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Ethics and Orphans: The `Monster Study'

Norma Jean Pugh, the youngest of the experimental subjects, above, was regarded as a misfit after she developed a stutter. Now known as Kathryn Meacham, she lives as a recluse.
SPECIAL TO THE MERCURY NEWS

Hazel Potter, who was 15 in 1939, above, says she knew the orphans were used for research. Her speech worsened after the stutter experiment ended.

BY JIM DYER
Mercury News

The package came in the twilight of Mary Tudor Jacobs' life. She stood in the doorway of her home in Moraga, the East Bay town where she had retired, and struggled to decipher the tiny letters scrawled on the wrapper. The address read: ``Mary Tudor Jacobs The Monster.''

The 84-year-old woman breathed faster. She looked at the name of the sender: ``Mary Korlaske Nixon Case No. 15 Experimental Group.''

``Oh dear,'' she said. She shook her head. Her hands began to tremble.

The package came from Iowa. A lifetime ago, as a graduate student, she had conducted an experiment on children in an orphanage there.

The experiment used psychological pressure to make children stutter. It was designed by her professor, Dr. Wendell Johnson, to test his new theory on the cause of stuttering. Several of the children suffered lasting damage, but the research helped support the theory and Johnson went on to become one of the nation's most prominent speech pathologists.

But he never disclosed the research. The study had ended just before World War II, and as the world learned of Nazi medical experiments on living subjects, the professor's associates warned him to conceal his work on the orphans rather than risk comparisons that could ruin his career.

The orphans were not told what had been done to them.

Mary Tudor spent half a century trying to forget.

Every so often a call would come from a researcher asking about the experiment. Then last year, a reporter called and Tudor began seriously examining that part of her life.

Now there was this package, addressed to her, addressed to The Monster. At the University of Iowa, where she had been a graduate student, the experiment came to be called the ``Monster Study.''

She looked at the sender's name again. Mary Korlaske? She couldn't place it. There had been so many orphans, 22 boys and girls, and most of their names -- Norma, Clarence, Hazel, Elizabeth -- had faded in her mind, just as they had on the hundreds of pages of records from the experiment that she had stored in her home all these years.

What had remained was a deep ambivalence about the experiment.

``It was a small price to pay for science,'' she would say many times, talking with the reporter. ``Look at the countless number of children it helped.'' And yet, she couldn't forget how the orphans greeted her each visit, running to her car and helping her carry in the very materials she used in the experiment.

``That was the pitiful part -- that I got them to trust me and then I did this horrible thing to them,'' she said.

She carried the package into her dining room and sat down at the antique oak table.

``I hope it isn't a bomb,'' she said.

Just a number: Remaining objective

On that day, Tudor and five fellow speech pathologists from the University of Iowa had gone to the Iowa Soldiers' Orphans' Home in Davenport, a small city on the Mississippi River, to begin screening children as subjects for an experiment on what causes stuttering. A complex of 22 cottages, a school and an administration building, the orphanage housed 500 to 600 children whom the state deemed neglected or dependent.

Tudor, a 23-year-old graduate student, had been told to remain objective and indifferent, to assign case numbers to the children and to refer to them in her records only by those numbers.

``It was scientific research, so I was supposed to remain detached,'' Tudor recalled.

Mary Korlaske, a 12-year-old fourth-grader, was one of 256 children screened for the experiment. The notes from that day follow her through the initial series of evaluations. First, she read aloud while the speech pathologists graded her fluency. Then she underwent a battery of eye and dexterity tests.

``She craved attention,'' Tudor noted.

Then, the records show, Tudor entered Mary Korlaske as ``Case No. 15 Experimental Group IIA. Normal speaker.''

A baffling torment: What causes stuttering?

Johnson made it his life's work to find the cause, and cure, for stuttering. When he arrived at the University of Iowa as a student in 1926, he intimately understood the affliction. Johnson was a severe stutterer. He brought with him the nickname Jack, after the prizefighter Jack Johnson, because of how he responded to teasing from classmates: He punched them.

A star athlete and student, Johnson arrived on campus with two goals: to become a writer, and to receive speech therapy. The university was a leader in the new field of speech pathology. The leading theory on stuttering at the time was that it had a genetic, or organic, cause.

Johnson spent hours in the speech clinic, often offering himself up as an experimental subject. Eventually he focused his graduate studies on speech pathology, especially stuttering.

