The Tuskegee Syphilis Study

The Tuskegee Syphilis Study is one of the modern world's most infamous incidents of unethical medical research. The study's researchers told its participants that they were being treated for syphilis, but in reality, they weren't.

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Episode Transcript

Speaker 1 (00:01):
Welcome to steph you missed in History Class from how
Stuff Works dot Com. Hello, and welcome to the podcast.
I'm Tracy B. Wilson and I'm Holly Fry. Today we
are talking about one of the modern world's most infamous

(00:24):
incidents of unethical medical research. It is the Tuskegee Syphilis Study,
which started in nineteen thirty two and ran until nineteen
seventy two. The studies researchers told its participants that they
were being treated for syphilis, but in reality they were not,
and the entire point of the study was actually to

(00:44):
observe how untreated syphilis progressed in black men. So this
study itself was part of a much greater pattern in
medical history of white doctors conducting unethical studies, experiments, and
procedures on minority patients. In terms of black patients, this
pattern includes the work of Jay Maryan Sims, who's known

(01:04):
as the Father of gynecology, who conducted surgeries on enslaved
women without anesthesia. You can hear more about that in
our sister podcast, Stuff Mom Never Told You in the
episode The Mothers of Gynecology. It also includes the use
of cancer cells taken from Henrietta Lax without her consent,
which you can learn about in Rebecca Sclute's exceptional book,

(01:26):
The Immortal Life of Henrietta Lax. But as we discussed
in our teen podcast on the Doctor's Riot of sevent
this pattern even continued after death, with grave robbers overwhelmingly
using black cemeteries as their source for medical cadavers. Apart
from its deeply unethical setup, the Tuskeee Study had real

(01:47):
and damaging effects that continued long after it was over
all of which we will talk about today. So to
give you a brief primer on syphilis, Syphilis is a
diseased caused by the bacteria um Treponema politum. And while
there are other similar diseases in the same family that
are spread through casual contact, syphilis is spread through sexual activity.

(02:10):
It can also move through the placenta during pregnancy, leading
to congenital syphilis in newborn babies. There are several hypotheses
about where this disease first originated. We know for sure
that it was present in the America's prior to Christopher
Columbus's first voyage, So the most popular explanation and it
was that it was carried back to Europe on Columbus's

(02:32):
ships in and then it spread really rapidly from there
because the population had no immunity to it. There are
also other theories that syphilis was already present outside the
America's at that point, but was more dike misdiagnosed as leprosy,
which is now known as Hanson's disease, and this second
theory the disease evolved to become more virulent in the

(02:54):
fifteenth century, and it was coincidentally after Columbus's first voyage.
In a first stage, syphilis presents as a sore on
the location where the bacteria entered the body. That sore
usually goes away within three to six weeks, even if
it's untreated, but the disease at that point is not cured.
It typically returns in a second stage, marked by a

(03:16):
rash that's sometimes the only symptom, but it can also
be accompanied by swollen lymph nodes, fever, fatigue, achiness, and
general symptoms of being unwell. Those symptoms also resolve without treatment.
From there, syphilis goes into a latent phase when it's
not treated and there are no symptoms at all. Sometimes

(03:37):
that lasts for the rest of the person's life, but
for up to thirty percent of people who don't receive treatment,
syphilis enters a very serious tertiary phase ten to thirty
years after the initial infection. This stage can affect multiple
parts of the body, including the heart and brain. Third
third stage syphilis can cause large sores on the body, blindness,

(04:00):
mental disorders, destruction of bone and soft tissue, paralysis, organ failure,
and death. It's primarily this third, debilitating, disfiguring, and deadly
phase that shows up in art and literature, as well
as in explanations for the brutal or erratic behaviors of
various monarchs, including even the Terrible. Regardless of whether syphilis

(04:25):
was really present outside the America's prior to free as
it spread through the fifteenth century and beyond, it became
really heavily stigmatized. People quickly understood that it was spread
through sexual contact, and that meant that in many cultures
and religions it was associated with sinfulness and immoral behavior.
Folklore about the origin of syphilis also frequently connected it

