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PHILADELPHIAFor two decades, a doctor at the University of Pennsylvania School of Medicine transformed a Philadelphia penitentiary into his personal laboratory. Albert Kligman, a world-famous dermatologist, conducted hundreds of experiments on inmates behind the walls of Holmesburg prison before a public outcry shut down his operation in 1974. Kligman's studies ranged from the seemingly harmlesstests of toothpaste, shampoo, and deodorantto the obviously risky, putting dioxin on prisoners' faces and having them consume mind-altering drugs. Along the way, he made millions of dollars from the pharmaceutical companies that financed his experiments.
One of Kligman's guinea pigs was Leodus Jones. When he crossed paths with Kligman in the 1960s, Jones was young and desperate for bail money. He could earn a mere 15 cents a day performing menial prison jobs like sewing trousers. Or he could become a test subject. Jones decided to join four experiments and earned close to $100 for letting researchers test chemicals on his feet, legs, arms, and back. Light and dark marks covered his body for several years afterward. Three decades later, Jones, now 55, still wonders what exactly he was exposed to and how it may have affected his and his children's health.
Now, a recently released exposé has sparked new interest in this controversial chapter of American medical history. Allen Hornblum's Acres of Skin: Human Experiments at Holmesburg Prison; A True Story of Abuse and Exploitation in the Name of Medical Science is the first in-depth account of what may have been the nation's busiest human laboratory. Like Miss Evers' Boys, the recent film about the infamous Tuskegee syphilis study, Acres of Skin calls attention to the shocking forms that medical research has taken over the years. In the wake of this book's publication, the ACLU's Pennsylvania chapter is considering filing a lawsuit on behalf of those who participated in the Holmesburg experiments.
The villain in Acres of Skinis Kligman, best known for creating the skin cream Retin A, which he tested on Holmesburg prisoners. Prison officials initially recruited the dermatologist to help with an outbreak of athlete's foot. But when Kligman walked into Holmesburg, "All I saw before me were acres of skin," Kligman told a reporter in 1966. "It was like a farmer seeing a fertile field for the first time."
With easy access to this 1200-plus inmate population, Kligman had no trouble finding cheap volunteers for medical trials--or companies willing to pay him to test their products. Most inmates agreed to participate in the experiments, which generated millions of dollars in revenue for Kligman and the University of Pennsylvania. Kligman's long list of clients included Pfizer, Helena Rubenstein, Johnson & Johnson, R. J. Reynolds Tobacco, and the U.S. Army.
Former inmates say the most common experiment was the "patch test." Researchers marked a gridon prisoners' backs and applied different lotions and ointments in each box. Then they stuck adhesive strips and gauze pads on the men's backs. "Guys looked like zebras when the patchescame off," a retired guard recalls in Acres of Skin. Today, at neighborhood pools in Philadelphia, former Holmesburg inmates can still identify one another by the designs on their backs.
Ugly scars were hardly the only side effects of Kligman's studies. When Roy Williams agreed to test shampoo, his hair started falling out. "I didn't really have a dandruff problem, but I did after that test," Williams said to Hornblum."The lotion removed my hair and anything else on my head."
Researchers told inmates little about the experiments. So prisoners quizzed fellow inmates who worked with the doctors in order to learn which tests were safest. Word on the prison grapevine was that Kligman's most dangerous studies took place inside the trailers parked at the prison. There, Kligman tested mind-altering drugs for the U.S. Army--even though this was far outside his specialty of dermatology.
One test subject was Johnnie Williams. Researchers gave him an injection, put him in a padded cell, and videotaped him. "Almost immediately I felt affected," Williams says in Acres of Skin."I couldn't control myself and I told them to get this shit out of me."
Williams began hallucinating. He ripped the toilet out of the floor and the cell door off its hinges. The drug's effects lasted for years, Williams believes. "I had been a guy who tried to avoid arguments," he told Hornblum, "but after the tests . . . I went from petty thievery and busting into cars to shootings and assaults. I had major problems after the tests. [They] made me violent."
Hornblum first learned about Kligman's experiments in 1971, when he was a 23-year-old literacy instructor at Holmesburg. He still remembers the shock he felt as he watched inmates walking around with gauze stuck to their backs. "You had an incarcerated population in a totalitarian atmosphere," Hornblum said in a recent interview. "The prison population at that point was overwhelmingly African American--about 85 per cent--and the education level was pitiful. You didn't have to be a bioethicist to know this is a recipe for disaster."
Still haunted by his memories of Holmesburg more than 20 years later, Hornblum decided to investigate. A longtime prison reform advocate, Hornblum was working as the chief of staff in the city sheriff's office in 1993. He quit his job, moved in with his mother, and began making daily trips to the University of Pennsylvania's medical library.
The Holmesburg experiments were difficult to research, however. For starters, Kligman had destroyed all his records after national publicity led to the closing of his laboratory. Jessica Mitford's 1973 exposé, Kind and Usual Punishment: The Prison Business, led to a ban on the nationwide practice of using inmates as guinea pigs. When Hornblum decided to dig up the truth about Kligman's involvement, he found dozens of former inmates who wanted to talk but knew virtually nothing about what they had been exposed to. And when Hornblum phoned doctors who had worked for Kligman, almost all of them hung up or cursed him out.
Eventually, by combining inmate interviews with documents he got under the Freedom of Information Act, Hornblum was able to piece together Acres of Skin.Still, he wonders how much has yet to be uncovered. Bernard Ackerman, who studied under Kligman and now heads the Institute for Dermatopathology at Philadelphia's Jefferson Medical College, believes there is much more to this tale. "Hornblum really only scratched the surface, but through no fault of his own," Ackerman says. "He got no cooperation."
Near the end of his reporting, Hornblum telephoned Kligman, who is now 82 and a professor emeritus at the University of Pennsylvania School of Medicine. Kligman spoke for only 20 minutes before cutting off the interview. "All we did . . . is offer them money for a little piece of their skin," Kligman said. He insisted his tests were innocuous, railed against the "liberals" and "do-gooders" who had opposed him, and bashed critics who compared his prison experiments to the work of Nazi doctors. "I'm Jewish!" he said. "It struck me as ludicrous and incredible that I'd be compared to that."
The University of Pennsylvania released a statement defending Kligman's work, which read in part, "In the 1950s and 1960s, the use of willing, compensated prisoners for biomedical research was a commonly accepted practice by this nation's scientists." Nevertheless, Hornblum opens Acres of Skinwith the Nuremberg Code, which was written after the Holocaust to ensure that doctors never again exploited powerless populations in the name of medical advancement. "What took place at Holmesburg is not on the same plane as what took place at Auschwitz, but it is on the same continuum," Hornblum says. At Holmesburg, "they weren't using kids at fancy prep schools. They weren't using the string section of the Philadelphia orchestra. They were using prisoners like lab rats. The inmates were brought out for a short period of time, they were experimented on, and then they were forgotten about."