1 00:00:01,466 --> 00:00:02,900 ANNOUNCER: The following program contains 2 00:00:02,900 --> 00:00:05,433 the use of racial epithets in historical context. 3 00:00:05,433 --> 00:00:07,433 Viewer discretion is advised. 4 00:00:15,433 --> 00:00:22,700 ♪ ♪ 5 00:00:27,966 --> 00:00:29,833 NARRATOR: In New York City, 6 00:00:29,833 --> 00:00:33,400 the line stretched around the block. 7 00:00:34,533 --> 00:00:35,933 In Philadelphia, 8 00:00:35,933 --> 00:00:39,600 women waited for hours outside their local church. 9 00:00:39,600 --> 00:00:42,566 While way out in Wyoming, 10 00:00:42,566 --> 00:00:44,766 even the smallest mountain town was ready. 11 00:00:47,733 --> 00:00:51,033 Everywhere, in the year 1958, 12 00:00:51,033 --> 00:00:55,633 women were asking for a brand new medical test: a Pap smear. 13 00:00:56,633 --> 00:00:57,966 And nobody had ever 14 00:00:57,966 --> 00:00:59,866 seen anything like it. 15 00:01:02,100 --> 00:01:05,100 RACHEL GROSS: In the 1940s and '50s, cervical cancer is killing 16 00:01:05,100 --> 00:01:07,133 thousands and thousands of women. 17 00:01:07,133 --> 00:01:10,600 This was definitely a major priority of American healthcare. 18 00:01:10,600 --> 00:01:13,700 The stakes are very high. 19 00:01:13,700 --> 00:01:16,633 NARRATOR: For the first time in history, 20 00:01:16,633 --> 00:01:20,066 there was a simple screening test for cancer. 21 00:01:20,066 --> 00:01:22,600 Its rollout and its propaganda 22 00:01:22,600 --> 00:01:24,433 were utterly unprecedented. 23 00:01:24,433 --> 00:01:25,833 DEBORAH KERR (archival): Costly cancer deaths, 24 00:01:25,833 --> 00:01:28,966 they deprive the world of too many people we love. 25 00:01:28,966 --> 00:01:32,500 Now is the time to strike back at cancer. 26 00:01:32,500 --> 00:01:35,966 NARRATOR: The campaign would require nothing short 27 00:01:35,966 --> 00:01:39,066 of a full national mobilization. 28 00:01:39,066 --> 00:01:41,466 DEIRDRE COOPER OWENS: It's so ubiquitous now, that we kind of 29 00:01:41,466 --> 00:01:43,366 don't think about the fact 30 00:01:43,366 --> 00:01:45,500 that it's not even a hundred years old yet. 31 00:01:45,500 --> 00:01:47,966 When we first hear about a Pap smear, 32 00:01:47,966 --> 00:01:52,100 we don't know that it's actually named after a human being. 33 00:01:52,100 --> 00:01:53,966 NEWSREEL NARRATOR (archival): This is the doctor, 34 00:01:53,966 --> 00:01:56,633 George N. Papanicolaou, professor emeritus 35 00:01:56,633 --> 00:01:58,633 of Cornell Medical College. 36 00:01:58,633 --> 00:02:02,200 NARRATOR: The truth was, George Papanicolaou never set out 37 00:02:02,200 --> 00:02:04,866 to revolutionize cancer detection. 38 00:02:04,866 --> 00:02:07,633 And not a single thing about bringing the Pap smear 39 00:02:07,633 --> 00:02:10,233 to the people had been simple. 40 00:02:10,233 --> 00:02:14,033 BARRON LERNER: There were lots of barriers and lots of steps 41 00:02:14,033 --> 00:02:16,366 to get to where the Pap test really became 42 00:02:16,366 --> 00:02:18,200 a life-saving test. 43 00:02:18,200 --> 00:02:19,200 NARRATOR: Behind it all 44 00:02:19,200 --> 00:02:20,633 was a coalition as remarkable 45 00:02:20,633 --> 00:02:22,833 as it was unusual-- 46 00:02:22,833 --> 00:02:25,066 from a Japanese-born artist, 47 00:02:25,066 --> 00:02:27,166 to a Black doctor in Philadelphia, 48 00:02:27,166 --> 00:02:30,400 to an entirely new class of female scientists. 49 00:02:30,400 --> 00:02:33,400 Yet they all shared a singular goal: 50 00:02:33,400 --> 00:02:36,233 to save American women from cancer. 51 00:02:38,233 --> 00:02:40,466 One of the things that surprises me about this story 52 00:02:40,466 --> 00:02:43,066 is sometimes when we look at things in retrospect, 53 00:02:43,066 --> 00:02:45,666 it seems inevitable that they were going to happen. 54 00:02:47,000 --> 00:02:48,300 When I look at this story, 55 00:02:48,300 --> 00:02:50,733 nothing seems inevitable about it. 56 00:03:01,033 --> 00:03:06,633 ♪ ♪ 57 00:03:14,733 --> 00:03:17,366 (fluid bubbling) 58 00:03:19,633 --> 00:03:23,300 ♪ ♪ 59 00:03:27,633 --> 00:03:31,733 NARRATOR: The Cornell Medical College, in the year 1914, 60 00:03:31,733 --> 00:03:33,533 was home to practically every kind 61 00:03:33,533 --> 00:03:36,366 of scientific endeavor imaginable. 62 00:03:36,366 --> 00:03:41,366 Here, one lab studied the bacteria in human saliva. 63 00:03:43,466 --> 00:03:45,466 A floor below, 64 00:03:45,466 --> 00:03:48,600 researchers were developing treatments for diabetes 65 00:03:48,600 --> 00:03:51,066 by removing the pancreas from dogs. 66 00:03:51,066 --> 00:03:55,966 ♪ ♪ 67 00:03:55,966 --> 00:03:58,500 Then there was the scientific illustrator 68 00:03:58,500 --> 00:04:01,866 who would have 5,000 live mosquitos shipped by mail 69 00:04:01,866 --> 00:04:04,200 as "artist supplies." 70 00:04:07,300 --> 00:04:08,733 Amidst it all 71 00:04:08,733 --> 00:04:10,800 was a 31-year-old Greek immigrant, 72 00:04:10,800 --> 00:04:15,166 a zoologist by the name of George Papanicolaou. 73 00:04:16,300 --> 00:04:18,400 Always at his microscope, 74 00:04:18,400 --> 00:04:20,833 Papanicolaou was convinced that cells-- 75 00:04:20,833 --> 00:04:22,833 the building blocks of all life-- 76 00:04:22,833 --> 00:04:25,766 could tell us more than anyone else had realized. 77 00:04:27,500 --> 00:04:32,333 It was their secrets that he'd been chasing for years. 78 00:04:32,333 --> 00:04:34,166 ♪ ♪ 79 00:04:34,166 --> 00:04:36,700 (trolley bell ringing) 80 00:04:39,133 --> 00:04:41,433 SAM KEAN: When he was in Greece growing up, 81 00:04:41,433 --> 00:04:43,000 George Papanicolaou's father wanted George 82 00:04:43,000 --> 00:04:44,466 to become a doctor, 83 00:04:44,466 --> 00:04:46,766 but George liked science more. 84 00:04:46,766 --> 00:04:48,866 He also was called to help people. 85 00:04:48,866 --> 00:04:50,333 So he wanted to combine both 86 00:04:50,333 --> 00:04:52,100 of those doing medical research. 87 00:04:52,100 --> 00:04:54,833   NARRATOR: "It is not my ideal to be wealthy," 88 00:04:54,833 --> 00:04:56,500 he'd once written to his parents, 89 00:04:56,500 --> 00:04:59,866 but to work to create." 90 00:04:59,866 --> 00:05:03,500 Papanicolaou received his medical degree in 1904, 91 00:05:03,500 --> 00:05:05,400 at age 21, 92 00:05:05,400 --> 00:05:08,766 then embarked on a PhD in zoology, 93 00:05:08,766 --> 00:05:12,366 researching sex determination in the tiny aquatic daphnia, 94 00:05:12,366 --> 00:05:14,933 or water flea. 95 00:05:14,933 --> 00:05:18,766 After graduate school, he embarked on a sea voyage 96 00:05:18,766 --> 00:05:21,233 with Prince Albert of Monaco, 97 00:05:21,233 --> 00:05:23,933 aboard his brand-new oceanographic research vessel, 98 00:05:23,933 --> 00:05:26,233 the Hirondelle. 99 00:05:28,066 --> 00:05:29,633 In film footage shot by the prince, 100 00:05:29,633 --> 00:05:32,100 Papanicolaou himself can be seen 101 00:05:32,100 --> 00:05:34,766 retrieving marine specimens from a large trap. 102 00:05:36,333 --> 00:05:39,700 ♪ ♪ 103 00:05:43,233 --> 00:05:46,366 KIRSTEN GARDNER: He ends up going on an oceanic voyage 104 00:05:46,366 --> 00:05:50,700 to help identify different sea creatures. 105 00:05:50,700 --> 00:05:53,200 He loved to categorize things. 106 00:05:53,200 --> 00:05:56,866 I think it really translates to his later work 107 00:05:56,866 --> 00:05:59,233 when he makes his way over to the United States. 108 00:06:01,166 --> 00:06:04,033 (footsteps shuffling) 109 00:06:04,033 --> 00:06:05,900 NARRATOR: When he landed in New York City 110 00:06:05,900 --> 00:06:09,600 with his young wife, Mary Mavroyeni, in 1913, 111 00:06:09,600 --> 00:06:13,566 Papanicolaou was an ambitious scientist on the rise. 112 00:06:13,566 --> 00:06:16,533 But nothing went as planned. 113 00:06:17,733 --> 00:06:19,833 RACHEL GROSS: He spoke German and Greek, 114 00:06:19,833 --> 00:06:21,333 but neither of them 115 00:06:21,333 --> 00:06:22,900 spoke much English at all. 116 00:06:22,900 --> 00:06:26,166 KEAN: He was taking odd jobs, 117 00:06:26,166 --> 00:06:28,333 playing his violin in a restaurant. 118 00:06:28,333 --> 00:06:30,733 (violin playing) 119 00:06:30,733 --> 00:06:33,733 He was working as a clerk at a Greek newspaper. 120 00:06:33,733 --> 00:06:36,300 He was a carpet salesman for a bit, and he was supposedly 121 00:06:36,300 --> 00:06:39,100 the worst carpet salesman they'd ever had. 122 00:06:39,100 --> 00:06:41,433 He could not close any deal. 123 00:06:41,433 --> 00:06:44,566 He just wasn't a forceful personality in that way. 124 00:06:46,466 --> 00:06:50,466 NARRATOR: Still, George was luckier than most immigrants. 125 00:06:50,466 --> 00:06:53,300 His doctoral work had brought him some renown, 126 00:06:53,300 --> 00:06:56,000 and he was offered a job studying reproduction 127 00:06:56,000 --> 00:06:59,600 in the laboratory of one Charles Stockard, 128 00:06:59,600 --> 00:07:01,633 an anatomist, zoologist, 129 00:07:01,633 --> 00:07:04,166 and prominent American eugenicist. 