(04:49):
to Hanson's disease, and that disease is also heavily stigmatized
and then culturally associated with sin and with being quote unclean.
Syphilis was so rever vial that nations named it after
whichever country they thought it came from, so in Italy, Germany,
and the British Isles it was the French disease, but
in France it was the Neapolitan disease. Russia blamed Poland,

(05:13):
and Poland blamed Germany. In some places, different religions took
the blame, with Hindus and Muslims each blaming each other
in northern India. Compounding all of the layers of stigma
was the fact that there wasn't a very effective treatment
available for syphilis until the twentieth century. Physicians tried a
range of herbs, compounds, and practices, and by the sixteenth century,

(05:37):
the most common treatment was mercury, which was highly toxic
and not particularly effective. In eighteen eighty four, doctors started
using business salts, which were less toxic and somewhat more
effective than mercury, but still only offered a cure about
thirty percent of the time, and that was after months
of difficult treatment that had high rates of side effects,

(05:58):
including death and arsenic derivative known as compounds six oh six,
was developed in nineteen O nine and that was apparently effective,
although it was difficult to administer and it could cause
tissue damage and death if it were given improperly. I
try to find some real solid information about how effective
compounds six oh six was. It was apparently hailed as

(06:22):
a miracle, but since it was replaced relatively quickly and
far far enough in the past that we don't have
a lot of evidenced based medical data about it, I'm
not quite sure whether it was as effective as people
build it as at the time. The reason it was
replaced pretty quickly was that in ninety eight Alexander Fleming
discovered the antibiotic penicillin, which was far far safer for

(06:46):
treating anything, but particularly syphilis, than compounds made from toxic
metals are. It became a standard treatment for syphilis intree
and this synopsis we've given is really an overview. If
you weren't to know more about the history of syphilis treatment,
check out the saw Bones episode on syphilis from March
of In the mid nineteen twenties, in the United States,

(07:10):
syphilis was a public health crisis. Conservative estimates put the
rate of infection at ten to fifteen percent, but estimates
go as high as thirty five percent of those people
of reproductive age. A nine nine study of rural Alabama
counties had found that it was particularly high in Macon County, Alabama,
home of the Tuskegee Institute. The Tuskegee Institute, which is

(07:34):
now Tuskegee University, was founded on July fourth, eighty one
as Tuskegee Normal School for Colored Teachers. A normal school
was a teacher's college, and Tuskegee was established after the
state of Alabama passed legislation that authorized its creation. Tuskegee's
first teacher was Dr Booker T. Washington. It became an

(07:55):
independent institution of higher learning. The Tuskegee Normal and Industrial
Institute in Tuskegee became home to more than just the university.
In nine three, it opened the Tuskegee v A Hospital
to provide long term care for black veterans. It was
also home to the Tuskegee Airman's flight training program in
World War Two. There's actually an episode on them in

(08:17):
our archive from past hosts Candice and Jayne. The research
on untreated syphilis that we're talking about today was conducted
by the US Public Health Service, but it took place
at Tuskegee Institute, with the involvement of some of the
staff there, and we were going to talk about it
after a quick sponsor break. The Tuskegee study was not

(08:44):
the only one in history to observe untreated syphilis. For example,
a study at the Oslo Venereal Clinic in Norway withheld
treatment from nearly two thousand patients between eighteen ninety and
nineteen ten. That clinics chief doctor was convinced pretty understandably
so that the syphilis treatments available at the time were

(09:05):
actually worthless. To protect the rest of the community from
the spread of infection during the study, the Oslo team
kept the participants hospitalized until they were symptom free. The
Oslo study found that for about seventy of the patients,
once the disease reached a latent phase, they had no
further problems and they weren't contagious. But for the other

