Luke Cage Comics and Race-Based Unethical Medical Experiments

 

Sharon Packer, M.D.


ABSTRACT


Luke Cage is an African-American comic book superhero who gained his superpowers when a medical experiment conducted on prisoners went awry. He remains America’s most popular Black superhero, even though he debuted in 1972, as a means to capitalize on the era’s Blaxploitation craze and to recapitulate the deadly 1971 Attica prison riots in Western New York State. His fictional story is being turned into a television series. Luke Cage’s story has important implications for the histories of medicine, public health and medical ethics. For his “origin story” recollects American medical practices that were officially condoned and even government-sponsored, but later became shameful examples of incomplete, coercive (or non-existent) informed consent, as well as race-based exploitation. Several such studies were exposed around the time that Luke Cage comics premiered, including the Tuskegee syphilis study on black men, the Willowbrook hepatitis studies on cognitively impaired students and medical experimentation on prisoners. Given that comics disseminate information about medical advances to readers, Luke Cage comics may have aided public awareness about unethical experimentation, race-based bias and the use of prisoners as human subjects. The highly publicized Attica riots cast an even brighter light on prison abuses, which disproportionately affected Black men. More established media sources, such as AP Press, New York Times and the Washington Star, were credited for publicizing the Tuskegee syphilis studies, but official medical sources condemned prisoner experiments in 1966. This article shows how Luke Cage comics (and other pop culture) indirectly contributed to shifts in standards used for human subjects.


INTRODUCTION


Luke Cage, the comic book character and African-American superhero, became emblematic of unethical medical experiments that came to public attention from the mid-1960s and mid-1970s. Also known as “Hero for Hire” or “Power-Man,” Luke Cage first appeared in Marvel Comics in 1972, one decade after Marvel began publishing (Thomas, 2005).
Luke Cage has been, and still is, the most popular Black superhero, and is often (erroneously) believed to be the first Black superhero. His original character and costume recall the Blaxploitation craze that was popular (and profitable) when he premiered. To increase his appeal for contemporary audiences, his garb and his speech were updated. A feature film about his exploits (and his exploitation) is long in the making, to be directed by John Singleton, a high-profile African-American filmmaker. A TV mini-series is currently in production in 2014 and scheduled for release in 2015, according to www.marvel.com, www.imdb.com, comicbookresources.com, comicbook.com, mtv.com, screenrant.com, ign.com, and (unofficial) Wall Street Journal press releases.
Luke Cage also highlights highly publicized prison riots that occurred the year before, when black militancy was at its peak and when prisoners rioted at Attica, in Western New York state. Inmates seized control of the prison and held hostages for four days straight. The Attica riots left 39 men dead and many more wounded, both physically and psychologically. Ten hostages and 29 inmates died after state police and National Guard fired into the prison yard, at the behest of then Governor Nelson Rockefeller. Revolts at other prisons followed in response to abuses at Attica. Both then and now, black men were vastly over-represented in the prison population (Gray, 2014).


LUKE CAGE’S “ORIGIN STORY”


