Writing Frame Form
Just like a picture hung on the wall looks the best when it is displayed in a frame that “fits” the picture, so too is writing at its best when it is written to fit inside its “frame.” The “frame” for writing consists of elements of the writing situation—your audience, your purpose, the genre in which you’re writing, and the time period in which you’re writing. These four elements compose a “frame” that allow you to craft the most effective piece of writing possible for the particular writing situation which you are attempting to address.
For each piece you write in this class you will be asked to identify the “frame” in which you’re writing.
Answer the following questions:
Who is your audience—in other words, who are you trying to write to? Be SPECIFIC! Don’t just say “general audience.”
My audience in this piece is my peers in and out of academia whom may have little to no knowledge of black American History, let alone the Tuskegee experiments.
What is your purpose—in other words, what effect do you want to have on your reader?
The purpose of this piece is to first introduce the event and give an overview of what happened. Second is to introduce research that shows how this event is still having an impact in black American society today.
What genre are you writing in? What are some of the conventions of this genre that might be important to consider as you begin your writing process?
Argumentative essays, such as this, can come across with an aggressive tone. Making sure to prove points with solid information and watching the language I use should help me avoid that.
How is your topic relevant to your audience NOW in the time period in which you’re writing?
This is the point of my essay. The study still affects the way black Americans receive health care and partake in medical trials, or rather the reasons some choose not to. Members of black American culture who have a mistrust of the government and medicine can only choose to start to rebuild that trust once there is nothing left to hide.
Given your audience and purpose, what kinds of evidence/support will you need/use to develop your purpose convincingly for your audience?
Evidence supporting the details of the event would be a good place to start. Studies from the last 5-10 years showing the difference in black Americans participation in medical studies and trials, as well as about why the difference exists in reference to the Tuskegee study would strengthen my argument. Articles showing mistrust among black Americans towards medical studies would be most beneficial.
How will you use YOUR own voice in this piece of writing? Why is YOUR voice important in this piece of writing?
This is the part I am having the hardest part with. I am not a black American, so I have a hard time finding where my voice plays any part in what moments in black American history are important. I feel that black Americans should tell me what moments they think I should view as important and why. Not because it is not something I care about, but rather the opposite. Black American history is a bigger piece of American history than my Irish and Norwegian forbearers’ and is a fascinating subject. I just don’t see where a blonde haired, blue eyed males’ voice has any place dictating black American historical importance in the same way I feel someone from Thailand may not be the best voice to convince anyone of the importance of Norwegian history. We as humans try to see things through other cultures “lenses” but so much is often misinterpreted as things we don’t understand we automatically view through our own lens.
Saying that, I suppose I will use my voice to verbalize what I am learning and make sense of the effects of the event for my own later use. In another sense, perhaps a white American voice may bring attention from a white American crowd regarding a black American topic that they would have otherwise been ignorant of.
Tuskegee Syphilis Study: Effects of a Not so Distant Past
Today in 2014, in an era where there is a black American standing in Presidential office, most people would like to think that the backward, ignorant ideals of racism and bigotry are a thing of a far distant past and that their effects have long since vanished with them. Most people would not believe that in 1972, a not so distant past, an abomination of a “study” done in the name of medical science was finally unearthed after existing unnoticed in the small rural and financially crushed Macon County, Alabama for 40 years. This study was called many names, but the most direct and explicitly worded title is the Tuskegee Study of Untreated Syphilis (TSUS) in the Negro Male.
Macon County, Alabama where the Tuskegee Study’s clinic acquired its victims was home to an onslaught of financial hardship beginning in the 1920’s and 1930’s. Harriet A. Washington, medical ethicist and award winning non-fiction author, paints a picture in her book Medical Aparthide of the ungodly economic conditions these men lived in; There were 27,000 blacks in the county. They accounted for 85% of the population and more than half of them lived on less than a dollar a day, which even in the 1930’s was meager, to say the least. The black residents, though free, still lived a very similar lifestyle to their enslaved forbearers. The reason for this was simple in many cases; they were just never paid by the people they worked for (158-160). It was in this poverty stricken Alabama County where Booker T. Washington, the founder of the all black college; the Tuskegee Institute, met with Juilus Rosenwald who was the founder of Sears, Roebuck & Company. Rosenwald, who was a wealthy man, had realized the stifling poverty surrounding the institute and the difficulty that would place on finding staff and growing as a university. Together, Booker and Juilius opened a health clinic aimed at the local populous under the premise of raising the level of health in the surrounding area to promote growth in the Tuskegee Institute. This care plan was in full effect by the 20’s. Unfortunately, in 1929 Rosenwald lost his fortune in the stock market crash and the program was abandoned. However, the clinic staff and facility would soon provide the framework for TSUS.
