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We have medals for you guys and we have to.

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I must tell you, we're gonna have to bring the woman's team. You do know that the video you just heard is our president talking to the men's U.S. hockey team after they had just won gold at the Winter Olympics in Milan. And he invites them to the White House for a little bit of partying and of course jokes. I mean, unfortunately we're gonn to invite the women's hockey team who also won gold. As a matter of fact, the US women's hockey team since 1998, since women's hockey was allowed in the Olympics has meddled every time and the men have not won since 1980. But they sit there in the locker room mocking them. And of course, true to form and as they should have, the women's US Hockey team has said, we're not going to the White House. They declined the invite after the video was published with Cash Patel in the locker room mocking them after their win. After their landslide win. I might point out, run like a girl, you throw like a girl, you're just gonna do this like a girl. It's not a joke. It's only a joke if everyone's laughing. Otherwise it's just bullying. I think a lot of us can learn a lot from the women's hockey team that we shouldn't be tolerating disrespect. It's never just a joke. It's about mocking women and making sure those women, even though they're better athletes, know their place, make sure they stay small. And to the ladies that are listening, I would say don't allow a to joke at your expense like this. It's mocking, it's degrading and it is meant to be bullying. It is meant to make you feel small. Eight of the 12 medals won by the United States in Milan were won by women. And they deserve respect and they deserve celebration for those achievements. And ladies, I don't care what man it is in your life if someone is making jokes at your expense, I encourage you to learn from the women's U.S. hockey team and say no and say, I'm not going to engage with you. I'm not going to be in your presence. And ladies, that also means that with our leadership, you stay informed, whether that person is a celebrity or a political leader. Staying informed as to how does this person actually believe about me? Will this person advocate for me? You as a woman have everything you need in your arsenal to make informed decisions to better your life, to follow your dreams. And you can start by using Ground News. And Ground News is a great way for you to check the news every single day, both globally and in the United States and make sure that you are well informed of who is running in your district, what's going on on a national level and be able to make decisions to better your life. Because ladies, you are not a joke. We never were. It was about humiliation and degradation. And if you want to take another step to be able to stay informed, make the best decisions you can and ignore men who would mock and ridicule you like this, you can get 40% off Ground News's Vantage plan, which comes to about $5 a month by subscribing@ground news.com tables to stay informed, start making better choices and do not tolerate anyone who disrespects you.

B (15:38)

Eczema is unpredictable, but you can flare less with epglis, a once monthly treatment for moderate to severe eczema after an initial four month or longer dosing phase. About four in ten people taking EBGLIS achieved itch relief and clear or almost clear skin at 16 weeks, and most of those people maintain skin that's still more clear at one year with monthly dosing.

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MGLIS Lebricizumab LBKZ a 250mg 2ml injection is a prescription medicine used to treat adults and children 12 years of age and older who weigh at least 88 pounds or 40 kilograms with moderate to severe eczema, also called atopic dermatitis, that is not well controlled with prescription therapies used on the skin or topicals or who cannot use topical therapies. EBGLIS can be used with or without topical corticosteroids. Don't use if you're allergic to ebglis. Allergic reactions can occur that can be severe. Eye problems can occur. Tell your doctor if you have new or worsening eye problems. You should not receive a live vaccine when treated with Eglis before starting ebglis, tell your doctor if you have a parasitic infection.

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Ask your doctor about eglis and visit ebglis.lilly.com or call 1-800-LilyRx are 1-800-545-5979 this

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I know that's earlier in the episode than ads typically are, but because we have three today, I wanted to get those done earlier so that you can sit back and relax. Throughout the 18th and 19th centuries, Black people were repeatedly used for medical testing because of captivity, coercion, and it was further justified by racial ideology and incentivized by institutional need. Keep in mind that in an environment of slave hospitals, plantations, alms houses and jails, consent is structurally impossible. When you have no autonomy and you are owned like cattle, you cannot consent. They were nothing more than clinical material in those settings and did not have the right of refusal. The issue with this era is that combined with the subjugation of black people, they were also often illiterate. And so the detailed written evidence we do have comes from the physicians, enslavers and medical schools that were abusing them rather than the victims of that abuse. One of the clearest early examples of forced medical testing comes from Boston smallpox epidemic in 1721-1722. The practice of variolation, which is inoculation with smallpox with smallpox material to produce a controlled infection, which is vaccines, would later become controversial. While they tested, they tested the inoculations on slave populations as proof of concept before being willing to use it on white New Englanders. The idea, of course, was not invented in New England and in fact had been used in parts of West Africa and elsewhere for a very long time. An enslaved African man named Onesimus described this method method to Cotton Mather, who then took credit for the idea during the outbreak because of course he did. During the outbreak in Boston, the test phase was started by Zabdiel Boylston. That's there's a name for you for anyone having a kid. Soon Zabdiel, who inoculated his own son and two enslaved people before expanding the treatment. The documented mortality comparison for that outbreak, far lower death rates among the