1 00:00:20,200 --> 00:00:22,070 NARRATOR: In New York City, 2 00:00:22,070 --> 00:00:25,640 the line stretched around the block. 3 00:00:26,770 --> 00:00:28,170 In Philadelphia, 4 00:00:28,170 --> 00:00:31,840 women waited for hours outside their local church. 5 00:00:31,840 --> 00:00:34,800 While way out in Wyoming, 6 00:00:34,800 --> 00:00:37,000 even the smallest mountain town was ready. 7 00:00:39,970 --> 00:00:43,270 Everywhere, in the year 1958, 8 00:00:43,270 --> 00:00:47,870 women were asking for a brand new medical test: a Pap smear. 9 00:00:48,870 --> 00:00:50,200 And nobody had ever 10 00:00:50,200 --> 00:00:52,100 seen anything like it. 11 00:00:54,340 --> 00:00:57,340 RACHEL GROSS: In the 1940s and '50s, cervical cancer is killing 12 00:00:57,340 --> 00:00:59,370 thousands and thousands of women. 13 00:00:59,370 --> 00:01:02,840 This was definitely a major priority of American healthcare. 14 00:01:02,840 --> 00:01:05,940 The stakes are very high. 15 00:01:05,940 --> 00:01:08,870 NARRATOR: For the first time in history, 16 00:01:08,870 --> 00:01:12,300 there was a simple screening test for cancer. 17 00:01:12,300 --> 00:01:14,840 Its rollout and its propaganda 18 00:01:14,840 --> 00:01:16,670 were utterly unprecedented. 19 00:01:16,670 --> 00:01:18,070 DEBORAH KERR (archival): Costly cancer deaths, 20 00:01:18,070 --> 00:01:21,200 they deprive the world of too many people we love. 21 00:01:21,200 --> 00:01:24,740 Now is the time to strike back at cancer. 22 00:01:24,740 --> 00:01:28,200 NARRATOR: The campaign would require nothing short 23 00:01:28,200 --> 00:01:31,300 of a full national mobilization. 24 00:01:31,300 --> 00:01:33,700 DEIRDRE COOPER OWENS: It's so ubiquitous now, that we kind of 25 00:01:33,700 --> 00:01:35,600 don't think about the fact 26 00:01:35,600 --> 00:01:37,740 that it's not even a hundred years old yet. 27 00:01:37,740 --> 00:01:40,200 When we first hear about a Pap smear, 28 00:01:40,200 --> 00:01:44,340 we don't know that it's actually named after a human being. 29 00:01:44,340 --> 00:01:46,200 NEWSREEL NARRATOR (archival): This is the doctor, 30 00:01:46,200 --> 00:01:48,870 George N. Papanicolaou, professor emeritus 31 00:01:48,870 --> 00:01:50,870 of Cornell Medical College. 32 00:01:50,870 --> 00:01:54,440 NARRATOR: The truth was, George Papanicolaou never set out 33 00:01:54,440 --> 00:01:57,100 to revolutionize cancer detection. 34 00:01:57,100 --> 00:01:59,870 And not a single thing about bringing the Pap smear 35 00:01:59,870 --> 00:02:02,470 to the people had been simple. 36 00:02:02,470 --> 00:02:06,270 BARRON LERNER: There were lots of barriers and lots of steps 37 00:02:06,270 --> 00:02:08,600 to get to where the Pap test really became 38 00:02:08,600 --> 00:02:10,440 a life-saving test. 39 00:02:10,440 --> 00:02:11,440 NARRATOR: Behind it all 40 00:02:11,440 --> 00:02:12,870 was a coalition as remarkable 41 00:02:12,870 --> 00:02:15,070 as it was unusual-- 42 00:02:15,070 --> 00:02:17,300 from a Japanese-born artist, 43 00:02:17,300 --> 00:02:19,400 to a Black doctor in Philadelphia, 44 00:02:19,400 --> 00:02:22,640 to an entirely new class of female scientists. 45 00:02:22,640 --> 00:02:25,640 Yet they all shared a singular goal: 46 00:02:25,640 --> 00:02:28,470 to save American women from cancer. 47 00:02:30,470 --> 00:02:32,700 One of the things that surprises me about this story 48 00:02:32,700 --> 00:02:35,300 is sometimes when we look at things in retrospect, 49 00:02:35,300 --> 00:02:37,900 it seems inevitable that they were going to happen. 