Though, the clinic’s original focus was the general health of Macon County, the loss of Rosenwald’s funding left it in the hands of men less concerned with wellbeing. The Public Health Service’s (PHS) physicians working at the clinic during this crucial stage were outspoken with their negative opinion of black Americans. Harriet A. Washington quotes one physician, Thomas Murrell, saying in regards to the area’s syphilis pandemic “So the scourge sweeps among them. Those that are treated are only half cured, and the effort to assimilate a complex civilization drives their diseased minds until the results are criminal records. Perhaps here, in conjunction with tuberculosis, will be the end of the negro problem. Disease will accomplish what man cannot do.” (160). Another physician under the employ of PHS at this time was Dr. Tailiaferro Clark. This man looked at the results from recent blood tests in the clinic that showed 36% of the black American men tested had syphilis. He disregarded a plan that would have eradicated the disease in the county, and instead came up with a way to save money on treatment which ultimately he successfully pitched to the head of the PHS. His plan was simple: sit back and watch as the disease ravaged the bodies of those men until death, then preform autopsies and, in the end, publishing the findings (160-161). TSUS involved a total of 399 black American males who had been diagnosed with syphilis since its conception in 1932. These men were lured to the clinic under the guise of free medical care and most of the men in the study had little or no formal education, no ability to know any better than what the doctors and nurses at the clinic told them. The infected men recruited for this medical study were not offered treatment, not even when antibiotics were found to cure syphilis in the 1940’s. The men were simply observed as they were ravaged by this deadly disease of which they were not even aware they had.
The very idea that 400 people, under the promise of care, were allowed to suffer a debilitating, life threatening affliction for which there were known treatments is enough to make my skin crawl. Though, I believe a basic idea of what syphilis does to the body is also needed to truly appreciate how malicious these studies were. According to the Center for Disease Control (CDC) website, after about a year of being infected with syphilis without treatment all physical symptoms cease. The rashes and sores go away and everything appears mostly normal. 15% of cases that reach this “latent” state proceed to the late stage between 10-20 years later where the disease may create tumorous growths and begins to disrupt nerve function, leading to loss of muscle control, paralysis, dementia or other mental instabilities and eventually death. The growths and general lowering of the immune system can lead to other deadly complications, as well (CDC.gov). All preventable with simple treatment, yet treatment was withheld and that was the fate knowingly cast upon 400 black American men and their families; a fate of death and suffering that lives well past the study’s 40 year life.
The timing for what I can only think to refer to as an atrocity like TSUS may seem unlikely in some ways. On one hand black Americans during the early 30’s in the American south were not a widely used example of a happy, prosperous, free people. Segregation was very much in full swing and poverty was prevalent, to name only a few stones in the mountain of issues that still needed (and many still need) to be overcome, but the image on the surface of American media (or what one can call a surface when making reference to black Americans in American media) at the time in which TSUS was being initiated and performed was one of progress, though slow and impeded. During the Tuskegee Study’s inception the Harlem Resonance was near its height. In 1935 the Supreme Court ruled that the University of Michigan allow black American students into its law school. 1947 was the year Jackie Robinson became the first black American to play major league baseball. In 1963 Martin Luther King Jr. gave the “I have a dream” speech in Washington. He was named Time magazine’s “Man of the Year” in 1964, and the same year, King became the youngest person to ever receive the Nobel Peace Prize. In 1965 Lyndon B Johnson finally gave black Americans the right to vote, and in 1972, the year TSUS was exposed, Barbara Jordon of Houston and Andrew Young of Atlanta were elected to congress, the first black Americans to hold congressional office since the post-civil war reconstruction era. This was certainly a period of progress… on the surface. This brief, yet powerful history in which it appears as though black Americans were finally starting to be given the respect as human beings that they deserved was so direly punctuated by the TSUS atrocity. That interruption very well could be a major contributing factor to the continued distrust of the American government, especially its role in medicine and research.
