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Review Author(s): Nancy Kang Review by: Nancy Kang Source: African American Review, Vol. 44, No.

Review Author(s): Nancy Kang Review by: Nancy Kang Source: African American Review, Vol. 44, No. 1/2 (Spring/Summer 2011), pp. 301-304 Published by: St. Louis University Stable URL: http://www.jstor.org/stable/41328747 Accessed: 04-03-2015 14:49 UTC

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was assumedto be a material issue, and thissomewhatnaïveconclusionis

cated

in the

Paul Finkelman, Ariela Gross, and Jeannine MarieDeLombard.

Lewis and Ardizzonebefore her, is also too

moment.WhileRhinelanderdied only a

laterlifeseemsto havebeen almost hermetic, the seemingly endless legal maneuvers

afterthetrial -

theevents leading to a setdement allowing thatdivorceto be

and threatsof

in referenceto boththetrialand thesetdement - offerrichbutstill untapped

potential formoreextendedconversationabout

in the

thebook's relatively thinsenseof the ways raceand materiality functioned

compli-

by

nineteenth-century American legalsystem groundexploredby

-

quick

in

scholarslike

Smith-Pryor, like

considering thehour after the

decade after losing thetrialand Jones'slong

suchas Rhinelander's attempts to obtainan "easy" Nevada divorce;

finalized; Jones's suits

suits against Rhinelander, his father, his father's estate, and so forth,

race,class,property, and gender

likely be

onlysubject matterand

likely findthat Smith-Pryor's

twentieth-century American legalsystem.

The brief comparison between Property Ritesand "LoveonTrialabovewill

argument butalso coverage and gaps.They

writing is

will

only one of many thatreaders draw,given similaritiesin not

basic

book is more"academic":its

denser, anditsnotationmuchfuller.Butthesedifferencesarenot

as thosetiedto thesourcesand

relieson a muchricherarchivalbase thandoes Loveon

thefull"Cases and Points:Recordsand Briefs"of the trial, whichoffersnot

trial transcripts, butalso textsof variousdocumentsfiled by bothsides.WhereLove

onTrialreliesalmost

readssuch

and a hostof othersources.

betweensources.As a

to herworkas a historian - and so

a bit drier, itstheoretical arguments a bit

of

nearly as important

approach

Property Rites. Smith-Pryor's account

Trial, specifically, she located

only

completely on thevoluminous presscoverage of thetrial (and

dialogue withtrialdocuments

Smith-Pryor thusalso regularly examines discrepancies

skillfully),Property Rites places that coverage in

expect

former attorney,Smith-Pryor also brings a lawyer'ssensibility

these

probesquestions of legalstrategy withacumen.

qualities to lead Property Ritestoward emphases and

Property

detail, for example, on the ways

inwhich legal structures

argued; therearealso severalmoresubtle

out suchdifferences

Smith-Pryor had more direcdy

she had consciously demonstratedwhather

and readersof Loveon Trial,

One would

conclusionsdifferentfromthoseinLoveonTrial - and sometimes they do.

Ritesoffersmuchmore

shaped how thecase was, and could be,

differencesin how theworkstreat race, racial labels, and passing. But one of the

most frustratingpieces of Property Ritesis itsfailureto point

and to engage LoveonTrial directly. Ardizzoneand Lewis each appearonly once in

the index, andtheirbook is briefly and obliquely referredto only a handfulof timesin

thetext. Property Riteswouldhavebeen muchricherif

insertedherselfintoa

sourcesand approach forcestudentsof the period,

to reconsiderand reevaluate.Withoutthat dialogue, readerswillstillwantto and stillhaveto readbothbooks and thinkhardaboutthenext steps in researching this

fascinating web of events.

dialogue - if

Susan M. Reverby.ExaminingTuskegee:

Legacy . Chapel Hill: U of NorthCarolina P, 2009. 384 pp. $30.00.

