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Health Studies
Denis Maxwell

HLTC02 WINTER 2013 Week # 10: “Rethinking the Tuskegee Syphilis Study: Nurse Rivers, Silence & The Meaning of Treatment by Susan Reverby  Tuskegee Syphilis Study stands as an American prime example of medial arrogance, nursing powerlessness, abusive state power, bureaucratic inertia, unethical behavior and racism in research  The Tuskegee study was a forty year (1932-72) “experiment by the US Public Health Service (PHS) to study “untreated syphilis in the male Negro”  399 men who tested positive for latent syphilis thought they were being treated for their bad blood, a term used in the black community to encompass syphilis, gonorrhea, and anemia  Men were watched, examined, intentionally untreated, given spinal taps euphemistically referred to as „back shots‟, promised burial insurance, autopsied, misled, and lied to until 1972 when this story broke nationwide  Following this there was national outrage, senate hearing, multimilliondollar law suit filed, a federal investigation, financial pay out to survivors or descendants of families affected, Bill Clinton gave a formal federal government apology to all the men involved in front of a ntional television audience  It is difficult to differentiate between shadow and act, image and rality  This study was situated and embedded in complex narratives and contexts influenced by race, class, gender, medicine, sexuality and intersectionality of all these domains  Centre of this chapter will be focused on Nurse Eunice Rivers Laurie – she represents the different geometry of the history of black women‟s representation, reality and intersectionality linked to race, gender, sexuality, class, and attached to create a politics of learning  Focus of the paper will be on the dilemmas for Nurse Rivers – an integral ambassador between the African American men of thestudy, the Tuskegee Institutite and the state and local health departments  Two possible theories on Nurse Rivers o Duped innoncence – did not know how bad this study was – innocent ignorant person o Epitome of race traitor – her willingness or uwillingness to use her class power within the black community to keep her job and sell out the rural men under her charge  Nurse Rivers testimony, testifying and silences are all very telling and tell more than what is visible at the surface of her words or lack thereof -“part of the tradition of black women who have spoken out – but whose choice of where to speak, what words to employ and what silence to make use of rquire us o listen in ways our culture has taught many of us not to hear o The concept of treatment is articulated in distinct ways which have certain meanings o Her voice helps to reconfigure the race medicine link thorugh nursing and gender as well as be a voice piece and translator of hegemonic discourse of race in the langue of medical and scientific theory  It is key to hone in on her testifying – this term has been defined as a ritualized form of communication in which the speaker gives verbal witness to the efficacy, truth, and power of some experience in which the group has shared  We must reconsider the term treatment o During the 1930s, there was much debate about the proper course of treatment – sometimes chemical treatments required sixty weekly visits of painful intramuscular injections o Sometimes it was touted the treatment was worse than the disease itself o Economic realities of America at that time made it impossible for many to have access to any if at all any treatment o This contextualizes why so many men participated in the study for so long, as there was no other better choice available o In Macon County, white physicians did not even imploy IM injections for syphilis balack patients as they thought it would be a waste  They wouln‟t complete the treatment  Inherent sexual promiscuisty apparently in Blacks  Cardiovascular complications more likely in Blacks compared to neurological complications in Whites HLTC02 WINTER 2013  At first, it was thought that treatment would be included for study participants but it quickly turned into a normalization of non-treatment o “purely a diagnostic procedure carried out to determine what has happened to the syphilitic Negro who has had no treatment  Location of where this study happened is very important, happened in Macon County, Alabama – an area in the south with old plantations, and hard scrabble living for the predominately black population o Area of sc  Originally, researchers wanted to determine if indeed the disease was wrose than the treatment or vice versa  Moton may have well thought it was a chance for o The men to receive treatment when necessary o An opportunity for Tuskegee to participate in a study of international significance since there had been a retrospective study on whites in Oslo earlier in the century o Screen out those who might not need extensive care o Hoping this study to dispel the myth that there is a biological difference between black and white  As the study progressed no treatment was given, the men were not of interest to the researchers really UNTIL they were dead and could be autoposied o They naturalized lack of treatment o Did not see men as patients or subjects but tratehr cadavers that had been identified while still alive 
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