Neither Victim nor Villain: Nurse Eunice Rivers, the Tuskegee Syphilis Experiment, and Public Health Work

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 © 1996 Journal of Women's History, Vol. 8 No. ι (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...