Luke Cage began life as “Carl Lucas.” He was born in Harlem to caring parents. As an adolescent, he acted out and associated with neighborhood gang members. He dabbled in drugs, but never became addicted. When he realized that his drug experimentation caused pain to his family, he abandoned drugs—but did not abandon friendships with drug-users. That was an unfortunate—but life determining--choice. The critical juncture came when one of those one-time friends tried to frame him by throwing a bag of heroin into his window.
The police discovered drugs in Lucas’ possession and surmised that Lucas himself was responsible. They arrested Lucas. He was convicted and sentenced to prison (as were a disproportionate number of African-American males in the early 1970s, and to this day (Alexander, 2012). He later transfers to Seagate prison off Georgia’s coast (in the South, closer to the site of the contentious Tuskegee, Alabama, syphilis studies).
Once in prison, Lucas is victimized again by prison officials, who insist that he will never be released. Then he is offered the opportunity for early parole—if he participates in an officially sanctioned medical experiment. Dr. Noah Burstein supervises the study (and later befriends Luke and comes to believe in his innocence). Dr. Burstein informs Lucas that he will be desensitized to the test chemicals gradually, to build his tolerance. He tells Lucas that the test chemicals will impart immunity to all illness.
Lucas agrees to the terms, convinced that he has no other way out of prison. Still, he is skeptical when someone arrives with a syringe. He queries, “Are you going to inject me . . . or infect me?” Lucas’ instinctive distrust is not far-fetched (especially if we know of the Willowbrook experiments in a Staten Island school). On an immediate level, we learn that the prison guard, Officer Rackham, holds Lucas responsible for his demotion and plans to retaliate. So Rackham sabotages the medical equipment. He turns the dial too high, exposing Lucas to high chemical concentrations far too soon. The chemicals burn. Lucas shrieks in pain. Then the prison guard informs him that prison officials never intended to honor their promises for parole.
Dr. Burstein’s bungling is unintentional, but the prison officials’ deception is premeditated. Regardless, Lucas is over-exposed to the mystery chemical. His skin hardens like metal. Metaphorically, he develops “thick skin” that enables him to shrug off society’s insults and assaults. At the same time, his skin becomes impenetrable to wounds, as if it were armor. Lucas gains muscle mass and physical power, enough to break through concrete walls (both literally and figuratively). He crashes through the prison’s cement barricades, leaving the deceitful guard behind. Like other black people of his era, he symbolically breaks through barriers that were once closed to him. Unlike the doomed real-life Attica prison rioters from the previous year, Lucas succeeds in his quest.
Carl Lucas never intended to be a superhero, but he needs a job now that he is out of the “joint.” Having been told that he acts like a superhero, he buys a costume and becomes a “Hero for Hire.” He is a free man, yet he retains his chains as reminders of his days in prison and his ancestor’s experiences in slavery. To celebrate the transition from his old self to his new life, Lucas changes his name to “Luke Cage.” His new surname reminds us of his time in “the cage,” and that he has “broken free” from his “cage.” Unlike most superheroes, he never dons a mask or conceals his physical identity.
By 1976, it was clear that superheroes with bifurcated names such as “Batman,” “Spider-Man,” or “Ironman” were more popular and sold more comics. Therefore, the Luke Cage character adds an epithet to his name, and becomes known as “Power Man.” The word “power” recollects the “Black Power” movement of the times, although Luke Cage’s name never includes the word “black,” as did several other African-American comic book superheroes, such as Black Panther or Black Captain America.
Unlike most superheroes, who are automatically altruistic, Luke Cage remains a “hero for hire.” There are times when he intervenes in the mistreatment of the underprivileged, be they black or white, but, in general, he demands recompense. By the time Hurricane Katrina strikes in 2005, Luke Cage is more humane, and volunteers to help his fellow African-Americans, who bore the brunt of the storm.
For nearly forty years, Luke Cage embarked on enough adventures and exploits to ensure that his character remained in print, either in his own comics or in team comics. Earlier on, Cage teamed up with Iron Fist, and more recently, he connects to The New Avengers. Luke Cage, Hero for Hire, is important to comics’ history, and his fictional character has a place in the chronicles of Black Americans and Blacks in the media and in fiction. Luke Cage comics also commemorate seminal events in medical and public health history and create a lasting memento of times and events that many Americans might rather forget. His connection to the Attica riots and the history of prison policy and prison reform deserves a separate study that is beyond the scope of this paper.

