Nurse Eunice Rivers Tuskegee Study Essay
This is part of a series of stories written by Auburn University journalism students in Professor Judy Sheppard’s class on the 40th anniversary of the expose of the Syphilis Study that involved male men from Macon County. For a web link of video that accompanies this story, go to http://youtu.be/m4SNf3Tjqi4
By ETHAN BERNAL
Even 40 years after the United States Public Health Service (USPHS) ended The Study of Untreated Syphilis in the Negro Male in Macon County, the name “Nurse Rivers” draws mixed emotions.
Eunice Rivers Laurie was the African-American nurse the USPHS hired to recruit the 399 black men in the county infected with syphilis and keep them in the study while they went untreated for four decades. Because she herself was an African-American, there is controversy surrounding Laurie’s role in the study.
“I think she made some decisions based upon her situation financially,” Tuskegee University history professor and archivist Dana Chandler said. “The fact is that she was being respected in the community at the time, not thinking about the consequences to come. But who’s to say? How do you look into the mind of somebody who’s dead?”
The debate continues in the Tuskegee community. Dr. Reuben Warren, director of bioethics at the National Center for Bioethics and Health Care at Tuskegee University, said Laurie has been unfairly portrayed as a villain.
“Somebody had to be blamed,” Warren said. “I think it was intentional. Absolutely. That was as unethical as what they did. People continue to raise the ‘Nurse Rivers.’”
Laurie was selected because she was African-American and could use her standing in the community to gain the participants’ trust. She gave the men special treatment and inviting them to “Miss Rivers’ Lodge.” The participants were told they had “bad blood” and promised free health care. Instead, the men weren’t informed they were infected and went untreated from 1932 until the New York Times and the Washington Post broke the story in 1972.
The study was supposed to last three months, but the USPHS continued its work and kept Laurie on to keep track of the participants and encourage them to stay in the study.
“You don’t know what she did,” Warren said. “You know what they said she did. The men trusted her. They continued to trust her. So the question is, did she really violate that trust?”
Chandler says the answer is clear.
“There’s no doubt about it,” Chandler said. “She was well aware of what she was doing. Like many people who try to justify things, maybe she was sold on the idea that this was an experiment that would bring solutions.”
Dr. Stephen Sodeke, assistant director of bioethics at Tuskegee University, said the situation must be put into context.
“This was a time when it was considered an outstanding opportunity to be asked to support any federal government study,” Tuskegee’ assistant director of bioethics Dr. Stephen Sodeke said. “Of all the nurses that could possibly be asked, she was singled out. So you can imagine how happy she was.”
Chandler agreed the situation must be put into context, but does not believe flattery played a factor in her lack of objection to the inhumane acts being performed.
“Context is always important,” Chandler said. “In this particular instance it’s the Depression. When she begins working with them, and working with a government agency making good money, it’s going to affect how she approaches things.”
An unaddressed letter written by Laurie in the Tuskegee archives, Laurie mentions the Great Depression as a motive for working with the government.
“I worked with the State Health Department of Alabama,” Laurie said. “At the end of four years the depression came which caused a retrenchment program and dropped me. Then in the fall of 1932, the U.S. Public Health Service started the study of untreated syphilis in the Negro male in Macon County.”
Laurie may not have turned “a blind eye,” Chandler said, “but an eye with a cataract in it. It’s all about survival.”
Laurie’s role in the study is also a hot-button issue in the Tuskegee community because she was a graduate of what was then Tuskegee Institute’s nursing school.
Tuskegee University maintains it had nothing to do with the study. But while the study was being conducted, Dr. Eugene H. Dibble Jr., the medical director of John A. Andrew Hospital where lab tests were performed, kept in contact with the university’s president Dr. L.H. Foster.
“(Laurie) has done a remarkably fine job and perhaps knows more about the public health on a rural basis than anyone else in this section,” Dibble wrote to Foster. “We at the John A. Andrew Memorial Hospital feel very proud of Mrs. Laurie’s record that is a credit not only to her but to Tuskegee Institute.”