inoculated versus naturally infected Bostonians helped normalize inoculation in the colonies and would contribute to the later acceptance of vaccination that unfortunately, unfortunately is now under attack because people believe YouTubers more than they believe doctors. I digress. Jefferson also participated in vaccine oriented abuse of enslaved people. After Edward Jenner's cowpox based vaccine spread, it was the American elites who helped test and circulate it. Jefferson kept detailed notes on his enslaved people that he would select as trial subjects. At Monticello we have records of slaves named Ursula Burwell Colbert and Joseph Fawcett. Of course, Jefferson also raped and impregnated his slaves. He would keep lists documenting vaccinations of enslaved people in later years. In the British Caribbean colonies, plantation hospitals functioned as controlled environments where physicians could observe disease progression and try treatments on enslaved laborers. John Choir in Jamaica freely experimented with smallpox inoculation among a large enslaved population during an epidemic period. These plantation experiments also intersected with European debates about whether results from enslaved women could be generalized to elite white women. Again, an explicitly racialized and classed framing of what valid subjects for the treatment of white women could be. The idea being that if white women were biologically different and superior, could the test results carry over? It's so so stupid anyways. No 19th century story more starkly shows the surgical experimentation enabled by slavery than than the development of the vesicovaginal fistula repair techniques by J. Marion Sims, who was an American physician often called the father of modern gynecology. He developed surgical techniques for treating vesicovaginal fistula, a severe childbirth injury that creates an abnormal connection between the bladder and vagina, causing chronic incontinence. Sims refined surgical tools and procedures in the 1840s while practicing in Montgomery, Alabama, and he would later found the Women's Hospital in the state of New York, which was one of the first hospitals dedicated to white women's health. Sims performed repeated operations on enslaved women, including those remembered as Anarcha, Betsy and lucy during the 1840s he was in Alabama. Procedures that were aimed at perfecting techniques that would later benefit many patients, especially white women with access to surgical care. And just to and just to Even now contrast how gynecology is has still has such great racial disparity. Even in America today, black women are about three times more likely to die from pregnancy related causes than white women. In 2023, pregnancy related mortality was 49.4 deaths per 1,000 births. For Black women. It was 14.9 deaths for white women. Black women ages 30 to 34 experience over four times the maternal mortality rate of white women in the same age group. And even after adjusting for income, insurance and hospital type, black women have a 53% higher risk of dying in hospital childbirth. But Sims own accounts notes that Anarcha, one of his test subjects, was operated on at least 30 times over several years without the use of anesthesia, even though it was readily available. Historical scholar Deidre Cooper owens explains how 19th century gynecology advanced through a racialized logic that treated enslaved women as exceptionally suited to pain exposure and repeated invasive procedures while denying them autonomy. 30 times like being operated in that area. Same area over and over 30 times, no anesthesia. Another central practical problem in the 18th and 19th century medical education was cadaver supply. Dissection was essential to training, but it was widely taboo and legal access to bodies was limited. So medical schools would fill the gap by body snatching and exploitation of unclaimed dead, disproportionately targeting poor and in many regions, black burial grounds and black communities. This is also so if you listen to my podcast highway to Hell, this is how H.H. holmes got his start. H.H. holmes, who's one of the probably the most prolific American serial killer, started by being a grave robber and he would sell cadavers to medical schools in addition to his insurance fraud schemes that he would do before he built his kind of little palace in Chicago in the World's Fair and started disappearing young women in New York City. Proximity between medical institutions and marginalized burial sites created a pipeline for what they called resurrectionists, which were body snatchers. Accounts of the 1788 Doctors Riot described how grave robbing and dissection, especially from quote, Negroes burying grounds and pauper cemeteries, sparked mass protests. Modern scholarship on medical racism in the US notes that American medical education relied on theft, dissection and display of bodies, many of whom were black, and that schools in some southern states advertised the availability of black anatomical material. Stealing black bodies was less likely to have consequences or upset. So that's what they did. One of the most recorded individual studies is Grandison Harris, an enslaved man purchased in 1852 and used to procure cadavers for the Medical College of Georgia by robbing graves, especially again in a cemetery serving the poor and the black residents, supplying anatomical dissection material for students. There's a recording of this account in the Smithsonian detailing how bodies were reserved, preserved in vats of whiskey, and how thousands of bones and fragments were later found beneath the old Medical college. Virginia Medical College also employed black resurrectionist Chris Baker, who stole freshly buried black bodies for dissection in the 1880s, all the way until the early 1900s across immunology, gynecology, anatomy and colonial disease. Research. The mechanism was consistent. They used captivity and dependency, like slavery, carceral institutions, and poverty, to restrict refusal. The institutional incentive. Medical schools needed cadavers. Ambitious surgeons needed cases. Colonial physicians wanted publishable results all for themselves, of course. Racialized medical tests, beliefs that black people felt less pain, were biologically different or were suitable for clinical material justified harsher interventions and the reuse of bodies and the asymmetry and documentation. Again, the written record often preserves the physician's voice rather than the subject, which can flatten lived experience and diminish abuse. And this didn't end with slavery