 

LUKE CAGE’S CONNECTION TO UNETHICAL MEDICAL EXPERIMENTS


As documented by historian Bert Hansen’s book and articles, visual imagery has a proven ability to publicize medical achievements (or shortcomings, as in this case). Comics in particular inform younger an appeal to countercultural audiences (Hansen, 2004; 2004; 2009). With this in mind, we can infer that the impact of Luke Cage stories extended far beyond mere entertainment or diversion.
His comics presumably enhanced awareness of ignominious experiments that made New York Times headlines in the very same month and year that Luke Cage debuted. The Times article and the first Luke Cage comic are each dated “June 1972”—but comics are printed with the date that they are pulled from distribution, rather than released for distribution. The opposite holds true for newspapers. Thus, Luke Cage comics made the newsstands—and made waves--before the history-making New York Times paper appeared on June 23, 1972.
Also in 1972, the mainstream medical press—in this case, the New England of Medicine—published a thought-provoking article about medical self-experimentation (Altman, 1972). The author was none other than Lawrence K. Altman, M.D., medical professor and medical correspondent for the New York Times. The month was February, four months before the Times broke the Tuskegee story. A quarter of a century later, University of California Press published Dr. Altman’s book length treatment of the same subject (Altman, 1987). His well-researched opinions carried the weight of a practicing physician and medical professor. Dr. Altman’s voice was familiar to radio listeners because his stories were broadcast. Altman reached well beyond Times’ readership.
Altman’s article on self-experimentation was by no means the first article on experimentation ethics to run in the New England Journal. Dr. Henry Beecher had documented unethical medical experimentation in a 1966 issue of New England Journal of Medicine (Beecher, 1966). Beecher was a medical insider, not a rabble-rouser. His research prepared the public (and professionals) for bad news about ethical lapses in medical experiments. Beecher’s paper remains a much-quoted classic in the field. He wrote about prisoner experiments and on alarming cancer experiments at Brooklyn’ Jewish Chronic Disease Hospital (JCDH) (Lerner, 2004), (Hornblum, 2013). Dr. Beecher reported on 22 studies in all, one more disturbing than the next. His descriptions of a young mother who agreed to surgical implantation of her dying daughter’s melanoma cells, in order to shed light on the cancerous process, is particularly heartbreaking. The daughter already died when the graft took place. The cancer killer the mother a year later.
Given this timeline, it is likely that the Luke Cage stories picked up on the pulse on prison experiments, and tapped into opprobrium about ethical breaches documented by Beecher. The uproar created by the Attica riots the year before added to that impact. Serendipitously, his comics appeared on the newsstands at the same time that the news broke about the syphilis experiments on black men in Alabama. The Tuskegee studies caused public outrage, and swayed public opinion against non-consenting or coercive human experimentation. In contrast, many prominent citizens supported prison studies, especially during the World War II era, when “everyone” aided the “war effort”.
Americans of all colors read Luke Cage comics, even though Marvel’s Stan Lee created them with Black Americans in mind. Stan Lee was also attuned to Attica. This was an era when blacks and whites rallied together to promote civil rights and supported equal opportunities for people of all colors, genders, and personal persuasions. It was also an era of prison riots, when Black militancy was at its peak, and when New York State’s Governor Rockefeller called attention to two disparate poles of opinion and action when he chose to fire on rioters and hostages, and created America’s bloodiest prison revolt.
Standing on opposite sides of that rift left by Rockefeller, students and social activists tried to tear down the walls that led to racial (and other) inequities. Commercial comics and underground comics, as well as broadsides, pamphlets and other unconventional literature, disseminated information on college campuses, in medical centers, at public squares, and at the various rallies and protest marches that occurred in the 1960s and early to mid-70s. At the same time, there was backlash and controversy.
