Examining Tuskegee

Since 1972, "Tuskegee" has become a word that stands for an infamous research study: a forty year endeavor on the part of the United States Public Health Service (PHS) to not treat African American men with late stage and presumably non-infectious syphilis, while promising them the aspirins, tonics and diagnostic spinal taps were treatment. The Study turned into a long effort (1932-72) to track nearly 400 men (the subjects) assumed to have the disease and nearly 200 men (the controls) assumed to be disease free in the countryside surrounding the city of Tuskegee in Macon County, Alabama. Despite the publication of a dozen research studies about the Study in medical journals over the years, there was major outrage when a newspaper reporter exposed it to the wider public in July 1972. Senate hearings, a federal investigative commission, a lawsuit, and new rules for medical and scientific research followed. Susan M. Reverby's new book, Examining Tuskegee: The Infamous Syphilis Study and its Legacy (Chapel Hill: University of North Carolina Press, 2009) brings the stories of this extraordinary study up to the present day.

In the early 1930s, syphilis — a sexually transmitted disease full of moral stigma and dangerous health effects — was a widespread public health problem in many communities across the country. As part of its effort to reach out to underserved rural black communities in particular, the Rosenwald Foundation and the PHS set up a demonstration project in six southern states to track and treat the disease. When the funds dried up in the Depression, the PHS's idea was to study in one county what happened without treatment to those assumed to no longer be contagious and in the disease's last and latent stage.

For the next forty years, the PHS came back into Macon County for more tests of the men, tried to follow up those who had left, and promised families money for burial in exchange for the right to autopsy those who died. None of the men were injected with syphilis, as it is often rumored. Not all of the men died of the disease. The doctors were supposed to choose only those not contagious, but some of the men did pass on the disease to their wives and sexual partners, and then possibly on to a fetus in utero. Despite the discovery of penicillin in the 1940s (which might have still helped some, but not all, of the men), despite a civil rights movement that engulfed the Tuskegee area, despite debates over the power of physicians, despite questions of morality of this research raised in the 1950s, the Study continued.

Moving away from seeing the men as just hapless victims and the doctors as racist monsters, Reverby captures the experiences of individuals in the Study. She finds examples of how the men might have gotten to treatment, despite the PHS's efforts. She raises questions about the kinds of medicines available for syphilis in its latent stages and what type of medical uncertainty the Study was supposed to explore. She separates out the concepts of supposed biological difference based on "race" and the practices of institutional racism.

In 1997, after much organizing from citizens and politicians, then president Bill Clinton apologized to the six remaining men from the Study and to all African Americans. Nearly forty years after the Study ended and ten years after the formal apology, "Tuskegee" is still invoked to explain the anger and fears of some black Americans over the betrayals of the federal government, the institutional racism in health care, and why medical research has to be reviewed and monitored.

In her book, Susan M. Reverby traces both what happened during those forty years, how differing individuals experienced and explained their participation, and how the Study has been remembered and evoked over the decades. She examines the Study's life in history, memory, bioethics, fiction, and political argument, exploring why evoking "Tuskegee" may not be a solution to treating racism in medicine and public health.

(http://www.examiningtuskegee.com/)

Escaping Melodramas: Reflections on Historical Events, Government Apologies and Public Outcries

Parchman's Plantation

New York Times article, "Parchman's Plantation," published on April 28, by James M. McPherson. Dr. McPherson reviews WORSE THAN SLAVERY: Parchman Farm and the Ordeal of Jim Crow Justice (NY Free Press)written by David M. Oshinsky.

Dr. McPherson writes, "Authors are not always well served by the publicity releases their publishers send out. The Free Press acclaims '' 'Worse Than Slavery' '' as ''a window into a shocking and neglected century of despair . . . a forgotten era in black history.'' The story of despair may indeed be shocking to many readers, but it has been neither neglected by historians nor forgotten by African-Americans, whose music, art and folklore have preserved it in all its depressing but vital diversity."