or after the end of Jim Crow. And it didn't even end with the civil rights movement and the passage of the Civil Rights act in 1964. During the 1960s and 70s, thousands of native American women were sterilized through programs run by the Indian health service, the IHS, which was a federal agency within the U.S. department of Health and Human Services responsible for providing medical care to federally recognized tribes. Many of these sterilizations occurred without proper informed consent, through coercion, misinformation, or consent forms signed under pressure during active childbirth or other medical procedures. A 1976 investigation by the US Government Accountability Office examined sterilizations performed at four Indian Health Services facilities between 1973 and 1976. The investigation found that in those three years alone, 3,406 sterilizations were performed on Native American women. And because the audit examined only a few hospitals, scholars, of course believe that true number is significantly higher. Research by Jane Lawrence, published in the Journal of American Indian Quarterly in 2000, estimated that 25 to 42% of Native American women of childbearing age were sterilized during the 1970s. Some tribal communities experienced even higher rates. These procedures included tubal litigations and complete hysterectomies, sometimes performed immediately after childbirth when women were still under anesthesia or under emotional distress. Investigations and testimonies revealed several unethical practices. Women were not told that the procedure was permanent. Consent forms were often signed while patients were medicated or in labor. Some women were threatened with the loss of welfare benefits or medical services if they refused to be sterilized. Language barriers prevented some women from fully understanding the consent form, and in some cases, women believed they were receiving reversible birth control. These practices were consistent with the broader 20th century Eugenics movement in the United States, which promoted sterilizations of populations, populations that were considered undesirable, including indigenous people, black Americans, people with disabilities, poor women, and lesbians, Native activists and organizations such as the American Indian Movement. Aim. Aim began raising alarms about these sterilizations in the 1970s. The issue gained national attention after legal advocacy groups and journalists documented widespread abuse in federal medical facilities. In response, the U.S. department of Health, Education and Welfare introduced new federal sterilization regulations in 1978, requiring informed consent procedures, a mandatory waiting period of typically 30 days, clear explanations of the procedure's permanence, consent forms available at, the patient's language. These reforms were intended to prevent coercive sterilization in federally funded health programs. And unfortunately, again, it's one of those things that you think, well, that should have been a prerequisite, that should have been there anyway. But this is a greater reflection of the eugenics movement in the US because if you're a white woman and you've been following the rollback of women's rights in the US you've heard and unfortunately happened recently in Tennessee where a woman who was already checked into the hospital, she had her IV and she was getting ready for a sterilization surgery. The ethics committee of the hospital came in and told her she can't have the surgery because it was their duty to protect her sacred fertility. And we see throughout. The founder of Christian marriage counseling, Paul Popeno, who was a eugenicist, coached pastors to teach women, white women that they shouldn't be on birth control. It was widely protested that a white woman could ask for a sterilization surgery. You weren't able to get those without your husband's consent. And even now as a white woman, especially if you're on the younger side, under 35, it's very difficult to get these sterilization procedures because of the way that eugenics shaped America and shaped how gynecology takes care of women and shaped who's promoted to increase the birth rate, who's promoted to not increase their birth rate. Because while Native American women and black women were being forcefully sterilized, white women didn't have access to sterilization surgeries, oftentimes unless given express consent or for a life saving intervention. And even now we see greater restriction on access to sterilization. And we still have not corrected these disparities. But it's really a reflection of that. When especially the current environment talks about the birth rate, they don't mean the birth rate overall, they mean the birth rate among white women. The sterilization of Native American women had profound consequences. Of course, many women discovered years later that they could never have children in small tribal communities. The loss of reproductive ability had demographic, cultural and emotional impacts. Of course, it did affecting family structures and tribal population growth. And that was the goal of this. The goal was to crush tribal population growth. Today, the episode is widely cited as a major example of reproductive injustice in the US medical history, along with other abuses such as again, forced sterilization in state eugenics programs and unethical medical experiments involving marginalized populations. So before we get into talking about what syphilis is and the Tuskegee study, we're going to take our second of two mid show sponsored breaks again. If you would like these ad free, you can subscribe@patreon.com montymater so let's two