Besides being a hothouse for growing political awareness and activism, the early 1970s were also the time when the Blaxploitation genre flourished. Luke Cage was conceived to capitalize on Blaxploitation’s commercial success, and to market comics to more African-Americans. For sure, Luke Cage’s character looks like a cardboard cutout from early 70s’ Blaxploitation. His criminalized character conforms to the mold that produced Cotton Comes to Harlem (1970), Shaft (1971) and Super Fly (1972).
In those years, shadowy, seamy, but superficially successful African-American figures starred on the big screen, attracting large African-American audiences. Marvel aspired to make the most of this trend, and so Stan Lee invented this underworld character to meet the needs of the studio. Since several members of Marvel’s staff were known to be socially conscious, and since the SF genre in general comments on society, it is conceivable that Luke Cage intentionally incorporated important messages about social justice (or injustice), current race-related controversies, plus medical history.
We cannot measure the direct impact of the fictional Luke Cage story retrospectively, but we can infer that the comics influenced some of the public’s opinions in the 1970s. Even if they did not directly pave the path for Jessica Mitford’s 1973 expose on prisons, they surely complemented the critique offered by this well-established writer, which appeared a year after the first Luke Cage comics. Mitford had gained fame for her reportage on the funeral business before she wrote Kind and Usual Punishment: the Prison Business (Mitford, 1973). Her book added credibility to Cage’s story. The tabloids’ treatment of the Attica uprising, plus previous and subsequent prison revolts, fleshed out the information offered in her book.
At a time when the youth culture dismissed “establishment” opinions outright, youth-oriented media, such as comics, spoke to this youth culture and the counterculture. The fact that psychiatrist Fredric Wertham, MD, testified against comics at congressional hearings in the 1950s made the medium even more appealing to the counterculture. Wertham’s scathing but best-selling The Seduction of the Innocent (1954) blamed comics for juvenile delinquency and youthful deviation from social norms. This critique boosted their “street cred” among the expanding anti-establishment crowd.
Academically established sources, such as the New York Times, the Washington Star, and the New England Journal of Medicine made strong impressions on their readers. Geraldo Rivera’s investigative reporting about the Willowbrook scandal, and his 1972 book on the topic, straddled both worlds: the book about unethical experiments on cognitively impaired students in a Staten Island school earned a Peabody Award for Rivera (Rivera, 1972). It also secured the support of former Beatle John Lennon, who hosted a benefit concert for the hepatitis-infected students. In those years, it was hard to conceive of better publicity than the Beatles.
As implied above, Luke Cage comics raise awareness of several other contemporaneous medical controversies, even though his origin story specifically revolves around medical experimentation on prisoners. The pros and cons of prisoner studies were provoked debates in the years before the Cage comic debuted. These studies invited even more discussion after the New England Journal of Medicine published Dr. Beecher’s article in 1966.
Prisoner experiments had been embraced by major medical pioneers but gradually fell out of favor, especially after they were co-opted by persons who were motivated by profits more than public health. The years between WWII and the Vietnam war witnessed a shift in the purpose (and profitability) of prison-based studies.
However, medical luminaries such as Joseph Goldberger employed prison studies. Dr. Goldberger recruited White Southern men from a Mississippi prison to show that pellagra is a nutritional disease, rather than an infection. He also self-experimented to prove his point. Andrew C. Ivy, MD, Vice-President of the large and prestigious medical school of the University of Illinois, publicly defended the use of prisoners in medical studies. For a time, so did Alfred Sabin, who gained fame (and some infamy) from his work on the polio vaccine. Eventually, the powers-that-be concluded that prisoners do not have the capacity to give fully informed, free will consent. Prisoner studies were banned in 1976 (Hornblum, 1977), a few short years after the first edition of Luke Cage (1972).