130 00:07:05,433 --> 00:07:08,233 KEAN: George's boss believed in controlling reproduction, 131 00:07:08,233 --> 00:07:10,366 controlling who reproduced, 132 00:07:10,366 --> 00:07:11,933 with the supposed aim 133 00:07:11,933 --> 00:07:14,166 of improving the stock of humankind. 134 00:07:14,166 --> 00:07:16,466 At the time, people thought they knew 135 00:07:16,466 --> 00:07:17,800 what good genes and bad genes were. 136 00:07:19,733 --> 00:07:22,333 Good genes were you were white, 137 00:07:22,333 --> 00:07:24,166 with healthy young children. 138 00:07:25,300 --> 00:07:26,666 Unfortunately, 139 00:07:26,666 --> 00:07:28,600 if you were an immigrant, a person of color, 140 00:07:28,600 --> 00:07:31,866 if you had a disease like epilepsy, 141 00:07:31,866 --> 00:07:34,933 you were often stigmatized as having bad genes. 142 00:07:37,133 --> 00:07:39,500 GROSS: There was an inkling that if you could 143 00:07:39,500 --> 00:07:42,933 control female reproduction, that would give you the tools 144 00:07:42,933 --> 00:07:46,066 to create the population you wanted. 145 00:07:47,500 --> 00:07:50,033 NARRATOR: Papanicolaou's new work in Stockard's laboratory 146 00:07:50,033 --> 00:07:53,000 involved answering basic questions, 147 00:07:53,000 --> 00:07:56,566 still unknown, about female biology. 148 00:07:56,566 --> 00:08:00,900 GARDNER: Dr. Papanicolaou was interested in tracing the cellular changes 149 00:08:00,900 --> 00:08:03,866 that happened during the reproductive cycle. 150 00:08:03,866 --> 00:08:06,833 He was very invested in finding that pattern, 151 00:08:06,833 --> 00:08:08,933 and when did cells change. 152 00:08:10,200 --> 00:08:12,500 NARRATOR: Papanicolaou threw himself into the work, 153 00:08:12,500 --> 00:08:13,900 and, unexpectedly, 154 00:08:13,900 --> 00:08:17,466 found a kindred spirit just down the hall. 155 00:08:17,466 --> 00:08:19,600 ♪ ♪ 156 00:08:19,600 --> 00:08:21,800 KEAN: Hashime Murayama was born in Japan. 157 00:08:21,800 --> 00:08:24,100 He went to the Kyoto Art School. 158 00:08:24,100 --> 00:08:26,300 Then he got a job at Cornell. 159 00:08:26,300 --> 00:08:29,266 He was doing cell illustrations for doctors. 160 00:08:30,900 --> 00:08:33,233 He had a good eye for essentially drawing 161 00:08:33,233 --> 00:08:36,733 exactly what he was seeing. 162 00:08:36,733 --> 00:08:39,566 HAZARD: There must have been some degree of kinship 163 00:08:39,566 --> 00:08:41,200 between George and Murayama, 164 00:08:41,200 --> 00:08:43,066 as both were immigrants to America. 165 00:08:44,400 --> 00:08:46,966   Neither of them would've sounded or maybe looked 166 00:08:46,966 --> 00:08:49,166 like their American peers. 167 00:08:50,733 --> 00:08:52,466 NARRATOR: At Cornell, 168 00:08:52,466 --> 00:08:55,633 Murayama was as interested in cells as George was, 169 00:08:55,633 --> 00:08:57,466 and had even patented 170 00:08:57,466 --> 00:09:01,066 a new technique to improve the accuracy of his drawings. 171 00:09:03,900 --> 00:09:06,833 Meanwhile, back in the Stockard laboratory, 172 00:09:06,833 --> 00:09:09,333 Papanicolaou had recently found himself 173 00:09:09,333 --> 00:09:12,800 questioning one of their basic research protocols. 174 00:09:14,566 --> 00:09:17,266 Their lab animal was the guinea pig, 175 00:09:17,266 --> 00:09:19,566 and in comparison to the little aquatic water fleas 176 00:09:19,566 --> 00:09:23,133 George had worked with in graduate school, 177 00:09:23,133 --> 00:09:25,933 the rodents were more complicated. 178 00:09:27,066 --> 00:09:29,366 GARDNER: In order to study the reproductive cells, 179 00:09:29,366 --> 00:09:31,600 he would have to kill the guinea pig. 180 00:09:33,133 --> 00:09:35,033 But when you kill the guinea pig, 181 00:09:35,033 --> 00:09:36,900 you only get a slice of the story. 182 00:09:36,900 --> 00:09:40,333 So then he began to consider that the cells 183 00:09:40,333 --> 00:09:42,933 may be changing in the vaginal fluid. 184 00:09:42,933 --> 00:09:45,233 ♪ ♪ 185 00:09:45,233 --> 00:09:46,533 NARRATOR: One morning, 186 00:09:46,533 --> 00:09:49,000 Papanicolaou took a tiny tool and scraped cells 187 00:09:49,000 --> 00:09:53,366 from inside a live guinea pig's cervix. 188 00:09:53,366 --> 00:09:56,000 Then he smeared the sample on a glass plate, 189 00:09:56,000 --> 00:09:58,466 and applied a series of stains. 190 00:10:00,433 --> 00:10:01,966 At last, 191 00:10:01,966 --> 00:10:06,166 he sat down at his microscope and it all came into focus. 192 00:10:07,300 --> 00:10:09,933 ♪ ♪ 193 00:10:12,300 --> 00:10:16,133 GROSS: George found that there were changes in the cells. 194 00:10:16,133 --> 00:10:20,633 He could see differences in these cells' shape and size. 195 00:10:22,033 --> 00:10:23,666 And they very clearly 196 00:10:23,666 --> 00:10:26,166 showed him what was happening in the uterus. 197 00:10:27,466 --> 00:10:30,600 NARRATOR: The discovery helped launch a new field: 198 00:10:30,600 --> 00:10:35,366 exfoliative cytology, the non-invasive study of cells. 199 00:10:36,933 --> 00:10:39,900 Papanicolaou had the highest hopes for his new method. 200 00:10:41,133 --> 00:10:43,766 And now, he couldn't help but wonder, 201 00:10:43,766 --> 00:10:46,633 could this novel technique also work 202 00:10:46,633 --> 00:10:49,333 for that most mysterious animal of all? 203 00:10:52,066 --> 00:10:54,800 (projector whirring) 204 00:10:54,800 --> 00:10:58,166 ♪ ♪ 205 00:11:07,000 --> 00:11:10,433 COOPER OWENS: There are many antiquated ways that scientists 206 00:11:10,433 --> 00:11:12,433 wrote about the female body. 207 00:11:14,500 --> 00:11:18,766 For instance, one might read that women are led, 208 00:11:18,766 --> 00:11:23,000 or guided by their uteri, and not their brains. 209 00:11:23,000 --> 00:11:25,100 Historically, women's bodies have really been 210 00:11:25,100 --> 00:11:26,933 subject to the male gaze. 211 00:11:26,933 --> 00:11:30,100 The reproductive tract has been seen as having two purposes: 212 00:11:30,100 --> 00:11:32,866 penis goes in, baby comes out. 213 00:11:33,966 --> 00:11:36,100 But in reality, 214 00:11:36,100 --> 00:11:38,400 there's all this other stuff happening 215 00:11:38,400 --> 00:11:41,100 99.99999% of the time. 216 00:11:43,900 --> 00:11:46,200 NARRATOR: Mary Papanicolaou was well aware 217 00:11:46,200 --> 00:11:48,733 that women's bodies had other functions. 218 00:11:48,733 --> 00:11:51,400 Seven years her husband's junior, 219 00:11:51,400 --> 00:11:54,433 she'd not only followed him to America, 220 00:11:54,433 --> 00:11:56,433 but into the laboratory as well, 221 00:11:56,433 --> 00:12:00,333 where she worked as both his technician and lab manager. 222 00:12:01,300 --> 00:12:04,000 GARDNER: They went to the lab every day together. 223 00:12:04,000 --> 00:12:06,100 They often worked to the point where it was dark 224 00:12:06,100 --> 00:12:07,800 when they came home at night. 225 00:12:07,800 --> 00:12:12,400 NARRATOR: Recently, George had embarked on a new experiment, 226 00:12:12,400 --> 00:12:16,166 and Mary had just become a guinea pig of sorts herself. 227 00:12:16,166 --> 00:12:19,466 LERNER: It was very common in the early 20th century 228 00:12:19,466 --> 00:12:23,066 for scientists to do experiments on their spouses, 229 00:12:23,066 --> 00:12:24,833 and on people they knew. 230 00:12:24,833 --> 00:12:26,966 And the idea behind this was, 231 00:12:26,966 --> 00:12:29,366 "If I'm willing to do an experiment on myself 232 00:12:29,366 --> 00:12:30,833 "or my family, 233 00:12:30,833 --> 00:12:33,933 it's safe enough for me to experiment on other people." 234 00:12:35,066 --> 00:12:37,133 NARRATOR: Every day, George would collect 235 00:12:37,133 --> 00:12:39,166 cells from Mary's cervix. 236 00:12:39,166 --> 00:12:40,833 Their goal: 237 00:12:40,833 --> 00:12:44,333 to be the first to document the minute morphological changes 238 00:12:44,333 --> 00:12:47,633 expressed during a human ovarian cycle. 239 00:12:47,633 --> 00:12:53,666 Mary was the heart, the soul, and the cervix of the operation. 240 00:12:53,666 --> 00:12:57,466 GROSS: Mary is the first person to get a Pap smear, 241 00:12:57,466 --> 00:12:59,566 but she also 242 00:12:59,566 --> 00:13:01,866 collects her own smears, organizes them, 243 00:13:01,866 --> 00:13:04,000 fixes them and stains them, 244 00:13:04,000 --> 00:13:06,033 and helps analyze them. 245 00:13:06,033 --> 00:13:09,133 She is an integral part of this scientific work. 246 00:13:10,400 --> 00:13:12,166 NARRATOR: Making their experiment possible 247 00:13:12,166 --> 00:13:14,500 was a gynecological tool perfected 248 00:13:14,500 --> 00:13:18,200 back in the 19th century-- the speculum. 249 00:13:18,200 --> 00:13:20,033 COOPER OWENS: No one really looked 250 00:13:20,033 --> 00:13:23,200   in the vaginal cavity, because it was taboo. 251 00:13:23,200 --> 00:13:24,900 And most certainly, 252 00:13:24,900 --> 00:13:27,600 a gentleman is not supposed to look 253 00:13:27,600 --> 00:13:30,633 into the inner cavity of a lady. 254 00:13:31,633 --> 00:13:34,033 NARRATOR: The speculum's controversial inventor, 255 00:13:34,033 --> 00:13:37,166 a physician named James Marion Sims, 256 00:13:37,166 --> 00:13:39,200 who would be remembered by some 257 00:13:39,200 --> 00:13:41,966 as the "father" of American gynecology, 258 00:13:41,966 --> 00:13:44,900 would later write that he hated nothing more 259 00:13:44,900 --> 00:13:48,100 than investigating the organs of the female pelvis. 