WEBVTT - Special Episode: Dr. Carl Elliott & The Occasional Human Sacrifice 0:00:43.600 --> 0:00:47.239 Hi, I'm Aaron Welsh and this is This Podcast Will 0:00:47.320 --> 0:00:50.720 Kill You. You're tuning in to the latest episode of 0:00:50.800 --> 0:00:54.200 the tp w k Y book Club, a series where 0:00:54.200 --> 0:00:57.520 I bring on authors of popular science and medicine books 0:00:57.600 --> 0:01:01.240 to chat about their latest work. Through this series, we've 0:01:01.280 --> 0:01:05.560 gotten to cover some fascinating and eye opening topics, from 0:01:05.760 --> 0:01:10.520 animal senses to John Calhoun's rat experiments, the history of 0:01:10.560 --> 0:01:14.959 the pelvic exam to the story of refrigeration. These episodes 0:01:15.040 --> 0:01:17.959 really run the gamut. 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Make 0:02:20.720 --> 0:02:23.720 sure that you're subscribed to the Exactly Right Media's YouTube 0:02:23.760 --> 0:02:27.520 channel so you never miss a new episode. Drop the 0:02:27.560 --> 0:02:33.320 Tuskegee Syphilis Study, the Willowbrook Hepatitis study, medical experimentation at 0:02:33.400 --> 0:02:37.720 Holmesburg Prison. If you've ever taken a bioethics class, or 0:02:37.800 --> 0:02:41.240 if you're a regular listener of the podcast, these cases 0:02:41.320 --> 0:02:44.560 are no doubt familiar to you as just a handful 0:02:44.680 --> 0:02:49.800 of the most infamous examples of unethical medical experimentation. We 0:02:50.000 --> 0:02:54.440 learn about these studies, the victims, the perpetrators, the circumstances 0:02:54.440 --> 0:02:57.960 that allowed them to happen. So as to prevent history 0:02:58.000 --> 0:03:02.080 from repeating itself like this is why we have patient 0:03:02.120 --> 0:03:05.680 protections such as informed consent. This is why we have 0:03:05.800 --> 0:03:10.200 these rules and mechanisms such as institutional review boards. But 0:03:10.560 --> 0:03:13.600 often missing in the telling of these stories is the 0:03:13.639 --> 0:03:17.800 person or persons who fought to expose these wrongs and 0:03:17.919 --> 0:03:22.320 bring them into the light, the whistleblower. What does it 0:03:22.440 --> 0:03:25.919 take for someone to speak out, especially when speaking out 0:03:26.000 --> 0:03:31.160 can lead to tremendous professional and personal costs In the 0:03:31.240 --> 0:03:35.800 occasional human sacrifice, medical experimentation and the price of saying No, 0:03:36.520 --> 0:03:41.000 Author and bioethicist at the University of Minnesota, doctor Carl Elliott, 0:03:41.360 --> 0:03:45.160 explores the moral dimensions of whistleblowing and how the resulting 0:03:45.280 --> 0:03:50.440 fallout leads to a long term, almost existential crisis. For 0:03:50.600 --> 0:03:54.120 doctor Elliott, this is a deeply personal topic, as he 0:03:54.200 --> 0:03:57.320 tried for years to uncover harms carried out in a 0:03:57.360 --> 0:04:01.240 study at his own university that led to a patient 0:04:01.320 --> 0:04:06.000 losing their life. His experience serves as backdrop and crucial 0:04:06.120 --> 0:04:09.320 context for the other stories of whistleblowers that he shares 0:04:09.400 --> 0:04:12.080 throughout this book, at the heart of which is a 0:04:12.160 --> 0:04:17.480 question why do whistleblowers do what they do? It's tempting 0:04:17.520 --> 0:04:20.120 to imagine that if each of us were placed in 0:04:20.160 --> 0:04:24.120 a situation with on ethical medical experimentation, we would stand 0:04:24.200 --> 0:04:28.440 up for what's right, but research shows that's rarely the case. 0:04:29.000 --> 0:04:33.560 Whistleblowing is a complex action guided by moral concepts such 0:04:33.600 --> 0:04:37.360 as shame and honor, and learning the stories of whistleblowers 0:04:37.400 --> 0:04:42.159 alongside the abuses they sought to expose, adds tremendous value 0:04:42.160 --> 0:04:47.560 and insight into human nature