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CHAPTER 1

Naturalizing Coercion

THE TUSKEGEE EXPERIMENTS AND THE LABORATORY LIFE OF THE PLANTATION

Britt Rusert

I have often been asked to define the term "Black Belt." So far as I can learn, the term was first used to designate a part of the country which was distinguished by the colour of the soil. The part of the country possessing this thick, dark, and naturally rich soil was, of course, the part of the South where slaves were most profitable, and consequently they were taken there in the largest numbers. Later, and especially since the war, the term seems to be used wholly in a political sense — that is, to designate the counties where the black people outnumber the white.

— BOOKER T. WASHINGTON, Up from Slavery

[T]he procedures adopted for the captive flesh demarcate a total objectification, as the entire captive community becomes a living laboratory.

— HORTENSE SPILLERS, "Mama's Baby, Papa's Maybe: An American Grammar Book"

A few years after the 1932 initiation of the Tuskegee Study, the U.S. Public Health Service's "observation" of "untreated syphilis in the male negro" in Alabama's Macon County, the first clinical article on the topic appeared in the Journal of the American Medical Association. The paper was presented at the 1936 annual meeting of the organization and emphasized an "unusual opportunity" that arose after a survey of the "southern rural areas" revealed that a "considerable portion of the infected Negro population remained untreated during the entire course of syphilis." The original survey, which provided treatment for rural populations with syphilis, was transformed by the Public Health Service (PHS) into a nontherapeutic study that tracked the natural course of the disease by following "the untreated syphilitic patient from the beginning of the disease to the death of the infected person." As is now well known, the participants only remained untreated because the PHS withheld treatment over the course of the study and misled recruited clinical subjects into thinking they were being cared for by government doctors. Embedded within an emerging biopolitical regime in the early twentieth century while anticipating the uneven distribution of health under neoliberalism, the fiction of governmental "care" in the Tuskegee Study masked a structure of scientific exploitation that was racialized, gendered, classed, and deeply connected to the history and afterlife of slavery. While the story of Tuskegee has been thoroughly detailed by scholars, it continues to provide powerful and prescient warnings about how "care" and "coercion" have been intertwined within and beyond the health "care" system under racial capitalism.

Clinical articles published over the next four decades continued to invoke the uniqueness of this situation in the South and repeatedly referred to the investigation as a study of the "natural history of syphilis." The test subjects were often figured in these accounts as mere incubators for the reproduction of the disease, their bodies effectively de-acculturated by the focus on natural history. As Allan Brandt has argued, the idea that "conditions in Tuskegee existed 'naturally'" — and were not influenced by institutionalized racism, widespread poverty, and socioeconomic inequality — enabled the PHS to present a deeply interventionist human experiment as a simple, observational "study in nature." For example, researchers cited the geographic isolation of the research population to justify the test group's lack of access to "modern treatment."

The PHS's dependence on a rhetoric of natural history in this geography of the U.S. South reveals an enduring scientific history on and of the plantation, which, in the age of slavery, served as an informal laboratory for all kinds of experimental investigations into the "natural history" of race. Despite the presence of an already established and pervasive discourse that the poor, rural plantation districts of Alabama existed outside of modern culture, an entrenched discourse about the South that certainly contributed to the study's conditions of possibility, researchers still worked hard to ensure their test subjects blended into the background of the laboratory's southern scene. The Tuskegee clinical articles, for example, represented the residents of Macon County as nonmodern folk who remained connected to a primitive agricultural landscape — the study was even scheduled around crop cycles to accommodate participants' work schedules. Most of the men selected for the syphilis experiments were sharecroppers who worked under white farmers in a system of debt peonage.

The PHS was clearly attuned to the role the plantation complex played in organizing the human and agricultural geography of Macon County. Researchers figured Macon County as an ideal laboratory, a perfectly enclosed system that was produced out of the peculiarities of an isolated and insular plantation system. In other words, an understanding of the plantation as a closed, even carceral, space that contained and enclosed a discrete population allowed PHS officials to figure Macon County as a scientific laboratory, cut off from the contingencies and unwanted variables of the outside world. Over and over again, researchers emphasized the "non-migratory nature" of their test population. It is true that in 1932, Macon County was still very much tied to its plantation past, but that past was itself part of the movements, reorganizations, and upheavals of industrial capitalism. Ignoring the reality of the Great Migration, the literature and on-the-ground experiments of Tuskegee naturalized both the coerced containment and forced migration of African Americans within ongoing processes of dispossession and displacement.