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Oh, sorry. Namaste. Visit 1-800contacts.com today to save on your first order, 1-800-contacts. Talk about syphilis. So if you're maybe a little rusty on your medical education, can't remember sex ed from high school? I never had sex ed. Actually, in my school it was considered uncouth and sinful. To teach kids about sex, you're just gonna make them want to do it. News flash people. Kids are going to want to do it whether you teach them or not, right? That's part of like puberty and becoming an adult. So maybe teach them how to do it safely and teach them how to not get an sti. Sti? Or unwanted pregnancy. Maybe that's the way to do it. Syphilis is caused by the bacterium Treponema pallidum, a sexually transmitted infection that progresses through multiple stages and eventually destroys the brain, heart and nervous system if it's left untreated. Before the discovery of antibiotics in the 20th century, penicillin in particular, the disease often resulted in decades of suffering and premature death. Understanding syphilis requires looking at three major aspects, which is when the disease first appeared in historical record. We're going to talk a little bit about famous individuals along the way who've died from it, and especially the biological process by which it progresses. So. The first widely documented syphilis outbreak in Europe occurred in 1494-1495. During the Italian War of 1494, the disease spread rapidly among soldiers in the army of Charles VIII of France, who had invaded Italy in a campaign to claim the throne of Naples. When the French army captured Naples, thousands of mercenaries and soldiers from across Europe were present in the city. Contemporary accounts describe a horrifying new illness spreading through the troops. Patients developed genital sores, severe skin eruptions, rotting flesh, disfiguring lesions. Many died in extreme pain. Because the disease appeared suddenly and spread rapidly, Europeans initially believed it was a new plague, which is reasonable considering their history. But the infection quickly spread across the continent as soldiers returned home after the campaign. And this was during a time where brothels were kind of widely accepted, but also there was a lot of action, you know, between soldiers that happened as well. So infections like this, without any kind of medical knowledge, would spread extremely quickly. Different nations blamed each other for the disease, which was. It's kind of hilarious to me to read these. It's. It's definitely very. It's definitely very xenophobic, where they're attacking another country because they don't like them. But in Italy and Germany, it was called the French. French disease. In France, it was. It was called the Italian disease. In the Netherlands, it was called the Spanish disease. And in Russia, it was called the Polish disease. The term syphilis was first used in 1530 by Italian physician and poet Girolamo Fracorstoro. Fracastoro. I'm gonna try that name again. Girolamo for Costero. There it is in a Latin poem that he titles Syphilis sive morbus gallicus or syphilis, or the French disease. In the poem, a shepherd that is named syphilis is punished by the gods with a terrible disease. Disease. And gave the illness its modern name. In early outbreaks, doctors had no idea, of course, how to treat it. One of the earliest treatments involved mercury, which the physicians believed could purge the disease from the body. Patients were subjected. Subjected to mercury ointments, steam baths, or oral compounds. And I don't know if you remember this, but mercury is extremely toxic. Patients would develop severe side effects, including losing their teeth, kidney failure, neurological damage, and death from mercury poisoning. Like the that because mercury therapy caused intense sweating and salivation, doctors developed a saying that said, a night with Venus, a lifetime with mercury. In the early 20th century, a more effective treatment appeared when German scientist Paul Ehrlich developed Salan in 1909. Salan was an arsenic based compound that could kill the bacteria responsible for syphilis. However, again, the treatment was complicated, toxic and required repeated injections. But the true breakthrough occurred in the 1940s when penicillin was discovered to be safe and highly effective cure for the disease. Remember 1940s, because that's very important for our timeline for the study. The disease of course, doesn't care who you are and some famous people who contracted the disease and died from it. Chicago gangster Al Capone contracted syphilicity young. As a young man, he never sought treatment. The effect, infection eventually progressed to neurosyphilis, damaging his brain. By the late 1930s, Capone exhibited severe cognitive decline, memory loss and confusion. At the end of his life, he was reported to have the mental capacity of a child. Frederick Nietzsche, the German philosopher, experienced a sudden mental collapse in 1889. Some historians believe that it was late stage. Syphilis caused and caused his neurological deterioration. Though of course other theories exist. We can't prove this, but after the collapse, Nietzsche spent the final decade of his life in a state of severe cognitive impairment. Guy de Maupassant, the French writer, contracted syphilis in his 20s. Over time, the disease affected his nervous system, producing hallucinations, paranoia and severe depression. He died in 1893 after prolonged medical decline. Henri de Toulouse Lautrec was a famous French painter who lived a life marked by heavy drinking and brothels in Paris. Very common. Some historians believe he suffered from syphilis. He's another one we're not sure, but may have contributed to his neurological complications before his death at 36. It's also been long speculated that Oscar Wilde, the Irish writer, may have died from syphilis, though historians again remain divided on the evidence of his death. Again, syphilis is caused by the spiral shaped bacterium Treptonema pallidum. The organism spreads primarily through sexual contact, but can also pass from mother to child during pregnancy. Stage one, or primary syphilis typically appears 10 to 90 days after exposure. The hallmark symptom is a chancre, a painless sore that develops at the site where the bacteria entered the body. The sore often appears in the genital area, the anus, or the mouth. Because the chancre is usually painless and may heal on its own, many people never realize they've been infected. During this stage, the bacteria is already spreading through the bloodstream. Stage two, or secondary syphilis, starts several weeks to months later. The untreated infection is entering the second stage that causes skin rashes across the body, lesions on the palms of the hands and the soles of the feet, fever, swollen lymph nodes, hair loss, fatigues and muscle aches. The rash is one of the most common distinct features of secondary syphilis and often appears as reddish or brown spots across the body. During this stage, the disease is highly contagious. In the latent stage, after secondary symptoms fade, the infection enters a latent phase which no visible symptoms occur. This stage is the most dangerous in a way because it can last for years or even decades. Someone can think, oh, I just had a weird rash. If they're not regularly getting tested, this is my my unpaid PSA to please go get tested every single year. No matter what, just do it. Keep yourself another safe Even