Here Is Where: Discovering America's Great Forgotten History (36 page)

More states followed Massachusetts and New York’s lead, ratcheting up the punishments for body snatching while also allowing medical schools to lawfully obtain the “friendless dead” from hospitals, prisons, almshouses, asylums, and other public institutions. Faced with mounting risks and declining profits, most resurrectionists went out of business by the early 1900s.

During the mid-twentieth century, as Americans benefited from miraculous advances in medicine, they became more willing to donate their bodies for scientific research. Today, medical schools rely primarily on plastic models and virtual cadavers instead of real ones. In 1993, under the auspices of the National Institutes of Health, scientists created the first digital representation of a human body, inside and out, from scalp to toe. Within hours of dying, a thirty-eight-year-old man named Joseph Jernigan was flown to a Denver laboratory, where his still-warm corpse was dipped and frozen solid in a –100 degree Fahrenheit gel and then sliced into more than eighteen hundred sections. Each millimeter-thin sliver was photographed and scanned into a computer, creating a seamless three-dimensional image.

Obese and lacking an appendix and one testicle, Jernigan wasn’t considered physically ideal, but there were logistical factors in his favor. He had willed his body to the Texas State Anatomical Board, and the Denver lab knew, months in advance, exactly when to expect him: August 5, 1993. This was the day that Jernigan, a convicted murderer, died by lethal injection.

“It’s very difficult to find an intact, non-traumatized, non-pathologic cadaver,” the project’s director, Dr. Vic Spitzer, later remarked, echoing a centuries-old lament. “I’m not condoning execution. But I don’t believe in wasting resources either.” What was left of Jernigan was cremated and disposed of locally.

Where each of the thirty-eight Dakotas ended up after being hanged and dissected isn’t recorded. There’s a strong possibility that some of their remains were sold or donated by the Mankato doctors to museums and other scientific institutions. Native American bones and relics had been highly sought out ever since the discovery of a Virginia burial mound in the 1770s containing one thousand skeletons of Monacan Indians. This was America’s first major archaeological dig, and the man credited with finding and excavating the barrow was Thomas Jefferson. (There’s just nothing this guy didn’t have his hands in.)

“We do know who got Cut Nose,” Bill Lass tells me as we leave the riverbank. “Dr. William Worrall Mayo.”

This, actually, I had read, and I’d also heard a coda to the story that even Bill wasn’t familiar with.

Before Cut Nose’s corpse began to putrefy, the doctor who acquired him boiled and cleaned the bones so that he could educate his young sons about human anatomy. Far from frightening the boys, it nurtured their passion to become doctors. After attending medical school and working with their father, Charles and William Mayo helped establish a clinic in Rochester, Minnesota, that has since grown into one of the most respected and emulated health facilities in the world.

RIGHT ON THIS
spot where I’m standing, just beside the train tracks across from the Mississippi State Hospital, a tribute was erected to Dr. Joseph Goldberger after his death in 1929 for finding “the cause and cure for pellagra near here at the Rankin Farm.” Years ago, however, the sign—which, by then, had been riddled with bullet holes—was torn from its foundations and vanished. According to the staff members at the Mississippi Department of Archives and History who provided me with a copy of the tribute’s full text, no one knows for certain who knocked it down or why, but regardless, due to budget constraints it won’t be replaced anytime soon. Except for a portrait of Goldberger that hangs in the National Institutes of Health (NIH), the agency he worked for back when it was called the U.S. Public Health Service (PHS), this marker was the last tangible memorial to a doctor responsible for eradicating an entire disease from the United States.

Goldberger’s official NIH biography was my first introduction to the man and a joy to behold. Here, at last, was a medical pioneer whose professional career seemed as inspirational as his personal life. In 1883 the nine-year-old sheepherder’s son from the Austro-Hungarian Empire landed in New York with five brothers and sisters. He then bootstrapped his way through school, wooed and wed an attractive high-society southern belle from New Orleans named Mary Farrar, and helped rid the United States of pellagra, a disease that was killing thousands of Americans each year. And he managed to accomplish all of this without murdering and chopping up any of his colleagues, claiming credit for medical breakthroughs that weren’t his own, or absconding into the night with Native American corpses.

Well, it turned out there was one small matter that both the NIH and the missing marker glossed over, and it concerns what happened during the summer and fall of 1915 at Rankin Farm here in Whitfield, Mississippi.

In February 1914, Surgeon General Rupert Blue personally asked Goldberger to head up the government’s war against pellagra after another
PHS doctor quit the post in frustration. Thirty-nine years old at the time, Goldberger was a living legend within the PHS for having risked life and limb to investigate other deadly epidemics. He nearly died from yellow fever in 1902 while tracking the virus in Mexico, fought a less serious though still agonizing bout of dengue fever five years later in Texas, and, during a return trip to Mexico in 1910, contracted typhus and teetered on the brink of death for several days. He rebounded and then gleefully wrote to his wife about the professional “notches” he was accumulating for having suffered through these “quarantinable diseases.” Mary, pregnant with their second son and tired of raising the first one alone, was somewhat less thrilled by it all.

Goldberger readily accepted Surgeon General Blue’s offer to combat pellagra and was eager to solve the epidemiological riddle that had bedeviled scientists for almost two hundred years. Nothing about the disease made sense. In the United States, pellagra attacked every age, race, and gender but hit the poor and African Americans the hardest. It struck year-round and in all parts of the country but primarily in rural southern towns where cotton fields dominated the landscape. Outbreaks seemed to increase after major flooding as well.