In their attempts to figure Macon County as a sealed laboratory that effectively enclosed a stable experimental population, the Tuskegee researchers extended the laboratory life of the plantation into the twentieth century. This essay attends to a prehistory of the Tuskegee Study in order to better understand how experimental plantation geographies were reproduced and managed well after Emancipation and Reconstruction. I track how an emergent New South discourse at the turn of the twentieth century sought to maintain the integrity of the plantation as a closed system even as the natural resources of the South were being offered up to the national and global economy. After slavery, industrialists and farmers alike scrambled to recontain black laboring bodies — as well as nonlaboring, "surplus" bodies — within carceral geographies sited on old plantation grounds, new work camps, and a growing prison system.

Turning to Booker T. Washington's Tuskegee Institute, which was founded in Macon County in 1881, this essay considers the relationships between the hygienic pedagogies of Washington's South and the kinds of spaces traversed — and bodies mined — for the benefit of the Tuskegee experiments. In many ways, what we discover in Washington's writings and speeches is an articulation of the relationship between blackness and what we would today call biopower, Michel Foucault's theory of the emergence of a new mode of governance in the nineteenth century in which the management of life, rather than death, became the object of power: "in this model of power, the expansion and efficiency of life, not its deduction, becomes the primary function of power, and deduction [death or debility] is merely an instrument in the service of expansion," and in the service of the "optimization" of life itself. But rather than resisting regimes of biopower operating under the guise of health, care, and life, Washington actually advocated for the transformation of African Americans, especially former slaves of the South, into a coherent population for the purposes of biopolitical governance and intervention. In other words, it is as if Washington recognized this new, emerging form of power being organized in the nineteenth century, and sought to encourage and economize the folding of the anatamo-political black body, and a newly coherent black population, into biopolitical regimes of power. Indeed, throughout his writings and at the Tuskegee Institute, Washington was obsessed with making his students as well as a larger population of ex-slaves "useful" to the state, advertising the local population as another resource to be exploited in what the sociologist Robert Bullard has called the "sacrifice zone" of the South. The focus on personal hygiene and cleanliness at the Tuskegee Institute opened the door for alliances with public health initiatives early in the twentieth century, making the school's student population as well as residents of surrounding counties subjects of intense hygienic surveillance. In short, the residents of Macon County had been transformed into a research population well before the 1932 initiation of the syphilis experiments.

Consistently and across several decades, Tuskegee researchers trafficked in discourses about the supposed "naturalness" of space and life in the Deep South to obscure technologies of experimentation that included the surveillance and coercive attempts to contain and control the research population for the purposes of the clinical study. Researchers and advocates benefited from the historical boundedness of blackness to the land in the plantation South to present the study as both noninvasive and controlled (it was neither). Moreover, researchers effectively ignored the historical reality of the Great Migration while dealing practically with the fact that the men in the study were continually moving, leaving, escaping all the time. Researchers drew on perceptions about the "primitiveness" and timelessness of black southern life to obscure the exploitations of the experiments at the same time as they understood the experiments to be central to a broader effort by the U.S. government to present itself as international leader in biomedicine in the postwar period. In this way, the dialectic of innovation and inequity that characterizes contributions to this volume here takes on a distinctly racialized temporality: Tuskegee was used to establish the position of the United States at the forefront of scientific innovation in the period, over and above Germany, but the study "participants" were continually pushed back to a mythic premodern past in order to obscure the violences that enabled innovations in modern medical "care." The fiction of slavery as a nonmodern, feudal system of serfs wedded to the land also proved useful for mitigating worries about the contingencies and actual movement of the Tuskegee research population.