itself. Through doctor Elliott's compassionate 0:04:47.640 --> 0:04:52.240 storytelling and contemplative analysis of whistleblowing as a moral dilemma, 0:04:52.720 --> 0:04:56.880 The Occasional Human Sacrifice is truly a must read and 0:04:57.080 --> 0:05:00.280 it will stay with me for quite some time. I 0:05:00.320 --> 0:05:03.600 do want to mention that this discussion includes descriptions of 0:05:03.640 --> 0:05:07.159 self harm, so please listen with discretion. We'll take a 0:05:07.160 --> 0:05:33.640 short break here and then get started. Doctor Elliot, thank 0:05:33.680 --> 0:05:35.600 you so much for taking the time to chat with 0:05:35.600 --> 0:05:36.120 me today. 0:05:36.640 --> 0:05:38.520 Well, thanks for having me. I appreciate it. 0:05:39.000 --> 0:05:42.520 In your book The Occasional Human Sacrifice, you seek to 0:05:42.600 --> 0:05:47.039 answer how unethical experiments are carried out and why blowing 0:05:47.080 --> 0:05:50.520 the whistle is so difficult to do. And as you describe, 0:05:50.520 --> 0:05:53.159 this is a personal issue for you, with you having 0:05:53.279 --> 0:05:57.800 firsthand experience as a whistleblower. Would you mind sharing the 0:05:57.839 --> 0:06:01.039 impetus for writing this book and how it led you 0:06:01.120 --> 0:06:05.440 into a broader contemplation of whistle blowing in medical research. 0:06:06.240 --> 0:06:11.360 Failure, basically how it led me into the book. So 0:06:12.640 --> 0:06:16.760 I guess for me, the story begins back in two 0:06:16.760 --> 0:06:21.480 thousand and eight, when I first learned about the suicide 0:06:21.480 --> 0:06:24.360 of a young man named Dan Markinson in a research 0:06:24.400 --> 0:06:27.000 study in our Department of Psychiatry here at the University 0:06:27.000 --> 0:06:31.760 of Minnesota. The circumstances of that were so gruesome and 0:06:31.800 --> 0:06:37.240 so horrific, and so sort of blatantly exploitative and unethical 0:06:38.240 --> 0:06:42.440 that I felt as if it needed an external investigation, 0:06:42.640 --> 0:06:47.240 partly because of the circumstances of his death, but also 0:06:47.760 --> 0:06:50.760 to ensure that the same thing had not happened to 0:06:51.040 --> 0:06:55.240 others in our department of psychiatry. And so I spent 0:06:55.320 --> 0:06:59.599 the better part of the next seven years basically trying 0:06:59.640 --> 0:07:04.960 to get that external investigation. So, Dan Markinson was a 0:07:05.000 --> 0:07:09.120 young man in his twenties who had become psychotic and 0:07:09.200 --> 0:07:14.360 delusional and dangerous as a result of a psychotic episode 0:07:14.600 --> 0:07:20.080 in the summer of two thousand and three, and his mother, 0:07:20.560 --> 0:07:24.920 after seeing him deteriorate over a period of months and 0:07:24.960 --> 0:07:28.080 seeing the kind of alarming things he had, called the 0:07:28.120 --> 0:07:32.080 police and he was eventually brought to Fairview Hospital, which 0:07:32.120 --> 0:07:35.000 is the teaching hospital here at the University of Minnesota, 0:07:36.240 --> 0:07:40.080 and he was seen by the head of our schizophrenia 0:07:40.160 --> 0:07:46.400 program here, who thought he was psychotic, delusional, dangerous, admitted 0:07:46.440 --> 0:07:50.080 him to a locked ward, had him placed under a 0:07:50.080 --> 0:07:56.760 civil commitment order, and fairly soon began to recruit him 0:07:57.000 --> 0:08:01.000 into an industry funded study of any psychotic drugs that 0:08:01.040 --> 0:08:04.000 he was doing. His mother objected. She didn't want him 0:08:04.040 --> 0:08:06.960 in a study. She felt he could not consent to 0:08:07.000 --> 0:08:12.080 the study, that he was psychotic and incompetent, and that 0:08:12.320 --> 0:08:18.480 the circumstances the civil commitment order, which essentially legally bound 0:08:18.560 --> 0:08:21.360 him to do whatever his psychiatrist was telling him to do, 0:08:22.760 --> 0:08:28.560 prohibited