Many people are familiar with the now infamous 1932 Tuskegee Syphilis Study. For forty years, the state, federal and local government allowed syphilis-infected Black men of Macon County, Alabama to go untreated for their “bad blood” to see the effects of primary, secondary and tertiary syphilis on them. During the time of the so-called study, the discovery of penicillin in 1947, a cure for the treatment of syphilis occurred, but, this treatment was withheld from the infected men. The “research”, conducted by the Macon County Public Health Service (PHS) included the official condonement by Tuskegee for the study, the key physicians (“The Syphilis Men”): Drs. Taliaferro Clark, Oliver Wenger, John Heller and Raymond Vonderlehr; Dr. Robert Moton, President of Tuskegee Institute and Dr. Eugene Dibble, head of the John Andrew Hospital at the Institute; sociologist Charles Johnson who conducted the study to obtain data on the poor Black citizens of Macon County; and Nurse Eunice Rivers.
Nevermind the health of their wives and girlfriends. Never mind the devastation of allowing syphilis to run rampant in the Black community when there was a treatment for it. Just to see human beings as experiments in the eyes of America’s Josef Mengele medical community was enough.
One person often cited in this case is Nurse Eunice Rivers (her maiden name at the time of the study).
The spinal taps on the Black men (insultingly called “back shots”), the lies told to the men that they were being treated, and the signing of documents they were led to believe were burial policies, which were in fact signing away their bodies for medical research when they died from the disease, all point to a long history of medical experiments on Black people since they have been in this nation.
The Tuskegee Syphilis Study is one of the most hateful acts of government brutality against its citizens. When the case broke via the Washington Star in 1972 to the public, 30 of the men had died directly of syphilis, 100 were dead of tertiary complications, 40 of the men’s wives were infected, and 19 of their children were born with congenital syphilis. Lawsuits were filed by the surviving men and their families, and the federal government enacted the National Research Act (July 12, 1974), which along with the Belmont Report (April 18, 1979), was created “to identify the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects and to develop guidelines which should be followed to assure that such research is conducted in accordance with those principles”. The legacy of the Tuskegee Study remains a barbaric episode in America’s long and continued insults against the sanctity and humanity of her Black citizens.
As for Nurse Rivers: villain or defenseless pawn?
You, readers, can decide after reading her story.
Eunice Verdell Rivers ( b. November 12, 1899 – d. August 28, 1986): nurse, public health advocate. Eunice Rivers may have been America’s most controversial and frequently discussed Black public health nurse. In 1958 she was given the U.S. Department of Health, Education and Welfare’s highest honor, the Oveta Culp Hobby Award, for her “notable service covering 25 years during which through selfless devotion and skillful human relations she has sustained the interest and cooperation of the subjects of a venereal disease control program in Macon County, Alabama.”
Fourteen years later, media coverage revealed that the control program was in reality what would be considered the United States’s longest-running unethical medical experiment. Nurse Rivers, as she was called in her community, had been crucial in sustaining the Tuskegee Syphilis Study. It was a forty-year “study” (1931-1972) by the U.S. Public Health Service for late-stage syphilis in 399 Black American men (and 201 others as controls) that kept its subjects ignorant of their disease and their experimental status while working to deny them treatment. When Black Americans express their concerns and fears of treatment at the hands of health care practitioners and scientists, “Tuskegee” becomes the one-word symbol for centuries of abuse. Nurse Rivers’ role in the study would remain a subject of debate among the public, media, artists, and scholars for generations.
Eunice Verdell Rivers was born in Early County, Georgia, the oldest child of three in the family of Albert and Henrietta Rivers. Ms. Rivers’ mother died when she was fifteen, and her father gained a modicum of independence by working a small farm as well as toiling in a sawmill. This kind of independence could be dangerous. A Ku Klux Klan bullet whizzed into their home after Albert Rivers was wrongly accused of aiding in the escape of a Black man wanted for the murder of a White policeman. To save the family, Albert Rivers moved them away and stayed to protect his home.
Eunice Rivers’ father also took a stand for her education. He sent her off to a school under the tutelage of a cousin in Fort Gaines, Georgia, and then to a mission boarding school in Thomasville. When Albert Rivers discovered that the mission school had only White teachers in the upper grades, he pulled his daughter out (one year shy of high school graduation) and sent her on to the Black-run Tuskegee Institute in Alabama in 1918.
Eunice Rivers spent her first year at Tuskegee learning handicrafts, in keeping with the school’s philosophy of vocational education. But Albert Rivers wanted more for his daughter, and he encouraged her to switch to nursing. Graduating in 1922, she did some private nursing and was subsequently hired to travel to Tuskegee Institute’s Moveable School, a truck that carried an agricultural extension and home demonstration agents, a public health nurse, and their equipment into Alabama’s countryside. Nurse Rivers focused primarily on the health needs of Black women and children, teaching basic health education, simple sanitation methods, and childcare. She also demonstrated cleanliness techniques to Alabama’s extensive network of midwives. At the timer, she was one of only four Black public health nurses in the entire state. She also worked for the state’s Bureau of Vital Statistics and devised techniques for midwives to report births accurately.
Nurse Rivers’ great skill was her non-judgemental understanding of the medical beliefs of rural Black Americans and her support of their dignity and individual needs in medical encounters. By 1931, however, the state had to cut its workforce, and Nurse Rivers lost her position. She was then hired as a night supervisor at Tuskegee’s John A. Andrew Hospital.
