Bad Blood: Historical Document Review of the Tuskegee Syphilis Study

Historical Context: The Tuskegee Syphilis Study began in Macon County, Alabama in 1932. This was during the Great Depression in the deep south, an area where Black sharecroppers worked tirelessly for low-pay. Jim Crow laws, segregation, and racial prejudice were a huge part of daily life for the poor and often uneducated workers in this area.

At this same time, syphilis was a disease spreading rampantly around the world. This Sexually Transmitted Infection (STI) would begin with painful sores and eventually, if left untreated, move on to attack the nervous system, including the brain, nerves, eyes and heart. There was no proven treatment for the disease. Researchers from the U.S. Public Health Service (PHS) theorized that the disease affected the nervous system of white people more often, and the cardiovascular system of Black people. There was little evidence for this, however there are many examples throughout history of the same sorts of racial prejudice in the medical field. In order to study this theory further, PHS researchers found a group of men in Macon County to test their hypothesis on.

600 men were selected for this study. 399 were identified to have syphilis and 201 did not test positive for the disease. The purpose of this PHS study was to compare untreated syphilis in the group of 399 against the group of 201 who did not have the disease and study the differences over their lifetimes. The group of the 399 participants were not told they had syphilis, instead being told they had “bad blood” and would receive free treatment through this study. The purpose of the study was never explained to the participants, which is a practice researchers call giving the participants Informed Consent.

In 1942 penicillin was first developed for widespread use. In 1947, the antibiotic was identified as an effective treatment for syphilis. PHS researchers in the Tuskegee Syphilis Study decided at this time not to provide the men in their experiment with penicillin, which would have cured their disease, instead continuing to give them a placebo in place of any real treatment.

In the mid-1960s a PHS disease investigator named Peter Buxton found out about this study. He reported to his superiors that he was concerned with the ethical and moral issues apparent. Supervisors at PHS reviewed the case, but ultimately decided to continue to continue the study. As men identified in the original study were dying, their bodies would be collected and autopsied by PHS, and the findings were determined too important to stop the study.

Peter Buxton continued to feel uneasy about what was happening, and contacted Jean Heller, a reporter for the Associated Press. Jean Heller broke the story in 1972, and amid a massive public outcry, the study was disbanded. To this day it is unknown how many people were affected by this disease which has been treatable since 1947.

Further Information and Context:

  1. Tuskegee University article “About the USPHS Syphilis Study”
  2. article “Tuskegee Experiment: The Infamous Syphilis Study”
  3. Newsy video “The Unknowns about the Tuskegee Syphilis Study
  4. TedEd video “Ugly History: The U.S. Syphilis Experiment- Susan M. Reverby

Essential Questions:

  1. When should an individual take a stand against what they believe to be an injustice? What are the most effective ways to do this?
  2. What are the causes and consequences of prejudice and how does an individual or group’s response to it reveal their morals, ethics, and values?
  3. How do racial stereotypes influence how we understand the world?
  4. When is it moral for scientists to study on human subjects, if the findings are “for the greater good?” Who determines what the greater good is?

Assignment: This lesson will utilize the historical thinking skills of sourcing and contextualization. Students will be asked to review images and text which assess their critical thinking skills of how a source provides a perspective on an historical event, how time and place influence a historical document, and how historical documents shape our understanding of history. Students will respond to guiding questions provided for each resource which will ultimately tie back to the larger themes presented in the essential questions.

Document One: Experiment Draft Report pages 1 and 2

Examine the pages of this draft report on the study. What is the purpose of the study as stated? What could be reasons for the edits in pencil? What jumps out at you as interesting about the edits? When was this report written and what do we know about the treatment of syphilis by this date?

Image courtesy of Picryl
Image courtesy of Picryl

Document Two: Classification Data

This is a classification set of data for the experiment, outlining factors of the men involved in the experiment. When was this data published and what do we know about the treatment of syphilis at this time, and the ethics concerns raised at the PHS by this time? What questions does this document raise about deaths as a result of this study? Since we know syphilis is sexually transmitted, what questions does this document raise about total deaths as a result of this study? Does this document give us any insight into how the researchers viewed the participants of this study?

Image courtesy of Picryl

Document Three: Images of Participants

What do we know about the lives of the men who participated in this study? How might the circumstances of living in the deep South under Jim Crow laws have influenced the ability of these men to advocate for themselves, or even to understand the purpose of the study? In these images the men are seen picking cotton. How can we compare and contrast the system of slavery with the syphilis study in the context of access to and ownership over the bodies of Black people?

Image courtesy of Picryl
Image courtesy of Picryl

Document Four: Memorandum re Termination of the Study and Thank You to Study Participants

How does (if at all) the Memorandum document address the reasons for the termination of this study? What do we know about the article written by Jean Heller and how this memo is a response to the publishing of that article? How do the memo and thank you certificate compare and contrast based on the date they were published in telling us how the U.S. government felt about this study?

Image courtesy of Picryl
Image courtesy of Picryl

Document Five: Interview Transcript and Images of Participants

How does this interview transcript give us more insight into the way the participants of the study were deceived or mislead about the purpose of the study? What do we know about the shots, spinals, and treatments given to the groups identified to have syphilis? Why are the details about the man who went blind important in the context of the study and of the symptoms of untreated syphilis?

Image courtesy of Picryl
Image courtesy of
Image courtesy of Picryl
Image courtesy of Picryl. Woman on the right identified as Nurse Eunice Rivers.

Final Thoughts:

An assignment of this sort may lend itself to shorter writing samples from the leading questions above each image, or possibly a longer essay responding to one of the essential questions. Students would be encouraged to connect this event to others in history and research further on questions which arise for them during the lesson (student questions are always preferable to the ones I come up with!). Students may also want to do some further reading on the participants of this study, and this CBS article from 2017 from the family members of participants may be a good place to start.