The

InfamousSyphilisStudy and Its

Reviewed by Nancy Kang, Clarkson University

blood"

usually

emotional spectrum thatstretchesfrom lingering distrust

from between lingering groups distrust

evokesthe idea of that

spectrum

hostile relations

stretches

or

Bad

individuals, an

individuals,

an emotional

to deep-seatedenmity. Yet as Susan M. Reverby's masterful ExaminingTuskegee: The

reviews

301

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302

InfamousSyphilisStudy andIts Legacyexplains, the

thecontextof American public health policyduring the Jim Crowera.As

illustrates,having "bad blood"

syphilis, also known throughout its longglobalpresence as "the pox,"

ease," and "lues venereal," itsLatinname (23). Yet the equation of epithet and epi-

approximately

600 AfricanAmericanmen (400 of whomhad thediseaseand 200 controlswho did

not), all participants in the forty-yearTuskegeeSyphilisStudy(1932-72).

ublicHealthService

Alabama city made famous by the legacy of BookerT.

tionisteducatorand authorof

The studysought to examinetheeffectsof nontreatmenton

noncontagious)syphilis, butdid so withouttheethical transparencyexpected of

today's medicalresearch community.Tuskegee's ruralmale

thattreatmentwas

would essentially be informative corpses,they were promised medications (a semblance

of treatment), free meals,transportation to and from testingsites, burialinsurance or assistance, and thesatisfactionof serving in an important initiativeaimedat the

greatergood

trust,possibleearly deathand disability, and the genesis

narrativeof stateabuse thatstill grips thenation'sethical imagination.

threeself-contained yetcomplementary sectionswithallitera-

tive sub-headings. Each explains thecentral preoccupation of thehistorianas an

excavatorof competing versionsof

all actsthattranscend anyparticular academic

established early on as detailed summary and

syphilis' cultural significance and thecrucesof

pertained to the segregation era's public

focuseson thenotionof voice - who

were heard, andwhose deservemoreconcentrated regard while offering short

charactersketchesof blackhealthcare personnelintegral to the study. These included

healthnurseEunice Verdell

Dr.

Instituteand

Eugene Rivers Laurie, most

meanderingforay intohow

channeledtheirmoral outrage intoart.

among

havenot

chargedcatalysts fora

thissectionare

Generaland a dissectionof theofficial apologyby theClintonadministration.After

a personally inflected epilogue, theauthorincludesextensive appendices,among them

a compendium of the majorfigures' namesas wellas a listof studyparticipants. This latterinformationwas released publicly forthefirsttimein 1997.Thereare

also tablesand chartson probable outcomesforuntreatedlatent syphilis, thedatesof

participantrecruitment, themen'srelative ages

statistics.Whileit appears thatthereis no dearthof informationon the

ExaminingTuskegeecompels

catchphrase tookon othernuancesin

Reverby

was a euphemism for carrying thevenerealdisease

the"bad dis-

immediate, especially to some

of the

The U. S.

Tuskegee, theMacon County, Washington, accommoda-

demicwas not always clearand

(PHS)

commenceditsresearchin

thewell-known autobiographyUpfromSlavery(1901).

late-stage, latent (thus,

subjects werenotaware

beingdeliberately withheld.Enticed byphysiciansseeking what

carefullyengineeredduping thatled to misplaced

of a

complex

and

damaging

truths. Hearingtestimony, testifying, and traveling are

specialty, so the scope

of thetextis

overviewof

morality,medicine, and raceas they

("Testifying")

whose stories

health apparatus. Parttwo

was silenced, who spokeup,

-

public NurseRivers.Partthree ("Traveling") is a

its imaginative arbiters

thecreative products,

(79). This was a

Reverby's texthas

broadlyinterdisciplinary. Partone ("Testimony") offersa

analysis of the study'shistory,beginning withan

H. Dibble of

Tuskegee commonly knownas

postwar American society and

Reverbyexplains how

'

themDavid Feldshuh's play MissEvers

Bays, andits subsequent movie version,

always been historically accurate; despitethis,they serveas emotionally

more

vigilant and

historically informed public. Also includedin

supportingchapters on Henry W.Foster Jr.'s failedbid for Surgeon

at thestartof the

study, and autopsy

subject,

us to

think again.

attempt to unpack

motivations, deconstruct assumptions, and grapple withtheendemicuncertainties

thatcharacterizedthe study anditsaftermath.The textdifferentiatesitselffromother

meditationson the

assumptions, andthe whys of

subjectbyfocusing on "contingencies,possibility for escape, racial

One abiding featureof Reverby's historicalassessmentis her

thedoctors thinking that they did

nothingwrong"(239).