In 1975, three years after news of the study was revealed to the public, Tuskegee Institute honored Laurie with an Alumni Merit Award for her 33-year nursing career.
“Your varied and outstanding contributions to the nursing profession — with the Alabama Extension Service, the Alabama State Health Department, and the United States Public Health Service — have reflected tremendous credit upon Tuskegee Institute.”
Neither Victim nor Villain: Nurse Eunice Rivers,the Tuskegee Syphilis Experiment, and Public Health Work Susan L. Smith From 1932 to 1972 white physicians of the United States PubUc Health Service (USPHS) carried out an experiment on approximately 400 rural black men in Macon County, Alabama. The study, which historian James Jones has described as "the longest nontherapeutic experiment on human beings in medical history," was predicated on following the course of untreated syphilis until death.1 Historians have focused on the study as sdentificaUy unjustifiable and as an unethical experiment that highUghts the radsm of American medicine and the federal government. While affirming the validity of these assessments, I reexamined the experiment to return to the troubling question of why black professionals, such as nurse Eunice Rivers (Laurie), supported the project. Black health workers and educators assodated with Tuskegee Institute , a leading black educational institution founded by Booker T. Washington in Alabama, played a critical role in the experiment. Robert Moton, head of Tuskegee Institute in the 1930s, and Dr. Eugene Dibble, the Medical Diredor of Tuskegee's Hospital, both lent their endorsement and institutional resources to the government study. However, no one was more vital to the experiment than Eunice Rivers, a black pubUc health nurse. Rivers acted as the liaison between the men in the study and the doctors of the USPHS. She worked in the public health field from 1923 until weU after her retirement in 1965. She began her career with the Tuskegee Institute Movable School during the 1920s in rural Alabama. This traveling school for African Americans provided adult education programs in agriculture, home economics, and health. After a decade of service with the school, Rivers became involved in the infamous Tuskegee SyphUis Study in 1932. How could a nurse dedicated to preserving life partidpate in such a project? Although historians have noted the key role that Rivers played in the experiment, they have presented her as a victim by virtue of her status as a woman, an African American, and a nurse. Groundbreaking work by James Jones, for example, interpreted much of Rivers's partidpation as driven by obedience to higher authority. A more satisfadory consideration of her role as an historical subjed is in order; yet, examination of Rivers's role does not necessarily lead to an interpretation of her as an evU nurse. What does it mean, then, to talk about the historical agency of black Â© 1996 Journal of Women's History, Vol. 8 No. Î¹ (Spring) 96 Journal of Women's History Spring women within radst and sexist social structures? Indeed, Rivers was neither a victim nor a villain but a complex figure who can only be understood within her historical context. She aded in ways she determined to be in her best interests and in the interests of promoting black health. Consistent with the responses of at least some black health professionals and educators at the time, Rivers did not question the experiment because she did not find it objedionable. I became curious about the response of Rivers and other black professionals to the syphilis experiment during my work on the National Negro Health Movement, a black public health movement during the first half of the twentieth century. A smaU but active group of black professionals in medicine, dentistry, nursing, and education, along with community women, organized public health programs across the nation to improve the health of African Americans. By 1930 black nursing schools and medical institutions had produced some 5,000 black nurses and 3,700 black physicians, many of whom were involved in community health projects.2 Drawing on federal records from the USPHS, manuscript coUections at Tuskegee University (the black college formerly known as Tuskegee Institute), and an oral history of Eunice Rivers, this article analyzes the meanings of the experiment from the perspective of black health professionals , espedaUy Rivers. Her story raises important questions about the gendered nature of public health work, the constraints on black middleclass reform efforts, and the costs and benefits to the poor. The adions of Eunice Rivers can best be understood when set within the context of twentieth-century pubUc health work. In her capadty as a pubUc health nurse...