McPherson continues with his book review: David M. Oshinsky, who teaches history at Rutgers University, would be the first to acknowledge his debt to historians like C. Vann Woodward, Vernon L. Wharton and many others whose work on the history of race relations in the South, and in Mississippi specifically, has made this field one of the most thoroughly cultivated in American historiography. Building on their studies of emancipation, Reconstruction and the post-Reconstruction ''New South,'' Mr. Oshinsky places the story of Mississippi's notorious Parchman prison farm in the context of sharecropping, convict leasing, lynching and the legalized segregation that replaced slavery. In vigorous, hard-hitting prose, he exposes the nature of the new system of race relations that was indeed worse in some ways than the kind abolished in 1865.

Yet this book makes clear that Parchman in its heyday as a prison farm was not the worst part of this new slavery. Actually, it may have been one of the least of the evils that characterized Mississippi's racial injustice. Mr. Oshinsky portrays Mississippi as consistently the nation's most violent state from the 1830's to the 1930's. Its frontier status in the early years of the antebellum cotton boom produced an astonishing crop of murders, duels, cuttings and gougings among white men. It also produced record crops of cotton grown by slaves working in a brutally repressive plantation system.

During Reconstruction the Ku Klux Klan and local rifle clubs murdered hundreds of freed slaves, now Republican voters, in the successful effort to make Mississippi safe for the Democratic Party. In the New South Mississippi led the nation ''in every imaginable kind of mob atrocity: most lynchings, most multiple lynchings, most lynchings of women, most lynchings without an arrest, most lynchings of a victim in police custody and most public support for the process itself.'' Nearly half a century later, in the 1930's, ''Mississippians earned less, killed more and died younger than other Americans. They were five times more likely to be illiterate than a Pennsylvanian and ten times more likely to take another person's life.''

This culture of violence provided the setting for the most infamous form of criminal justice in American history, the convict leasing system that prevailed in most Southern states for a generation or more after emancipation. Not surprisingly, Mississippi invented convict leasing. Under slavery, black criminals had been punished on the plantation. Virtually the only jail inmates were whites. The Civil War destroyed many jails and penitentiaries, while emancipation more than doubled the free population. The crime wave and political violence that accompanied Reconstruction overwhelmed the few and inadequate jails. In desperation, Mississippi and other states turned to an expedient that quickly became an institution: the leasing of convicted criminals to private contractors, who paid a fee to the state and agreed to feed, clothe and shelter the convicts during their term of punishment.

But the motives of lessees were most emphatically not altruistic; they were in this business for profit. They used convicts to build railroads, to mine coal and iron, and to fell timber, make turpentine, clear land and grow cotton. Since nearly all leased convicts were black, few whites cared what happened to them. And if the supply of convicts fell below the demand, compliant legislators and country sheriffs stood ready to increase the supply. In 1876 the Mississippi legislature enacted the egregious ''pig law'' defining the theft of a farm animal or any property valued at $10 or more as grand larceny, punishable by up to five years in state prison. The convict population quadrupled overnight. Many contractors made fortunes from the cheap labor that they could exploit with impunity. Slaves had at least possessed the protection of their value as property; the lives of black convicts had no value in the eyes of whites. Mortality rates in convict camps rose to shocking levels. The death rate among convicts in Mississippi during the 1880's ranged from 9 to 16 percent annually. ''Not a single leased convict,'' Mr. Oshinsky notes, ''ever lived long enough to serve a sentence of 10 years or more.''

It was this system, not the Parchman prison, that the Southern reformer George Washington Cable described as ''worse than slavery.'' By the 1880's the barbarism of convict leasing had become an embarrassment even to white Mississippians. Reformers in all Southern states crusaded against the system. By the early 20th century they had succeeded in getting it abolished almost everywhere, though in several states it was replaced by state or county chain gangs -- not necessarily a great improvement.