50 00:02:39,240 --> 00:02:40,540 When I look at this story, 51 00:02:40,540 --> 00:02:42,970 nothing seems inevitable about it. 52 00:02:53,270 --> 00:02:58,870 ♪ ♪ 53 00:03:06,970 --> 00:03:09,600 (fluid bubbling) 54 00:03:11,870 --> 00:03:15,540 ♪ ♪ 55 00:03:19,870 --> 00:03:23,970 NARRATOR: The Cornell Medical College, in the year 1914, 56 00:03:23,970 --> 00:03:25,770 was home to practically every kind 57 00:03:25,770 --> 00:03:28,600 of scientific endeavor imaginable. 58 00:03:28,600 --> 00:03:33,600 Here, one lab studied the bacteria in human saliva. 59 00:03:35,700 --> 00:03:37,700 A floor below, 60 00:03:37,700 --> 00:03:40,840 researchers were developing treatments for diabetes 61 00:03:40,840 --> 00:03:43,300 by removing the pancreas from dogs. 62 00:03:43,300 --> 00:03:48,200 ♪ ♪ 63 00:03:48,200 --> 00:03:50,740 Then there was the scientific illustrator 64 00:03:50,740 --> 00:03:54,100 who would have 5,000 live mosquitos shipped by mail 65 00:03:54,100 --> 00:03:56,440 as "artist supplies." 66 00:03:59,540 --> 00:04:00,970 Amidst it all 67 00:04:00,970 --> 00:04:03,040 was a 31-year-old Greek immigrant, 68 00:04:03,040 --> 00:04:07,400 a zoologist by the name of George Papanicolaou. 69 00:04:08,540 --> 00:04:10,640 Always at his microscope, 70 00:04:10,640 --> 00:04:13,070 Papanicolaou was convinced that cells-- 71 00:04:13,070 --> 00:04:15,070 the building blocks of all life-- 72 00:04:15,070 --> 00:04:18,000 could tell us more than anyone else had realized. 73 00:04:19,740 --> 00:04:24,570 It was their secrets that he'd been chasing for years. 74 00:04:24,570 --> 00:04:26,400 ♪ ♪ 75 00:04:26,400 --> 00:04:28,940 (trolley bell ringing) 76 00:04:31,370 --> 00:04:33,670 SAM KEAN: When he was in Greece growing up, 77 00:04:33,670 --> 00:04:35,240 George Papanicolaou's father wanted George 78 00:04:35,240 --> 00:04:36,700 to become a doctor, 79 00:04:36,700 --> 00:04:39,000 but George liked science more. 80 00:04:39,000 --> 00:04:41,100 He also was called to help people. 81 00:04:41,100 --> 00:04:42,570 So he wanted to combine both 82 00:04:42,570 --> 00:04:44,340 of those doing medical research. 83 00:04:44,340 --> 00:04:47,070 NARRATOR: "It is not my ideal to be wealthy," 84 00:04:47,070 --> 00:04:48,740 he'd once written to his parents, 85 00:04:48,740 --> 00:04:52,100 but to work to create." 86 00:04:52,100 --> 00:04:55,740 Papanicolaou received his medical degree in 1904, 87 00:04:55,740 --> 00:04:57,640 at age 21, 88 00:04:57,640 --> 00:05:01,000 then embarked on a PhD in zoology, 89 00:05:01,000 --> 00:05:04,600 researching sex determination in the tiny aquatic daphnia, 90 00:05:04,600 --> 00:05:07,170 or water flea. 91 00:05:07,170 --> 00:05:11,000 After graduate school, he embarked on a sea voyage 92 00:05:11,000 --> 00:05:13,470 with Prince Albert of Monaco, 93 00:05:13,470 --> 00:05:16,170 aboard his brand-new oceanographic research vessel, 94 00:05:16,170 --> 00:05:18,470 the Hirondelle. 95 00:05:20,300 --> 00:05:21,870 In film footage shot by the prince, 96 00:05:21,870 --> 00:05:24,340 Papanicolaou himself can be seen 97 00:05:24,340 --> 00:05:27,000 retrieving marine specimens from a large trap. 98 00:05:28,570 --> 00:05:31,940 ♪ ♪ 99 00:05:35,470 --> 00:05:38,600 KIRSTEN GARDNER: He ends up going on an oceanic voyage 100 00:05:38,600 --> 00:05:42,940 to help identify different sea creatures. 101 00:05:42,940 --> 00:05:45,440 He loved to categorize things. 102 00:05:45,440 --> 00:05:49,100 I think it really translates to his later work 103 00:05:49,100 --> 00:05:51,470 when he makes his way over to the United States. 