(09:26):
thirty percent, the tertiary stage followed and it was serious
and severe. Once compound six oh six was introduced. The
Oslo study was ended. The study had demonstrated that untreated
syphilis could be serious or deadly, making it unethical to
withhold and effective though risky treatment once it was available. Yeah,

(09:46):
there are plenty of other ethical questions about this study.
It's it's complicated by the fact that the doctor running
the study was correct and the fact that the treatments
that were available were not actually doing much. But study
did stop once there was a treatment that people did
think actually worked available to them. So this Oslo study

(10:07):
was one of two that informed the Tuskegee syphilis study.
The other was the study we referred to before the break.
That one was a U S Public Health service study
as well, and it was paid for by the Rosenwald Fund.
It was undertaken with the goal of figuring out whether
a mass syphilis treatment program would be feasible or successful
in rural areas, and its findings suggested that yes, a

(10:30):
mass treatment program would. Unfortunately, also saw the start of
the Great Depression. Funding for a mass treatment program for
black patients with a sexually transmitted disease already would have
been incredibly difficult to find, but with the Great Depression
it became impossible. The Rosenwald study and its optimistic conclusions

(10:50):
about the success of a treatment program fell by the wayside,
But in nineteen thirty two, Dr Talia Faro Clark, chief
of the U s Public Health serve A Spunereal Disease Division,
who had actually authored that study, returned to those results
with an idea for another approach. This would be a
counterpoint to the previous OSLO study, which had been on

(11:12):
white subjects, Theorizing that syphilis progressed differently among black patients
than white patients, Clark decided to take advantage of the
high rate of syphilis infection in Making County and observe
how the disease progressed when left untreated in black men
over a period of six months. Underpinning this plan were
a set of racist stereotypes about black men, their sexual behavior,

(11:36):
and their supposed lack of interest in or compliance with
medical treatment. Basically was the idea was that if these
men weren't going to get treated anyway, the medical community
might as well observe what happened when they didn't. Clark
called this a quote ready made situation to conduct quote
a study in Nature. As a side note, the racism

(11:58):
threaded through this study did not end with the stereotypes
that were framing how the white medical establishment was approaching it.
It's not really a matter of a set of implicit
biases that were guiding them in such a strange and
horrifying direction. The correspondence of the studies white doctors with
one another are laced with incredibly racist attitudes and views.

(12:22):
They are gross. Every time I would find another quotation
from one of them, I would get angrier, because they
are really really offensive. US Surgeon General Hugh Smith Coming
then contacted our our Moten, director of the Tuskegee Institute,
to enlist the institute's help, calling the proposed study a

(12:44):
quote an unparalleled opportunity for carrying on this piece of
scientific research which probably cannot be duplicated anywhere else in
the world. In that same letter, Coming said the study
could have quote a marked bearing on the treatment or conversely,
the non necessity of treatment in cases of latent syphilis.

(13:05):
The Tuskegee Institute ultimately agreed to cooperate, and later in
ninety two, doctor Raymond Vanderler began trying to recruit black
men with syphilis who were between the ages of twenty
five and sixty for the study. He ran into difficulty
really quickly when he advertised the study was open to
men with a minimum age of twenty five people can

(13:26):
suspected that he was actually there conducting draft physicals, and
nobody came so. Even though the study was only to
be done on men, the initial physicals were conducted on
women as well. Another hiccup was that the prevalence of
syphilis in Macon County was not as high as the
Rosenwald study had suggested. The Public Health Service had expected

(13:47):
an infection rate of thirty five percent, but once Vonderler
was actually testing subjects, that rate turned out to be
more like and completely contrary to the stereotype that the
men being studied were innately unlikely to go to the doctor,
they found that a lot of Macon County residents had
already seen a doctor for syphilis and received treatment. Also

(14:09):
contrary to the prevailing stereotypes, overwhelmingly, the men that Wonderler
approached about this study were only willing to participate if
participating would result in their being treated, so this idea
that was guiding their entire study approach. This idea that
black men were unlikely to seek treatment was completely unfounded.