though the person appears to be healthy, the bacteria remain in the body and continue damaging internal organs. Tertiary syphilis, which if Left untreated, approximately 30 to 40% of infected individuals eventually develop what's called tertiary syphilis. This Stage can occur 10 to 30 years after initial infection and involves severe organ damage. Three major forms of tertiary syphilis occur. One is cardiovascular syphilis. The bacteria attack the heart and blood vessels, especially the aorta. This can lead to aneurysms, heart failure and sudden death. Gomatus syphilis, which is soft tumor like growths called gummas, develop in the organs such as the liver, bones or skin. These lesions can destroy tissue and cause severe disfigurement and neurosyphilis, which is the infection, invades the nervous system. In the brain, this form is often the most devastating. In the final stage, which is neurosyphilis, can produce a wide range of neurological symptoms including dementia, personality changes, hallucinations, loss of coordinations, paralysis, blindness and then death. One classic form is called general paresis, in which patients develop progressive cognitive decline and severe psychiatric symptoms. Another form of neurosyphilis, called tabis dorsalis, damages the spinal cord and causes intense pain, difficulty walking and loss of sensation. At this stage, the disease often leads to death. But there's also congenital syphilis. So when a pregnant person has untreated syphilis, the infection can pass to the developing fetus. Congenital syphilis can cause miscarriage or stillbirth, severe birth defects, bone deformities, blindness, neurological damage and in the early 20th century, congenital syphilis was a major cause of infant mortality. Today, of course, syphilis is easily treated with antibiotics, particularly penicillin. When detected early, the infection can be cured with a single injection, and that is what makes the Tuskegee study so deeply harmful and offensive. And before I dive into the study so we can really just sit and listen to the whole story in its entirety. This is our third of three our final ad sponsor Break again if you want these ad free patreon.com montemater this

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The Tuskegee Syphilis study stands as one of the most disturbing episodes in the history of American medicine. Again conducted between 1932 and 1972 by the U.S. public Health Service, the experiment involved hundreds of black men in rural Alabama who were intentionally denied treatment for syphilis so researchers could observe the disease's natural progression. The men were deceived about their diagnosis, manipulated into remaining in the study, and prevented from receiving medical treatment. The study took place in Macon County, Alabama, which is a rural agricultural region in the Deep south whose economic and social landscape was shaped by the legacy of slavery and post Civil War sharecropping. By the early 20th century, Macon county had a predominantly black population, many of whom worked as tenant farmers, cultivating cotton on land they did not own. Poverty was widespread, educational opportunities were limited, and access to health care was extremely scarce. The town of Tuskegee itself held a special place in African American history. It was home to the Tuskegee institute, founded in 1881 by the educator Booker T. Washington, the institute became one of the most influential black educational institutions in the United States, training teachers, farmers and skilled workers during a period when opportunities for African Americans were severely restricted. Despite the presence of the Tuskegee Institute surrounding countryside remained medically underserved. Many residents had never visited a doctor or received a formal medical treatment. Infectious diseases, malnutrition and untreated chronic illnesses were common in the early 20th century. One disease in particular attracted the attention of public health officials, which was syphilis. And again before the discovery of antibiotics. Syphilis was one of the most feared diseases in the United States states. The infection, of course, progressed like we talked about through multiple stages, and initial symptoms included rashes or sores. If left untreated, it could lie dormant before attacking the nervous system, heart and brain. By the late 19th and early 20th centuries, doctors recognizing devastating consequences of late stage syphilis, blindness, paralysis, dementia and death. Yet effective treatment options were limited. Again, we used early. Early treatments were mercury and toxic arsenic that really were difficult for patients to take. Public health surveys conducted in the American south during the 1920s revealed alarmingly high infection rates in Macon County. Studies suggested that as many as one third of the adult residents had syphilis or had been exposed to it. The prevalence of disease in rural black communities attracted the interest of federal health officials who believed it presented an opportunity for research. In 1932, the U.S. public Health Service launched what was officially titled the quote, Study of Untreated Syphilis in the Negro Male, end quote. The project was designed by a group of physicians within the federal government's Venereal Disease Division. Several key figures were involved in the creation of the study, such as Talia Farrow Clark, a senior Public Health Service physician who helped initiate the project Raymond A. Vonderhleer, who later directed the research John R. Heller, who became the chief of public health services, Venereal Disease Branch and Eunice Rivers, a nurse who served as the primary contact between researchers and participants. Participants. Initially, the study was supposed to last only a few months. Researchers hoped to document the progression of untreated syphilis before providing therapy to participants. However, the onset of the Great Depression dramatically reduced funding for public health programs. And instead of canceling the project, which would have been the ethical thing to do, federal officials made a decision that would transform the experiment into an ethical catastrophe. They would continue observing the men indefinitely and perform autopsies after their death to study the disease's full progression. To carry out the study, researchers recruited 600 Black men from Macon County. Of these participants, 399 were already infected with syphilis. 