260 00:13:50,633 --> 00:13:54,600 GROSS: There was this repeated association of female genitals 261 00:13:54,600 --> 00:13:58,500 with something that you should hide and cover up. 262 00:14:01,300 --> 00:14:04,766 Every time a, usually, male anatomist 263 00:14:04,766 --> 00:14:08,100 would "discover" the clitoris or the vulva, 264 00:14:08,100 --> 00:14:09,966 they would name it after the word shame. 265 00:14:09,966 --> 00:14:12,433 So in the 1500s, a French anatomist 266 00:14:12,433 --> 00:14:16,466 studied the human clitoris, and he named it the shame member. 267 00:14:16,466 --> 00:14:21,200 We still have today in OB-GYN textbooks, this word pudendum, 268 00:14:21,200 --> 00:14:23,600 which means "the part for which you should be ashamed." 269 00:14:25,666 --> 00:14:27,233 NARRATOR: For the Papanicolaous, 270 00:14:27,233 --> 00:14:30,200 nothing about their new work was shameful. 271 00:14:30,200 --> 00:14:32,933 "We stand at the very threshold," 272 00:14:32,933 --> 00:14:37,266 George would explain, "of this new science." 273 00:14:37,266 --> 00:14:41,066 Now, George was hoping to expand the study 274 00:14:41,066 --> 00:14:43,933 beyond what he termed his "special case." 275 00:14:43,933 --> 00:14:45,766 ♪ ♪ 276 00:14:45,766 --> 00:14:47,500 Soon, there were rumors 277 00:14:47,500 --> 00:14:50,133 that if you went to the Paps' for dinner, 278 00:14:50,133 --> 00:14:52,766 female guests might be asked to sit for a smear. 279 00:14:52,766 --> 00:14:55,433 ♪ ♪ 280 00:14:55,433 --> 00:14:57,766 HAZARD: Mary herself was fundamental 281 00:14:57,766 --> 00:14:59,966 in recruiting some of her friends to come 282 00:14:59,966 --> 00:15:02,500 and get smear tests in the name of medical progress. 283 00:15:04,166 --> 00:15:05,666 It's difficult to kind of piece together 284 00:15:05,666 --> 00:15:07,366 exactly how those initial 285 00:15:07,366 --> 00:15:10,533 smear parties really happened, but I think what we can say 286 00:15:10,533 --> 00:15:13,666 is that George was very keen on expanding this sample size. 287 00:15:15,366 --> 00:15:17,700 NARRATOR: In February 1925, 288 00:15:17,700 --> 00:15:20,933 George was finally able to establish a collaboration 289 00:15:20,933 --> 00:15:24,000 with the Woman's Hospital of the City of New York. 290 00:15:24,000 --> 00:15:26,266 KEAN: So he started looking at cysts, 291 00:15:26,266 --> 00:15:29,200 started looking at fibroid matters, trying to figure out 292 00:15:29,200 --> 00:15:30,600 if there was a correlation 293 00:15:30,600 --> 00:15:33,300 between these changes in the cells 294 00:15:33,300 --> 00:15:35,600 and the diseases that women were experiencing. 295 00:15:35,600 --> 00:15:37,333 ♪ ♪ 296 00:15:37,333 --> 00:15:39,433 NARRATOR: Then, one day at the microscope, 297 00:15:39,433 --> 00:15:42,933 Dr. Pap saw something altogether different. 298 00:15:43,933 --> 00:15:46,633 A sample with cells oddly shaped, 299 00:15:46,633 --> 00:15:50,900 their nuclei overlarge, their chromosomes jumbled. 300 00:15:52,933 --> 00:15:55,900 There was no mistaking those distinctive signs: 301 00:15:57,033 --> 00:15:58,866 it was cancer. 302 00:16:00,166 --> 00:16:04,033 HAZARD: This was not what George was looking for, 303 00:16:04,033 --> 00:16:06,966 but so much of good science is about luck 304 00:16:06,966 --> 00:16:11,033 and opportunity and incidental findings. 305 00:16:11,033 --> 00:16:13,433 And George, being a keen and perceptive scientist, 306 00:16:13,433 --> 00:16:17,400 must have known the significance of what he has detected. 307 00:16:18,566 --> 00:16:20,033 NARRATOR: He would remember it as 308 00:16:20,033 --> 00:16:23,400 the single most thrilling experience of his career. 309 00:16:23,400 --> 00:16:26,066 At hand was a new technique 310 00:16:26,066 --> 00:16:30,066 that had the power to save millions of women's lives. 311 00:16:30,066 --> 00:16:32,600 And the fight Dr. Pap was now joining 312 00:16:32,600 --> 00:16:35,566 could not have been more urgent. 313 00:16:35,566 --> 00:16:40,600 ♪ ♪ 314 00:16:42,500 --> 00:16:44,833 GROSS: Cancer was deeply feared at this time. 315 00:16:44,833 --> 00:16:48,366 It was known as the dread disease. 316 00:16:48,366 --> 00:16:50,200 Often doctors wouldn't even use the word cancer 317 00:16:50,200 --> 00:16:51,500 giving you a diagnosis. 318 00:16:53,200 --> 00:16:57,166 COOPER OWENS: Cervical cancer patients suffered in pain. 319 00:16:57,166 --> 00:16:59,100 By the time 320 00:16:59,100 --> 00:17:00,833 they found out that it was cancer, 321 00:17:00,833 --> 00:17:03,800 it was too late, so it was certainly a death sentence. 322 00:17:05,233 --> 00:17:08,766 NARRATOR: By the late 1920s, cancer was on the rise. 323 00:17:08,766 --> 00:17:11,466 And it seemed to be killing mostly women-- 324 00:17:11,466 --> 00:17:14,000 some 40,000 a year. 325 00:17:15,033 --> 00:17:16,400 A new organization, 326 00:17:16,400 --> 00:17:19,433 the American Society for the Control of Cancer, 327 00:17:19,433 --> 00:17:22,166 had recently been created to get the word out. 328 00:17:23,666 --> 00:17:25,433 Now, for its first 30 years, 329 00:17:25,433 --> 00:17:27,933 it was sort of a mom and pop shop. 330 00:17:27,933 --> 00:17:30,433 So the money that they did raise mostly 331 00:17:30,433 --> 00:17:32,800 went to people with cancer. 332 00:17:32,800 --> 00:17:36,633 It was almost a bit like a charity organization. 333 00:17:36,633 --> 00:17:40,133 NARRATOR: The society occasionally printed pamphlets, 334 00:17:40,133 --> 00:17:43,266 like "What Every Woman Should Do About Cancer." 335 00:17:43,266 --> 00:17:46,266 But that was the full extent of their campaign. 336 00:17:47,366 --> 00:17:51,833 LERNER: The notion of trying to find a cervical cancer early 337 00:17:51,833 --> 00:17:53,800 wasn't on anyone's radar screen, 338 00:17:53,800 --> 00:17:56,633 because nobody had thought of it before, 339 00:17:56,633 --> 00:17:58,833 and nobody thought there was a way to do that. 340 00:18:00,666 --> 00:18:02,833 (dog barking) 341 00:18:04,633 --> 00:18:07,633 NARRATOR: In early January 1928, 342 00:18:07,633 --> 00:18:10,133 armed with his new cancer detection method, 343 00:18:10,133 --> 00:18:13,633 Dr. Pap traveled to Battle Creek, Michigan, 344 00:18:13,633 --> 00:18:16,166 excited to tell his colleagues about his discovery. 345 00:18:17,333 --> 00:18:21,466 It was called the "Race Betterment Conference," 346 00:18:21,466 --> 00:18:24,566 a high-profile event sponsored by prominent members 347 00:18:24,566 --> 00:18:26,400 of the eugenics movement. 348 00:18:28,500 --> 00:18:31,766 It is a who's who of the academic world. 349 00:18:31,766 --> 00:18:35,033 It's a who's who of the scientific world. 350 00:18:35,033 --> 00:18:38,566 You had a number of prominent thinkers 351 00:18:38,566 --> 00:18:43,333 who were invested in these racist ideas. 352 00:18:44,966 --> 00:18:47,666 ♪ ♪ 353 00:18:47,666 --> 00:18:49,700 LERNER: It was very common 354 00:18:49,700 --> 00:18:52,333 for mainstream scientists not doing eugenic research 355 00:18:52,333 --> 00:18:54,300 to present at these conferences. 356 00:18:54,300 --> 00:18:57,100 Dr. Pap didn't see his research particularly 357 00:18:57,100 --> 00:18:59,200 as promoting the eugenics cause, 358 00:18:59,200 --> 00:19:01,366 but it was reproductive research. 359 00:19:01,366 --> 00:19:04,700 So he took the chance and decided to present there. 360 00:19:05,700 --> 00:19:09,233 NARRATOR: On the third day, Papanicolaou took the stage 361 00:19:09,233 --> 00:19:12,600 and launched into an explainer of his new technique. 362 00:19:13,933 --> 00:19:17,466 GARDNER: It was a disastrous presentation. 363 00:19:17,466 --> 00:19:19,433 The first problem was his slides, 364 00:19:19,433 --> 00:19:21,566 by all accounts, were terrible. 365 00:19:21,566 --> 00:19:25,733 (slides clicking) 366 00:19:25,733 --> 00:19:28,300 So if you're making a presentation 367 00:19:28,300 --> 00:19:30,466 where you're trying to argue that the key 368 00:19:30,466 --> 00:19:32,566 to identifying irregular cells 369 00:19:32,566 --> 00:19:35,533 is so that you can create these classifications... 370 00:19:35,533 --> 00:19:37,100 (slide clicking) 371 00:19:37,100 --> 00:19:39,366 ...and then your slides are some of the worst that anyone 372 00:19:39,366 --> 00:19:44,433 has seen at the conference, it's just not that convincing. 373 00:19:44,433 --> 00:19:47,200 Two: the gold standard was the biopsy. 374 00:19:47,200 --> 00:19:49,966 NARRATOR: The biopsy involved an operation 375 00:19:49,966 --> 00:19:52,566 to collect tissue from within a tumor. 376 00:19:52,566 --> 00:19:56,633 It was effective, but often painful. 377 00:19:56,633 --> 00:19:59,933 HAZARD: So doctors at this betterment conference, 378 00:19:59,933 --> 00:20:02,633 they don't understand why it would be appealing 379 00:20:02,633 --> 00:20:06,233 to switch from the biopsy, 380 00:20:06,233 --> 00:20:08,600 a painful, invasive diagnostic, 381 00:20:08,600 --> 00:20:13,266 to one that was arguably uncomfortable, but not painful. 