The now-worthless nature of the data being generated was underscored by the 1943 announcement that penicillin cured syphilis quickly and with no noteworthy side effects.36 The dreaded disease was being cured with one or two inexpensive injections—unless the patient was a Tuskegee test subject. Some of the 399 received the treatment anyway, when they happened to consult doctors outside Macon County; and in 1952, Dr. Vonderlehr shared a worry with another doctor: “I hope that the availability of antibiotics has not interfered too much with this project.”37
THE TUSKEGEE STUDY IN THE MEDICAL LITERATURE
In retrospect, it is strange to note that, while the nature of the study was a secret to its human subjects, there was no cover-up of the Tuskegee Syphilis Study in the medical world. The USPHS seemed inexplicably proud of its work, and the doctors conducting the study published numerous articles in medical journals that documented its results. The first article appeared in 1936, when the study was just beginning. Authored by Dr. Vonderlehr, Dr. Taliaferro Clark, and Dr. J. R. Heller, it described the study’s background: “The administration of adequate treatment in early syphilis is recognized as the most important factor in the prevention both of communicable relapse and of the early complications so detrimental to the health of the individual patient.”
That does seem logical. However, the doctors carefully worded the next section as if they are simply finding their study subjects, not creating them:
As a result of surveys a few years ago in southern rural areas it was learned that a considerable portion of the infected Negro population remained untreated during the entire course of syphilis. Such individuals seemed to offer an unusual opportunity to study the untreated syphilitic patients from the beginning of the disease to the death of the infected person.38
The article appeared in the Journal of the American Medical Association as “Untreated Syphilis in the Male Negro.” As the years went on, more reports of the study documented the damage being done to its human subjects. A 1946 report found that 25 percent of the untreated syphilitics were already dead, versus 14 percent of noninfected persons chosen as controls. It estimated that the disease would reduce the life expectancy of the untreated syphilitic patients by 20 percent.39 That 20 percent figure was cited by USPHS’s Dr. O. C. Wenger addressing a seminar in 1950. He added the following:
Remember these patients, wherever they are, received no treatment on our recommendation. We know now, where we could only surmise before, that we have contributed to their ailments and shortened their lives. I think the least we can say is that we have a high moral obligation to those that have died to make this the best study possible. This is the last chance in our country to make an investigation of this sort.40
Dr. Wenger’s reference to “high moral obligation” is shocking. The obligation, as he sees it, is not to treat the patients, but to do the best possible job of studying them as they die.
A follow-up study in 1956 found that the syphilis damage was steadily expanding. Among the 159 surviving patients, ten were dying from neurosyphilis, six were going blind, six had aneurisms, four were dying from congestive heart failure, and twelve had syphilitic destruction of the skeletal system. Compared to the controls, the untreated syphilitics had more abnormal electrocardiograph readings (33 percent versus 20 percent) and were more likely to have enlarged hearts (64 percent versus 37 percent), high blood pressure (58 percent versus 33 percent), and hardening of the arteries (72 percent versus 50 percent). Twenty years of untreated syphilis were ruining the men’s circulatory systems. The study concluded: “Review of those still living … reveals that an appreciable number have late complications of syphilis which probably will result, for some at least, in contributing materially to the ultimate cause of death.”41
A 1964 article wrote of the thirty-year follow-up. Its summary began: “The syphilitic group continues to have higher mortality and morbidity than the uninfected controls, with the cardiovascular system most commonly affected. As of Dec. 1, 1963, approximately 59% of the syphilitic group and 45% of the control group were known to be dead …”42
The 1964 article had an unexpected result: someone actually objected to the morality of the study. A young Michigan cardiologist, Irwin Schatz, wrote to the primary author:
I am utterly astounded by the fact that physicians allow patients with a potentially fatal disease to remain untreated when effective therapy is available. I assume you feel that the information which is extracted from the observations of the untreated group is worth their sacrifice. If this is the case, then I suggest that the United State Public Health Service and those physicians associated with it need to reevaluate their moral judgments in this regard.43
The letter got bucked down the chain of command to a coauthor, Dr. Anne Yobs, for her to answer. She noted on the routing slip, “This is the first letter of this type we have received. I do not plan to answer this letter.”44 The study had been ongoing for thirty years, had repeatedly been publicized in the medical literature, and only one person had objected—and that in a private letter.45 But the study was about to find its whistleblower.