In Mississippi, convict leasing was replaced by Parchman, a prison farm located on 20,000 acres of the world's richest cotton land, in the Yazoo-Mississippi delta. The best chapter in '' 'Worse Than Slavery' '' describes life and work for the inmates at Parchman from 1904 to the 1930's. During that time the proportion of black inmates declined from 90 to 70 percent. Whether Parchman was ''worse than slavery'' is not clear from Mr. Oshinsky's account. What is clear is that it was very much like slavery. The superintendent functioned like a slaveowner. The white guards (''sergeants'') were the overseers, and the ''trusties'' armed with shotguns and rifles resembled nothing so much as the black drivers on slave plantations. And Parchman was a huge plantation, growing thousands of bales of cotton, which produced a handsome profit for the state of Mississippi. Exploitation, violence, racism and repression characterized Parchman. Mr. Oshinsky reproduces the words of several blues songs that portray the Parchman experience with sad eloquence. But what emerges from Mr. Oshinsky's account is a set of ironies that he implicitly acknowledges but does not explicitly develop. Parchman was better than convict leasing. It was probably less brutal in its treatment of black inmates than the prisons or chain gangs of other Southern states. And in an odd twist, it may have been better in some respects than what the civil rights revolution of the 1960's forced it to become.

At that time, with in-your-face spite, Mississippi officials jailed hundreds of civil rights activists for a brief time at Parchman, including James Farmer and Stokely Carmichael. Their reports of dismal conditions focused a national spotlight on Parchman's dark corners that resulted in a class-action suit. A Federal district court ordered the state to reform, upgrade and desegregate the prison. Since 1970 it has been ''reformed.'' As a consequence, inmates who formerly worked from dawn to dusk in Parchman's cotton fields and fell into an exhausted sleep in the barracks now sit in their cells with little to do except vent their energy in deadly fights with one another. In desegregated barracks, black and white convicts who were once kept rigidly separated now prey on each other in organized gangs. ''The Federal court had shifted the balance of terror from the keepers to the inmates,'' Mr. Oshinsky writes, and in 1990 the Parchman emergency room treated the ''staggering number'' of 2,305 cases of assault.

Perhaps the ultimate irony was voiced by an elderly black inmate of almost 50 years at Parchman. In the old plantationlike prison, he said, he had ''the feeling that work counted for something . . . kept us tired and kept us together and made me feel better inside.'' But today, he added, ''I look around . . . and see a place that makes me sad.'' (source: New York Times)

Give My Poor Heart Ease



Parchman Farm Blues Bukka White

New Orleans Plantation Police

The Plantation Police, or Home Guard examining Negro passes on the levee road below New Orleans. (click on photo for larger view)

The caption underneath the picture states: "The Plantation Police or Patrol was an institution peculiar to the Slave States. It was a semi-military organization, raised and supported by the planters, but not recognized by the old State authorities. Their principal duty was to visit the various plantations and patrol their roads by night, arresting all Negroes and other slaves that did not have the proper passes. The war, the President's proclamation, and the actual possession of most of the State of Louisiana by the Federal authorities, rendered these patrols doubly rigorous. Some of the Negroes submitted reluctantly. The colored man in the foreground is a specimen of that class. He seems to yield to the superior force of a tottering power, satisfied that his day is at hand; others show the obsequious submissive stamp--the Negro is satisfied with his lot if he is clothed and fed. "

I guess the more things change the more they stay the same.

EARLY LABOR MONOPOLISTS

The profits of rice culture, in which no poor man could engage, increased the ability, without at all diminishing the eagerness of the richer class to possess slaves. No regard to the general welfare could restrain the importation.

In an address to the King, about 1750, it is stated: "The only commodity of consequence produced, is rice." The "negroes are ready to revolt on the first opportunity, and are eight times as many in number as there are white men able to bear arms."

"At the lowest computation," the export of rice is declared to be two hundred and twenty thousand pounds sterling in value, and to require the use of one hundred and sixty ships. This crop was almost wholly the produce of slave-labor.

Little or no result of the labor of white men was exported, and the free laboring men were constantly engaged in trying to preserve something of their few legal rights, from the rapacity and ambition of the rich, slave-owning aristocracy.

Olmsted, Frederick Law, A Journey in the Seaboard Slave States;

With Remarks on Their Economy:

1861.