(14:32):
When faced with this dilemma, the doctors involved with the
study lied. They told participants they had bad blood and
that they were being treated for that then to keep
up the deception that participants were given ineffective quote treatments
like mercury, ointments, aspirin, and actual drugs that were at
too low a dose to be effective in any way.

(14:54):
Bad blood was used to describe syphilis, but was also
kind of a catch all term for other diseases as well. Regardless,
it was referred to pretty consistently as bad blood when
talking to the patients who were part of this study.
The doctors also described spinal taps more accurately called lumbar

(15:14):
punctures as treatment, even though a spinal tap is not
a treatment. Uh they were they were being used to
diagnose whether the men had neuro syphilis, whether they had
the syphilis infection in their their brain and their nervous
system tissue. Because spinal taps are uncomfortable and they carry
risks of complications and side effects, these were scheduled last

(15:37):
in the physical exams with the hope that word of
their unpleasantness would not spread and lead people to drop
out of the study because they were going to have
to have a spinal tap. When it was time for
the spinal taps, the participants got a letter that read
quote some time ago, you were given a thorough examination,
and since that time, we hope you've gotten a great
deal of treatment for bad blood. You will now be

(16:00):
given your last chance to get a second examination. This
examination is a very special one, and after it is finished,
you will be given a special treatment if it is
believed you're in a condition to stand it. This language
makes me so angry. I've never had a spinal tap,
but I drove my mom, my mom back and forth

(16:22):
to the doctor for at least one, because she has
a neurological condition. They're rough, unpleasant, is like, that's the
nice word the doctor will say to you. Yeah, I
have not had one either. I have had both friends
and relatives that have had them. I witnessed one of them.
It was horrifying. Um. Once the study reached the end

(16:44):
of its original planned six months, the United States Public
Health Service decided to continue it indefinitely. In spite of
the fact that the subjects had defied their expectations regarding
whether they would seek treatment, they still believed that it
was quote natural to keep this study going. The researchers
came to believe that they would need to conduct autopsies,

(17:05):
not just examine living patients in order to get a
clear picture of how untreated syphilis progressed. This changed the
scope of a study added a further layer of deception.
In addition to keeping secret the fact that the men
were not being treated for syphilis, the doctors had to
also keep secret that they never would be and the

(17:26):
autopsies were kept secret as well, because they were concerned
that subjects would leave the study if they found out
they would have to be autopsied after they died. Only
after the US Public Health Service approved this indefinite extension
to the study did the team decide it should also
have a control group, and they recruited men who were
syphilis free. If any contracted syphilis during the course of

(17:50):
the study, they were then moved to the test group.
In the end, there were three hundred and ninety nine
men in the test group and two hundred and one
men in the control group. This is the least of
the problems with the study. But moving somebody from your
control group into your test group is not That's not
how it's supposed to happen. That's not good science. That's
a bad methodology. Like I said, that is the tiniest

(18:15):
of the problems here. So, like we said earlier, a
person has who has a latent syphilis infection can be
symptom free for their whole life. And suspecting that the
men would probably drop out of the study after for
a while if they continued to be symptom free and
they weren't seeing any benefit to this treatment, the Public
Health Service also offered a number of incentives to keep

(18:37):
people involved. Subjects received transportation to and from the Tuskegee
Institute for their medical exams, as well as a hot
meal on a day. They were allowed to stop in
town to run errands or visit friends. Afterward, if they
got sick with something besides syphilis, they got medical care
for free. Uh, the area where this was taking place

(18:57):
was pretty impoverished. A lot of the people in the
study where sharecroppers and people who had a very subsistence
level of living. So all of these incentives did make
the study really appealing for people to participate in. But
that still had the complicated question of the autopsy. Knowing
that it would be unlikely to secure permission to have
an autopsy done if the subject died somewhere other than