him from being enrolled ethically. And she objected, but 0:08:28.600 --> 0:08:31.240 she was told, you know, sorry, he's an adult. He 0:08:31.320 --> 0:08:35.000 signed the consent form. He's in the study. She then 0:08:35.520 --> 0:08:39.560 spent the next four months trying desperately to get him 0:08:39.559 --> 0:08:42.200 out of the study. He had been discharged to a 0:08:42.240 --> 0:08:48.280 halfway house. She could see him getting worse, becoming increasingly agitated, 0:08:48.800 --> 0:08:53.200 and she was afraid violent. She called, she sent emails, 0:08:53.320 --> 0:08:56.440 She went to the Department of Psychiatry, She wrote to 0:08:56.480 --> 0:09:00.000 the chair of psychiatry again and again expressing her work 0:09:00.000 --> 0:09:03.200 where he's eventually left a voicemail message for the study 0:09:03.280 --> 0:09:06.600 coordinator saying does he have to kill himself or somebody 0:09:06.679 --> 0:09:11.880 else before anybody is going to do anything? And three 0:09:12.400 --> 0:09:16.240 weeks or so after she left that message, his body 0:09:16.400 --> 0:09:18.960 was found in the shower of a halfway house where 0:09:18.960 --> 0:09:23.360 he was staying, and next to his body was a 0:09:23.480 --> 0:09:26.720 note that said, I went through this experience smiling. 0:09:27.720 --> 0:09:32.640 When did you learn about this and what happened after? Like, 0:09:32.720 --> 0:09:35.640 when did this become public knowledge? When did this become 0:09:35.720 --> 0:09:39.160 something that was a news story? 0:09:40.040 --> 0:09:44.080 Not for another four years? I read about it in 0:09:44.160 --> 0:09:48.400 the Saint Paul Pioneer Press, and I believe would have 0:09:48.400 --> 0:09:51.400 been May of two thousand and eight. I was actually 0:09:51.400 --> 0:09:53.720 on sabbatical at the time. I was in South Africa. 0:09:54.440 --> 0:09:56.360 A friend of mine who was one of the reporters 0:09:56.400 --> 0:09:59.920 who did that, Paul Toasto, had sent me links to 0:10:01.360 --> 0:10:04.760 I found it so alarming that when I got home 0:10:05.080 --> 0:10:08.600 a few months after that, I started asking around and 0:10:08.640 --> 0:10:13.920 trying to find out what had happened, because it's actually 0:10:14.640 --> 0:10:18.720 my area of work. I mean, I work on research ethics. 0:10:18.840 --> 0:10:22.440 I work on psychiatric ethics. I had been on the 0:10:22.440 --> 0:10:25.599 institutional review board at the university for several years. I 0:10:25.640 --> 0:10:29.719 knew people in the Department of psychiatry, and yet this 0:10:29.960 --> 0:10:34.520 grizzly death I had heard nothing about it. And when 0:10:34.520 --> 0:10:36.839 I started to ask around it, it just felt as 0:10:36.840 --> 0:10:41.240 if no one was as alarmed by it as I was. 0:10:42.200 --> 0:10:44.600 Not people in the Department of Psychiatry, not people in 0:10:44.640 --> 0:10:50.320 the bioethic Center, not administrators. And eventually it became clear 0:10:50.360 --> 0:10:53.920 to me that it was going to take some kind 0:10:53.960 --> 0:10:57.720 of pressure from the outside to get the university to act, 0:10:58.720 --> 0:11:01.440 and so I got in touch with Mary Wis Dan 0:11:01.559 --> 0:11:05.359 Markinson's mom. She was not happy to hear from me, obviously, 0:11:05.640 --> 0:11:09.480 she had a lot of suspicions of the university. She 0:11:09.600 --> 0:11:12.360 agreed to talk to me, and then after we talk 0:11:12.520 --> 0:11:16.800 she agreed to let me have access to everything I wanted, 0:11:17.080 --> 0:11:23.120 court records, medical records, Dan's diaries, anything that would be useful. 