201 served as a control group without the disease. Again, these men were mostly poor sharecroppers who had very little Formal education, and extremely limited access to health care. Many were illiterate. Researchers exploited these vulnerabilities when presenting the study. The participants were never told they had syphilis. Instead, doctors told them that they were being treated for bad blood. And again, this was a common phrase used to describe a very a variety of ailments, including anemia, fatigue, or an sti. By using this vague term, the researchers avoided disclosing the true nature of the disease. And to encourage participation, the government offered incentives that were significant for men living in poverty during the Great Depression. Free medical examinations, free meals on clinic days, transportation to health facilities, and burial insurance that would pay their funeral expenses. For families struggling to survive economically, these benefits made participation really appealing. There was also Eunice Rivers. Eunice Rivers played one of the most complex and kind of debated controversial roles in the study. Again, this was black men who were intentionally left untreated. She was born in 1899 in rural Alabama during the height of the Jim Crow era, when segregation shaped every aspect of social and economic life in the American South. Opportunities for black women in professional fields were extremely limited, and nursing was one of the few medical careers open to them. She trained as a nurse at the Tuskegee Institute, one of the most prominently historical black educational institutions in the United states. Founded in 1881 by Booker T. Washington, the Tuskegee Institute had become the center for black education and professional training in the South. The school's nursing program aimed to address the severe shortage of medical care available to black communities in rural Alabama. After completing her training, Rivers began working as a public health nurse in Macon county, Alabama, a region plagued by poverty and limited access to health services services. Many of the people she served were sharecroppers, again who had little or no contact with formal medical systems. And in this environment, nurses played a crucial role in connecting patients with doctors and clinics. When the study was launched in 1932, Rivers was recruited to assist the federal physicians overseeing the research. Her job was to act as the intermediary between the government doctors and the local black population. The men again enrolled in the study were almost entirely poor rural laborers that didn't have a lot of formal education and they distrusted, reasonably so, outside institutions. Because the physicians conducting the research were white federal officials, it was believed that a black nurse from the local community would be essential for building trust. She became the primary contact for participants. She visited their homes, scheduled appointments, distributed medications, and helped transport them to clinics for examination. She also maintained long term relationships with the men and their families, sometimes attending community events and funerals her presence is a key reason that the study continued for four decades. Many of the men trusted her deeply and believed that she was advocating for their well being. Throughout the 40 years of the experiment, Rivers played again this central role in keeping participants engaged in the programs. She was the one who reminded them of their appointments, ensured they received meals and travel reimbursements, and reassured them the doctors were helping them them. The men were told they were receiving treatment for bad blood. They were never informed they had syphilis. And when penicillin became readily available, they were not given it and not treated. And again, as the study progressed, the men often relied on Rivers not only as a nurse, but as a trusted community figure and a friend. Her involvement reinforced the belief that the program was legitimate and beneficial. And we don't know to the extent what Rivers knew. If she knew they were being denied care, it's possible she did. That is the part that makes it the ethical implications controversial. But it becomes more significant after penicillin was discovered to be an effective Cure. In the 1940s, public health campaigns across the US began treating thousands of patients with syphilis. The men in Tuskegee study were intentionally denied the antibiotic so researchers could continue to observe the disease's progression. And Rivers remains involved in the program after this period. So she knew they were being denied care. She knew that these men were being set up to die, and she remained anyway. She maintained these relationships and kept the study functioning after an effective cure existed. Many survivors of the study later described Rivers as compassionate who appeared genuinely concerned for their well being. She visited their homes, provided basic medical care and sometimes helped them navigate other health services. She represented a familiar and trustworthy face inside a government program that otherwise would have seemed distant, impersonal, that they wouldn't have trusted. This dual role, a caregiver and a facilitator of an unethical experiment, has complicated how historians interpret her actions. And I'm inclined to believe that she did know that they weren't being treated. I find it hard to rationalize being her being such an integral part of the study and not knowing that that treatment was not being given. But again, scholars have debated to the extent with which Rivers understood the full ethical implications of the studies. Some argue that she was deeply involved in maintaining the deception that allowed the experiment to continue. By reassuring participants, encouraging continued participation, she helped sustain a system that denied them life saving treatment. Others suggest that her position as a black nurse in a segregated south limited her ability to challenge the federal physicians who controlled the project, which I would also agree with, and within the rigid racial and professional hierarchies of the time, her authority to question the study may have been minimal. There's also evidence that Rivers believed the men were receiving valuable medical attention that would otherwise have been unavailable to them. And in an era where many rural black communities had almost no access to doctors, the regular examinations and services provided by the study may have appeared beneficial. Rivers is the only member of the study staff who remained involved for its entire 40 year duration, and her name quickly became associated with the