Even before Beecher’s influential article in 1966, the public was made aware of medical studies conducted in American prisons, partly because of information revealed by Nazi doctors during the Nuremberg Tribunal (which will be discussed at length below) and partly because of Nathan Leopold’s book about malaria studies in the Illinois penitentiary where he served his sentence (Leopold, 1958). In 1958, Doubleday published Leopold’s book, Life plus 99 years. Leopold was one of two perpetrators of the so-called “crime of the century.” The shock associated with the highly publicized Leopold-Loeb child murder from 1924 Chicago still simmered. Leopold became one of 400 prisoners who agreed to be bitten by malaria-carrying mosquitoes, to test treatments. Leopold had next-to-no chance for parole but he wrote that he wanted to do his part for the war effort. Leopold’s partner in crime, Loeb, was long dead, having been murdered in prison.
There were reasons why Nathan Leopold’s account of his experiences in prison-based medical experiments continued to make waves. Long before his book went to press, and long before their conviction and incarceration, Leopold and Loeb were privileged University of Chicago students. The pair murdered an innocent child in a Nietzsche-inspired crime intended to prove their intellectual superiority and their lack of obeisance to ordinary moral authority. In 1924, Clarence Darrow defended the two. They were spared the death sentence by dint of Darrow’s legal and oratory skills.
The crime gained notoriety at the time it was committed. Its details were recounted over the decades through several fictionalized and near-factual accounts. Hitchcock loosely based Rope (1948) on this event. Meyer Levin’s novelistic retelling of the crime in Compulsion (1959) rekindled interest in Leopold and Loeb. Levin’s book stayed on the bestseller list for 54 weeks—for over a year! In the same year that Levin’s book appeared, Orson Welles starred in a film based on Levin’s novel. In the late 1950s and through the 1960s, it was nearly impossible not to know about Leopold-Loeb.
Nathan Leopold’s version of the prisoner-malaria studies was released the year before Meyer Levin’s novel and Orson Welles’ film. Leopold downplayed the study’s adverse impact on prisoners—as befitting an anti-social murderer--but he detailed the events nonetheless. He wrote about the incessant mosquito bites, raging fevers, nausea, vomiting, blackouts, repeated exposures to untested medicinal treatments, and occasional relapses of malaria, noting that, “no one squawked. They all took it like men.” (Leopold, 1958). What a strange description from a homoerotic murderer!
The American public was not distressed by malaria studies conducted on prisoners during the World War II years. After all, malaria was taking a devastating toll on American servicemen and women stationed in the South Pacific, where malaria was endemic, and where the need for treatment was immediate. The public praised those prisoner studies. Like all Americans who stepped forward for the “war effort,” even prisoners were doing their duty by participating in medical experiments. Or so it seemed at the time. The pendulum would swing to the other side during the Vietnam War years.
The sequence of events at the Nuremberg Trials is even more relevant than the sensationalized Leopold-Loeb crime (and punishment). The Nuremberg Tribunal never received as much media attention as the 1961 Eichmann Trial, partly because mass media was not nearly so well developed or widespread in the late 1940s as in 1961. Professor Rothman, an expert on social medicine and history of medicine, contends that the Nuremberg Trial of Nazi doctors received little press coverage (Rothman, 1987), although this author’s review of related articles in the New York Times’ English-language archives suggests otherwise (New York Times 1941, 1946, 1948; Schmidt, 1946; Schmidt, 1947, Schmidt, 1948).
The Eichmann Trial would excavate recollections of the Nazi horrors and ensure awareness of that era (Taylor, 1961). Just a few years after Compulsion the novel and Compulsion the film appeared, and soon after the publication of Leopold’s Life plus 99 Years, television networks broadcast Eichmann’s trial in Jerusalem in 1961. Thanks to TV, the world could witness the trial on the screen. Not a word was lost in translation. Audiences heard accounts of the horrific war crimes orchestrated by Eichmann and committed by a cadre of other Nazis. By 1954, most American homes had at least one television set. By 1961, TV sets were a staple. Pre-packaged TV dinners and so-called “TV trays” became popular, as TV viewing replaced family dinner conversations in many homes.