0:11:23.800 --> 0:11:26.120 And so I wound up writing about it and a 0:11:26.200 --> 0:11:30.199 sort of larger backdrop to it, which was a sort 0:11:30.200 --> 0:11:35.320 of scandal about research integrity involving the sponsor of the study, 0:11:35.360 --> 0:11:40.080 Astra Zeneca, and eventually wrote about it in Mother Jones Magazine, 0:11:40.320 --> 0:11:43.959 sort of hoping that having exposure in a national publication 0:11:44.080 --> 0:11:49.880 would shame the university into acting. But that again was 0:11:50.640 --> 0:11:54.760 a complete failure. I mean, it really accomplished nothing at 0:11:54.760 --> 0:11:59.120 all except to make the entire academic hialth Center very 0:11:59.120 --> 0:11:59.760 angry with me. 0:12:00.520 --> 0:12:06.160 As you write, whistleblowing is incredibly isolating and disillusioning, and 0:12:06.240 --> 0:12:08.440 that kind of flies in the face of a lot 0:12:08.480 --> 0:12:14.480 of popular media representations or stereotypes about whistleblowers or stories 0:12:14.480 --> 0:12:18.120 that feature whistleblowers. They might be brave and bold or 0:12:18.160 --> 0:12:22.319 bitter and disgruntled, but they tend to follow this certain 0:12:22.760 --> 0:12:27.040 narrative arc which you describe or you label as Vonna 0:12:27.040 --> 0:12:29.920 gets Man in a Whole narrative. Can you tell me 0:12:30.000 --> 0:12:34.400 more about this narrative, what it fails to capture, and 0:12:34.480 --> 0:12:36.439 what it's really like down in that hole. 0:12:37.360 --> 0:12:40.880 Kurt Vonnegut described the Man in a Whole story as 0:12:41.120 --> 0:12:44.360 somebody gets into trouble and gets out again, And he said, 0:12:44.400 --> 0:12:48.120 you know, we love this story. The Wizard of Oz 0:12:48.800 --> 0:12:53.440 Dorothy kills the Wicked Witch and returns to Kansas, the 0:12:53.480 --> 0:12:58.520 Prodigal Son, Robinson, Crusoe, David and Goliath. The reason we 0:12:58.679 --> 0:13:02.360 like these stories is is that they sort of reassure 0:13:02.440 --> 0:13:05.920 us that the world has a kind of moral sense 0:13:06.000 --> 0:13:09.120 to it, that the universe is a fair and just place. 0:13:10.240 --> 0:13:14.240 And if you watch, you know, whistleblower movies or TV 0:13:14.280 --> 0:13:17.240 shows about whistleblowers, they usually follow some version of that 0:13:17.280 --> 0:13:22.679 man in old story, the whistleblower takes down the corrupt organization. 0:13:23.400 --> 0:13:28.040 What I found when I started looking deeper into these stories, 0:13:28.440 --> 0:13:32.440 actual whistleblower stories, is that they usually don't follow that 0:13:32.480 --> 0:13:35.640 sort of narrative arc. I mean, they usually don't have 0:13:35.760 --> 0:13:41.439 happy endings, and the whistleblowers themselves usually come out of 0:13:41.480 --> 0:13:47.160 the experience with these sort of very deep moral wounds. 0:13:48.000 --> 0:13:52.679 It's almost as if it's a kind of existential disorientation 0:13:53.200 --> 0:13:57.600 because everything that they thought about how the world works 0:13:58.200 --> 0:14:03.000 is upended. I mean, they just assume everybody just assumes 0:14:03.320 --> 0:14:05.520 if they've gotten to the point where they feel like 0:14:05.559 --> 0:14:09.839 there's nothing else to do, they assume that the rest 0:14:09.840 --> 0:14:12.240 of the world is going to be as morally outraged 0:14:12.440 --> 0:14:15.280 by what they have found. And what they're trying to 0:14:15.320 --> 0:14:18.960 reveal is they were when they found it out, and 0:14:19.000 --> 0:14:21.000 then when they blow the whistle, it turns out that 0:14:21.000 --> 0:14:23.920 that's not the case, they think the authorities are going 0:14:23.960 --> 0:14:25.880 to do something, that they're going to leap into action 0:14:26.000 --> 0:14:30.120 and rectify the injustice, and then that doesn't happen, and 0:14:30.160 --> 0:14:32.040 they think their friends are going to stand by them, 0:14:32.080 --> 0:14:35.280 and then that doesn't happen. Even if they have some 0:14:35.400 --> 0:14:38.240 measure of success, they very often come out of it 0:14:38.800 --> 0:14:43.440 with a kind of almost obsession with what they've been through, 0:14:43.960 --> 0:14:46.760 an inability to get over it and put it behind them, 0:14:46.840 --> 0:14:50.360 because it's so disruptive to the way that they had 0:14:50.400 --> 0:14:51.560 always seen the world. 