Now that I have laid a bit of a knowledge base about TSUS and the situations surrounding its creation and exposure, I would like to recall Murrell and Clark, who I had mentioned before as key members in the creation of TSUS and ranking members in the PHS. Those men, who so maliciously and greedily took advantage of the lives of other men based on race and ignorance, were leading officials in a sect of the United States government meant to protect the health of the public, the very public they watched suffer and die from a treatable disease. I believe the radiating effects of such a ghastly wrong doing are still felt today and they strengthened a certain mistrust in the black American community regarding the American medical system, clinical trials and medical testing. In an article titled Reverence and Ethics in Science, Jeffery Kovack of the University of Tennessee expresses the destructive nature of scientific misconduct; Instances when scientists go against the very nature of science and lie, or manipulate data, and knowledge of the event becomes public, the foundation of trust between science and people is damaged (755). I think that because of the duration of, and the lack of acknowledgment in the media and academia, the Tuskegee Study of Untreated Syphilis was one of the most crippling of blows ever made to that trust and greatly influences the medical decisions of black Americans today.
To take a more in depth look at modern day statistics reflecting this claim, I turn to an article by Vickie Mays, Courtney Coles and Susan Cochran from the University of California, Los Angeles which lists the results regarding biomedical studies and the origins of HIV/AIDS from a survey of 510 black Americans and 253 Latinos. The results are heavy. 32% of black males think AIDS was created in a test tube and spread in Africa by Scientists doing research. 38% believe there is a cure, but the government will not distribute it. 32% agreed that AIDS was developed as a plot to destroy the black community. When compared to the number of Latinos who agreed with said statements, the statistics dropped heavily. In the same order as the statements and percentages listed above, 14%, 16% and 7%. To compare, when Latinos asked if AIDS was created to destroy the Latino community only 8% agreed, which is only one percent higher than when Latinos were asked if AIDS had been created to destroy the black community (468). One third of the sample population of black Americans feel that AIDS was created by the government to specifically kill them. More than a third thinks that the American government is performing a mass version of TSUS by watching as people die from AIDS while they sit on a cure. The same study also found that 29% of black American males knew of Tuskegee, but thought the scientists had injected the victims of TSUS with syphilis. Though, this is not entirely true, as the men in the study already had the disease, the number of people in the sample group who had knowledge of TSUS and the outcomes of the survey lead me to believe that there is a correlation between being aware of the event and the level of trust in western medicine within the black American community.
This link is further explored in an article of the New York Amsterdam News by Carla Zanoni where she ties black American males’ unwillingness to take part in HIV/AIDS programs funded by the government to the Tuskegee study. She states that black Americans made up only 18% of the population in 2000 and yet they accounted for 54% of all new HIV/AIDS diagnoses (31). Does this simply mean that black Americans are more prone to HIV due to having a higher level of drug users or people who have unsafe sex? Zanoni quotes Antonne Moore of the Black AIDS Institute in California in response “None of those things are true. When you look at it, poverty, drug use, and homophobia are not unique to the Black community. But, when you combine it with conspiracy fears, suspicion of government agencies, racism, suspicion of the medical industry, they become barriers to HIV prevention and treatment.” (31). Zanzoni further addresses the issue by saying that black American’s have not participated in government medical programs for a number of reasons, one of them being a feeling of distrust that runs deep. Later in the article, Zanzoni says that Moore specifically names TSUS as a leading reason for this feeling of mistrust (31). The knowledge of TSUS cannot alone be the cause for so many black Americans infected with HIV/AIDS to remain untreated and wary of medical care, but it seems to me that a link cannot be denied.
A potential rationalization for the attitude of black Americans towards medicinal science might be reducing it to simply a minority issue assuming that this same mistrust is prevalent among all non-white communities. This simply is not the case. If the differing perceptions on HIV/AIDS between blacks Americans and Latinos needs backing up, a focus group study performed by Bates, PhD and Harris, Phd meant to gather information on the effects of the Tuskegee Study on public perception of biomedical research found that “Indeed, TSUS (Tuskegee Study of Untreated Syphilis) was a marker for distrust of biomedical research for African Americans.” (1056). They go on to say that the members of the black American groups of the study were the only ones to bring up Tuskegee and directly correlated it to their distrust of the medical sciences. I think the combination of studies shows the far reaching effects of TSUS on black Americans quite clearly.