In 1966, Peter Buxtun was a new investigator for a USPHS venereal disease clinic in San Francisco. The military had trained him to be a combat medic, then a psychiatric social worker, so the USPHS had sounded like a good career move. While eating lunch in the facility’s coffee room one day, he overheard a conversation between two nurses and a professional officer who worked for the Centers for Disease Control. Fifty years later, he still could remember distinctly what the officer told the nurses:
He spoke of a patient who was elderly and insane, so his family, not knowing what else to do, took him to a doctor some distance away. The doctor didn’t know of the Tuskegee study. He gave the patient a blood test, a VDRL test [for syphilis] and found he had a high titre, so he gave him a big shot of penicillin. The next thing the doctor knew, the county medical society and the county board of health were jumping all over him, “look what you’ve done, you’ve ruined our study!”46
The nurses left and Buxtun spoke with the CDC staffer. It became apparent that the study involved using a group of ill-educated rural people as human guinea pigs.
Buxtun’s job left him time for administrative details, in which he could request files from other offices. He called the CDC and asked for copies of the Tuskegee Study. The files arrived in a large manila envelope. While the study described its patients as “volunteers with social motives,” reading the documentation made it quite clear that no one had volunteered in any real sense; they thought they had something called “bad blood” and were receiving treatment for it.
Buxtun told his immediate superior, Dr. John Harper, that he was going to send a letter to Dr. William Brown, head of the CDC’s Division of Venereal Disease, suggesting that the study be brought to a halt and all the patients be given real treatment. Dr. Harper nervously replied that he had a family and needed to keep his job—“Don’t mention my name when you get fired.” Buxtun wrote the letter as a private citizen arguing that it was not appropriate for the Public Health Service to leave citizens ignorant of their condition and untreated.47
The CDC’s first response came in about a month. A CDC headquarters staffer was coming to San Francisco for a Christmas visit with family, and Dr. Brown asked him to interview Buxtun. The staffer read questions off a clipboard, the first of which was “Why did you send that letter to Dr. Brown?”
Around a month after the interview, Buxtun received a letter directing him to fly to CDC headquarters in Atlanta. He knew that the Venereal Disease headquarters staff had meetings; presumably a decision was going to be made at one of those meetings. After arriving at headquarters, he was told he would not be taking part in any such meeting. He was ordered to sit in a chair in the corner, and at 5:00 p.m., five men came up and told him to come with them.
In the basement, Dr. John Cutler, who headed the Tuskegee Study, began giving Buxtun a tongue-lashing. The study was yielding important data, Cutler cla
imed, and everyone in it was a volunteer. Buxtun produced a document from the files, which stated that without “suasions” (the free medical care and other benefits promised to the subjects), it would be impossible to secure the cooperation of the subjects of the study.
Buxtun later said, “The look on their faces—it was as if you could see lightbulbs go on over their heads. They realized ‘we have a problem here.’” The study scientists discussed what to do for about twenty minutes before they remembered that Buxtun was listening to everything and dismissed him. By then, Buxtun was tiring of the USPHS. Switching careers entirely, he won admission to Hastings Law School.