In the clinic, Johnson was hypnotized, psychoanalyzed, prodded with electrodes, and told to sit in cold water to have his tremors recorded. Like Demosthenes, the ancient Greek stutterer, Johnson placed pebbles in his mouth. Johnson had his dominant arm, the right, placed in a cast to help prove his professor's controversial ``cerebral dominance'' theory; the idea was that forcing him to use his left arm would equalize the imbalance of the hemispheres of his brain.

Nothing seemed to work for long. In 1936, Johnson wrote in his journal, ``I'm a professional white rat.''

Still, Johnson persisted. He intimately knew the harmful effects that stuttering had on emotional and social growth and lectured about them, to packed auditoriums, throughout the Midwest. Children who stutter often experience a drop in grades, a loss of morale and self-respect, and self-imposed isolation, he said. Fear, humiliation and dread can lead to suicide attempts.

``The stuttering child is a crippled child,'' he wrote.

In diaries, he methodically recorded his own progress, noting his delight on days he spoke well and his dejection when he relapsed. In public life, he hated formality and enjoyed telling jokes and reciting limericks. He found that humor relieved stress and reduced his stuttering.

By 1936, Johnson began to doubt the prevailing theory that stuttering was an inborn condition and proposed experiments to test its validity, his diaries show. Two years later, he reached a turning point with a series of case studies, in which he conducted interviews with parents and their stuttering children. Every child, he discovered, had been labeled a stutterer at a very early age.

``Stuttering begins in the ear of the listener, not in the mouth of the child,'' he theorized.

All children have trouble with their speech when they are young, often repeating words and syllables. By drawing attention to their speech, he reasoned, overzealous parents would make their children so self-conscious and nervous that the children would repeat more words. In time, the children would become so sensitized to their speech that they would not be able to talk without stuttering.

Johnson came to attribute the origins of his own stuttering to a first-grade teacher who misdiagnosed his normal repetitions as the early stages of stuttering. She had told Johnson's parents, who corrected him. Unfortunately, the more the boy tried to talk normally, the worse he stuttered.

``The affliction is caused by the diagnosis,'' Johnson said.

Testing a theory: The study starts

But he needed direct evidence, preferably research conducted in a controlled environment.

He turned 50 miles east, to the state-run Iowa Soldiers' Orphans' Home. The university had already conducted numerous research projects using orphans there, among them a decades-long study to see if developmental retardation would be more common among children who remained in the overcrowded and unstimulating orphanage than among children placed in a special new preschool.

``They used that orphanage as a laboratory rat colony,'' said Franklin Silverman, a professor of speech pathology at Marquette University who studied under Johnson at the University of Iowa in the 1960s.

In the autumn of 1938, Johnson received permission from orphanage officials to begin his experiment. Then he called Mary Tudor into his office.

``Have you chosen anything for your master's thesis?'' Tudor remembers Johnson asking her.

Tudor remembers Johnson outlining the experiment and telling her that he had chosen her because he noticed that she had a great rapport with children. She listened attentively as he explained the details of the experiment.

Tudor would work with two groups of children: one of stutterers, and another of normal speakers. Half the children from each group would be assigned to an experimental group, the other half to a control group. Children in the control groups would be labeled normal speakers and receive positive therapy. Children in the experimental groups would be labeled stutterers and given negative therapy.

First she would make sure the children in the experimental groups knew what stuttering was. Then she would warn them they were showing signs of stuttering. She would systematically sensitize them to their speech, stopping and lecturing them whenever they repeated a word.

Tudor was told she would have to lie to the orphanage's teachers and matrons, telling them she was there to do speech therapy, so that they would become unwitting participants in the experiment. If Tudor labeled a child a stutterer, the teachers and matrons would have to reinforce that negative label, Johnson said.

Tudor was excited that Johnson had chosen her. She knew how much weight a thesis directed by Wendell Johnson would have in her career. Moreover, his theory made sense to her. She remembered the case studies of the children in the clinic that summer and was intrigued by the prospect of helping her adviser find the cause, then possibly a cure, for stuttering.

But she had not expected the depressing conditions she found when she arrived at the orphanage, nor how difficult she would find it to hurt the children.

After reviewing the speech of 256 orphans, she and the other speech pathologists culled 22 subjects: 10 stutterers and 12 normal speakers. They paired the children based on similarities in age, sex, IQ and fluency. Then they randomly assigned one from each pair to the control group and the other to the experimental group.