104 00:05:53,400 --> 00:05:56,270 (footsteps shuffling) 105 00:05:56,270 --> 00:05:58,140 NARRATOR: When he landed in New York City 106 00:05:58,140 --> 00:06:01,840 with his young wife, Mary Mavroyeni, in 1913, 107 00:06:01,840 --> 00:06:05,800 Papanicolaou was an ambitious scientist on the rise. 108 00:06:05,800 --> 00:06:08,770 But nothing went as planned. 109 00:06:09,970 --> 00:06:12,070 RACHEL GROSS: He spoke German and Greek, 110 00:06:12,070 --> 00:06:13,570 but neither of them 111 00:06:13,570 --> 00:06:15,140 spoke much English at all. 112 00:06:15,140 --> 00:06:18,400 KEAN: He was taking odd jobs, 113 00:06:18,400 --> 00:06:20,570 playing his violin in a restaurant. 114 00:06:20,570 --> 00:06:22,970 (violin playing) 115 00:06:22,970 --> 00:06:25,970 He was working as a clerk at a Greek newspaper. 116 00:06:25,970 --> 00:06:28,540 He was a carpet salesman for a bit, and he was supposedly 117 00:06:28,540 --> 00:06:31,340 the worst carpet salesman they'd ever had. 118 00:06:31,340 --> 00:06:33,670 He could not close any deal. 119 00:06:33,670 --> 00:06:36,800 He just wasn't a forceful personality in that way. 120 00:06:38,700 --> 00:06:42,700 NARRATOR: Still, George was luckier than most immigrants. 121 00:06:42,700 --> 00:06:45,540 His doctoral work had brought him some renown, 122 00:06:45,540 --> 00:06:48,240 and he was offered a job studying reproduction 123 00:06:48,240 --> 00:06:51,840 in the laboratory of one Charles Stockard, 124 00:06:51,840 --> 00:06:53,870 an anatomist, zoologist, 125 00:06:53,870 --> 00:06:56,400 and prominent American eugenicist. 126 00:06:57,670 --> 00:07:00,470 KEAN: George's boss believed in controlling reproduction, 127 00:07:00,470 --> 00:07:02,600 controlling who reproduced, 128 00:07:02,600 --> 00:07:04,170 with the supposed aim 129 00:07:04,170 --> 00:07:06,400 of improving the stock of humankind. 130 00:07:06,400 --> 00:07:08,700 At the time, people thought they knew 131 00:07:08,700 --> 00:07:10,040 what good genes and bad genes were. 132 00:07:11,970 --> 00:07:14,570 Good genes were you were white, 133 00:07:14,570 --> 00:07:16,400 with healthy young children. 134 00:07:17,540 --> 00:07:18,900 Unfortunately, 135 00:07:18,900 --> 00:07:20,840 if you were an immigrant, a person of color, 136 00:07:20,840 --> 00:07:24,100 if you had a disease like epilepsy, 137 00:07:24,100 --> 00:07:27,170 you were often stigmatized as having bad genes. 138 00:07:29,370 --> 00:07:31,740 GROSS: There was an inkling that if you could 139 00:07:31,740 --> 00:07:35,170 control female reproduction, that would give you the tools 140 00:07:35,170 --> 00:07:38,300 to create the population you wanted. 141 00:07:39,740 --> 00:07:42,270 NARRATOR: Papanicolaou's new work in Stockard's laboratory 142 00:07:42,270 --> 00:07:45,240 involved answering basic questions, 143 00:07:45,240 --> 00:07:48,800 still unknown, about female biology. 144 00:07:48,800 --> 00:07:53,140 GARDNER: Dr. Papanicolaou was interested in tracing the cellular changes 145 00:07:53,140 --> 00:07:56,100 that happened during the reproductive cycle. 146 00:07:56,100 --> 00:07:59,070 He was very invested in finding that pattern, 147 00:07:59,070 --> 00:08:01,170 and when did cells change. 148 00:08:02,440 --> 00:08:04,740 NARRATOR: Papanicolaou threw himself into the work, 149 00:08:04,740 --> 00:08:06,140 and, unexpectedly, 150 00:08:06,140 --> 00:08:09,700 found a kindred spirit just down the hall. 151 00:08:09,700 --> 00:08:11,840 ♪ ♪ 152 00:08:11,840 --> 00:08:14,040 KEAN: Hashime Murayama was born in Japan. 153 00:08:14,040 --> 00:08:16,340 He went to the Kyoto Art School. 