USPHS eventually appointed a “blue-ribbon panel” to look into the study. The handpicked panel wound up more concerned with improving the study’s scientific quality than with its deep moral problems. As part of the improvements, USPHS delegates persuaded the Macon County doctors to reaffirm their decision to withhold antibiotics from any study subject that consulted them.48
In 1950, Edward Nevin died in a San Francisco hospital, after being infected with an obscure bacterium, Serratia marcescens. Decades later, his descendants discovered that the military had conducted experiments in biological warfare that included releasing an enormous fog of that bacterium over the city.49 They sued the government, but the Ninth Circuit ruled that the government’s choice to infect its own citizens was protected by the discretionary function exception.50
Buxtun waited for a year, then sent another letter to the chief of the Venereal Disease Branch. Trying hard to sway him, he pointed out that the study group is “100% negro,” making it “political dynamite” for the agency. The subjects of the study were not willing volunteers; they had little medical knowledge and had been swindled into signing up. This was not a question of “informed consent”: the subjects had not even been told they had syphilis, so they had given no consent at all. Buxtun argued that anyone today would regard it as “morally unethical” to do such a thing. He ended, “I earnestly hope that you will inform me that the study group has been, or soon will be, treated.”51
He received no reply. Four years later, Buxtun mentioned the study to a friend who worked for the Associated Press. Then, suddenly, things got quite lively. On July 25, 1972, AP reporter Jean Heller’s story broke across the country. The Washington Star, then D.C.’s afternoon paper, carried it on page one under the headline “Human Guinea Pigs / Syphilis Patients Died Untreated.”52 The next day the New York Times carried it, also on its front page, under “Syphilis Victims in U.S. Study Went Untreated for 40 Years.”53 The stories quoted the head of the CDC’s Venereal Disease Branch, Dr. J. D. Millar, as saying that he had “serious doubts about the program.” He added that the patients were not denied drugs, they just weren’t being offered drugs—which was both irrelevant and untrue.
The Department of Health, Education, and Welfare convened a committee to investigate,54 which found that the study was “ethically unjustified in 1932,” and that the study subjects should have been treated with penicillin no later than 1953. Two doctors on the committee went on record to note that at least forty participants had had their life spans shortened by the failure to treat. They added that the patients in the study had been “exploited, manipulated, and deceived. They were treated not as human subjects but as objects of research.”
No one was held accountable. The creators of the Tuskegee Syphilis Study were long retired, and likely deceased, by the time Peter Buxtun could get any attention. There is no indication that any of the persons who extended the study to its termination in 1972 were disciplined, let alone prosecuted.
After the story broke, a survivor named Charlie Pollard sought out civil rights attorney Fred D. Gray, who had years before represented Rosa Parks and who, as it turned out, had read the AP story.55 Gray accepted the case and took an unusual approach.
The discretionary function exception would probably have voided any Federal Tort Claims Act (FTCA) suit. Did any law or regulation command USPHS staff to treat every case of syphilis they encountered? No. In withholding treatment, did the staff violate any binding orders? No, in fact, the study had been approved by the highest levels of USPHS leadership. Then Dr. Vonderlehr, Dr. Clark, and all the others who withheld treatment were exercising governmental discretion, and they and the USPHS were immune from lawsuit.
But, Gray realized, the USPHS seemed to have gone out of its way to recruit only black participants. Of the six hundred persons enrolled, not a single one was white. Notices seeking participants for the study were circulated only at black schools and churches (segregation was legal in the 1930s). The published articles detailing the results uniformly referred to effects of nontreatment “in the male negro.” If the government physicians responsible for the study were not racists, they had done an uncommonly good job of acting like ones. So Gray brought the suit on a racial discrimination theory, rather than as an FTCA suit. This approach had an additional advantage: jury trials are allowed in civil rights actions, but not in FTCA suits. The government would have to explain its decision to treat four hundred black Alabamians as if they were human lab rats to a mixed-race Alabama jury.
The case ultimately settled for $10 million, but spread across all the victims, which meant surviving infected persons only received $37,500 and the heirs of deceased $15,000.56 Still, it was $10 million more than the victims would have gotten under the FTCA and its discretionary function exception.
CHAPTER 4
RUBY RIDGE, IDAHO: FBI OBEYS “SHOOT ON SIGHT” ORDERS
What the plan boiled down to was this: we’d gas the place and rip it up until everybody inside was too hysterical to think straight, and then HRT [FBI Hostage Rescue Team] operators would go into close-quarters battle with women and children.