HOLC Loans in Portland’s 1940 Census: Investigating the Effects of the Great Depression on My Family

My family tree goes back many years in Portland and the neighboring Oak Grove on both my mother and father’s sides. For the purposes of this project I focused on my maternal grandfather’s family and the way the Great Depression affected their financial situation, speculating on how it may have related to HOLC Loans.

Living in Sellwood neighborhood, outlined as area C-19 on the Mapping Inequality: Redlining in New Deal America, my great-grandparents were in a “middle yellow” neighborhood. Sellwood was an area characterized by its “age and obsolescence,” but also had a high percentage of home ownership and “remote level of infiltration,” with 10 percent foreign-born families.

Image on the left from the Redlining website, on the right is a current map of Portland.

In the 1940 Census I was able to find more information about my great-grandparents and grandfather. At the time Clyde Newstrum was 41 years old, his wife Valentine was 38, and my grandfather Richard was nine. At the time he was in third grade, attending the same elementary school I would go to many years later. My great-grandfather Clyde worked for a collection agency, and my great-grandmother Valentine made about $5.00 a week working at a local bakery decorating cakes. Although Valentine made $300.00 in 1939, she was not listed as having a profession or career on the census, which I can only imagine is because of the stigma against women working outside of the home at the time. Coming out of the depression of the decade prior, in the 1940 census Clyde was listed as making no income, likely because as a collector during the the past decade there was probably not a lot of money to be collected. Their home, built in 1926 according to Zillow, was owned and cost $3,500.00.

Screenshot from the 1940 census, found at this website.

One thing that also surprised me about the census information, was Valentine not identifying as an immigrant. Valentine was born as one of 18 children in Quebec, Canada to parents who immigrated to Canada from France. In later years, during the Korean War, my grandfather Richard served stateside as a Lieutenant, advanced through the ranks because of his Masters in Fine Arts. After being approached for a special project, he was later rejected due to the immigration status of his mother. It’s possible that Valentine did not know she wasn’t born in Oregon, and later in life she did achieve citizenship with the help of my mother. It could also be possible that she chose not to identify as an immigrant due to the unfavorable societal view of immigrants.

My grandfather on his wedding day 1954, standing in front of his parent’s home.

The HOLC loans were intended to assist people purchase homes after the Great Depression of the 1930s. This system of state-sponsored loans, however, led to racial discrimination in the form of redlining, or classifying different neighborhoods into favorable or unfavorable based on the amount of immigrants and people of color in the area. HOLC loans were often denied to people of color.

I’m not sure if my great-grandparents were in a position to need to take a loan on their home, but I think that if they were, they would likely have been able to secure one. They had a demonstrated need according to the 1940 census, and although my great-grandmother’s status as an immigrant should have counted against them, white immigrants from Northwestern European countries were seen as more desirable candidates, mostly because of racist stereotypes.

The changing role of women in the PRC

Image courtesy of Picryl

Target audience/setting: The target audience for this lesson is my 12th grade 20th Century History class. The unit this lesson comes from is about Mao’s domestic policy after taking control of the People’s Republic of China (PRC). Students will need to have an understanding of the rise of Communism in China and some information about how Mao Zedong rose to prominence and consolidated power. This lesson could also be used in a class concerning women in history.

Content: The content of this lesson provides background information on the role of women in China prior to the PRC, focusing on some of the misogynistic and repressive policies and laws which governed the lives of women. It then provides information for how Mao’s policies changed the lives of women, and asks students to examine some final questions about how these policies improved the lives of women, and how they still may have been room for more improvement. This content is usually something that is not addressed, or breezed over quickly in history classrooms. By examining the perspective of a marginalized society, but also one which makes a huge percent of the population of China, we can gain more knowledge about how Mao was able to consolidate power and gain the support of the people of China, and why to this day he is still loved. Students will be able to articulate how the role of women changed in China after 1949 and how this shifting role was a portion of a larger societal change as China became a Communist country.


  1. Review Jamboard with historical images of women in China before the establishment of the PRC. Most images are from the late 19th century. Ask students to make notes about what they think is happening in the pictures, who is in them, and how they may give us insight into the role of women at this time. 8 minutes.
  2. Explain the background of each image. 3 minutes.
  3. Watch three short videos clips from the longer documentary series China: A Century of Revolution which explains more about how women were treated before the PRC and how their role changed after 1949. 5 minutes.
  4. Review via a slideshow some of the information seen in the images and documentary. Explain the Marriage Reform Act, the criminalization of foot binding and prostitution, etc. 5 minutes.
  5. Review takeaway questions from the lesson and allow students some time to answer in short paragraph form several questions from the lesson. If time allows, students can discuss in small groups or in a teacher-led discussion. 5 minutes.


Google Slides

Google Jamboard

Stalin’s Great Terror: Choose Your Fighter Edition

Image of Stalin and Kirov, 1925. Kirov’s assassination served as Stalin’s catalyst to try and execute former party leaders. Courtesy of Picryl.

Below is a choose your own adventure Google Form related to Stalin’s Great Terror. This form fits perfectly as an example project for my senior IB 20th Century History students. It’s an informative and educational way to present the fate of several key party leaders who Stalin rose through the ranks with and eventually outfoxed to become the leader of the USSR. Students also have some element of choice, and the form uses humor to help students remember who these characters were and the parts they played.

I will use this as an example of a type of project the students can create for a summative assessment of their understanding of how Stalin used fear tactics to consolidate power in his early years as leader of the Communist Party, eventually consolidating the power to the point of being the only authoritarian leader of Russia.

Link to Google Form.