Images of Eichmann in captivity captivated television viewers. This trial invited flashbacks of the Nuremberg Tribunal and the Doctors’ Trial conducted over a decade earlier, in 1947. The courtroom scenes recollected the Nuremberg Tribunal, which was specifically relevant to our discussion of prisoner studies. During the Nuremberg trials, many Nazi officers faced charges of mass murder. A special Doctors’ Trial was held before an American military tribunal (but not before the International Military Tribunal). Twenty-three persons (20 physicians and 3 medical administrators) faced trial for participating in human experiments on concentration camp inmates. Dr. Josef Mengele, the most infamous of the Nazi doctors, never stood trial. He reportedly died in South America many years later, after eluding diligent “Nazi hunters”. Some of the accused suicided, either before or after standing trial.
Interested parties who found the broadcast trial too daunting, or too poignant, or even too tedious (because of all the legalese) could learn more about Nuremberg by watching the multiple awarding-winning film, Judgment at Nuremberg (1961). Directed by Stanley Kramer, the film is a fictionalized account of the Nuremberg Trials that took place soon after WWII ended. The all-star cast includes Spencer Tracy, Bert Lancaster, Richard Widmark, Marlene Dietrich, Maximilian Schell, Judy Garland, Werner Klemperer, William Shatner and Montgomery Clift. As a film, Judgment at Nuremberg was unforgettable. At the same time, it memorialized history’s harshest moments.
Importantly for our purposes, one of the Nazi doctors tried at Nuremberg defended himself by pointing to American medical experiments conducted on prisoners. While on trial for his life, Dr. Georg August Weltz, the chief of the Institute for Aviation Medicine in Munich, told of an American doctor who also experimented on prisoners in the name of medical science: Dr. Joseph Goldberger. Weltz’ counsel equated people imprisoned in concentration camps because of their ethnicity (or “race”) or their politics with persons incarcerated for crimes committed in Mississippi. The Nazis railed about the “Jewish race” (but did not concern themselves with Judaism as a religion). In the eyes of the Third Reich, Jewish blood defined this race, just as “black blood” defined race in the U.S. Both America and Nazi Germany passed detailed laws defining “race.”
Nazi doctor Weltz’s analogy convinced judge and jury. Thanks to this argument, however spurious it was, Weltz was acquitted, as were several other Nazi doctors. Some of the convicted asked the U.S. government to intervene on their behalf.
For those familiar with public health history, the name of Dr. Goldberger is as revered as much as Dr. Mengele’s name is reviled. Dr. Joseph Goldberger was a public health official who dedicated himself to uncovering the source of pellagra. Pellagra is known to medical students by the acronym DDDD (dementia, diarrhea, dermatitis, death). Pellagra was a scourge of the southern United States. At one time, pellagra landed large numbers of people in long-term mental hospitals in the South (Rosen, 1968).
Goldberger believed that a dietary deficiency afflicted poor and provincial Southerners, but his colleagues blamed sanitation or heredity. To prove his theories, Goldberger recruited twelve white male prisoners from Mississippi’s Rankin Farm prison. He chose white men because that group was least affected by pellagra.
Goldberger had gained permission from Mississippi’s Governor Earl Brewer before performing his studies on human subjects. The inmates were promised a pardon in return for volunteering. Goldberger then deprived the prisoners of protein, and fed them the traditional southern staple of cornbread, sweet potatoes, grits, rice and nothing but. In doing so, he induced a deficiency of vitamin B. This diet reproduced pellagra symptoms and thus proved that the disease resulted from vitamin deficiency.
Like Luke Cage, the prisoners screamed in pain as pellagra appeared, but the experiment continued until Dr. Goldberger made his point in 1916. Perhaps Dr. Goldberger served as a role model for Dr. Burstein in the Luke Cage comics—or perhaps Dr. Burstein references Einstein. There is an important point of departure: Dr. Goldberger’s inmates were all white, and intentionally so, for scientific reasons, whereas Luke Cage is black, and his blackness is a prominent part of his character and his history.