0:14:52.160 --> 0:14:55.880 Right, they're never truly free of that hole, or of 0:14:56.680 --> 0:14:59.240 the feeling of what it was like down in that hole. 0:15:00.120 --> 0:15:02.600 Yeah, I mean, being the whole is a very is 0:15:02.640 --> 0:15:05.400 a very dark place, and it tends to turn people inward, 0:15:06.600 --> 0:15:10.800 and in the hole you can't really think about anything 0:15:11.160 --> 0:15:14.720 other than yourself and what this is doing to you 0:15:14.760 --> 0:15:16.880 and how you get out of the hole. I mean, 0:15:16.880 --> 0:15:22.320 I can remember talking to the whistleblowers in Sweden and 0:15:22.360 --> 0:15:26.440 the power of Machirini scandal and hearing, you know, from them, 0:15:26.720 --> 0:15:30.800 just how obsessed they became, you know, because they could 0:15:30.960 --> 0:15:33.080 they could see it. They were surgeons, they could see 0:15:33.080 --> 0:15:36.480 what was happening. They could see that things were going 0:15:36.600 --> 0:15:40.120 very bad, and that people were dying and no one 0:15:40.120 --> 0:15:43.239 would believe them, and so there's a kind of desperation 0:15:43.400 --> 0:15:46.840 to it, you know, this feeling that nothing else is 0:15:47.120 --> 0:15:51.800 as important as making people aware of this, and yet 0:15:52.240 --> 0:15:53.400 no one is paying attention. 0:15:54.840 --> 0:15:57.080 Let's take a quick break, and when we get back, 0:15:57.240 --> 0:16:16.120 there's still so much to discuss. Welcome back everyone. I've 0:16:16.120 --> 0:16:19.040 been chatting with doctor Carl Elliott about his book The 0:16:19.080 --> 0:16:23.880 Occasional Human Sacrifice, Medical Experimentation and the Price of saying No. 0:16:24.360 --> 0:16:28.080 Let's get back into things. At the heart of your 0:16:28.120 --> 0:16:32.280 book is the question of why not why do these 0:16:32.360 --> 0:16:36.320 unethical medical experiments happen, but why does someone decide to 0:16:36.360 --> 0:16:38.000 blow the whistle in the first place. 0:16:38.640 --> 0:16:39.200 What did you. 0:16:39.280 --> 0:16:43.480 Discover in your quest to answer this question? And what 0:16:43.600 --> 0:16:46.720 roles do honor and shame play in this decision that 0:16:46.760 --> 0:16:47.320 people make. 0:16:48.040 --> 0:16:52.840 Part of it is that very often it doesn't really 0:16:52.960 --> 0:16:56.840 feel like a decision. It feels like there's no choice. 0:16:57.160 --> 0:17:00.000 I mean, people will say, really, I had no choice, 0:17:00.080 --> 0:17:02.280 I had to do it. Fred Alford, who wrote a 0:17:02.360 --> 0:17:06.919 terrific book on whistle blowers, said the question presents itself 0:17:06.960 --> 0:17:10.960 to whistleblowers not so much as what should I do? 0:17:11.600 --> 0:17:14.639 But how did it happen that I found myself in 0:17:14.680 --> 0:17:16.960 a position where there is nothing else for me to 0:17:17.000 --> 0:17:21.080 do but act? I had initially just sort of expected 0:17:21.560 --> 0:17:26.640 that when I began to ask people to explain how 0:17:26.680 --> 0:17:28.400 it got to the point where they felt they had 0:17:28.440 --> 0:17:31.720 to act or to sort of justify themselves to me, 0:17:32.400 --> 0:17:34.879 that they would make a kind of moral argument, you know, 0:17:34.920 --> 0:17:38.320 that they would explain the situation. And it turned out 0:17:38.400 --> 0:17:41.760 that they didn't really do that. Nobody talked about even 0:17:41.760 --> 0:17:44.720 the doctors. They didn't talk about the Hippocratic oath, and 0:17:44.760 --> 0:17:48.199 they didn't talk about the Bible or some sort of 0:17:48.280 --> 0:17:53.800 legal principle. They would say things like if I kept quiet, 0:17:54.240 --> 0:17:56.359 how could I hold my head up? Or if I 0:17:56.440 --> 0:17:59.720 kept quiet, how could I look at myself in the mirror? 