molding mass

As thename implies, thePublicHealthServicehad a pivotal rolein

AFRICANAMERICANREVIEW

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perceptions about prevention, disease, and treatment options.By

approach to the goals of thePHS and Tuskegee,

department bothcreatedand reaffirmed misconceptions aboutracialdifference.An

example is the stigmatization of blackmalesas

degeneracy; theidea thatthis groupposed a symbolic, if notliteralthreatto white

healthfoundsubtlebutdefinite expression in the

denials, racewas a central consideration, especially the pervasive notionof blacks'

"sanitary sins" (26) and hencetheir particularsusceptibility to venerealdiseaseslike

syphilis.Ironically, the Tuskegeeparticipants

PHS rhetoricthatfollowedthemediafallout - wereconstruedas serving a greater

national good bydonating theirbodies to science.

taking a critical

theauthor highlights how the

vectorsof

sexual,moral, and social

study. While meeting with vigorous

-

called"volunteers"in muchof the

An endowed

professor in

theWomen'sand Genderstudies department at

theandrocentrismof the

WellesleyCollege,Reverby offersan especiallyprobingcommentary on blackwomen's

roles

ExaminingTuskegee notesthatthewomenwho weretestedin

twicetheamountof

suing treatmentand physical examinationwhenthesewereavailable

clinicsinMacon County had twiceas many womencome forwardforassistancethan

men (57). Clearly this population, while relativelyuneducated,rural, and poor,

neither apathetic noruninformedabouthealthissues.Men

pursued what they believedto be treatment, even though the PHS, in its underlying

need to

and

the story broke nationally, itbecame increasingly clearthatnotall the

This realizationhad serious impli-

cationsfortheintimate partners, wives, and familiesof thetest

thewomen'sstorieshave hardly been thefocusof muchcritical commentary. In the

approximately $10-million setdementthatwas reachedin 1974, each

subject with

received $15,000(246). Parttwoincludesa moredetailedconversationaboutthe

study'simpact on womenand children,including thefactthatno effortsweremade

to findand

promise to providelifelong medicalcareto

Perhaps themost enigmaticpresence in Reverby's textis assistantand lateras a full-time employee of thePHS. The

haze of questions thatsurroundedthis

would"careforthefamiliesand meetneeds"

treatmentas

subjects with syphilis

late-stagesyphilitics were beyondcontagion(97).

during the studyperiod.Despite

experiment'spremise,

preliminary roundshad

persistent in pur-

(43).

Mobüe

was

seropositive testsas the men;

they werealso

andwomen enthusiastically

discourage treatment, ended up offering iron tonics, vitamin packs,aspirin,

elixirs"insteadof

moreeffective pharmaceuticals(55-57).

After

supposedly

subjects,although

living male

other "simple

syphilis received $37,500, whileheirsof deceased

inform nonspousal

sex

partners,although the government did fulfillits

immediate family members (131).

Nurse Rivers, hiredas an author acknowledges the

"privatepublic

(72)

while

health nurse," someonewho simultaneouslydiscouraging

part

of her professional mandate (121). Riverscollectedand transmitted

humanumbilicus connectingtestingagency with sheneverreferredto themenas mere

dataforthe researchers, a kindof

deperson-

alized

The writer attempts to understandthemoraldilemmaof the

nursewhose

sentimentalism,Reverbygrapples withthe question

middle-classracetraitoror a

Rivers's achievementswereremarkable given theracismand sexismthat permeated themedical profession at thetime. Chapter ninehas a strong discussionof Rivers's

background, heramicable relationship withthe men, and her

secure permissions for autopsies; theseformsended up being the

gatheredduring the study(48).

Reverby'sdeployment of

viewthewomanas eitheran "evilmulatto" aligned withwhitedoctorsor a mulatto,"morally lostbecause of her misplacedloyalties. The relevanceof

ticular comparison is questionable becauseRivers'sstatusas a mixed-race person was

this par-

unclear; Reverby herselfmentionshow censusinformationdefinedRiversas black

test subjects.Yet, as Reverbynotes,

"subjects,"preferring themore protective and humanizing term "patients"(52).

"hypervisible black

caringappeared

to havebeen

deadly"(168). Sensitively, butwithout

of whetherRiverswas "eithera Publicly honoredforher service,

powerless nurse" (168).

underlyingquest

to

only writtenconsent

Less compelling in the analysis of theRivers myth is

Linda Williams's Tom/ Anti-Tomdialecticand how we can

"tragic

reviews

303

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304

in 1900, mulattoin 1910, and

or blood quantum, shewas stillconstruedas a

quite

whetherthesameattitude prevailed forElizabeth Kennebrew, hersuccessorand certainly a potential sourceof discussionin otherstudiesof this nursing role (103).

again

blackin 1920 (169). Whateverher complexion

non-threatening,friendlypresence,

differentfromthe perceived attitudesof thewhite physicians. One wonders

ExaminingTuskegee is

richly immersedin the

Zeitgeist of twentieth-century

Migrationcomplicatedattempts

possibility that

personnel.