382 00:20:13,266 --> 00:20:15,233 There probably wasn't really a recognition 383 00:20:15,233 --> 00:20:17,866 that the woman's comfort and the patient's preference 384 00:20:17,866 --> 00:20:21,200 would be in any way a deciding factor. 385 00:20:21,200 --> 00:20:24,700 ♪ ♪ 386 00:20:24,700 --> 00:20:27,633 NARRATOR: When journalists caught wind of Papanicolaou's findings, 387 00:20:27,633 --> 00:20:29,900 it made national headlines. 388 00:20:29,900 --> 00:20:33,200 ♪ ♪ 389 00:20:33,200 --> 00:20:35,700 But as Dr. Pap himself would note, 390 00:20:35,700 --> 00:20:37,633 "I failed to convince my colleagues 391 00:20:37,633 --> 00:20:39,900 of the practicability of the procedure." 392 00:20:41,266 --> 00:20:44,100 KEAN: George just sort of shrunk back and took the criticism. 393 00:20:45,466 --> 00:20:47,400 And he didn't really give 394 00:20:47,400 --> 00:20:48,900 up on the work, 395 00:20:48,900 --> 00:20:50,800 he just wasn't pushing for it. 396 00:20:50,800 --> 00:20:53,200 He wasn't that assertive of a person. 397 00:20:54,933 --> 00:20:56,233 NARRATOR: Little did George know, 398 00:20:56,233 --> 00:20:59,766 the war on cancer was just beginning. 399 00:20:59,766 --> 00:21:01,700 And new voices, 400 00:21:01,700 --> 00:21:04,666 and new faces, were about to change 401 00:21:04,666 --> 00:21:06,766 the nature of the fight. 402 00:21:07,866 --> 00:21:10,700 ♪ ♪ 403 00:21:15,933 --> 00:21:20,033 FILM NARRATOR (archival): Cancer challenges every man and woman. 404 00:21:20,033 --> 00:21:24,166 It is a test of our civilization's ability 405 00:21:24,166 --> 00:21:27,333 to organize for health and happiness. 406 00:21:29,300 --> 00:21:31,300 NARRATOR: The Women's Field Army, 407 00:21:31,300 --> 00:21:32,733 an offshoot of the American Society 408 00:21:32,733 --> 00:21:34,333 for the Control of Cancer, 409 00:21:34,333 --> 00:21:36,100 was determined to make cancer 410 00:21:36,100 --> 00:21:38,966 a part of the national conversation. 411 00:21:38,966 --> 00:21:42,400 And soon, their message seemed to be everywhere. 412 00:21:46,000 --> 00:21:47,666 GARDNER: The idea is they are going 413 00:21:47,666 --> 00:21:49,400 to invade American homes 414 00:21:49,400 --> 00:21:51,466 with knowledge about cancer. 415 00:21:51,466 --> 00:21:53,633 And whether that means knocking on doors 416 00:21:53,633 --> 00:21:56,500 and giving out pamphlets, 417 00:21:56,500 --> 00:21:58,133 getting placards in the subway, 418 00:21:58,133 --> 00:22:01,766 going to fairs and setting up a health booth, 419 00:22:01,766 --> 00:22:03,700 these women were going to do it. 420 00:22:03,700 --> 00:22:06,266 NARRATOR: By 1938, 421 00:22:06,266 --> 00:22:09,366 the Women's Field Army had even successfully lobbied Congress 422 00:22:09,366 --> 00:22:12,266 to make April "Cancer Control Month." 423 00:22:13,933 --> 00:22:16,366 ♪ ♪ 424 00:22:16,366 --> 00:22:18,233 GARDNER: What begins to happen 425 00:22:18,233 --> 00:22:21,400 is women carving out an identity for themselves 426 00:22:21,400 --> 00:22:23,166 really as public health activists. 427 00:22:25,166 --> 00:22:27,900 We might not be the MDs who have these theories, 428 00:22:27,900 --> 00:22:29,866 but we can certainly be the educators 429 00:22:29,866 --> 00:22:32,166 who translate these theories to the public, 430 00:22:32,166 --> 00:22:34,433 so that they can be more effective. 431 00:22:35,633 --> 00:22:39,233 NARRATOR: But the outreach, as groundbreaking as it was, 432 00:22:39,233 --> 00:22:43,066 mostly ignored the plight of large swaths of the population. 433 00:22:43,066 --> 00:22:45,966 AMEENAH SHAKIR: The Women's Field Army, 434 00:22:45,966 --> 00:22:49,400 documenting some of these cases in white women patients, 435 00:22:49,400 --> 00:22:52,533 there was not as much of a focus on 436 00:22:52,533 --> 00:22:55,533   how uterine and ovarian cancer were actually 437 00:22:55,533 --> 00:22:57,533 impacting Black women. 438 00:22:57,533 --> 00:23:00,666 The perception at the time was that 439 00:23:00,666 --> 00:23:04,966 African Americans did not live long enough to get cancer, 440 00:23:04,966 --> 00:23:08,300 were not civilized enough to get cancer. 441 00:23:08,300 --> 00:23:12,133 Cancer was considered to be a disease of the elite. 442 00:23:12,133 --> 00:23:14,666 ♪ ♪ 443 00:23:14,666 --> 00:23:17,366 NARRATOR: An hour south of the Field Army's Manhattan headquarters, 444 00:23:17,366 --> 00:23:20,733 down in Philadelphia, a young doctor was about 445 00:23:20,733 --> 00:23:24,833 to discover a very different reality. 446 00:23:24,833 --> 00:23:28,266 Her name was Helen Dickens. 447 00:23:28,266 --> 00:23:30,300 Born in Dayton, Ohio, 448 00:23:30,300 --> 00:23:33,833 to parents Daisy and Charles Dickens, 449 00:23:33,833 --> 00:23:37,066 her father had escaped from slavery in Kentucky. 450 00:23:38,100 --> 00:23:40,600 He'd taught himself to read, and took the name 451 00:23:40,600 --> 00:23:43,600 Charles Dickens, whose writings he loved. 452 00:23:44,700 --> 00:23:47,066 Tragically, he'd died when his daughter 453 00:23:47,066 --> 00:23:48,866 was just eight years old. 454 00:23:50,400 --> 00:23:52,766 HELEN DICKENS (archival): He always wanted me to be a nurse. 455 00:23:52,766 --> 00:23:54,800 But somewhere along the way, 456 00:23:54,800 --> 00:23:56,766 I decided that if I was going to be a nurse, 457 00:23:56,766 --> 00:23:58,766 I might as well be a doctor. 458 00:23:58,766 --> 00:24:02,133 I had never seen a woman doctor, either Black or white. 459 00:24:02,133 --> 00:24:04,166 It never occurred to me there was a barrier. 460 00:24:05,366 --> 00:24:07,633 JAYNE HENDERSON BROWN: Oh, my mother loved school. 461 00:24:09,266 --> 00:24:11,300 She wanted to know so much, 462 00:24:11,300 --> 00:24:12,333 and learn so much 463 00:24:12,333 --> 00:24:14,800 and that was what she was about. 464 00:24:14,800 --> 00:24:18,966   NARRATOR: At 17, Dickens graduated from high school, 465 00:24:18,966 --> 00:24:23,533 taking night classes and summer school to finish early. 466 00:24:23,533 --> 00:24:24,833 Three years later, 467 00:24:24,833 --> 00:24:26,600 she was accepted to medical school 468 00:24:26,600 --> 00:24:27,966 at the University of Illinois, 469 00:24:27,966 --> 00:24:32,133 where she was the only Black woman in her class. 470 00:24:32,133 --> 00:24:33,466 GROSS: In medical school, 471 00:24:33,466 --> 00:24:36,533 students would taunt her, use slurs and gestures. 472 00:24:36,533 --> 00:24:39,333 And she said her strategy for avoiding them was always 473 00:24:39,333 --> 00:24:40,833 to sit in the front row of the class 474 00:24:40,833 --> 00:24:42,500 where she couldn't see them, 475 00:24:42,500 --> 00:24:44,100 and if anyone else wanted a good view, 476 00:24:44,100 --> 00:24:46,000 they had to sit next to her. 477 00:24:47,466 --> 00:24:49,500 NARRATOR: By June 1934, 478 00:24:49,500 --> 00:24:52,366 the medical school had a new graduating class. 479 00:24:54,033 --> 00:24:56,633 And there was Helen Dickens. 480 00:24:58,366 --> 00:25:01,200 COOPER OWENS: Helen Dickens was Black and a woman. 481 00:25:01,200 --> 00:25:03,366 And because she exists in one body 482 00:25:03,366 --> 00:25:05,433 with those intersecting identities, 483 00:25:05,433 --> 00:25:06,933 it was a challenge. 484 00:25:06,933 --> 00:25:09,766 And yet, here she rose to the top, 485 00:25:09,766 --> 00:25:11,366 to become an MD. 486 00:25:12,566 --> 00:25:14,600 NARRATOR: Now, age 26, 487 00:25:14,600 --> 00:25:18,300 Dickens had taken a job in North Philadelphia, 488 00:25:18,300 --> 00:25:19,766 working with a doctor 489 00:25:19,766 --> 00:25:22,300 who would change the course of her career. 490 00:25:22,300 --> 00:25:26,566 SHAKIR: Virginia Alexander, African-American woman physician 491 00:25:26,566 --> 00:25:28,966 who had something called the Aspiranto Health Home. 492 00:25:29,966 --> 00:25:32,033 This was similar to what we would now call 493 00:25:32,033 --> 00:25:34,300 a birthing home. 494 00:25:34,300 --> 00:25:37,233 DICKENS (archival): The patients came to us. 495 00:25:37,233 --> 00:25:40,933 She had two rooms in her house for patients 496 00:25:40,933 --> 00:25:43,766 and one little room where you delivered patients. 497 00:25:43,766 --> 00:25:45,666 Oh, it was different. 498 00:25:45,666 --> 00:25:48,933 The O.B. patients stayed in nine days. 499 00:25:50,733 --> 00:25:52,133 Most of them were poor. 500 00:25:52,133 --> 00:25:54,433 People weren't able to pay, 501 00:25:54,433 --> 00:25:56,866 they weren't expected to pay a lot. 502 00:25:57,933 --> 00:26:00,633 NARRATOR: Aspiranto was a world unto itself 503 00:26:00,633 --> 00:26:03,666 in a segregated society. 504 00:26:03,666 --> 00:26:07,000 COOPER OWENS: It's not as if Black people can just go 505 00:26:07,000 --> 00:26:08,366 to the county hospital. 506 00:26:08,366 --> 00:26:11,333 You have to go to the hospital for the Negro. 507 00:26:12,366 --> 00:26:14,333 And oftentimes they're underfunded, 508 00:26:14,333 --> 00:26:16,433 they're understaffed. 