0:18:00.760 --> 0:18:04.919 So they sort of turn this moral question about the 0:18:04.920 --> 0:18:08.040 well being of other people into a moral question about themselves. 0:18:09.080 --> 0:18:12.480 They always talked about how it would reflect on them 0:18:13.040 --> 0:18:16.160 if they said nothing. It seems really interesting me and 0:18:16.440 --> 0:18:22.160 almost unexpected or counterintuitive. But the more I heard this 0:18:22.560 --> 0:18:25.919 story and tried to think about it, the more it 0:18:25.960 --> 0:18:28.520 seemed to me that they were speaking a kind of 0:18:29.560 --> 0:18:33.840 language of honor and shame because the honor ethic, and 0:18:33.880 --> 0:18:37.760 what distinguishes the honor ethic from many other sort of 0:18:37.800 --> 0:18:43.480 ways of justifying actions morally is this idea of obligations 0:18:43.480 --> 0:18:48.360 to yourself. That honor is essentially about respect. It's about 0:18:48.680 --> 0:18:51.840 getting the respect of others, but it's also about self 0:18:51.840 --> 0:18:56.200 respect and being able to respect yourself as a result 0:18:56.280 --> 0:19:02.200 of what you do, and the necessity of avoiding shaming 0:19:02.240 --> 0:19:05.240 yourself in the eyes of other people and also in 0:19:05.320 --> 0:19:08.679 your own eyes. And so when people say things like, 0:19:09.280 --> 0:19:11.960 you know, how could I hold my head up, it's 0:19:12.000 --> 0:19:16.960 a very vivid sort of image of respect. How can 0:19:17.000 --> 0:19:21.760 I respect myself? That sort of explanatory frame runs through 0:19:21.800 --> 0:19:24.920 the book, and I have to say it fits some 0:19:25.000 --> 0:19:28.240 of the whistleblowers that I talked to much more than 0:19:28.280 --> 0:19:33.840 it does others. But almost everybody that I spoke to 0:19:34.640 --> 0:19:39.879 spoke of the choice as this sort of very personal, 0:19:40.280 --> 0:19:44.040 existential moment where they had to act in a way 0:19:44.080 --> 0:19:46.960 that they felt they could live with afterwards. 0:19:47.840 --> 0:19:51.479 Like you said, it's not even having a choice, it's 0:19:51.760 --> 0:19:54.440 this is what you are compelled to do because of 0:19:55.400 --> 0:19:59.840 who you are, even if there is no whistleblower type personality. 0:20:00.080 --> 0:20:03.200 Yes, exactly, who you are. You know you're the kind 0:20:03.200 --> 0:20:05.840 of person who has to act in this situation. 0:20:06.440 --> 0:20:10.040 A question that kept popping into my head as I 0:20:10.080 --> 0:20:13.280 was reading your book was do we all have the 0:20:13.920 --> 0:20:20.400 capacity to go along with unethical medical experimentation and or 0:20:20.440 --> 0:20:24.640 do we all have the capacity for whistle blowing? And 0:20:24.800 --> 0:20:26.600 I don't know if there's an answer to that, but 0:20:26.640 --> 0:20:29.880 it did make me think about what it is that 0:20:30.640 --> 0:20:34.359 allows someone to blow the whistle, or requires them to 0:20:34.359 --> 0:20:35.120 blow the whistle. 0:20:35.600 --> 0:20:40.640 I think there has to be something to the circumstances 0:20:41.000 --> 0:20:43.440 in which people find themselves that makes it more or 0:20:43.520 --> 0:20:46.439 less likely that they can blow the whistle, or that 0:20:46.480 --> 0:20:50.240 they will blow the whistle and one of them. I 0:20:50.320 --> 0:20:54.639 think if there is some sort of proximity, either as 0:20:55.320 --> 0:21:00.640 a caregiver, someone who's taking care of patients, or personal knowledge, 0:21:01.400 --> 0:21:05.920 that makes it harder for people to stay quiet. I'm thinking, 0:21:05.960 --> 0:21:12.040 for example, of John Pisondo, who was the oncologist at 0:21:12.080 --> 0:21:15.480 the Fred Hodge Cancer Center out in Seattle who blew 0:21:15.520 --> 0:21:20.199 the whistle on these lethal bone marrit transplant trials. This 0:21:20.320 --> 0:21:23.360 would have been eighties and nineties, and they eventually came 0:21:23.400 --> 0:21:27.639 to light in two thousand and one. He learned about 0:21:27.640 --> 0:21:30.840 them by virtue of being on the IRB there, so 0:21:30.880 --> 0:21:34.520 he learned about them abstractly as a result of evaluating 0:21:34.560 --> 0:21:38.560 them to try to ensure that they're ethical if the 0:21:38.600 --> 0:21:43.240 IRB were working right, which wasn't and it was his specialty. 