(19:21):
the hospital, the Public Health Service offered about fifty dollars
per person and burial expenses to encourage people to come
into the hospital and be admitted. If they became ill
that way, they would pass away in the hospital and
it would make it easier to conduct their autopsy. Keeping
the study going also required the Tuskegee team to collude
with health professionals elsewhere and for incoming directors and officers

(19:45):
in the public health service to maintain this deception through
multiple changes in administration. They gave lists of participants to
doctors in Making County, to the Alabama Health Department, and
to the Draft Board to make sure none of them
treated or reckon ended treatment to the participants. Apart from
the fact that they were literally convincing other doctors to

(20:06):
withhold appropriate care, they were also violating participants privacy by
disclosing to a whole lot of other doctors that they
had syphilis. Now conceived as a lifelong effort, the Tuskegee
study also needed a liaison between its medical team and
its subjects, and someone to basically ensure the continuity of
care for as long as the study lasted. That liaison

(20:30):
was Nurse Unice Rivers Laurie, known as Nurse Rivers for
nearly all of the studies duration because she got married
later on in her life. A graduate of the Tuskegee
Institute's nursing program, Nurse Laurie was an experienced public health nurse.
There are a number of contradictory truths about Nurse Laurie's work,
which lasted until the study ended, even after she officially retired.

(20:55):
She was an active participant in the medical team's deception
of the studies subjects. As liaison between the doctors and
the community, she was possibly the most instrumental in getting
the men to stick with the study and follow the
doctor's instructions. The more social community aspects of the study
became known as MS. Rivers Lodge. At the same time,

(21:15):
she was caring for men she knew who were part
of her community, including as they became ill, suffered, and
died as a result of their untreated syphilis. A lot
of the depictions of of Unice River's larry are either
that she was basically a helpless victim of a Jim

(21:37):
Crow era South herself uh or that she was like
an evil participant in this completely racist and unethical study.
These are all things that are multiple, Like the things
we just said are all true at the same time. Right.
It's rarely as as simple and easy to quantify in

(21:59):
one statement when you're dealing with a situation like this
as hero or villain, good or bad, there are there
are layers and layers to the whole thing. Yeah, there's
actually a hbo Um movie called Miss Evers Boys that
is a fictionalized account of this. That's basically a fictionalized

(22:21):
version of her story. One of the things that we
don't have much of it much of is uh documentation
from her about how she framed this for herself, or
about how she approached a lot of the huge ethical
concerns that were part of her work. Um So, I

(22:42):
think a lot of the things that portray her as
either a total unwilling person with no agency or a
complete villain like neither of those seems like a an
accurate picture. Unlike in the Oslo study, which ended when
compound six or six became available, the Tuskegee Study started

(23:05):
after compound six or six was already out. It continued
for another twenty nine years after penicillin became the standard
treatment for syphilis. When the study ended, only seventy four
of its subjects were still living, and the number who
had died as a consequence of their untreated syphilis is unclear.
It was at least twenty eight but possibly more than

(23:27):
a hundred. The number of people who contracted syphilis as
the result of this study, which was telling them that
they were being treated when they really were not, is unknown,
and the damaging effects of the study didn't stop when
the study stopped. In July of a National Bureau of
Economic Research working paper reported that when the study became

(23:51):
publicly known in nine two, it led to increases in
both mistrust of the medical community and immortality within the
black community. The paper estimates that for black men at
the age of forty five when the study was exposed,
life expectancy dropped by almost a year and a half,
contributing to up tot of the disparity in life expectancy

(24:14):
between black and white men as of nineteen eighty. And
to be clear, that is everywhere in the United States,
not just in Tuskegee, Alabama. Like that's that. This this,
the fact that the study existed ah appears to have
led to bad health outcomes, especially for black men, ongoing

(24:37):
for decades after the study was over. We will talk
about how this study came to light and what happened
afterward after another quick sponsor break. Although this study, which
was ultimately known as the Tuskegee Study of Untreated Syphilis
and the Negro Mail, was highly deceptive, was not in