509 00:26:16,433 --> 00:26:19,600 The chief physicians tend to be white men, 510 00:26:19,600 --> 00:26:22,733 and there is a condescension that goes on, 511 00:26:22,733 --> 00:26:24,500 a kind of patronizing attitude. 512 00:26:26,200 --> 00:26:28,200 SHAKIR: So Dickens and Alexander 513 00:26:28,200 --> 00:26:30,300 really provides this alternative. 514 00:26:30,300 --> 00:26:35,866 Alexander helped Dickens to formulate a consciousness around 515 00:26:35,866 --> 00:26:38,600 how healthcare could be used as a site of activism. 516 00:26:40,600 --> 00:26:43,633 NARRATOR: Beyond the walls of the Aspiranto Health Home, 517 00:26:43,633 --> 00:26:48,033 Dr. Dickens was working more and more out in the community. 518 00:26:48,033 --> 00:26:49,633 DICKENS: Going in the middle of the night, 519 00:26:49,633 --> 00:26:51,833 and you were going into all kinds of communities. 520 00:26:51,833 --> 00:26:53,166 You were going into the homes, 521 00:26:53,166 --> 00:26:54,933 you were seeing all these people. 522 00:26:54,933 --> 00:26:59,700 You were taking responsibility for care of people. 523 00:27:00,933 --> 00:27:03,400 BROWN: The more she was in it with the women she came across, 524 00:27:03,400 --> 00:27:05,566 the more she knew about 525 00:27:05,566 --> 00:27:07,733 what their struggles and concerns were health-wise. 526 00:27:09,166 --> 00:27:12,066 NARRATOR: One of the things that Dickens saw again and again 527 00:27:12,066 --> 00:27:13,600 was cancer. 528 00:27:13,600 --> 00:27:16,600 Her patients were dying, 529 00:27:16,600 --> 00:27:18,500 and she now knew that the perception 530 00:27:18,500 --> 00:27:21,500 that Black people didn't get cancer was a lie. 531 00:27:22,733 --> 00:27:26,400 Dickens was determined to document cancer's deadly toll, 532 00:27:26,400 --> 00:27:31,066 and to tell Black women what they so urgently needed to know. 533 00:27:32,533 --> 00:27:35,366 (trolley bell ringing, car horn honking) 534 00:27:35,366 --> 00:27:38,700 (motorcycle revving) 535 00:27:38,700 --> 00:27:41,700 ♪ ♪ 536 00:27:43,500 --> 00:27:46,700 NARRATOR: Back in New York, in 1939, 537 00:27:46,700 --> 00:27:50,000 Dr. Papanicolaou had had 11 years to stew about 538 00:27:50,000 --> 00:27:52,000 the failure of his smear technique 539 00:27:52,000 --> 00:27:55,533 to pique the interest of the medical community. 540 00:27:55,533 --> 00:27:58,466 He'd moved on to other research, 541 00:27:58,466 --> 00:28:00,900 but he and Mary had always carried on 542 00:28:00,900 --> 00:28:03,166 with the daily smears. 543 00:28:03,166 --> 00:28:04,566 He stayed in the same lab. 544 00:28:04,566 --> 00:28:06,000 He stayed in similar work. 545 00:28:07,366 --> 00:28:10,400 He always had his wife next to him. 546 00:28:10,400 --> 00:28:13,000 That was probably incredibly comforting 547 00:28:13,000 --> 00:28:15,866 while he continued with his work. 548 00:28:19,800 --> 00:28:21,600 NARRATOR: There's a saying in science 549 00:28:21,600 --> 00:28:24,000 that luck comes to the prepared. 550 00:28:24,000 --> 00:28:27,233 Death, of course, comes for us all. 551 00:28:27,233 --> 00:28:31,666 Both came to the Cornell Medical College that April. 552 00:28:31,666 --> 00:28:35,133 Charles Stockard, Papanicolaou's boss, 553 00:28:35,133 --> 00:28:37,800 had died, age 60, 554 00:28:37,800 --> 00:28:41,833 and he was replaced by one Dr. Joseph Hinsey. 555 00:28:41,833 --> 00:28:43,500 KEAN: George's new boss, 556 00:28:43,500 --> 00:28:45,966 he understood how deadly cervical cancer was 557 00:28:45,966 --> 00:28:47,966 and he wanted to help women. 558 00:28:47,966 --> 00:28:51,233 Coincidentally, George had been rethinking his work, 559 00:28:51,233 --> 00:28:54,166 because before he was looking at tumors 560 00:28:54,166 --> 00:28:55,966 when they were already pretty advanced, 561 00:28:55,966 --> 00:28:57,700 and at that point, fairly deadly. 562 00:28:57,700 --> 00:28:59,366 But he started thinking, 563 00:28:59,366 --> 00:29:03,366 maybe we could look at cells on their way to becoming cancer. 564 00:29:06,066 --> 00:29:09,266 NARRATOR: If he was to try to detect cancers earlier, 565 00:29:09,266 --> 00:29:11,566 Papanicolaou needed new subjects. 566 00:29:11,566 --> 00:29:13,400 And by October, he had them. 567 00:29:14,766 --> 00:29:18,166 The top brass at New York Hospital had decreed 568 00:29:18,166 --> 00:29:20,833 that every woman admitted to the gynecological unit 569 00:29:20,833 --> 00:29:23,633 would now be required to have a smear. 570 00:29:27,033 --> 00:29:28,633 The results were better 571 00:29:28,633 --> 00:29:30,966 than even Dr. Pap could have expected. 572 00:29:32,933 --> 00:29:35,900 The smear was able to identify suspicious cells 573 00:29:35,900 --> 00:29:39,100 some ten years before they developed into cancer. 574 00:29:41,966 --> 00:29:44,333 GROSS: His research was already a game-changer, 575 00:29:44,333 --> 00:29:48,300 to be able to find cancer when there are no outward signs, 576 00:29:48,300 --> 00:29:49,466 but now, 577 00:29:49,466 --> 00:29:51,700 he also realizes that you can find cancer 578 00:29:51,700 --> 00:29:53,533 before it technically exists, 579 00:29:53,533 --> 00:29:56,333 so that really is unprecedented. 580 00:29:58,366 --> 00:30:00,733 NARRATOR: Remembering his disastrous slides 581 00:30:00,733 --> 00:30:02,433 at the Race Betterment Conference, 582 00:30:02,433 --> 00:30:05,133 this time, Papanicolaou was determined 583 00:30:05,133 --> 00:30:07,633 to launch the smear the right way. 584 00:30:07,633 --> 00:30:10,166 And he knew that to do so, 585 00:30:10,166 --> 00:30:12,466 he would need some help. 586 00:30:14,033 --> 00:30:17,100 ♪ ♪ 587 00:30:17,100 --> 00:30:20,400 NARRATOR: Scientific illustrator Hashime Murayama 588 00:30:20,400 --> 00:30:23,333 wasn't just down the hall anymore. 589 00:30:23,333 --> 00:30:24,733 Back in 1921, 590 00:30:24,733 --> 00:30:26,966 he'd been offered his dream job 591 00:30:26,966 --> 00:30:31,133 as a staff illustrator at the National Geographic Society, 592 00:30:31,133 --> 00:30:35,700 and had moved his family down to Washington, D.C. 593 00:30:35,700 --> 00:30:38,366 Murayama and his wife Nao had kept in touch 594 00:30:38,366 --> 00:30:40,433 with the Papanicolaous over the years. 595 00:30:42,433 --> 00:30:45,733 There'd been the usual pleasant exchange of Christmas cards, 596 00:30:45,733 --> 00:30:48,133 and family news. 597 00:30:49,500 --> 00:30:53,833 In January 1941, Murayama was retiring 598 00:30:53,833 --> 00:30:56,400 from a remarkable 20-year career 599 00:30:56,400 --> 00:30:58,600 during which his attention to detail 600 00:30:58,600 --> 00:31:03,933 had become as famous as his drawings of fish and fowl. 601 00:31:03,933 --> 00:31:07,433 ♪ ♪ 602 00:31:17,833 --> 00:31:20,200 HAZARD: The pictures are absolutely stunning. 603 00:31:21,200 --> 00:31:22,566 Colors are rich, 604 00:31:22,566 --> 00:31:24,866 the attention to detail is immaculate. 605 00:31:26,233 --> 00:31:29,533 KEAN: There were famous stories of him counting all the scales 606 00:31:29,533 --> 00:31:31,533 on the fish that he would draw, 607 00:31:31,533 --> 00:31:34,333 because he wanted to make sure he got things exactly right. 608 00:31:34,333 --> 00:31:36,400 He was a really nice combination of 609 00:31:36,400 --> 00:31:37,966 meticulous attention to detail, 610 00:31:37,966 --> 00:31:39,300 but also bringing things to life. 611 00:31:39,300 --> 00:31:41,066 ♪ ♪ 612 00:31:41,066 --> 00:31:43,233 NARRATOR: Murayama once explained that 613 00:31:43,233 --> 00:31:47,233 "Art is the expression of feeling without reason, 614 00:31:47,233 --> 00:31:51,600 "science the expression of reason without feeling. 615 00:31:51,600 --> 00:31:55,600 "Mine is the task of depicting scientific facts 616 00:31:55,600 --> 00:31:59,133 "so that they shall have both human and artistic interest." 617 00:32:00,500 --> 00:32:04,433 GROSS: Scientific illustrators are science communicators. 618 00:32:04,433 --> 00:32:07,366 There's a million tiny judgments about what to leave out 619 00:32:07,366 --> 00:32:09,633 and what to enhance and what will be 620 00:32:09,633 --> 00:32:12,866 the most useful, but also visually compelling, 621 00:32:12,866 --> 00:32:15,366 and what will get people's attention. 622 00:32:18,866 --> 00:32:21,233 NARRATOR: In New York, Dr. Pap and Mary 623 00:32:21,233 --> 00:32:22,800 were in the midst of putting together 624 00:32:22,800 --> 00:32:24,433 a definitive book 625 00:32:24,433 --> 00:32:27,566 about their revolutionary diagnostic tool. 626 00:32:27,566 --> 00:32:28,833 Knowing what a difference 627 00:32:28,833 --> 00:32:31,266 Murayama's illustrations could make, 628 00:32:31,266 --> 00:32:33,300 George wrote to his old friend, 629 00:32:33,300 --> 00:32:34,966 and by October 1, 630 00:32:34,966 --> 00:32:38,200 Murayama had taken on the massive project 631 00:32:38,200 --> 00:32:40,500 of illustrating the progression of cancer 632 00:32:40,500 --> 00:32:42,833 across cervical cells. 