0:21:43.320 --> 0:21:46.679 He was an immunologist and oncologist, and so he understood 0:21:46.680 --> 0:21:52.560 the studies abstractly, but he also took care of subjects 0:21:52.560 --> 0:21:58.159 in the study on the wards and that clearly was 0:21:58.359 --> 0:22:05.119 incredibly difficult for seeing two women in particular with lymphoma 0:22:05.640 --> 0:22:09.479 die as a result of being in these poorly designed, 0:22:09.560 --> 0:22:13.520 poorly thought out studies. And you know, you could see 0:22:13.520 --> 0:22:16.439 the same thing in New Zealand with Ron Jones and 0:22:16.480 --> 0:22:20.840 the Unfortunate Experiment cervical cancer trials there with the Willowbrook 0:22:21.119 --> 0:22:26.360 hepatitis studies at on Staten Island. If you're up close 0:22:26.880 --> 0:22:30.520 rather than at a distance, and particularly if you identify 0:22:30.880 --> 0:22:34.160 with in some way the institution in which the studies 0:22:34.200 --> 0:22:40.199 are happening, and you feel implicated, then that is a 0:22:40.480 --> 0:22:43.680 sort of predictor of whether or not you'll speak out. 0:22:44.800 --> 0:22:48.200 In your book, you share the story of many different 0:22:48.280 --> 0:22:52.560 whistleblowers throughout the decades, and there was one in particular 0:22:52.680 --> 0:22:56.960 that was surprising for me to learn about. I grew 0:22:57.000 --> 0:22:59.560 up in northern Kentucky. I went to undergrad at the 0:22:59.640 --> 0:23:02.600 Universe City of Kentucky, did a masters at the University 0:23:02.600 --> 0:23:05.480 of Louisville, where I learned about medical ethics, you know, 0:23:05.560 --> 0:23:08.240 took a class on it. And still your book was 0:23:08.280 --> 0:23:10.679 the first that I had heard of the radiation experiments 0:23:10.720 --> 0:23:14.440 at the University of Cincinnati just up the road. Can 0:23:14.480 --> 0:23:17.600 you take me through the story of these experiments and 0:23:17.720 --> 0:23:23.359 the whistleblower Martha Stevens and I especially was it really 0:23:23.400 --> 0:23:28.080 struck me the comparison of the memorial of whistleblowing and 0:23:28.440 --> 0:23:31.719 hidden behind a bush in contrast with the you know, 0:23:32.119 --> 0:23:35.160 the lab that bears the name of the person responsible 0:23:35.240 --> 0:23:37.240 for these unethical trials. 0:23:37.760 --> 0:23:40.880 One thing I should say about that before I start, though, 0:23:41.000 --> 0:23:43.120 is that that's one of the few places that has 0:23:43.720 --> 0:23:46.760 in recent years started to try it to make amends 0:23:47.920 --> 0:23:53.680 for the atrocities, not because of anything or anyone who 0:23:53.920 --> 0:23:56.280 had anything to do with them at the time, but 0:23:56.440 --> 0:24:01.120 a result of students largely who have who've learned about 0:24:01.160 --> 0:24:05.080 them and have essentially tried to shame the university in 0:24:05.480 --> 0:24:08.000 trying to make this right. But anyway, I'm getting ahead 0:24:08.000 --> 0:24:13.440 of myself. So the radiation experiments were these Pentagon funded 0:24:13.800 --> 0:24:17.960 studies done during the Vietnam War at the University of 0:24:17.960 --> 0:24:24.280 Cincinnati to try to figure out how American soldiers would 0:24:24.359 --> 0:24:29.080 respond to being irradiated from a nuclear weapon, and so 0:24:29.720 --> 0:24:36.000 to do that, they were exposing largely poor patients, about 0:24:36.000 --> 0:24:40.320 sixty percent of them black. At the University of Cincinnati. 