AfricanAmericanlife (6). It divulges how theGreat

at tracking someof itsnow-mobile subjects,especially becauseof the

themen might receiveantibiotictreatmentswhileunmonitored by PHS

This kindof

Airmen, the jurisprudential milestoneof the

the

populations. The relationship between Nuremburg and Tuskegee,byReverby's own

to how unscrupulous statescan take advantage of theirmorevulnerable

NurembergTrials, and the awakening of

logistical concernis juxtaposed withthe inspiringstory of the Tuskegee

a "historical fog" of

facts, comparisons, and extrap-

Readers might benefitfrommorediscussionon theconnections

up

as

opposites"(66). Reverbyconscientiously

to theNational

public

interpretation, is a slipperyone,

olations

betweenthe Nuremberg Code on researchethicsand theU. S. treatmentof human

subjects, since"Americanresearchand Nazi murderwerenevermentionedin the

same

renders policy decisionslikethe

ResearchAct of

criterionformuchof the

internationaland local observers (69). The textalso

discovery of

frustrated attempts at

evenmore

(192).

breath;indeed,they wereset

KennedyHearings(which led

1974),reiterating how

diagnoses"(69)

the study's "unclear categories and uncertain

createddoubtsaboutits

legitimacy forboth

emphasizes how the postwar

penicillin revolutionized syphilis treatment, making whistleblowers'

confronting thePHS

andtheCenterforDisease Control (CDC)

desperate,ironical, and tragic.

allits

emphasis on uncertainties,Reverby's text emphatically dismisses

physiciansdeliberatelyinjected

dignity of the

and sensationalized allegation thatPHS

study'sproblematic architects, and

scope

of

inquirybydebating thechoiceof some ethiciststo

theNationalInstituteof Healthand

Uganda. The anti-retroviral drugs weremeantto prevent

disparities that

Despite

popular

the

subjects withthedisease (201). She consistently stressesthehuman

survivors, avoidswholesaledemonizationof the

reflects upon "how easily medical uncertainty masksethicalblindness" (119). The

Epilogue

compareTuskegee'slegacy withAZT trials by

theCDC in countrieslike

mother-to-childtransmissionof HIV/ AIDS. She outlinesthebioethicsinvolvedon

a globalscale,explaining how theGlobal Southand theAmericanSoutharenot

interchangeable,especially inviewof thehistoricaldifferencesand

alterthe

reminds us, can affordthesamestructuresof oversight for malpractice and account-

ability as the

book thatunearthedtheGuatemala syphilisexperiments of

U. S.-ledethicalbreachforwhichthefederal governmentformallyapologized in2010.

broadensthe

respectivepopulations' accessto medicalcare.Not everycountry, theauthor

present-day UnitedStates. Indeed, itwas Reverby's researchforthis

suchrecentdiscussionsof

1946-48, a transnational,

race,medicine,history, and

Historyof

Medical

ExaminingTuskegeejoins

bioethicsas Harriet Washington's Medical Apartheid: TheDark

onBlackAmericans

Experimentation

NationalBook CriticsCircleAward.

duly accessible.The readerfindsoccasional

For

ticipant Lucious Pollard, is a

untiltheend of the epilogue. This story is on the

discussionbeforetheauthorlaunchesintovoluminous pages of annotation.In

ways, thereader's journey fromdisorientated ignorance to

symbolic of theethicaldilemmas posed by

writerasksus to journey withherto a tentativeend - a

"GONE BUT NOT FORGOTTEN" - butthereis no realsenseof

no easy rest.

from ColonialTimestothePresent winnerof the2007

,

Reverby's textis strenuously researchedand

inconveniences, but

they remainminor.

photographsection, the gravestone of studypar-

many

eventual recognition is

theentire Tuskegeeexperience. The

mossygravestonereading

completion,

instance, thelast entry in the

bit confusing becausewe do notlearnwho Pollardis

penultimatepage

of themain

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