, Dibble sees Clark and Wenger to their own car. Smiling, he waves goodbyes, they drive off, clout of dust and their weight. As it settles, he pictures the years ahead and 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 his 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. Dibble shakes the feeling off and returns to his office. Dr. T. Washington isn't here. This is a different time. It's September 1932. Dr. Tolliver Clark is in Baltimore, Maryland at Johns Hopkins University. He's there to speak with Dr. Joseph Errol Moore, Dr. Albert Kydell and the Venerable Disease Clinic. He's feeling somewhat desperate for their expertise. Clark knows he wants to study untreated syphilis and Alabama blacks. He's got all the official buy in he needs. But when it comes down to the finer points of actual scientific protocol, he still has a lot to sort out. Which syphilitic blacks will be observed? He obviously can't include all of making counties infected 36%. How many test subjects does he need? And which one should they be? He's hoping Moore and Kydell would contribute suggestions to flesh out the Tuskegee study so he can begin in earnest. As the doctors walk across the school's expansive campus on a crisp fall afternoon, Clark gets all the suggestions he could hope for and more. Of the two Johns Hopkins doctors, Moore is the more talkative. He warns Clark of pitfalls to avoid. First, the study can't be about black people. That doesn't mean examined people above the races, he says. It means examined black men only. Clark writes that down, but wants to know why. Moore 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 a woman, early syphilis symptoms can easily be mistaken for something else. That makes sense to Clark. He asks if there's anything else. And Moore says there is. Ideally, no men under 30. The younger the test subject, the more difficult it will be to observe the late stage manifestations of the illness. The next Moore suggests that the men be brought in batches to the Tuskegee clinic and asked to provide a full and accurate medical history. Only men who can identify exactly when their infection took place should be allowed to participate in the study, as this will make Clark's job much easier. Additionally, Clark should seek a total of 200 to 300 patients. Given making counties infection rates, it shouldn't be hard to find enough men who meet these criteria. Finally, Moore reminds Clark of something very important. Something Clark already feels he knows, but to him, it's worth remembering. Moore tells him not to forget that syphilis in the Negro is in many respects almost a different disease from syphilis in the white. Like Clark, Moore's eager to see how the data derive from the blacks and makin will compare with the data obtained from the whites in Oslo. Clark and Moore believe that whites and 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 in whites and the cardiovascular system more in blacks. Clark hopes that his study with its real time examination of subjects will prove this once in for all. For the past eight months, Eunice Rivers has been the supervisor of Knight Nurses in Andrew Hospital at the Tuskegee 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. As you'll get used to it, for as long as she can remember, she strived to make her father proud. Albert Rivers was a man so illiterate 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 lived near a 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 Tuskegee Institute with what little money he had. She took up handicrafts, but her father put a stop to that. He told her she had potential and could be a great nurse. Eunice proved her father right. She excelled, which is why Dr. Dibble promoted her to Knight Manager. But when Dr. 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, did I make a mistake? Did I mix up the X Raid 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. Come in. You wanted to see me, Dr. Dibble? Yes, nurse rivers. Please sit down. Dr. Dibble seems happy, so nurse rivers relaxes. Maybe she was wrong. She relaxes more as Dibble begins to talk. He says he's always been an admirer of hers, respects her work ethic, her medical background, her way with patients. He mentions Dr. Clark with the Public Health Service, then he comes to the point. So all that said, I have good news, nurse rivers. The Ph.S. is going to do a study and is picked to ski to facilitate it. Well, that's so exciting, Dr. I'm happy to hear that, and I want you to help with the study. Rivers has taken a back. Well, how can I help, Dr.? Well, the study's going to examine men in our local community. Black men, specifically. The study will examine the effects of untreated syphilis in the Negro male. You have a solid background in public health projects, so I'd like you to be the special scientific assistant for the study. Will you do it? Well, yes, of course, but what? Well, I just don't think I know syphilology and enough detail to be useful. It's certainly not enough to be anyone's special scientific assistant. You can do whatever they want done. I don't have to worry about that. Rivers smiles. If the medical director believes in her, she can believe in herself. She allows herself a laugh. Well, well now, what's so funny in her strivers? Well, I have to be honest with you, Dr. I would have done almost anything to be off night duty. Yes, 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 1932, Dr. Tallah 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 Board of Health, the Macon County Board of Health, and the Tuskegee Institute with all its black personnel at his disposal. The Tuskegee study of untreated syphilis in the Negro male will last around six to eight months and begin in October, which is just a few short weeks away. Clark's source through his male and his glad to see a letter from his colleague, Dr. Wenger. He opens the letter up and beams as he reads. In it, Wenger expresses his eagerness to begin and eagerness Clark shares. Wenger ends his letter with, I am confident the results of this study, if anywhere near our expectation will attract worldwide attention. It will either cover us with mud or glory when completed. Clark couldn't agree more. Next, on American Scandal, the Tuskegee study of untreated syphilis in the Negro male officially begins and quickly becomes something darker and far from glorious. After the selection of the test subjects, Dr. Clark reveals what he's truly after, but the black medical professionals of Tuskegee find they're in too deep to turn back. From Wenger, this is American Scandal. 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 executed produced by me, Lindsey Graham, for airship, sound designed by Derek Barons. This episode is written by Hannibal Diaz, editing by Casey Minor and Emma Cortland. Executive producers are Stephanie Gens, Jenny Lauer, Beckman, and her nonlope as For Wondering.