With the stroke of her pen, Tudor split up friends and siblings. She placed Jane Anne Pugh in a control group and her younger sister, Norma Jean Pugh, in an experimental one. She divided the Albertson brothers, Lester and Noah, in the same way. Mary Korlaske and her friend Marion Higdon were paired; Mary landed in the experimental group and Marion became her control.

``There but for the grace of God, I could have been placed in an experimental group,'' Donna Lee Hughes Collings, another of the orphans, said 62 years later. ``It could have been my life that was destroyed.''

Eager to please: Hoping for new mother

Mary Korlaske, however, has never forgotten. It had been one of her best days at the orphanage, she remembers. She thought that Mary Tudor might become her new mom.

Korlaske, 74, recalled those days in conversations with a reporter over the past six months. When she was located by the Mercury News, she did not know about the experiment or understand what had happened to her in the winter and spring of 1939. Nor did Collings or any of the other subjects from the experiment who were found by the Mercury News.

But many of them vividly remembered their years in the orphanage -- none more than Mary Korlaske.

She still remembers how beautiful Tudor looked to her -- tall and slender with dark wavy hair and welcoming brown eyes. The graduate student reminded Korlaske of her own mother.

Mary had been living in the orphanage for five years. Her mother had sent her and her two older brothers away when she was 7 years old. The Great Depression had devastated the young girl's family, sweeping through Iowa and bankrupting farms and businesses in her hometown of Emmettsburg.

Mary said that as a child in the orphanage, she often thought about her last day at home and tried to figure out why she was sent away. That day had started out gloriously: Her mother had taken her to town and bought her a pretty oilcloth purse and a new white handkerchief. But when they got home, her mother ushered her into a waiting black car.

``You'll be safe,'' she told her baby girl. She pressed a keepsake, a silver thimble, into her hand. ``You'll be all right.''

As the car pulled away, Mary clutched the thimble and watched her mother from the rear window.

Five years later, Mary Korlaske met Tudor. Throughout the experiment, she wondered if Tudor was married and had any children. She hoped Tudor had come to adopt her. She remembers waiting impatiently during school to be called into the speech therapy sessions and eagerly following Tudor to the testing room. To make a good impression, she talked a lot.

Negative therapy: Creating anxiety

Tudor's memories are impressionistic. She remembers staying overnight and feeling depressed when she awoke to find the children scrubbing floors and working around the institution. She remembers setting up her experimental room and walking into the school to pull the children out one by one.

But she saved hundreds of pages of records from the experiment, including transcribed dictaphone recordings of the sessions. The documents provide a clear, clinical picture of how the children were used.

The first experimental session was held on Jan. 19, 1939. Tudor asked Mary Korlaske if she knew anyone who stuttered and Mary said she knew a girl named Dorothy Ossman. Then Mary eagerly began to tell Tudor a story. In the middle of it, Tudor interrupted her when she made a simple repetition, warning the 12-year-old that she was not only beginning to stutter, but that if she didn't work hard to improve it, she would stutter as badly as Dorothy.

``She reacted to the suggestion immediately,'' Tudor noted in her report on the session, ``and her repetitions in speech were more frequent.''

Then Tudor gave Mary advice that she said would help. In fact, it was negative therapy, designed to make the girl more conscious of her speech:

``Take a breath before you say the word if you think you're going to stutter on it. Stop and start over if you stutter. Put your tongue on the roof of your mouth. Don't speak unless you can speak correctly. Watch your speech all the time. Do anything to keep from stuttering.''

Tudor observed that Mary was ``very easily influenced.'' Her suggestions caught on immediately and Mary became so conscious of her speech that by the following session she was already repeating words.

Every week or two, Tudor returned for more sessions. By March, Tudor's dictaphone recordings showed Mary's speech had deteriorated markedly. The girl was having particular problems with words beginning with ``w'' or ``s'' or ``r.''

In a subsequent transcribed session, Mary Korlaske had regressed to incomplete sentences. Tudor asked the girl: ``How is your stuttering, Mary?''

``Stuttering is stopping.''

``How do you know it is?''

``Because I listen to myself talk.''

``What do you hear?''

``Hear myself going ah ah -- saying words twice.''

``Did you ever listen to yourself before?''

``No, teacher has been stopping me and having me say it over.''

Tudor was pleased the teachers were reinforcing the stuttering labels and the negative therapy.