154 00:08:16,340 --> 00:08:18,540 Then he got a job at Cornell. 155 00:08:18,540 --> 00:08:21,500 He was doing cell illustrations for doctors. 156 00:08:23,140 --> 00:08:25,470 He had a good eye for essentially drawing 157 00:08:25,470 --> 00:08:28,970 exactly what he was seeing. 158 00:08:28,970 --> 00:08:31,800 HAZARD: There must have been some degree of kinship 159 00:08:31,800 --> 00:08:33,440 between George and Murayama, 160 00:08:33,440 --> 00:08:35,300 as both were immigrants to America. 161 00:08:36,640 --> 00:08:39,200 Neither of them would've sounded or maybe looked 162 00:08:39,200 --> 00:08:41,400 like their American peers. 163 00:08:42,970 --> 00:08:44,700 NARRATOR: At Cornell, 164 00:08:44,700 --> 00:08:47,870 Murayama was as interested in cells as George was, 165 00:08:47,870 --> 00:08:49,700 and had even patented 166 00:08:49,700 --> 00:08:53,300 a new technique to improve the accuracy of his drawings. 167 00:08:56,140 --> 00:08:59,070 Meanwhile, back in the Stockard laboratory, 168 00:08:59,070 --> 00:09:01,570 Papanicolaou had recently found himself 169 00:09:01,570 --> 00:09:05,040 questioning one of their basic research protocols. 170 00:09:06,800 --> 00:09:09,500 Their lab animal was the guinea pig, 171 00:09:09,500 --> 00:09:11,800 and in comparison to the little aquatic water fleas 172 00:09:11,800 --> 00:09:15,370 George had worked with in graduate school, 173 00:09:15,370 --> 00:09:18,170 the rodents were more complicated. 174 00:09:19,300 --> 00:09:21,600 GARDNER: In order to study the reproductive cells, 175 00:09:21,600 --> 00:09:23,840 he would have to kill the guinea pig. 176 00:09:25,370 --> 00:09:27,270 But when you kill the guinea pig, 177 00:09:27,270 --> 00:09:29,140 you only get a slice of the story. 178 00:09:29,140 --> 00:09:32,570 So then he began to consider that the cells 179 00:09:32,570 --> 00:09:35,170 may be changing in the vaginal fluid. 180 00:09:35,170 --> 00:09:37,470 ♪ ♪ 181 00:09:37,470 --> 00:09:38,770 NARRATOR: One morning, 182 00:09:38,770 --> 00:09:41,240 Papanicolaou took a tiny tool and scraped cells 183 00:09:41,240 --> 00:09:45,600 from inside a live guinea pig's cervix. 184 00:09:45,600 --> 00:09:48,240 Then he smeared the sample on a glass plate, 185 00:09:48,240 --> 00:09:50,700 and applied a series of stains. 186 00:09:52,670 --> 00:09:54,200 At last, 187 00:09:54,200 --> 00:09:58,400 he sat down at his microscope and it all came into focus. 188 00:09:59,540 --> 00:10:02,170 ♪ ♪ 189 00:10:04,540 --> 00:10:08,370 GROSS: George found that there were changes in the cells. 190 00:10:08,370 --> 00:10:12,870 He could see differences in these cells' shape and size. 191 00:10:14,270 --> 00:10:15,900 And they very clearly 192 00:10:15,900 --> 00:10:18,400 showed him what was happening in the uterus. 193 00:10:19,700 --> 00:10:22,840 NARRATOR: The discovery helped launch a new field: 194 00:10:22,840 --> 00:10:27,600 exfoliative cytology, the non-invasive study of cells. 195 00:10:29,170 --> 00:10:32,140 Papanicolaou had the highest hopes for his new method. 196 00:10:33,370 --> 00:10:36,000 And now, he couldn't help but wonder, 197 00:10:36,000 --> 00:10:38,870 could this novel technique also work 198 00:10:38,870 --> 00:10:41,570 for that most mysterious animal of all? 199 00:10:44,300 --> 00:10:47,040 (projector whirring) 200 00:10:47,040 --> 00:10:50,400 ♪ ♪ 201 00:10:59,240 --> 00:11:02,670 COOPER OWENS: There are many antiquated ways that scientists 202 00:11:02,670 --> 00:11:04,670 wrote about the female body. 203 00:11:06,740 --> 00:11:11,000 For instance, one might read that women are led, 204 00:11:11,000 --> 00:11:15,240 or guided by their uteri, and not their brains. 