633 00:32:42,833 --> 00:32:44,800 GARDNER: So, when you're drawing 634 00:32:44,800 --> 00:32:47,100 these small little parts of the cell, 635 00:32:47,100 --> 00:32:49,733 he would spend an agonizing amount of time 636 00:32:49,733 --> 00:32:51,866 getting them correct. 637 00:32:51,866 --> 00:32:53,933 He used colors in a way 638 00:32:53,933 --> 00:32:56,733 that made differences in the cells 639 00:32:56,733 --> 00:32:58,666 much easier to identify-- 640 00:32:58,666 --> 00:33:01,500 they were very rich and they were very defined. 641 00:33:03,666 --> 00:33:06,166 NARRATOR: Murayama had been on the project for only two months 642 00:33:06,166 --> 00:33:08,100 when everything changed. 643 00:33:08,100 --> 00:33:11,600 (muffled horn blaring) 644 00:33:14,233 --> 00:33:16,800 ♪ ♪ 645 00:33:20,000 --> 00:33:23,400 Soon after the United States declared war on Japan, 646 00:33:23,400 --> 00:33:25,500 Murayama was arrested, 647 00:33:25,500 --> 00:33:28,366 his house back in D.C. ransacked. 648 00:33:30,400 --> 00:33:32,266 Murayama faced a lot of discrimination 649 00:33:32,266 --> 00:33:33,500 because of his ethnicity. 650 00:33:35,066 --> 00:33:37,066 At this time, there was widespread 651 00:33:37,066 --> 00:33:38,500 anti-Japanese hysteria. 652 00:33:38,500 --> 00:33:41,333 ♪ ♪ 653 00:33:42,800 --> 00:33:45,600 J. EDGAR HOOVER: We ask every citizen to immediately report 654 00:33:45,600 --> 00:33:49,466 any information regarding espionage, sabotage, 655 00:33:49,466 --> 00:33:51,066 or un-American activities 656 00:33:51,066 --> 00:33:53,566 to the Federal Bureau of Investigation. 657 00:33:53,566 --> 00:33:56,733 NARRATOR: On March 26, 1943, 658 00:33:56,733 --> 00:33:58,833 the Enemy Alien Hearing Board-- 659 00:33:58,833 --> 00:34:01,500 a citizen-led Department of Justice project 660 00:34:01,500 --> 00:34:04,500 that decided the fate of each Japanese, Italian, 661 00:34:04,500 --> 00:34:06,100 or German immigrant-- 662 00:34:06,100 --> 00:34:08,966 placed Murayama in an internment camp 663 00:34:08,966 --> 00:34:10,633 on Ellis Island. 664 00:34:12,666 --> 00:34:15,166 It was used as a detention camp 665 00:34:15,166 --> 00:34:16,800 for people who were like Murayama, 666 00:34:16,800 --> 00:34:18,000 who'd done nothing wrong 667 00:34:18,000 --> 00:34:19,933 besides being born in Japan. 668 00:34:21,000 --> 00:34:23,966 ♪ ♪ 669 00:34:23,966 --> 00:34:27,066 NARRATOR: Every professional acquaintance of Murayama's was interviewed, 670 00:34:27,066 --> 00:34:31,466 and asked to give a written statement about his loyalties. 671 00:34:33,833 --> 00:34:37,266 A file was prepared for Hoover and the FBI. 672 00:34:37,266 --> 00:34:39,466 The Murayama case, 673 00:34:39,466 --> 00:34:42,866 like so many tens of thousands of others, 674 00:34:42,866 --> 00:34:46,100 grew to include masses on masses of documents, 675 00:34:46,100 --> 00:34:49,633 a sea of paper chasing a crime that simply wasn't there. 676 00:34:51,833 --> 00:34:56,166 ♪ ♪ 677 00:34:56,166 --> 00:35:00,333 Papanicolaou tried to argue on his collaborator's behalf, 678 00:35:00,333 --> 00:35:03,066 writing to the board that "Murayama's work 679 00:35:03,066 --> 00:35:05,533 "could not well be duplicated by anyone 680 00:35:05,533 --> 00:35:07,000 not having his talent." 681 00:35:08,066 --> 00:35:09,933 In mid-June, 682 00:35:09,933 --> 00:35:12,200 in a letter three pages long, 683 00:35:12,200 --> 00:35:14,866 Murayama himself wrote: 684 00:35:14,866 --> 00:35:17,400 "I am 64 years old, 685 00:35:17,400 --> 00:35:21,166 "having lived here for more than a half of my life, 686 00:35:21,166 --> 00:35:24,333 "I have no intention to return to Japan. 687 00:35:24,333 --> 00:35:26,100 "I intend to remain here, 688 00:35:26,100 --> 00:35:28,933 "and to devote the remainder of my life 689 00:35:28,933 --> 00:35:31,100 "to the precious work which would contribute 690 00:35:31,100 --> 00:35:33,533 toward saving American women's lives." 691 00:35:37,033 --> 00:35:38,933 Then, on August 9, 692 00:35:38,933 --> 00:35:41,533 some four months after his arrest, 693 00:35:41,533 --> 00:35:43,600 something remarkable happened. 694 00:35:44,866 --> 00:35:48,233 KEAN: The attorney general of the United States, Francis Biddle, 695 00:35:48,233 --> 00:35:52,200 intervenes on behalf of Murayama. 696 00:35:52,200 --> 00:35:53,866 Biddle knows about the work 697 00:35:53,866 --> 00:35:56,900 that Papanicolaou is doing on cancer screening. 698 00:35:56,900 --> 00:36:00,233   And Biddle considers this of vital national importance. 699 00:36:01,666 --> 00:36:03,233 NARRATOR: As luck would have it, 700 00:36:03,233 --> 00:36:05,566 the man in the attorney general's office 701 00:36:05,566 --> 00:36:07,066 had long harbored doubts 702 00:36:07,066 --> 00:36:09,966 about the country's policy of internment. 703 00:36:09,966 --> 00:36:11,466 FRANCIS BIDDLE (archival): We must remember 704 00:36:11,466 --> 00:36:15,933 our grandparents or our great-grandparents 705 00:36:15,933 --> 00:36:19,266 all were aliens in their day. 706 00:36:20,266 --> 00:36:22,533 NARRATOR: But behind Biddle's decision, 707 00:36:22,533 --> 00:36:25,433 there was also proof of something else. 708 00:36:25,433 --> 00:36:28,833 HAZARD: The fact that Murayama was released from Ellis Island 709 00:36:28,833 --> 00:36:31,433 shows just how seriously the government 710 00:36:31,433 --> 00:36:33,966 took this threat of cervical cancer, 711 00:36:33,966 --> 00:36:37,866 and consequently, the value of George's research 712 00:36:37,866 --> 00:36:39,500 and Murayama's role in it. 713 00:36:41,133 --> 00:36:45,633 ♪ ♪ 714 00:36:58,100 --> 00:37:01,266 NARRATOR: As the Papanicolaous and the Murayamas 715 00:37:01,266 --> 00:37:03,600 celebrated his release that summer, 716 00:37:03,600 --> 00:37:05,633 the book that they had all been working on 717 00:37:05,633 --> 00:37:07,666 was finally published. 718 00:37:08,933 --> 00:37:11,066 It was the result of 719 00:37:11,066 --> 00:37:12,966 untold hours at the microscope. 720 00:37:12,966 --> 00:37:16,133 3,014 women had given the smears 721 00:37:16,133 --> 00:37:18,300 that made it all possible. 722 00:37:19,733 --> 00:37:21,633 But it was Murayama's illustrations 723 00:37:21,633 --> 00:37:23,766 that made it a sensation. 724 00:37:26,233 --> 00:37:29,400 HAZARD: Science really is nothing without our ability 725 00:37:29,400 --> 00:37:31,266 to communicate it to the rest of the world. 726 00:37:32,433 --> 00:37:37,800 To have accurate, powerful illustrations of those cells 727 00:37:37,800 --> 00:37:41,000 was completely fundamental to the success of George's work. 728 00:37:41,000 --> 00:37:43,400 ♪ ♪ 729 00:37:43,400 --> 00:37:45,800 GARDNER: What those visual images did 730 00:37:45,800 --> 00:37:49,600 is they allowed the public to imagine 731 00:37:49,600 --> 00:37:54,133 how you could categorize cancerous cells. 732 00:37:54,133 --> 00:37:56,633 If you have an epiphany at your desk 733 00:37:56,633 --> 00:37:58,133   and then you have no support for it, 734 00:37:58,133 --> 00:37:59,500 it's not going to go anywhere. 735 00:38:00,666 --> 00:38:03,366 So these moments of change and innovation, 736 00:38:03,366 --> 00:38:05,466 they're part of a network. 737 00:38:08,566 --> 00:38:11,333 ♪ ♪ 738 00:38:12,466 --> 00:38:14,733 (crowd cheering, horns honking) 739 00:38:14,733 --> 00:38:16,566 GROSS: There's this period right after World War II 740 00:38:16,566 --> 00:38:18,400 where there's a lot of 741 00:38:18,400 --> 00:38:20,000 faith in technology 742 00:38:20,000 --> 00:38:21,933 as the thing that helped us win the war. 743 00:38:21,933 --> 00:38:25,166 ♪ ♪ 744 00:38:25,166 --> 00:38:27,933 And it's now being applied to medicine. 745 00:38:29,733 --> 00:38:32,600 NARRATOR: Nowhere were the postwar changes more evident 746 00:38:32,600 --> 00:38:36,600 than at the American Society for the Control of Cancer. 747 00:38:36,600 --> 00:38:39,900 Newly renamed and fully rebranded, 748 00:38:39,900 --> 00:38:42,633 the American Cancer Society had become 749 00:38:42,633 --> 00:38:45,200 a completely different organization. 750 00:38:45,200 --> 00:38:46,666 Its transformation 751 00:38:46,666 --> 00:38:49,533 had been led by the will of one woman. 752 00:38:49,533 --> 00:38:52,533 MARY LASKER (archival): I have some pictures here by Cézanne, 753 00:38:52,533 --> 00:38:55,533 and Manet, and Renoir. 754 00:38:55,533 --> 00:38:57,433 Van Gogh. 755 00:38:57,433 --> 00:39:00,600 LERNER: Mary Lasker was a philanthropist, 756 00:39:00,600 --> 00:39:05,833 and she had a housekeeper who had died of cancer. 757 00:39:05,833 --> 00:39:07,900 She was surprised to learn 758 00:39:07,900 --> 00:39:10,666 how little was being done 759 00:39:10,666 --> 00:39:12,833 to prevent these cancers and treat these cancers. 760 00:39:12,833 --> 00:39:16,900 So Lasker made it her goal to modernize 761 00:39:16,900 --> 00:39:19,633 the American Society for the Control of Cancer, 762 00:39:19,633 --> 00:39:21,433 and that's what she did. 763 00:39:21,433 --> 00:39:22,733 LASKER (archival): The amount of money 764 00:39:22,733 --> 00:39:25,233 that's being spent for medical research is... 765 00:39:25,233 --> 00:39:26,566 well, it's just piddling. 