—Danny Coulson, Deputy Assistant Director, Federal Bureau of Investigation1
You killed my wife! Vicki’s dead! You murdered my boy Sam and wounded my other son Kevin! He may die tonight! Aren’t you a brave bunch of bastards?
—Randy Weaver, shouting to FBI Hostage Rescue Team2
SOME PEOPLE MARCH TO THE BEAT of a different drummer. Randy and Vicki Weaver, the unfortunate victims of Ruby Ridge, had their own marching band. Not that it started out that way—quite the contrary.
Randy Weaver grew up in small-town Iowa, where he attended community college. At age twenty, he volunteered for a three-year hitch in the Army and qualified for the Special Forces, the “Green Berets.” His technical engineering assignments kept him stateside through the height of the Vietnam War.
At the community college, he’d developed an interest in Vicki Jordison, a similar small-town student who was beautiful, intelligent, and strong willed. They married a month after his discharge, and over the next ten years she bore three children—two daughters, Sara and Rachel, and a son, Sammy.
In 1983, the Weavers announced to friends that a drastic change would soon occur in their lives. They sold their Iowa homestead, relocating to northern Idaho to live a life apart, raising their family without the corruptions of ordinary society. Randy would later write:
Quitting your job, leaving family and friends, selling most of what you own to move to a place you have never been, is more risk than most people are willing to take.
Vicki and I had come to the conclusion that we wanted to raise our children away from the rat race and the ever-increasing intrusions of government. I could no longer envision spending the rest of my life working in a factory for forty or fifty hours a week and waiting all year for my three-week vacation.3
The Weavers had another motivation: they were convinced that the end of the world was approaching, the “Days of Tribulation,” when the faithful would be persecuted by the forces of evil. Vicki believed the persecution would begin with a multinational attack arriving through Canada and thought that a self-sufficient family located away from population centers and other potential targets would have the best chance of survival.
That summer, the Weavers lived in a rented trailer
while building their cabin on twenty acres they had purchased at a location known as Caribou Ridge or Ruby Ridge. The construction took months. Kevin Harris, a teenager separated from his parents, usually stayed with the Weavers and helped with the construction. The children acquired a new sibling when Elisheba was born in late 1991.
The cabin grew into a comfortable two-story affair, situated on a knoll with excellent views. The location was isolated but not too remote. A general store with a post office stood about a mile distant, and Bonner’s Ferry (population 2,500) was eight or nine miles away.
The locals tolerated eccentric beliefs; after all, Bonner’s Ferry is home of the 1974 Kootenai Indian War, when the tribe’s sixty-five members declared war on the United States. (The war consisted of charging ten-cent tolls for use of a nearby highway.) The tribe ultimately settled for a six-square-mile reservation on which they built a prosperous casino, a very favorable outcome for people who had declared war on a superpower.
The Weavers remained self-sufficient for eight years, growing crops, raising chickens, and homeschooling the children. Apart from Randy’s unsuccessful campaign for sheriff, their only contact with government came when they paid their taxes. They were, in short, a decidedly eccentric but harmless family … that would shortly become the target of three federal law enforcement agencies.
Randy Weaver was a racial separatist but insisted he was not a racist, saying that “to hate someone just because they’re of another race is sheer ignorance.”4 He would sometimes attend the Aryan Nations’ annual meetings, staying outside to talk.5
It was a safe bet that some, maybe most, of the Aryan Nations’ leadership were violating federal gun laws, which are enforced by the Bureau of Alcohol, Tobacco and Firearms, or BATF, an agency then in the Department of the Treasury. (The agency is today known as the Bureau of Alcohol, Tobacco, Firearms and Explosives, and its law enforcement operations are part of the U.S. Department of Justice.) BATF had one low-level informant inside the Aryan Nations and wanted more access for him, as well as additional informants. Weaver seemed like a person who could be useful for both objectives, but he turned down the offer. Federal agencies know how to deal with stubbornness: set the person up as a lawbreaker then make them an offer they can’t refuse.
I'm from the Government and I'm Here to Kill You Page 7