(25:00):
any way secret findings were published and presented repeatedly, beginning
at the American Medical Association annual meeting in nineteen thirty six.
At least fifteen different papers on it were published out
in public for people to see over the duration. Even
though these reports consistently detailed serious and damaging consequences of

(25:25):
untreated syphilis, that alone was never enough to stop the study.
A meeting at the Centers for Disease Control about whether
to continue the study, at which some of the participants
of that of that meeting did criticize it as being
an ethical they ultimately approved the study to go on,
and that was in nineteen sixty nine. Then in July

(25:48):
of nineteen seventy two, The New York Times in the
Washington Post published an associated Press article called Syphilis Victims
in US Study went Untreated for forty Years by Gan Heller.
And it was this report and the outrage that followed
that finally brought about the end of the study. That
report was possible thanks to a whistleblower. Also following the

(26:11):
studies end, uh We're congressional hearings and a class action
lawsuit filed by civil rights attorney Fred Gray that ended
in a ten million dollar out of court settlement. The
United States government established the Tuskegee Health Benefit Program to
pay for medical care and burials of the participants, whose
wives and children were later added to the program as well.

(26:32):
The Department of Health, Education, and Welfare also formed an
advisory panel to evaluate the study, eventually ruling that it
was quote ethically unjustified. Seventy one of the survivor's medical
records were released in the nineties seventies. That's less than
twenty of those who had been part of the studies
infected group. At that point. It was discovered that at

(26:54):
least a portion of the participants did wind up receiving
at least some penicillin sometime between when it became the
standard treatment for syphilis and the end of the study.
A lot of the people who did wind up getting
some penicillin during the course the study were treated by
two doctors, Dr Murray Smith, of the Making County Health

(27:15):
Department and doctor Eugene Dibble at the Tuskegee Institute's Johnny
Andrew Hospital. They both prescribed penicillin to people who were
in the test group as a treatment for other conditions,
including colds, flu, and back pain. It's completely unclear whether
this was an accidental oversight of the fact that these
men were in the studies test group, or if it

(27:37):
was an intentional and covert way to treat them for
syphilis without raising the red flag from the people running
the study. Others were able to receive treatment after moving
away from Tuskegee, at which point either the Public Health
Service lost track of them or the doctors at their
new home refused to withhold treatment from them in spite
of the study staff's attempts to convince them otherwise. Is

(28:01):
On May sixteenth, President Bill Clinton issued an apology for
the study on the behalf of the government, specifically naming
the eight men in the study who were at that
point still living Carter Howard, Frederick Moss, Charlie Pollard, Herman Shaw,
Fred Simmons, Sam Donner, Ernest Hendon, and George Key. Five

(28:23):
of the men were present at this apology and the
three who could not attend were represented by members of
their family. The last surviving participant of the study died
in two thousand four. There's a widespread and very persistent
piece of misinformation that the men in the study were
deliberately infected with syphilis. This, based on all the information available,

(28:46):
is completely untrue. There was, however, a completely different US
Public Health Service study conducted in Guatemala in the nineteen
forties which did indeed infected subjects with sexually transmitted infections
on purpose. That was actually uncovered while the researcher was
looking for information about the Tuskegee study, and they happened

(29:09):
to find this isn't like two thousand and five, not
that long ago, happened to find documents about this Guatemala
study um that definitely did infect people with sexually transmitted diseases.
Another piece of misinformation that's followed the study and is
it's a piece of misinformation and yet it's responsible for
important work. Is that its main flaws where it's failure

(29:32):
to get participants informed consents, and that the withholding of
the penicillin once it was available it was an ethical
But these are really kind of beside the point, compound
six oh six was available as a syphilis treatment before
the study even started. So even though penicillin was a
lot safer and had a lot fewer side effects and