766 00:39:26,566 --> 00:39:29,466 Less is spent on, on cancer research 767 00:39:29,466 --> 00:39:31,300 than we spend on chewing gum! 768 00:39:32,466 --> 00:39:36,266 NARRATOR: Lasker's new fundraising tactics soon paid off, 769 00:39:36,266 --> 00:39:38,566 and in no time, the society's annual budget 770 00:39:38,566 --> 00:39:42,266 had grown over a hundredfold. 771 00:39:42,266 --> 00:39:44,433 Now, what the ACS really needed 772 00:39:44,433 --> 00:39:46,600 was a big, ambitious project-- 773 00:39:46,600 --> 00:39:50,100 something to show the public that cancer was a disease 774 00:39:50,100 --> 00:39:51,866 that you could actually do something about. 775 00:39:53,833 --> 00:39:56,833 The Pap smear was the perfect tool for the job, 776 00:39:56,833 --> 00:39:58,666 but its roll out would introduce 777 00:39:58,666 --> 00:40:01,433 an entirely new set of challenges. 778 00:40:01,433 --> 00:40:04,233 PAPANICOLAOU (archival): A trained and skilled cytotechnician 779 00:40:04,233 --> 00:40:06,833 cannot examine more than 780 00:40:06,833 --> 00:40:08,833 12 specimens a day. 781 00:40:08,833 --> 00:40:10,500 That is about 60 a week 782 00:40:10,500 --> 00:40:12,433 or 3,000 a year. 783 00:40:12,433 --> 00:40:13,566 You can figure out how many 784 00:40:13,566 --> 00:40:15,900 technicians are needed 785 00:40:15,900 --> 00:40:18,366 to study the specimens 786 00:40:18,366 --> 00:40:19,766 from the population of the United States. 787 00:40:19,766 --> 00:40:23,233 ♪ ♪ 788 00:40:23,233 --> 00:40:28,466 NARRATOR: Recently, Papanicolaou's lab had become a teaching center, 789 00:40:28,466 --> 00:40:31,100 a place where the next generation of cytologists 790 00:40:31,100 --> 00:40:32,433 could be trained. 791 00:40:33,633 --> 00:40:36,433 At the heart of the classes and the instruction 792 00:40:36,433 --> 00:40:38,700 was, more often than not, 793 00:40:38,700 --> 00:40:40,233 Mary Pap herself. 794 00:40:42,000 --> 00:40:44,133 GARDNER: Every technician that came in there, 795 00:40:44,133 --> 00:40:45,766 she sat down and she worked with them 796 00:40:45,766 --> 00:40:48,033 in terms of how we stain the slides, 797 00:40:48,033 --> 00:40:50,766 how we identify the slides. 798 00:40:50,766 --> 00:40:52,966 NARRATOR: Mary would later explain 799 00:40:52,966 --> 00:40:56,433 that she believed that people are born scientists. 800 00:40:56,433 --> 00:41:00,333 She'd been the one who'd decided they wouldn't have children, 801 00:41:00,333 --> 00:41:03,700 so that they could keep working together, always. 802 00:41:04,800 --> 00:41:07,866 "There was no other option for me," she'd say, 803 00:41:07,866 --> 00:41:10,700 "but to follow him inside the lab, 804 00:41:10,700 --> 00:41:13,366 making his way of life mine." 805 00:41:14,400 --> 00:41:15,800 For 21 years, 806 00:41:15,800 --> 00:41:17,600 she'd had a smear every day. 807 00:41:17,600 --> 00:41:22,533 Some 7,665 smears in all. 808 00:41:23,633 --> 00:41:27,033 You can just imagine what that was like... 809 00:41:27,033 --> 00:41:28,066 or can you? I mean, 810 00:41:28,066 --> 00:41:29,266 none of us have submitted to 811 00:41:29,266 --> 00:41:30,900 such a kind of long-term 812 00:41:30,900 --> 00:41:34,266 invasive campaign of personal investigation. 813 00:41:35,733 --> 00:41:39,266 To involve your body, and your life, 814 00:41:39,266 --> 00:41:41,800 to that extent in your partner's work 815 00:41:41,800 --> 00:41:43,600 is really remarkable. 816 00:41:43,600 --> 00:41:46,100 And I think to describe her as an equal partner 817 00:41:46,100 --> 00:41:47,300 in George's work 818 00:41:47,300 --> 00:41:49,866 is almost even to do her a discredit, 819 00:41:49,866 --> 00:41:52,700 because she immersed herself in it, 820 00:41:52,700 --> 00:41:54,733 body and soul. 821 00:41:54,733 --> 00:41:58,733 NARRATOR: Mary Papanicolaou had made the smear possible. 822 00:41:58,733 --> 00:42:01,733 But there were limits to what even she could do. 823 00:42:03,600 --> 00:42:05,366 HAZARD: It would've been really challenging 824 00:42:05,366 --> 00:42:08,733 to win hearts and minds, especially in the '50s. 825 00:42:08,733 --> 00:42:10,766 You know, to be invited in for a screening program 826 00:42:10,766 --> 00:42:12,933 where you have to lift your dress and open your legs 827 00:42:12,933 --> 00:42:15,233 would not have been an easy sell. 828 00:42:16,933 --> 00:42:19,433 NARRATOR: As both George and Mary well knew, 829 00:42:19,433 --> 00:42:22,966 there were millions of women in America. 830 00:42:22,966 --> 00:42:25,933 Every single one of them needed to hear 831 00:42:25,933 --> 00:42:28,200 how the Pap could save their life. 832 00:42:29,800 --> 00:42:32,466 And for that, what was really needed 833 00:42:32,466 --> 00:42:34,200 were people on the ground. 834 00:42:36,233 --> 00:42:39,133 ♪ ♪ 835 00:42:39,133 --> 00:42:41,433 In Philadelphia, in 1948, 836 00:42:41,433 --> 00:42:44,366 Helen Dickens was busier than ever. 837 00:42:45,766 --> 00:42:48,700 SHAKIR: She would do workshops like "Cancer in Women," 838 00:42:48,700 --> 00:42:50,566 "Cancer in the Uterus." 839 00:42:50,566 --> 00:42:52,800 But also working specifically 840 00:42:52,800 --> 00:42:55,100 with these club women's groups in Philadelphia, 841 00:42:55,100 --> 00:42:56,866 like the Pyramid Club, 842 00:42:56,866 --> 00:43:00,933 the Junior Business and Professional League. 843 00:43:00,933 --> 00:43:03,966 But Dickens doesn't just work with those societies. 844 00:43:03,966 --> 00:43:08,800 She also would do workshops for hairdressers. 845 00:43:08,800 --> 00:43:11,100 People kept calling on her 846 00:43:11,100 --> 00:43:12,533 to speak here and there. 847 00:43:12,533 --> 00:43:14,900 The more she did, 848 00:43:14,900 --> 00:43:16,633 the more people heard about her. 849 00:43:16,633 --> 00:43:18,800 Word spread, quickly. 850 00:43:18,800 --> 00:43:23,466 NARRATOR: Now, Dr. Dickens was in a new position of power. 851 00:43:23,466 --> 00:43:25,333 After passing her boards 852 00:43:25,333 --> 00:43:29,766 to become the only Black female OB-GYN in all of Philadelphia, 853 00:43:29,766 --> 00:43:31,133 she'd taken a job 854 00:43:31,133 --> 00:43:34,933 as the head of the department at Mercy Hospital. 855 00:43:34,933 --> 00:43:38,266 BROWN: She didn't leave the office and come home. 856 00:43:38,266 --> 00:43:39,700 She didn't do that. 857 00:43:39,700 --> 00:43:41,666 There were phone calls at home. 858 00:43:41,666 --> 00:43:43,600 She called patients back. 859 00:43:43,600 --> 00:43:46,166 She was interested in their families. 860 00:43:46,166 --> 00:43:49,033 Many of them became friends. 861 00:43:49,033 --> 00:43:52,000 In retrospect, I get it. 862 00:43:52,000 --> 00:43:53,166 As a kid, I was like, 863 00:43:53,166 --> 00:43:56,200 "Oh my goodness." (laughs) 864 00:43:56,200 --> 00:43:58,633 She was gone. 865 00:43:58,633 --> 00:44:01,500 She was there for them. 866 00:44:01,500 --> 00:44:04,466 NARRATOR: Always on the lookout for any cutting-edge medical tool 867 00:44:04,466 --> 00:44:06,033 that could help her patients, 868 00:44:06,033 --> 00:44:09,733 when a publication about the smear came across her desk, 869 00:44:09,733 --> 00:44:13,200 Dickens saw its potential at once. 870 00:44:13,200 --> 00:44:18,433 BROWN: She did study what Dr. Papanicolaou was doing, 871 00:44:18,433 --> 00:44:20,700 and thought that if she could just spread that technique, 872 00:44:20,700 --> 00:44:22,733 it was lifesaving. 873 00:44:22,733 --> 00:44:25,566 But it was an uphill battle. 874 00:44:27,133 --> 00:44:29,200 ♪ ♪ 875 00:44:29,200 --> 00:44:31,533 NARRATOR: Since its very beginnings, 876 00:44:31,533 --> 00:44:34,933 the practice of gynecology in America had been tied to-- 877 00:44:34,933 --> 00:44:38,533 and made possible by-- the institution of slavery. 878 00:44:40,866 --> 00:44:43,400 Surgeons like James Marion Sims, 879 00:44:43,400 --> 00:44:46,033 the man behind the modern speculum, 880 00:44:46,033 --> 00:44:47,933 had developed the field 881 00:44:47,933 --> 00:44:50,733   without any ethical restraints whatsoever. 882 00:44:51,966 --> 00:44:55,200 COOPER OWENS: James Marion Sims founds the first hospital 883 00:44:55,200 --> 00:45:00,666 dedicated to women's conditions in the 1840s 884 00:45:00,666 --> 00:45:02,500 in Montgomery, Alabama. 885 00:45:02,500 --> 00:45:05,233 And it's essentially a hospital for enslaved women. 886 00:45:05,233 --> 00:45:08,766 ♪ ♪ 887 00:45:08,766 --> 00:45:09,866 They are experimented on 888 00:45:09,866 --> 00:45:11,900 for a number of years. 889 00:45:15,233 --> 00:45:17,533 one young woman, Anarcha, 890 00:45:17,533 --> 00:45:20,966 she was experimented on almost 30 times. 891 00:45:24,966 --> 00:45:26,866 Without anesthesia. 892 00:45:30,066 --> 00:45:32,633 NARRATOR: With the rise of the eugenics movement, 893 00:45:32,633 --> 00:45:36,233 certain doctors had advocated for-- and performed-- 894 00:45:36,233 --> 00:45:39,566 sterilizations on women of color. 895 00:45:39,566 --> 00:45:41,366 ♪ ♪ 896 00:45:41,366 --> 00:45:43,900 COOPER OWENS: It was considered "Mississippi appendectomy." 