scandal. After the study ended, she largely withdrew from the public. And unlike many of the federal officials who designed and directed the project, she was a local nurse who had worked closely with the participants and their families for decades. She died in 1986, more than a decade before the US government would formally apologize to the victims of the study. During the study, participants were subjected to numerous examinations and procedures over the course of the experiment, some necessary, some not. Doctors performed blood tests, physical examinations, and spinal taps to measure the progression of the disease. The spinal tap procedure, which involved inserting a needle into the spine to collect cerebral spinal fluid, is, and was particularly painful. Like, oh, my goodness, I can't. Oof. It makes my stomach hurt to think about a needle that size going into my spine. Fine. But again, researchers. Researchers describe the procedure to participants as a, quote, special free treatment. So they're telling them, I have to, this is a free treatment I'm going to give you in your back when what they're really doing is collecting spinal fluid. In the. In the reality, the spinal taps were not to treat anything. They were purely diagnostic and had no therapeutic benefit for the patient. This deception extended to other parts of the study. Participants were given medications that had little to no effect on syphilis, allowing doctors to maintain the illusion that they were giving treatment, treatment, but they were not treating what the men actually had. So there was, There was levels of deception to this because, again, this. The study starts in 1932. During World War II, penicillin becomes widely recognized as a highly effective treatment. This study lasts until 1972, and none of those men were ever given that treatment. So researchers actively prevented participants from receiving penicillin by informing local doctors not to treat these men, removing them from treatment lists, and intervening when participants sought medical care elsewhere. Even when some of the men were drafted into the military during World War II, where syphilis testing and treatment were routine, researchers intervened to make sure they didn't get therapy. The decision to deny penicillin allowed the study to continue documenting the natural course of the disease. But it also, of course, guaranteed that many participants would suffer severe complications and die over the course of 40 years. Obviously, medical records showed us later that 28 participants died directly from syphilis. More than 100 died from related complications. 40 wives unknowingly contracted the disease, which led to 19 children being born with congenital syphilis. Beyond these numbers, of course, were the lived experiences of the participants themselves. Many endured years of debilitating symptoms, including chronic pain, neurological damage, blindness, mental deterioration. Their families, of course, were deeply affected. Wives unknowingly contracting the disease, and children being born with severe medical complications. One of the men enrolled in the study was Herman Shaw, a resident of Macon county who joined the program in the early years of the experiment. Shaw believed he was receiving legitimate medical care from government doctors. Like many participants, he regularly traveled to clinics for examinations and procedures, trusting that the medical staff were helping him. Decades later, Shaw discovered the truth. The doctors had known he had syphilis all along and had intentionally denied him treatment. Despite the betrayal, Shaw later became known for his remarkable composure. When he attended the White House ceremony where the government apologized in 1997, he expressed hope that such abuses would never happen again. Another participant, Charlie Pollard, spent years believing the government doctors were treating his illness. Pollard was a farmer who had joined the study expecting medical care. When the scandal became public in 1972, he learned that the treatments he had received were ineffective and that doctors had allowed his disease to progress for decades. Aids. Pollard would become one of the plaintiffs in a class action lawsuit against the federal government after the study was exposed. So I do want to say that not everyone in the medical community supported this study. Those who knew about it anyways. Over the years, several doctors had expressed concern about its ethics. In 1965, a young physician named Irwin Schatz read about the experiment in a medical journal and wrote a letter condemning it as unethical, and his objections were dismissed. For years, the study continued, largely unquestioned, within the Public Health Service. The turning point. Sorry. For years it had. So up until this point, it's really not been questioned overall, and it's being. It's a formally run government study. But the turning point came in 1966 when a public Health Service investigator named Peter Buxton learned about the Tuskegee study. Buxton was shocked by what he discovered. A federal program deliberately allowing hundreds of men to suffer untreated syphilis. Syphilis. Despite the availability of a cure. And like a relatively easy cure, he filed formal complaints with his superiors, arguing that the Experiment violated basic human rights. They ignored his warnings. Frustrated by the lack of response, Buxton eventually decided to leak the story to journalists. In July of 1972, reporter Gene Heller of the Associated Press published an article revealing the details of the Tuskegee study. The story sparked immediate national outrage, as it should. Americans across the country were stunned. The federal government had conducted such an experiment for 40 years. Like that's longer than I've been alive. Within months the study was officially terminated. In 1973, civil rights attorney Fred Gray filed a class action lawsuit on behalf of the victims and their families. The case resulted in a settlement. In 1974. The federal government agreed to pay $10 million in compensation and provide lifetime medical benefits for surviving participants and their families. Now this scandal had a profound impact on the regulation of medical research. I mean things again that should have been such no brainers to begin with with. But in 1974 Congress passed what was called the National Research act, which established new safeguards for research involving human subjects. The law created institutional review boards to evaluate ethical standards of medical studies and ensure participants provided informed