(29:53):
I think probably a lot more effective, had trouble answering
that question specifically. It wasn't like there was no treatment
and then they continued the study after treatment was available,
Like there was a treatment available from the beginning, from
the very start, and the point was always to withhold treatment. Uh,
the failure to get informed consent from the participants, it's

(30:15):
also really secondary to the fact that the study every
step of the way was intentionally about deceiving people into
participating and then withholding a treatment for a treatable illness
without their knowledge for decades. Yeah, the idea of informed consent, Yes,
that is really important. I am glad that such, uh,

(30:36):
such a focus on informed consent followed this particular study.
Like there's even a bioethics center at Tuskegee Institute now
in part as a response to the study. All of
that is super duper important, But like, informed consent not
really the biggest problem in a study that was literally,

(30:56):
we're going to lie to people and withhold an available
treatment for decades until they die, and then we will
conduct an autopsy on their body and see what happened
when like we already knew, we already knew what happened,
which was that untreated syphilis can kill you, Like we
knew that stuff already. So well, I always wonder when
we're any time we're talking about things like this, this

(31:20):
one in particular, because it's recent enough and it's in
the South, that I feel like, you know, I know
the kinds of people who may have been employed in
in a place like that, And I'm like, what kind
of mental gymnastics were some of these people having to
do with themselves to be like, no, no, we have
to keep doing this, yeah, because at some point your
brain raises a flag and goes, hey, this is not okay,

(31:41):
this is maybe bad. Well, and that's especially like from
the first publications there were people who could kind of went, hey, uh,
this seems wrong, and the study continued in spite of
the criticism saying, hey, this seems wrong. Um, in spite
of the you know, for the whole time. Um. There
are also people who will bring up the fact that, like, uh,

(32:05):
Eunice River's Larie was black, and some of the doctors
at the Tusky Institute who were participating in like allowing
this to happen on the Tusky Institute campus. We're also black,
and like people will try to wrap their mind around
that in such a way of being like, well, it
must have been okay if there were black people involved
in this treatment on black No, that's not that's not

(32:26):
correct at all. Uh, And that is really every time
I've seen that argument, it's been basically an attempt to
derail that Yes, this was awful, it was wrong, and
it was racist, and it has continued to have damaging
effects continuing probably until today. Yeah, I mean, like you said,

(32:50):
the thing is right, Like, you can't track really the
depth and resonance of what this created. Because these are
people that we're getting treated, some of whom were presumably
sexually active that probably passed it on to other people.
We don't know where the ripples go from there, you
know what I mean. There's so many lives that can

(33:10):
be affected in this sort of echoing horrible nous that well,
and then then when the news came out about it,
everything was compounded with the fact of, like, these were
doctors who people knew and trusted and in some cases
had been seeing for years and people had been seeing
uh Nurse Rivers later known as Nurse Larry, like they

(33:31):
had been seeing her for years, she had been taking
care of them for years, and people were like, how
can I ever trust another doctor ever again? And how
can I trust the government ever again? Like there was
there were definitely causes to mistrust the medical establishment and
the government before that point, but this was such an
immediate and visceral response that I think it has carried

(33:53):
through for generations. Yeah, and you you can't fault someone
at that point for having no faith in in uh,
you know, the medical treatments available to them or the
medical professionals available to them, which stinks. It's such a
disservice to the rest of the medical community. Like in
addition to the people that were being victimized by this

(34:15):
horrible study, obviously we feel ways about this, uh And
I laugh, not not to make light of it, but
just to uh, to to laugh at how embroiled in
our hearts it becomes. Yeah, I've researched a lot of
really horrible, horrifying, horrifying episodes on this show, and like

(34:36):
this is one of the hardest ones to me. Yeah, uh,
what's the listener male situation? It's not a much lighter
a much lighter note than this. It's also a throwback
to an episode that was from a while ago. This
is from Shelley. Shelley says, Hi, Holly and Tracy. She
has introduction to us and some thank you, and then
she says, I recently listened to the podcast about Hildegarde