Eight months and many sleepless nights later, Nurse Rivers was offered a new half-time day position as a scientific assistant to what was referred to in the medical literature as a “study of untreated syphilis in the male Negro”. The racist belief of the time held that syphilis manifested itself differently in Blacks as compared to Whites. The study was done because of the belief of racists in the medical field and in much of American society that Blacks were “a nototriously syphilis-soaked race”. Nurse Rivers’ job for the next forty years was to find men for the study, follow-up on their condition; assist in their examinations, which included painful spinal taps; provide aspirin and tonics; gain agreement from many of their families for autopsies; and modify the primarily White physicians’ behaviours towards their “subjects”. She also helped the men’s families in numerous ways, providing referrals to doctors and food for the hungry.
The Tuskegee Study Group Letter inviting subjects to receive “special treatment”, actually a diagnostic lumbar puncture.
Some of the Tuskegee Study Group clinicians. Dr. Reginald D. James (third to right), a black physician involved with public health work in Macon County, was not directly involved in the study. Nurse Rivers is on the left.
Document from Tuskegee Syphilis Study, requesting that after test subjects die, an autopsy be performed, and the results sent to the National Institutes of Health
Taliaferro Clark (Credited with the origin of the study. Disagreed with the plan to conduct an extended study. He retired the year after the study began.
Oliver Wenger (Director of the regional PHS Venereal Disease Clinic in (Hot Springs, Arkansas.) Advised and assisted the Tuskegee Study when it turned into a long-term, no-treatment observational study.
Raymond A. Vonderlehr (medical doctor)
John Heller (medical doctor)
Eugene Dibble (medical doctor)
When the story of the “study” broke on the Associated Press wire on July 26, 1972, it caused an uproar across the nation. Charges of racism, genocidal medicine, and paternalism gone awry were among the outraged criticisms of the health care system’s notorious willingness to use poor people, especially Black Americans, for experimentation without any kind of consent. Senator Edward M. Kennedy convened hearings in the United States Senate, a federal investigation condemned the study, the institutions and governmental units involved offered varying justifications, and a class-action civil suit filed by the prominent civil rights attorney Fred Gray ended in a $10 million out-of-court settlement for survivors and their families. The outcry was instrumental in the creation of institutional review boards (IRBs) to monitor human subject research. Nurse Rivers, however, was never called before the Senate panel hearings, or named in the lawsuit.
Different interpretations of Nurse Rivers’ role were put forward. The attorney Fred Gray argued that she was as much a victim as were the male subjects. In Miss Evers’ Boys, a widely produced play and television movie that is a fictionalization of the story, the playwright and physician David Feldshuh showed Nurse Rivers torn between her devotion to the men and the Black and White physicians’ assurances that what she was doing was proper. Nursing ethicists have pointed to her lack of power.
Historians found evidence that Nurse Rivers may have helped some of the men to get treatment and leave the study.
Based on the available health care resources, Nurse Rivers believed that the benefits of the study to the men outweighed the risks. She knew the men recieved no treatment for syphilis, but she explained:
Honestly, those people got all kinds of examinations and medical care that they never would have gotten. I’ve taken them over to the hospital and they’d have a GI series on them, the heart, the lung, just everything. It was just impossible for just an ordinary person to get that kind of examination.
She continually asserted that the men recieved good medical care despite the fact that the men received mostly diagnostic, not curative, services. The most basic of medical care done to gauge the development of syphilis in the men, after she had earned their utmost trust. Trust in her while the disease worked it ravages on them in body and mind. Trust in her while the men in their infectious state were infecting the women in their lives. Yet Nurse Rivers maintained:
….they’d get all kinds of extra things, cardiograms, and . . . .some of the things that I had never heard of. This is the thing that really hurt me about the unfair publicity. Those people had been given better care than some of us who could afford it.
After public censure forced the halt of the experiment, Nurse Rivers declared her innocence in the face of criticism, on the grounds that she insisted that she had acted on her own convictions. She emphasized:
I don’t have any regrets. You can’t regret doing what you did when you knew you were doing right. I know from my personal feelings how I felt. I feel I did good in working with the people.
I know I didn’t mislead anyone. (7) (8)
Nurse Rivers remained convinced that she had acted in the best interests of the poor Black men.
Table depicting number of subjects with syphilis and number of controlled non-syphlitic patients, and how many of the subjects have died during the experiments, 1969
The physicians who headed the experiment unanimously agreed that the experiment was worth doing. Dr. Taliaferro Clark was happy when they began work on the study, and he confided to a friend: “I am confident the results of this study, if anywhere near our expectation, will attract worldwide attention.” Dr. Oliver Wenger’s hopes ran even higher. With more foresight than he could have possibly realized, he predicted: “It will either cover us with mud or glory when completed.” (4)
Nurse Rivers died in Tuskegee.
On May 16, 1997, more than a decade later, President Bill Clinton apologized to the last eight survivors and the nation for the federal government’s role in the study.
America never had a chance to hear Nurse Rivers tell the public what she really thought of her involvement in the Tuskegee Syphilis Study.
Thank you letter sent by the U.S. government to test subjects of the Tuskegee Syphilis Study Category:Tuskegee Syphilis Experiment
Memo released in 1972 from the Assistant Secretary of Health, to the Director of the Center for Disease Control, ordering the termination of the Tuskegee Syphilis Study.