consent. In 1979, the Belmont Report further established the principles of ethical research which we mentioned earlier were respect for persons, beneficence and justice. And on May 6th of 1997, Bill Clinton invited the surviving participants to the White House. Only eight men were still alive. Out of those 600 men, only eight were still alive by the time the government apologizes. Standing before them, Clinton issued a formal apology on behalf of the United States government. He acknowledged the injustice and suffering caused by the study and declared that what had happened was morally wrong. This was the first marked official recognition of the study and of of the government's role in it. Obviously this remains one of the most profound ethical failures in the history of modern medicine. And unfortunately, in a lot of ways we haven't changed. There's still disparity in how people get treated, whether it's due to class or race. And we don't have a government that is interested in getting equitable affordable medical care treatment to the US from 1932 to 1972, hundreds of black men in Macon County, Alabama again were deceived and denied treatment for syphilis. By working with the U.S. public Health Service. They told they were receiving care for bad blood, when in reality they were being observed as part of a long term experiment designed to study the natural progression of untreated disease. Even if that progression led to death. Four decades of blindness, neurological damage, cardiovascular complications, premature death, and some unknowingly given the disease to their wives and their children. Even after penicillin was discovered, researchers deliberately intervened to prevent the men from receiving that treatment. TREATMENT thankfully, due to whistleblower Peter Buxton in the 1970s and the published work by journalist Jane Heller of the Associated Press, the national outrage was finally able to close the investigation. And there was financial compensation. Thanks to the lawsuit filed by attorney Fred Gray. The study started in 1932. It wouldn't be until 1997 that Bill Clinton would formally apologize on behalf of the United States. This dramatically transformed ethical standards in medical research, unfortunately, a long racially based divide in the United States. The US Government implemented sweeping reforms such as the National Research act of 1974, the creation of institutional review boards requiring of informed consent. Participants have to be fully aware of risks, benefits and purposes of any study before they participate, and further ethical guidance came through the Belmont Report in 1979. These are now standard backbone of medical ethics and are applied to research institutions across the world. But beyond regulatory reform, there's a lot of lasting impact from a study like this, from history like this. The Tuskegee Study left, of course, a lasting psychological and social impact in the African American communities. The revelation that a federal government had knowingly allowed black men to suffer untreated disease contributed to a deep mistrust of medical institutions, again reasonably significant. So researchers and sociologists have documented that the study became a symbol of systemic racism in healthcare. For many people, it reinforced they their already predetermined fear that medical systems might exploit or neglect them. This mistrust continues to influence public health efforts today, particularly within black men, who are far less likely to follow a treatment course or far less likely to see a doctor unless that doctor is black. During vaccination campaigns, clinical trials and other medical initiatives, public health officials often acknowledge the legacy of Tuskegee when addressing concerns about safety and transparency. This has become a central case study in medical schools, public health programs and ethics training. It is frequently used to teach future doctors and researchers about the importance of patient autonomy, honesty and accountability. It also serves as a warning about how social prejudice and scientific ambition can combine to produce harmful outcomes when ethical safeguards are absent. Today, regulations governing medical research are designed specifically to prevent abuses like those seen in Tuskegee institutional review boards informed consent that hopefully encourage patient right protections, no matter who they are, what they look like or where they come from. The men in the study obviously suffered enormously, and their story helped reshape the ethical foundation of modern medicine, the medicine that was founded in racial pseudoscience that used Black bodies for experimentation over and over and over, denied any acknowledgement of their pain, and often even misused their bodies after death. Death, their ex, their experiences exposed systemic failures and forced the United States to confront uncomfortable truths about racism, power and responsibilities of medicine and scientific research. The Tuskegee Syphilis study, therefore, has a dual kind of role in history. It's both a tragedy and a turning point, one that I hope continues to level the playing field, especially since we see such great disparities between the treatment of black versus white and the United States still in the year 2026. It reminds the world that scientific progress must never come at the cost of human dignity and that protecting the rights of patients must always remain at the center of medical practice. And this is one of those particular times where history is so frustrating and it's so angering and it's so aggravating. It's one of the moments for me that I didn't learn about the syphilis study until I was in my 20s. I didn't learn that something like this was sanctioned by the United States government. But I'm a firm believer that when we're honest about history and we talk about it, it allows us to abandon any illusions we have about exceptionalism or to skip the truth in favor of a comfortable lie and instead decide what kind of future do we want to live in? What kind of nation do we want to be a part of? What kind of equality do we want to create that protects everyone? And I will see you next week on Flipping Table.

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Spring just slid into your dms. Grab that boho. Look for that rooftop dinner, those sandals that can keep up with you and hang some string lights to give your

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patio a glow up.

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Spring's calling, Ross, work your magic.