(34:58):
up being in how Over. I quickly realized that I
must have mistaken this Hilleguard for a different of the
same name that I'm familiar with. No worries, I'm game
for an adventure in learning. I learned from the two
of you about her church training and her choice to
be an anchorous and then I hear it her musical
training again. You mentioned her lyric poems and hymns and
the musical lines ago with them. This is why I
tuned into the podcast. So this podcast really made me

(35:20):
scratch my head. I have a master's degree in music
and Hildegard is a huge part of our music history courses.
That you only mentioned her musical contributions in passing and
then in all capital letters with an exclamation point. This
is crazy. I had no idea about any of her
journeys in life. Sure I knew she was a religious
gal as most Western music of the Middle Ages of

(35:41):
liturgical in origin, but I had no clue of the
extent of her religious commitments. I was inspired to go
through some of my old music history books and brush
up on Hildegard, and sure enough, the extent of her
religious involvements are not mentioned much. There are two sentences
that describe her visions. Quote, during moments that we might
today identify as severe migraine headaches, she heard voices and

(36:02):
saw visions accompanying accompanied by great fashion flashes of light,
a serpent like Satan devouring pedals of a scarlet rose,
or the blood of Christ streaming in the heavens, for example.
And that was from right sims Uh music and Western civilization.
They later credit those visions with her quote extremely colorful
visions in her music. The music industry is a male

(36:24):
dominated arena, but Hildegard was crashing through the glass ceilings
in the eleventh century. She left many chants preserved in
her symphonia, as well as her liturgical drama Ordo virtue Um,
the first religious opera I recently recommended your podcast to
a friend of mine. I got her hooked with the
Haunted Management episodes and being a musician a college music
professor on her own, she also picked up Hildegard to

(36:45):
Being In for a listen. She almost turned the episode
off because she thought it was the wrong Hildegard. Hildegarden
to Being In is a staple and every trained musician's curriculum,
every conservatory school and Department of music student has had
a listening and content test on her. She's a really
big deal in bold with an exclamation point. After discussing
this and being truly astonished the lack of music mentioned

(37:05):
in your episode, we laughed it off. I'm inspired by
what an astonished, astonishing woman she was. Thank you, ladies
for this was truly something I missed in history class.
Keep up the great work, Shelly. Thank you for the note. Shelly.
I had an interesting response to this email, which is that, uh,
what seems weird to me is to have um a

(37:26):
focus on Hilly Guard Hildy Guard that is solely on
her music because her religious instruction and upbringing and the
fact that she was able able I mean I say
able and quotation marks. Her parents literally gave her to
the church, possibly as part of the tithe Like all
of those things are how she was even able to

(37:47):
have a body of music as part of her work
because she was devoting her life to God and living
in a monastic setting. So it is strange to me, Like,
it doesn't surprise me that people who have a music
history degree would know about Hildegard primarily through her music,

(38:08):
But she did a lot of other things besides right music. Um,
she was also shattering glass ceilings in terms of her writing,
and in terms of her religious instructions of other people,
and in terms of like uh founding, um, like founding
a religious community of women. So uh, yeah, it doesn't

(38:30):
surprise me that music instruction would focus primarily on her music,
but like that's definitely not the only thing, or I
would even argue the core thing about Hildegard in her
life and work. Yeah, if you would like to write
to us about this or any other podcast or history
podcasts at how stuff works dot com, russo on Facebook,
Facebook dot com slash mss in history, and on Twitter

(38:51):
at miss in history basically all of our social media
or at the user name miss in history. You can
have to our parent company's website, which is how stuff
Works dot com and find all kinds of information about
cool stuff. You can come to our website, which is
missed in History dot com, and you will find show
notes to the episodes Holly and I have done in
an archive of every episode. Ever. We also have four

(39:12):
videos we made and those are all on our website too,
So we can do all that and a whole lot
more at how stuff works dot com or missed in
History dot com. For more on this and thousands of
other topics, is it how stuff works dot com