Its symptoms were also uniquely grotesque. Pellagra marked its victims with a painful, bright-red, butterfly-shaped rash across the face and caused the lips to dry up, crack, and bleed. Inflammation spread across the hands and forearms, like formal long gloves, and encircled the neck (a condition called Casal’s necklace, named after the Spanish doctor, Gaspar Casal, who discovered pellagra in 1735), creating a macabre, costume-like appearance. The lesions eventually crusted over and sloughed off, leaving the skin hard and scaly. Internally the disease ravaged the intestines and brought on acute diarrhea and nausea. Many pellagrins, as the victims were called, slipped into comas or developed dementia, and approximately one out of three died.

Goldberger crisscrossed the South inspecting hospitals, group homes, orphanages, insane asylums, and prisons where pellagra was rampant. He probed water sources for bacteria, scrutinized bathroom
facilities and sleeping quarters for their sanitary conditions, and checked for bug and mold infestations in kitchens, food pantries, and grain-storage bins. Many southern doctors believed that, because pellagra cases abounded in areas where people ate mostly corn-based diets, some microbe or parasite was infecting the kernels. Other health officials insisted that the disease was contagious. No obvious answers came to light, but Goldberger did conclude his whirlwind tour with one critical question: At all of these institutions, why weren’t the staff members coming down with the disease?

On a hunch, in May 1914 Goldberger began cataloging the food served at both the Methodist Orphans’ Home, where approximately 30 percent of its children were afflicted, and at the Mississippi Baptist Orphanage, whose administrators so feared the stigma attached to pellagra that they insisted their orphans were suffering only from severe sunburns. Goldberger estimated that about 50 percent had pellagra.

Cornmeal, beets, rice, cabbage, and other low-cost fare represented the bulk of the children’s meals, while staff members were fed higher-quality foods. Goldberger soon suspected that the problem wasn’t what the orphans were eating but what they were
not
eating. With funding from the PHS, Goldberger supplied each facility with large quantities of quality meats, eggs, fresh milk, beans, and other protein-rich foods. The results were overwhelming. Within days, virtually everyone improved and no additional cases emerged.

None of this shed light on why pellagra cruelly disfigured its victims or spared some but not others (although the same could be said of countless disorders), but if Goldberger’s diet-related theory were true, it would explain other mysterious aspects of the disease. Pellagra was disproportionately affecting impoverished communities because sharecroppers, who were scraping by only marginally better than the slaves who had worked the land before them, subsisted mostly on corn bread, grits, and the occasional slab of fatback, washed down with coffee. Fruits and vegetables had been crowded out by cotton, a more lucrative crop, and floods wiped out harvests and cattle, causing farmers to further restrict their already meager diets.

Goldberger was guardedly optimistic about his findings but realized that they ran counter to the conventional wisdom. His premise, however, wasn’t entirely without precedent; goiter and scurvy were two other known “deficiency diseases” cured by simple nutritional changes. Goiter, identified by swollen thyroid glands, could be prevented by ingesting iodine (hence the reason we iodize table salt), and scurvy was easily treated with foods rich in vitamin C. British sailors earned the nickname “limeys” for consuming large quantities of limes and other citrus fruits on long voyages.

Dr. James Hayne, South Carolina’s public health director, wasn’t buying Goldberger’s theory. Hayne and numerous other southern doctors were convinced that pellagra was transmitted through some contaminating agent, and they took particular umbrage at Goldberger’s insinuation that the South’s entrenched poverty was responsible for exacerbating the disease. Hayne also dismissed Goldberger’s orphan studies as scientifically lacking.

On this last point Goldberger didn’t disagree. He himself realized that, to prove his thesis, he needed to perform a long-term trial under controlled conditions that could be verified by other doctors. And this time it wouldn’t be enough for him to simply alleviate the disease, as he’d done at the orphanages. He would have to induce it.

Pellagra was excruciating to endure under the best of conditions, and no one, Goldberger assumed, would voluntarily sign up for such an ordeal out of pure selflessness. So in January 1915 he devised a plan and met with Mississippi’s governor, Earl Brewer, to outline what he intended to do. Despite the political risks involved, Brewer gave Goldberger his blessing, and Surgeon General Rupert Blue signed off on the proposal, too. Pellagra cases were on the rise, and the three men believed urgent measures were required.

On April 19, Goldberger started feeding a group of twelve white men, all of whom worked on Rankin Farm and ranged in age from twenty-four to fifty, a carbohydrate-based diet that would “hopefully” give them pellagra within six months. Goldberger and his colleague
Dr. George Wheeler carefully supervised the men’s food intake and checked them daily for symptoms.

May, June, and July passed with no results.

Once August came, Goldberger began to fear that he might have been wrong about the disease. Then in late September the first rashes sprouted, and by October, Goldberger’s subjects started coming down with full-blown pellagra. Goldberger brought in a group of dermatologists to corroborate, and they all agreed with his diagnosis.

That Goldberger had selected for his Rankin Farm study only Caucasians—which he did to dispel the stereotype that African Americans were more predisposed to pellagra—is not what most troubled later generations of medical ethicists and historians. What has stained Goldberger’s otherwise stellar reputation is that all of his subjects were prisoners.

Before the Mississippi State Hospital was built on this site, the property belonged to the Mississippi State Penitentiary. About five hundred feet away from MSP’s main detention complex but still part of the prison was a screened-in cottage surrounded by fields and animal pens. That was Rankin Farm, home to Goldberger’s sequestered “pellagra squad.” He had considered other penal facilities, but the Rankin setup was ideal because the inmates could be isolated and yet still remain within the same general environment of the control group—that is, the rest of MSP’s inmate population. Goldberger did not want his subjects smuggling in food or becoming infected (if indeed pellagra turned out to be contagious) by anyone beyond their cluster. This was the whole point of using prisoners; they were, by definition, contained, allowing Goldberger to confirm to the scientific community that no outside influences had made them sick.