On the ground, and in the Tuskegee clinical literature, poor communities of the rural South were thus transformed into nonmodern enclaves that existed in a natural state, apart from the nation-state and beyond the jurisdiction of modern medicine. Such characterizations, of course, obscured the systematic withdrawal of resources from the post-Reconstruction South, removed blackness from modernity, and used — but not did not serve — southern black communities in the quest for establishing the centrality of the United States to a global scientific-technological modernity. In this way, Tuskegee's naturalization of socioeconomic inequalities, paired with the merging of black bodies with the southern environment, effectively resignified the commodifiable, exploitable enslaved body — or what Hortense Spillers refers to as captive "flesh," upon which anything can be done — for postslavery scientific modernity. As under slavery, New South discourse and initiatives, from business journals to the showcasing of black talent at world's fairs and expos within and outside the United States, offered up black workers to the North and to emerging global labor markets as "natural resources," akin to and wedded to the rest of the exploitable South. And as the history of the Tuskegee experiments demonstrates, if black southerners weren't able to work because they were ill or otherwise incapacitated, they would be put to "use" in other ways, in the name of science and life itself.

NATURAL RESOURCES OF THE NEW SOUTH

Although public health intervention in the southern states focused primarily on urban spaces, the rural plantation became a site of legitimate concern for the medical establishment by the mid-nineteenth century. James H. Cassedy marks the 1840s as the period in which "plantation hygiene" took shape in the context of the growth of medical topography, the rise of geological surveying, the establishment of the American Medical Association, the enthusiasm generated by sanitation reform in the North, and the increase in medical journalism in the South. Observers of the period believed that disease emanated from recently cleared land: since the turning of soil was believed to unearth unhealthy elements, medical authorities encouraged planters to build their plantations quickly in order to counteract or minimize disease conditions. Experts directed planters to keep the entire architecture of the plantation, including the "culture of soil, building, drainage, ditching, and manure making," as organized as possible, since disordered plantation geographies were thought to engender disease. Plantation organization in the nineteenth century was, therefore, tightly conjoined with healthfulness: the ordered plantation, in these discourses, itself becomes the cure, the picture of health in the antebellum South. The plantation was figured as a kind of biopolitical institution of health management early on, as planters sought to keep an entire ecology of slaves, crops, animals, and environmental factors in a salubrious order.

Just as the industrial factory was modeled on the colonial plantation, the plantation emerged at the frontier of biopolitical innovation, as an institution "where[in] certain subjects became objects of knowledge and at the same time objects of domination," but were transformed into such in the name of "health" and "life." In the postbellum plantation South, African American labor could be separated from a concern with the body in a way that was impossible under the auspices of a plantation system that needed to keep an internal ecology of crops and enslaved laborers in balance to maximize profit. Of course, slavery was in no way a humane institution that properly cared for slave health, but it is crucial to draw attention to the important role of sickness management in the day-to-day operation of antebellum plantations. Such regimes of plantation soundness established a kind of governance over African American subjects in the South that seemed to have become obsolete with emancipation. However, industrial schools and other training sites that were established for the education of ex-slaves effectively reanimated systems of health management in order to incorporate black subjects back into the coercive labor structures of the New South and into emerging regimes of biopolitical governance. Houston Baker has written on the ways in which particular institutions in the postwar South worked to confine African American subjects within "plantation arrangements" into the twentieth century. Tuskegee serves as his prime example. Indeed, Tuskegee's success in propelling such plantation arrangements was due in large part to how health management at "Mr. Washington's plantation" stood central to the school's practices and pedagogies. New South institutions picked up where the plantation left off: continued interest in maintaining the health of an institutional environment enfolded the bodies of black subjects — not just their labor — back into intimate structures of the New South economy. As in so many plantation environments under enslavement, Tuskegee's management personnel were concerned with keeping the health of an entire institutional ecology in balance.

Washington foregrounds personal hygiene throughout his writings, most notably in his 1901 autobiography, Up from Slavery. Washington primed for his civilizing missions at Tuskegee in his domestic role as "house father" to Native American students at Hampton Normal and Agricultural Institute in Virginia. In 1881, Washington was invited upon General Armstrong's recommendation to head up an industrial school in Macon County, Alabama. The state legislature had recently approved an act that sought "to establish a Normal School for colored teachers at Tuskegee" and granted the school $2,000 annually, a meager sum compared to the allowances given to other educational institutions in the state. Washington eagerly took up the mission to bring the Hampton model of education into the Deep South, to provide students with a "practical education" that favored practice in agricultural and work-related tasks over a classical curriculum that would apparently go unused in the rural South. In the process of "working with the hands," students would grow to love the menial tasks that differed little from the toil of the (old South) plantation.

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