Because Luke Cage is an African-American man who undergoes government-sanctioned medical experiments, his fictionalized experiences segue into the now-reviled Tuskegee syphilis studies. Those studies stopped in 1972, after the New York Times and Washington Post published front-page articles on research conducted by none other than the U.S. Public Health Service (Arens, 1972). Until then, the study had a forty year run. American public health doctors involved with the study claimed that they thought that the Nuremberg Laws against prisoner experimentation applied to German doctors only. This excuse prompted the public to look back at Nuremberg, and at the [Nazi] Doctors’ Trial.
In this now-shameful episode in U.S. public health history, poor black sharecroppers who were known to be infected with syphilis were denied curative treatment, even after 1947, when penicillin treatment proved effective in halting the disease (without reversing damage already done). Researchers observed their subjects over the years, collecting and recording data about the natural progression of untreated syphilis, never informing their subjects about effective antibiotics that became available. Later reviews of the study questioned the diligence of the data collection and pointed out that the subjects were not fully “treatment-naïve,” given that some men had used (incompletely effective) mercury and arsenicals prior to entering the study (Jones, 1981). Thus, some subject did not meet criteria for inclusion in the study in the first place.
Untreated subjects—as well as some wives and children--developed a wide range of bone, optic, cardiovascular, neuropsychiatric and dermatological problems. Some became blind or psychotic. Death rates were higher than expected, which might not have happened with early intervention, but which would be expected of a disease that can erode the aorta and leave it vulnerable to rupture some 10-40 years after infection.
The USPHS did not act alone. It enlisted the cooperation of the prestigious all-black Tuskegee Institute, as well as local doctors and hospitals, both black and white.
Uproar followed these revelations, resulting in increased scrutiny of the already-suspect prisoner studies and the establishment of IRBs (Institutional Review Boards) for hospital and health care facility-based studies. Treatment of prisoners was already under investigation after the deadly Attica uprising. Most states stopped prisoner studies soon after. By 1976, federal institutions banned prisoner medical experiments—like the kind that Luke Cage undergoes in 1972. Luke Cage’s fictional experiences supposedly became relics of the past (until data about similar studies in Guatemala surfaced in 2010).
Luke Cage comics have other important implication. They tangentially recollect the Willowbrook hepatitis studies conducted on intellectually limited residents between the years of 1956-1972. Dr. Beecher had reported on those studies, but additional details surfaced in 1972, in the year of the Luke Cage comics’ premier. Willowbrook became far better known after former Beatle John Lennon performed a benefit concert for the victims. Lennon was inspired by Rivera’s reports, and America was inspired by Lennon.
The year 1972 was a watershed year for uncovering unethical medical experimentation—and for the new Luke Cage comic book. When Luke Cage asks if he is about to be “injected or infected,” readers reflexively think of Willowbrook.
Dr. Beecher had called attention to the Willowbrook research in 1966, having learned that parents signed away the rights of their cognitively impaired children, allowing them to be infected with the hepatitis virus so that vaccine studies could be conducted. Some parents later claimed that they felt coerced, fearing that their children would lose a place in the residence if they did not consent to the studies. Others suggested that children whose parents signed consents for experiments earned preferential admission to the Staten Island school.
We can claim that Luke Cage’s origin story of unethical medical experimentation gone awry, even though formally approved by government authorities, connects to several other violations that took place shortly before his comic debuted. In Illinois, psychotic patients housed in state hospitals were infected with malaria and used as test subjects for malaria medications (Rothman, 1987). In 60s’ era Brooklyn, doctors injected live cancer cells into demented geriatric patients, in hopes of learning about cancer transmission. These subjects had no voice, and no ability to consent or dissent. Luke Cage, the comics’ character and superhero, speaks for those who could not speak for themselves, by using soundless word bubbles and visual imagery instead.