205 00:11:15,240 --> 00:11:17,340 Historically, women's bodies have really been 206 00:11:17,340 --> 00:11:19,170 subject to the male gaze. 207 00:11:19,170 --> 00:11:22,340 The reproductive tract has been seen as having two purposes: 208 00:11:22,340 --> 00:11:25,100 penis goes in, baby comes out. 209 00:11:26,200 --> 00:11:28,340 But in reality, 210 00:11:28,340 --> 00:11:30,640 there's all this other stuff happening 211 00:11:30,640 --> 00:11:33,340 99.99999% of the time. 212 00:11:36,140 --> 00:11:38,440 NARRATOR: Mary Papanicolaou was well aware 213 00:11:38,440 --> 00:11:40,970 that women's bodies had other functions. 214 00:11:40,970 --> 00:11:43,640 Seven years her husband's junior, 215 00:11:43,640 --> 00:11:46,670 she'd not only followed him to America, 216 00:11:46,670 --> 00:11:48,670 but into the laboratory as well, 217 00:11:48,670 --> 00:11:52,570 where she worked as both his technician and lab manager. 218 00:11:53,540 --> 00:11:56,240 GARDNER: They went to the lab every day together. 219 00:11:56,240 --> 00:11:58,340 They often worked to the point where it was dark 220 00:11:58,340 --> 00:12:00,040 when they came home at night. 221 00:12:00,040 --> 00:12:04,640 NARRATOR: Recently, George had embarked on a new experiment, 222 00:12:04,640 --> 00:12:08,400 and Mary had just become a guinea pig of sorts herself. 223 00:12:08,400 --> 00:12:11,700 LERNER: It was very common in the early 20th century 224 00:12:11,700 --> 00:12:15,300 for scientists to do experiments on their spouses, 225 00:12:15,300 --> 00:12:17,070 and on people they knew. 226 00:12:17,070 --> 00:12:19,200 And the idea behind this was, 227 00:12:19,200 --> 00:12:21,600 "If I'm willing to do an experiment on myself 228 00:12:21,600 --> 00:12:23,070 "or my family, 229 00:12:23,070 --> 00:12:26,170 it's safe enough for me to experiment on other people." 230 00:12:27,300 --> 00:12:29,370 NARRATOR: Every day, George would collect 231 00:12:29,370 --> 00:12:31,400 cells from Mary's cervix. 232 00:12:31,400 --> 00:12:33,070 Their goal: 233 00:12:33,070 --> 00:12:36,570 to be the first to document the minute morphological changes 234 00:12:36,570 --> 00:12:39,870 expressed during a human ovarian cycle. 235 00:12:39,870 --> 00:12:45,900 Mary was the heart, the soul, and the cervix of the operation. 236 00:12:45,900 --> 00:12:49,700 GROSS: Mary is the first person to get a Pap smear, 237 00:12:49,700 --> 00:12:51,800 but she also 238 00:12:51,800 --> 00:12:54,100 collects her own smears, organizes them, 239 00:12:54,100 --> 00:12:56,240 fixes them and stains them, 240 00:12:56,240 --> 00:12:58,270 and helps analyze them. 241 00:12:58,270 --> 00:13:01,370 She is an integral part of this scientific work. 242 00:13:02,640 --> 00:13:04,400 NARRATOR: Making their experiment possible 243 00:13:04,400 --> 00:13:06,740 was a gynecological tool perfected 244 00:13:06,740 --> 00:13:10,440 back in the 19th century-- the speculum. 245 00:13:10,440 --> 00:13:12,270 COOPER OWENS: No one really looked 246 00:13:12,270 --> 00:13:15,440 in the vaginal cavity, because it was taboo. 247 00:13:15,440 --> 00:13:17,140 And most certainly, 248 00:13:17,140 --> 00:13:19,840 a gentleman is not supposed to look 249 00:13:19,840 --> 00:13:22,870 into the inner cavity of a lady. 250 00:13:23,870 --> 00:13:26,270 NARRATOR: The speculum's controversial inventor, 251 00:13:26,270 --> 00:13:29,400 a physician named James Marion Sims, 252 00:13:29,400 --> 00:13:31,440 who would be remembered by some 253 00:13:31,440 --> 00:13:34,200 as the "father" of American gynecology, 254 00:13:34,200 --> 00:13:37,140 would later write that he hated nothing more 255 00:13:37,140 --> 00:13:40,340 than investigating the organs of the female pelvis. 