Mary said she was having trouble reading in class. Tudor noticed that her speech interruptions increased steadily throughout the experimental period. Over the course of four months, they had more than doubled.

The other children in Mary's experimental group showed similar effects. Six-year-old Norma Jean Pugh, a first-grader with curly, light brown hair and blue eyes, spoke freely and connectedly at the beginning of the experiment. At the end, she was barely speaking.

Her speech became jerky and hesitant, and she covered her face and slid down in her chair during the sessions, according to Tudor's records. She knew exactly when she would stutter. During one session, she started to say the word ``red'' and changed suddenly to ``pink'' because she ``was afraid she'd stutter on `red,' '' Tudor wrote. By the April 24 session, her speech had become completely disjointed. Tudor asked her to tell a story and, after much coaxing, Norma finally replied:

``There's a jar. There's a fox. Got a coat on. There's a tree. Little girl. An' here's some flowers. An' there's a fence. Teapot. Flower bowl.''

She stuttered on words like ``hand'' and ``got,'' and when she read ``The Three Bears,'' she stuttered on ``porridge,'' although months earlier she had little trouble reading the story.

Nine-year-old Elizabeth Ostert and 12-year-old Phillip Spieker saw their grades plummet because they became afraid to talk in class. ``It's almost impossible to get the boy to speak in a situation other than play,'' Tudor wrote.

Other boys at the orphanage began teasing Clarence Fifer, a chubby 11-year-old, because of his speech, which during the experiment went from normal to ``jerky and laboured,'' Tudor wrote. The boys on the playground noticed.

``They kind of laughed,'' he told Tudor during one recorded session.

``What did you do then?''

``Walked away.''

``Does it bother you much?''

``Yes, feel pretty bad.''

Hazel Potter, a skinny 15-year-old, was showing more severe effects. ``During the experimental period she developed mannerisms characteristic of some stutterers, such as snapping her fingers to get a word out. . . . and occasionally she presented the phenomenon of writing the same word two or three times in her compositions,'' Tudor wrote.

By spring, the experiment had become emotionally and physically draining for Tudor. She had found it hard to maintain the scientific detachment her adviser recommended. In many of the entries in her records, she referred to the children by name, only subsequently crossing the names out and replacing them with case numbers.

After every session, she left the orphanage more disillusioned by the effect the experiment was having on the children. She remembers handing in her results to Johnson and hoping he would stop the research. But he seemed more excited after each session.

``I didn't like what I was doing to those children,'' Tudor recalled. ``It was a hard, terrible thing. Today, I probably would have challenged it. Back then you did what you were told. It was an assignment. And I did it.''

On May 24, 1939, Johnson drove to the orphanage with Tudor and the crew of speech pathologists to see firsthand the final testing of the 22 orphans. In the experimental groups, subjected to negative therapy, speech had deteriorated for five of the six normal speakers and for three of the five stutterers. In the control groups, only one child suffered more speech interruptions at the end of the experiment.

Tudor doesn't remember talking to Johnson about the experiment after the final session. She recalls only the long hours afterward, transcribing the dictaphone recordings, and counting and logging every speech irregularity of the children.

By the end of the summer her 256-page thesis was done. The experiment had ended. She moved on to a job as a speech therapist in northeastern Wisconsin, a day's drive from the Iowa Soldiers' Orphans' Home.

But the orphans remained, and the teachers and matrons continued what they had been told was therapy to help the children with their speech.

``When I left that orphanage, that experiment was over for me,'' she said. ``Apparently, it wasn't over for those children.''

In the package: An accusation

``I can't see the orphans' faces, but I can see that orphanage and where I stayed overnight. If you do a study like that, you don't ever forget it,'' Tudor said.

The unexpected package from Mary Korlaske that arrived in March brought Tudor's hazy memories into painful focus.

Tudor slowly tore open the wrapping. Inside was a letter and another package -- small and curiously shaped, tightly bound in tissue paper and white medical tape.

She picked at the thick tape, but couldn't break the binding. She tore open the envelope instead and pulled out a three-page letter, creased and folded into a small square.

The writing was messy and at times incoherent. There were many spelling errors. But the message was clear.

``You destroyed my life,'' the letter said. ``I could have been a scientist, archeaologist or even president. In stead I became a pityful stutter. The kids made fun of me, my grades fell off, I felt stupid. Clear into my adulthood, I still want to avoide people to this day.''

Tudor's brown eyes welled. Her hands shook. She stared at the small package, still unopened on her dining room table.