CONCLUSION


Writing in Picturing Medical Progress from Pasteur to Polio (Rutgers UP, 2009), historian of medicine Bert Hansen alerts us to the power of the visual image in reflecting and forming public opinion about medical care. Professor Hansen credits comics with informing lay readers about medical milestones. Hansen devotes an entire chapter to “Popular Medical History in Children’s Comic Books of the 1940s.” He emphasizes the “heroic era of medicine,” when the public showed near religious reverence for medical discoveries. In that era, comics portrayed successful scientists as if they were superheroes of sorts. Hansen argues that the popular press (including comic books) had more impact than more academic medical sources.
In contrast to the heroic medical achievements chronicled in Hansen’s chapter on the 1940s (which includes the WWII years), Luke Cage comics appeared at the height of Vietnam controversy, when the counterculture reigned, and when the establishment in general—and the medical establishment as well—were subjects of suspicion. Black militancy was at its peak, and the Attica prison uprisings polarized the public even more. The Luke Cage comics spoke to social activists and public health advocates who pushed aside the “triumphalists,” and thus set the groundwork for the skepticism that shrouds medical research to this day. Luke Cage is a counterpoint to the 1940s’ comics that portrayed research scientists as heroes that possibly deserved an abode on Olympus. Those scientists were kindred spirits of the superheroes that populated other comic books.
Very recently, in 2010, Rebecca Skloot’s book about HeLa cells cultured from a poor African-American woman named Henrietta Lacks received much attention from respected reviewers (Skloot, 2010; Shah, 2010). Cells cultured from Lacks’ cervical cancer lived on when other cell cultures did not survive, for reasons that remain unexplained. “HeLa cells” are very familiar to medical researchers and students, having facilitated countless medical studies. However, her financially disadvantaged family was not aware that her cells persisted and did not reap any financial benefits. In 1971—one year before the Luke Cage comics debut—the prestigious Johns Hopkins University broke her confidentiality and published her name when identifying the HeLa cells.
Skloot’s book implies that privileged (white) scientists from Johns Hopkins benefited from the cell cultures, while neither the poor woman nor her heirs enjoyed material rewards from these often-reproduced cell cultures. It implies that the inequitable distribution of benefits was mostly race-based, even though education, social class and economic disparities were equally prominent. Unlike the unfortunate Alabaman men included in the syphilis studies (or some of their wives or children who acquired syphilis unwittingly and suffered irreversible consequences), Ms. Lacks was not directly harmed by those cell cultures, although her memory may have been blighted by this breach of confidentiality. Unfortunately, her survivors did not learn of this breach for many years.
Lacks did not survive her cancer, but not because her cells were cultured, but in spite of the fact that her cells were cultured, and cultured, and cultured, many times over. The attention accorded this story highlights the ever-present emotional impact of race-based disparities in medical research and treatments. Some critics view this event on a continuum with Tuskegee, and represents a pervasive disregard for human rights for persons of all races, or even a failure to acknowledge the humanity of such subjects.
Details about strikingly similar syphilis studies performed on Guatemalan men, by the USPHS, were released in 2010, providing further proof that unethical research approaches have not fully faded away. It remains to be seen how much will be revealed in the future. Until then, studying Luke Cage comics can provoke serious thought about a very un-funny subject—unethical medical experimentation.
By reexamining post-WWII examples chronicled by Henry Beecher, MD, and fortifying Beecher’s post-war examples with earlier data, from Europe, Asia as well as America, we can show that unethical medical experimentation is not necessarily restricted to race—or that “race” does not always allude to African-Americans. “Race” can be as important in Asia as in America, as the horrific pre-WWII Japanese medical experiments performed on Manchurian-Chinese proved. In fact, as the Nazi era proved, race is defined by society rather than biology, to meet the needs of the host society.
The Tuskegee study on black men in Alabama was the longest non-therapeutic experiment on human beings in medical history'' (Jones, 1981; Jones and King, 2013), but, sadly, it is not the only illustration of unethical medical experimentation, race-based or not. Awareness of Tuskegee tragedies catalyzed the adoption of additional safeguards against future events, but even those measures were not foolproof. Somehow, Guatemalan victims of similar USPHS studies escaped detection until 2010, making us wonder what else remains to be discovered.
Luke Cage’s story highlights how pop culture embeds medical history and how mainstream and not-so-mainstream media publicize medical controversies. Cage’s origin story fossilizes research approaches that were once socially and academically acceptable. Those who prefer pictures to polemics can refer to the images and information in these 70s-era comics, which will “live again” when this story appears on big and small screens.
In the interim, it is possible that Luke Cage’s story can re-open much-needed dialogues between medical researchers and practitioners, public health systems, and minority members who receive (or reject) health care, because of distrust of “the system.”


REFERENCES


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Copyright Priory Lodge Medical Education Limited 2014 -

First Published December 2014.

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