897 00:45:43,900 --> 00:45:45,900 Oftentimes, that's what the doctors 898 00:45:45,900 --> 00:45:47,400 would tell these patients. 899 00:45:47,400 --> 00:45:48,900 And they would go in, 900 00:45:48,900 --> 00:45:51,933 and perform hysterectomies on very young Black women. 901 00:45:54,300 --> 00:45:58,766 The long-term effect of those sterilization surgeries 902 00:45:58,766 --> 00:46:02,066 is that you have a community of people 903 00:46:02,066 --> 00:46:05,566 who do not trust doctors, 904 00:46:05,566 --> 00:46:08,133 particularly when it comes to reproduction. 905 00:46:09,300 --> 00:46:10,666 NARRATOR: For years, 906 00:46:10,666 --> 00:46:13,900 Dickens had worked to gain her patients' trust. 907 00:46:13,900 --> 00:46:17,133 And now, she was going to need it. 908 00:46:17,133 --> 00:46:18,966 SHAKIR: With the Pap smear, 909 00:46:18,966 --> 00:46:20,733 what she's really concerned about 910 00:46:20,733 --> 00:46:22,566 educating the public about, 911 00:46:22,566 --> 00:46:25,666 "This is not a form of sterilization, 912 00:46:25,666 --> 00:46:27,566 but it in fact will help to prevent you 913 00:46:27,566 --> 00:46:28,833 from getting cancer." 914 00:46:30,000 --> 00:46:33,466 COOPER OWENS: She understands some of the trepidation, 915 00:46:33,466 --> 00:46:35,500 and she's saying, "Look, I'm a product of this, 916 00:46:35,500 --> 00:46:38,066 and I'm telling you that you can trust me." 917 00:46:39,066 --> 00:46:40,800 NARRATOR: In 1953, 918 00:46:40,800 --> 00:46:42,266 a new cancer center opened 919 00:46:42,266 --> 00:46:45,000 under Dickens' direction at Mercy Hospital. 920 00:46:46,033 --> 00:46:47,700 It would finally document 921 00:46:47,700 --> 00:46:49,666 the instances of reproductive cancer 922 00:46:49,666 --> 00:46:52,300 in the Black community. 923 00:46:52,300 --> 00:46:54,466 As Dickens would argue, 924 00:46:54,466 --> 00:46:58,066 "No woman need die from cervical cancer." 925 00:46:58,066 --> 00:47:00,566 But it remained an open question. 926 00:47:00,566 --> 00:47:03,900 When those clinics opened, would women go? 927 00:47:05,133 --> 00:47:07,733 (indistinct chatter) 928 00:47:12,966 --> 00:47:15,800 HAZARD: The first wide-scale screening program 929 00:47:15,800 --> 00:47:19,566 that involved the Pap smear took place in Tennessee. 930 00:47:20,766 --> 00:47:22,500 KEAN: A lot of this work was done at clinics, 931 00:47:22,500 --> 00:47:23,900 but they also used 932 00:47:23,900 --> 00:47:27,400 what they called Pap stations that would pop up-- 933 00:47:27,400 --> 00:47:29,400 small, mobile clinics 934 00:47:29,400 --> 00:47:32,133 at schools, businesses. 935 00:47:32,133 --> 00:47:36,700 NARRATOR: It was called the Memphis Cancer Survey Project. 936 00:47:36,700 --> 00:47:42,100 Over five years, from 1952 to 1957, 937 00:47:42,100 --> 00:47:45,433 it would enroll hundreds of thousands of women, 938 00:47:45,433 --> 00:47:49,433 and become the first real-world test of the Pap smear. 939 00:47:51,533 --> 00:47:54,266 ♪ ♪ 940 00:47:54,266 --> 00:47:56,266 Meanwhile, across the country, 941 00:47:56,266 --> 00:48:00,466 the American Cancer Society was funding the training 942 00:48:00,466 --> 00:48:03,466 of an entirely new labor force. 943 00:48:03,466 --> 00:48:05,666 And it was an army of women. 944 00:48:11,833 --> 00:48:13,233 HAZARD: There's a story about how 945 00:48:13,233 --> 00:48:15,500 these women were looking at these cell samples, 946 00:48:15,500 --> 00:48:18,466 and on the wall they had Murayama's paintings. 947 00:48:19,933 --> 00:48:21,900 ♪ ♪ 948 00:48:21,900 --> 00:48:24,000 And so if they were looking at a slide and, 949 00:48:24,000 --> 00:48:26,266 "Oh, I'm not quite sure. Does that look normal?" 950 00:48:26,266 --> 00:48:28,600 they could look at this amazing reference point 951 00:48:28,600 --> 00:48:29,966 and go, "Oh, yeah. Okay. 952 00:48:29,966 --> 00:48:31,566 "That's what I should be looking for. 953 00:48:31,566 --> 00:48:33,700 This is cancer," or "This isn't cancer." 954 00:48:35,566 --> 00:48:38,433 NARRATOR: Hashime Murayama, by this time, 955 00:48:38,433 --> 00:48:41,400 was well and truly retired. 956 00:48:41,400 --> 00:48:43,100 But there was no question that 957 00:48:43,100 --> 00:48:44,600 he'd delivered on his promise. 958 00:48:45,966 --> 00:48:48,100 He'd devoted his considerable skill 959 00:48:48,100 --> 00:48:51,233 to helping save American women's lives. 960 00:48:53,600 --> 00:48:56,733 ♪ ♪ 961 00:48:56,733 --> 00:49:01,033 GROSS: Mass trials in Tennessee reveal that this test 962 00:49:01,033 --> 00:49:05,833 is 98% or more effective at detecting cancer. 963 00:49:05,833 --> 00:49:07,566 And that's really 964 00:49:07,566 --> 00:49:09,666 the kind of confirmation that you need 965 00:49:09,666 --> 00:49:11,500 to start spreading this as a medical tool. 966 00:49:12,700 --> 00:49:14,366 NARRATOR: In Philadelphia, 967 00:49:14,366 --> 00:49:17,100 Dr. Helen Dickens was leading the charge. 968 00:49:17,100 --> 00:49:19,400 She'd gone out and taught the technique 969 00:49:19,400 --> 00:49:22,500 to as many other Black doctors as possible, 970 00:49:22,500 --> 00:49:25,433 and soon had grown her army of one 971 00:49:25,433 --> 00:49:27,700 into a force more than 200 strong. 972 00:49:28,866 --> 00:49:31,766 DICKENS (archival): You took a van and went out 973 00:49:31,766 --> 00:49:33,600 to the churches in various places, 974 00:49:33,600 --> 00:49:36,200 and invited women in 975 00:49:36,200 --> 00:49:39,333 to have a Pap smear done. 976 00:49:39,333 --> 00:49:41,066 She really made it her mission 977 00:49:41,066 --> 00:49:44,166 to use any means available to her 978 00:49:44,166 --> 00:49:45,400 to get the word out. 979 00:49:45,400 --> 00:49:47,633 She would recommend that families 980 00:49:47,633 --> 00:49:49,066 appoint a female representative 981 00:49:49,066 --> 00:49:50,766 who made sure every woman in the family 982 00:49:50,766 --> 00:49:52,066 got their Pap smear. 983 00:49:54,066 --> 00:49:55,600 NARRATOR: In the end, 984 00:49:55,600 --> 00:49:59,766 Dr. Dickens had simply refused to wait for people to come. 985 00:49:59,766 --> 00:50:02,133 She'd gone to them. 986 00:50:02,133 --> 00:50:05,266 SHAKIR: She's always thinking of herself as a worker, 987 00:50:05,266 --> 00:50:08,500 and for her, work means the liberation of Black people 988 00:50:08,500 --> 00:50:10,033 through medical activism. 989 00:50:10,033 --> 00:50:15,566 BROWN: Her legacy is the gift she gave of healthcare 990 00:50:15,566 --> 00:50:18,166 to every woman who came, you know, 991 00:50:18,166 --> 00:50:19,366 within ten feet of her. 992 00:50:20,700 --> 00:50:22,566 DICKENS (archival): The care of women, the dealing with women. 993 00:50:22,566 --> 00:50:24,500 That was the specialty I liked. 994 00:50:26,833 --> 00:50:31,500 NARRATOR: By 1958, the Pap smear was triumphant, 995 00:50:31,500 --> 00:50:35,633 and both George and Mary were invited to the White House, 996 00:50:35,633 --> 00:50:37,766 where they dined with Eisenhower 997 00:50:37,766 --> 00:50:40,266 and the queen of Greece. 998 00:50:40,266 --> 00:50:44,966 Their simple test for cancer had long since left the lab 999 00:50:44,966 --> 00:50:48,533 to become a vital part of women's lives. 1000 00:50:49,566 --> 00:50:52,666 LERNER: The Pap test helped de-stigmatize cancer. 1001 00:50:52,666 --> 00:50:54,600 By the late 1960s, 1002 00:50:54,600 --> 00:50:56,900 you could go to the public and say, 1003 00:50:56,900 --> 00:50:59,000 "Go get this test at your doctor. 1004 00:50:59,000 --> 00:51:00,600 "Sure, we might find cancer, 1005 00:51:00,600 --> 00:51:01,966 but we have something to do about it." 1006 00:51:01,966 --> 00:51:03,633 "Let's get cancer out of the closet. 1007 00:51:03,633 --> 00:51:06,700 Let's make this a disease that everybody can talk about." 1008 00:51:06,700 --> 00:51:07,933 WOMAN: I have an appointment 1009 00:51:07,933 --> 00:51:10,100 that I make once a year for my checkup. 1010 00:51:10,100 --> 00:51:12,633 Of course I go for a Pap test, every lady should. 1011 00:51:12,633 --> 00:51:15,800 My daughter went for a Pap test and she's fine. 1012 00:51:15,800 --> 00:51:20,133 COOPER OWENS: The ways that this medical discovery 1013 00:51:20,133 --> 00:51:24,266 literally changed the globe is incredible. 1014 00:51:24,266 --> 00:51:28,466 The Pap smear educated people about medicine, 1015 00:51:28,466 --> 00:51:30,300 and preventative healthcare. 1016 00:51:30,300 --> 00:51:31,400 And more importantly, 1017 00:51:31,400 --> 00:51:33,400 it saved people's lives. 1018 00:51:33,400 --> 00:51:36,166 HAZARD: The Pap smear changed the landscape 1019 00:51:36,166 --> 00:51:38,633 for cancer, for its detection, 1020 00:51:38,633 --> 00:51:40,633 its diagnosis, management, and treatment. 1021 00:51:40,633 --> 00:51:42,100 Suddenly we could envision a time 1022 00:51:42,100 --> 00:51:44,233 when we could screen healthy people, 1023 00:51:44,233 --> 00:51:47,600 and we could all be thriving in a new and quite exciting way. 1024 00:51:54,666 --> 00:52:01,300 ♪ ♪ 1025 00:52:14,466 --> 00:52:21,133 ♪ ♪ 1026 00:52:30,933 --> 00:52:37,733 ♪ ♪ 1027 00:52:44,300 --> 00:52:51,033 ♪ ♪