Counter argument can be found in the Vickie Mays, Courtney Coles and Susan Cochran study I have drawn on before. The idea suggests that the link between TSUS and black American distrust of western medicine may not be as strong as others think, as when surveyed 71.9% of black Americans had never even heard of the study (466). Though, I have to disagree with the notion that the high percentage of people ignorant to the event supports the argument that TSUS’s effect on black American society today is not of importance. I see the percentage of people who were aware of TSUS being within just a few percent of those who believe that AIDS was engineered to end black society. As mentioned, the 29% that did know of the study thought the experimenters gave syphilis to the victims, rather than them coming into the study already infected. This misinformation may be further encouraging black Americans to resist going to clinics when they are sick for fear of being given something much worse, such as AIDS, syphilis or experimental medication.
General trepidation demonstrates the implicit value, I think, in the teaching and discussion of TSUS’s existence, and its acknowledged failure within western medicine, especially in the black American community. The value is not monetary, but rather one of understanding and peace of mind. Despite understanding that TSUS was an utter failure in 1972, when someone within the PHS finally took a step back to look at the 40 years of “data” collected in the name of science and realized “nothing learned will prevent, find, or cure a single case of infectious syphilis or bring us closer to our basic mission of controlling venereal disease in the United States.” (1), it was not until 1997 that the government put forth an official apology to the survivors of the experiment and admitted publicly that TSUS was “clearly racist,” as put by President Bill Clinton (Youtube.com). It took the government that paid for and performed this “study” 35 years to apologize and that alone is an outrage. While researching TSUS I scanned over dozens of newspapers from the weeks following the uncovering of the study and did not find more than a few small columns and not a single front page article; a sad insight into American media and government policy. To build trust in any relationship the parties involved have to remain honest and transparent. When a wrongdoing has occurred, the party at fault is responsible for admitting the wrongdoing as a first step to rebuilding the damaged trust. Covering up only worsens the wound caused and betrays the need to remain honest. The lack of acknowledgement of TSUS and the apology that didn’t come for 35 years after the experiment was exposed is no doubt a deeply felt offence, and in an age of such advancement in the treatment of illness, a deep seeded feeling of mistrust in medical science would be a major health drawback in any community and is a bridge needing rebuilding.
The importance of TSUS being a taught part of black American history can be seen in the burdensome mistrust that surrounds the medical institutions put in place to help. As I have shown, that mistrust is clearly visible in the way that black Americans view HIV/AIDS and its treatment. This mistrust is fueled by the lack of acknowledgment of the study and the lack of education of the actual events. By bringing this dirty piece of America’s not so distant past into light, there can then be work to build trust and understand the series of events that lead to 40 years of torture in the name of medicinal science. Knowledge of TSUS is a power needed by black Americans to make sure something like it does not happen again. Not only is this knowledge important to black Americans, but to all Americans. Knowing that such a hardship was endured, who it was implemented by and the ongoing effects of such a monstrosity are nesicary pieces of information for non-black Americans in understanding medical trends, such as the possible driving causes in the high rates of HIV/AIDS, and to ensure that the ignorant ideas that drove TSUS are not perpetuated in the future. Awareness, not ignorance, of TSUS is the first step down the long road to rebuilding the bridge between black society and western medicine.
Zanoni, Carla. “The Deadly Disease: African American men battle with HIV/AIDS Epidemic”
New York Amsterdam News Nov 11-17 (2004) Vol. 95, No. 46. Pg 1+31. Print.
Mays, Vickie M. Courtney Coles, Susan Cochran.” Is There a Legacy of the U.S. Public Health Syphilis
Study a Tuskegee in HIV/AIDS-Related Beliefs Among Heterosexual African Americans and Latinos?”
Ethics and Behavior 22,6 (2012) Web.
Bates, Benjamin PhD, Tina Harris PhD. “The Tuskegee Study of Untreated Syphilis and Public perceptions
of Biomedical Research: a Focus Study.”
Journal of the national Medical Association Vol. 96 No. 8 (2004): 1051-1058.
Brunner, Borgna. “The Tuskegee Syphilis Experiment.”
Infoplease.com Pearson Education 2014.
Kovak, Jeffrey. “Reverence and Ethics in Science.”
University of Tennessee (2012) Web: 745-756
Washington, Harriet. Medical Apartheid: the Dark History of Medical Experimentation on Black
Americans from Colonial Times to the Future. New York: Doubleday,
Clinton’s Presidential Library. “Apology to Survivors of the Tuskegee Syphilis Experiment” Youtube
Youtube. 2 May 2002 Web.
Brown, Mitchell. “Timeline of Events in Martin Luther King, Jr’s Life” Louisiana State Libraries
Louisiana State University. (2014) Web.
CDC Syphilis information