0:24:40.440 --> 0:24:46.080 These are patients with cancer to total body irradiation, without 0:24:46.160 --> 0:24:49.040 telling them that it was for the military, without telling 0:24:49.119 --> 0:24:52.680 them that it was not intended to cure their cancer, 0:24:53.520 --> 0:24:56.560 and without telling them how dangerous it was and that 0:24:56.600 --> 0:24:59.760 they might die as a result. These things were going 0:24:59.800 --> 0:25:02.560 on in nineteen I guess Matha must have found out 0:25:02.600 --> 0:25:04.960 about it in nineteen seventy two, so they'd been happening 0:25:05.040 --> 0:25:08.440 for a decade or so at the University of Cincinnati 0:25:09.280 --> 0:25:12.840 when an English professor, a very young English professor at 0:25:12.840 --> 0:25:16.480 the time, Martha Stevens, found out about them. It was 0:25:16.520 --> 0:25:18.760 an article that was handed to her by someone in 0:25:18.760 --> 0:25:21.680 the political science department, and she got worked up about 0:25:21.680 --> 0:25:25.600 it and started trying to dig into it, was rebuffed 0:25:26.040 --> 0:25:30.200 at every turn by the Dean of Medicine. She was 0:25:30.240 --> 0:25:34.840 a very persistent woman. Eventually got a hold of those records, 0:25:35.680 --> 0:25:41.160 and despite having no medical background whatsoever, made her way 0:25:41.200 --> 0:25:45.680 through them, understood right away what was wrong with them, 0:25:46.240 --> 0:25:50.800 why they were unethical, and wrote it up in a 0:25:50.920 --> 0:25:55.399 kind of memorandum and held a press conference with her 0:25:55.640 --> 0:26:00.399 junior faculty association to make it public. And there was 0:26:00.440 --> 0:26:03.760 a stringer for the Washington Post in town who happened 0:26:04.040 --> 0:26:07.240 to come to the press conference. And at the time, 0:26:07.760 --> 0:26:13.240 there were hearings being held by Senator Ted Kennedy at 0:26:13.280 --> 0:26:18.440 the time about unethical experiments, largely as a result of 0:26:18.720 --> 0:26:21.840 the exposure of the Tuskegee Syphilist study at the time, 0:26:22.000 --> 0:26:26.280 and so Ted Kennedy read this piece, got interested in it, 0:26:26.400 --> 0:26:29.679 entered it into the Congressional record, and then started looking 0:26:29.760 --> 0:26:32.480 into it. And as a result of that, it was 0:26:32.520 --> 0:26:36.080 shut down. But it was kept very quiet. It was 0:26:36.119 --> 0:26:40.359 not publicized in any way, and the victims of the 0:26:40.400 --> 0:26:44.960 study were not notified. The families of the victims were 0:26:45.000 --> 0:26:47.359 not notified that their family member had been in a 0:26:47.400 --> 0:26:49.720 research study, or that it was funded by the Pentagon 0:26:49.800 --> 0:26:52.600 or anything else. That had shut it down very quietly, 0:26:53.760 --> 0:26:57.399 and that was a kind of partial success. I think 0:26:57.600 --> 0:27:01.159 for Martha Stevens and you know, her husband Jerome and 0:27:01.200 --> 0:27:04.040 the rest of the faculty members who were opposed to 0:27:04.080 --> 0:27:09.280 this thing, but not really a full victory, and they 0:27:09.320 --> 0:27:11.960 had no way of finding out who the victims were 0:27:12.280 --> 0:27:15.000 or their families, and just sort of forgot about it. 0:27:15.359 --> 0:27:19.800 But then twenty years later the entire issue became a 0:27:19.800 --> 0:27:25.800 live one again when during the Clinton administration, it became evident, 0:27:26.160 --> 0:27:30.320 as a result of some investigative work by Eileen Wilson, 0:27:30.560 --> 0:27:34.359 a reporter in New Mexico, that there was a whole 0:27:34.480 --> 0:27:39.520 series of military fund and government funded radiation experiments happening 0:27:39.560 --> 0:27:42.879 at universities all over the country, and so there was 0:27:42.920 --> 0:27:47.040