256 00:13:42,870 --> 00:13:46,840 GROSS: There was this repeated association of female genitals 257 00:13:46,840 --> 00:13:50,740 with something that you should hide and cover up. 258 00:13:53,540 --> 00:13:57,000 Every time a, usually, male anatomist 259 00:13:57,000 --> 00:14:00,340 would "discover" the clitoris or the vulva, 260 00:14:00,340 --> 00:14:02,200 they would name it after the word shame. 261 00:14:02,200 --> 00:14:04,670 So in the 1500s, a French anatomist 262 00:14:04,670 --> 00:14:08,700 studied the human clitoris, and he named it the shame member. 263 00:14:08,700 --> 00:14:13,440 We still have today in OB-GYN textbooks, this word pudendum, 264 00:14:13,440 --> 00:14:15,840 which means "the part for which you should be ashamed." 265 00:14:17,900 --> 00:14:19,470 NARRATOR: For the Papanicolaous, 266 00:14:19,470 --> 00:14:22,440 nothing about their new work was shameful. 267 00:14:22,440 --> 00:14:25,170 "We stand at the very threshold," 268 00:14:25,170 --> 00:14:29,500 George would explain, "of this new science." 269 00:14:29,500 --> 00:14:33,300 Now, George was hoping to expand the study 270 00:14:33,300 --> 00:14:36,170 beyond what he termed his "special case." 271 00:14:36,170 --> 00:14:38,000 ♪ ♪ 272 00:14:38,000 --> 00:14:39,740 Soon, there were rumors 273 00:14:39,740 --> 00:14:42,370 that if you went to the Paps' for dinner, 274 00:14:42,370 --> 00:14:45,000 female guests might be asked to sit for a smear. 275 00:14:45,000 --> 00:14:47,670 ♪ ♪ 276 00:14:47,670 --> 00:14:50,000 HAZARD: Mary herself was fundamental 277 00:14:50,000 --> 00:14:52,200 in recruiting some of her friends to come 278 00:14:52,200 --> 00:14:54,740 and get smear tests in the name of medical progress. 279 00:14:56,400 --> 00:14:57,900 It's difficult to kind of piece together 280 00:14:57,900 --> 00:14:59,600 exactly how those initial 281 00:14:59,600 --> 00:15:02,770 smear parties really happened, but I think what we can say 282 00:15:02,770 --> 00:15:05,900 is that George was very keen on expanding this sample size. 283 00:15:07,600 --> 00:15:09,940 NARRATOR: In February 1925, 284 00:15:09,940 --> 00:15:13,170 George was finally able to establish a collaboration 285 00:15:13,170 --> 00:15:16,240 with the Woman's Hospital of the City of New York. 286 00:15:16,240 --> 00:15:18,500 KEAN: So he started looking at cysts, 287 00:15:18,500 --> 00:15:21,440 started looking at fibroid matters, trying to figure out 288 00:15:21,440 --> 00:15:22,840 if there was a correlation 289 00:15:22,840 --> 00:15:25,540 between these changes in the cells 290 00:15:25,540 --> 00:15:27,840 and the diseases that women were experiencing. 291 00:15:27,840 --> 00:15:29,570 ♪ ♪ 292 00:15:29,570 --> 00:15:31,670 NARRATOR: Then, one day at the microscope, 293 00:15:31,670 --> 00:15:35,170 Dr. Pap saw something altogether different. 294 00:15:36,170 --> 00:15:38,870 A sample with cells oddly shaped, 295 00:15:38,870 --> 00:15:43,140 their nuclei overlarge, their chromosomes jumbled. 296 00:15:45,170 --> 00:15:48,140 There was no mistaking those distinctive signs: 297 00:15:49,270 --> 00:15:51,100 it was cancer. 298 00:15:52,400 --> 00:15:56,270 HAZARD: This was not what George was looking for, 299 00:15:56,270 --> 00:15:59,200 but so much of good science is about luck 300 00:15:59,200 --> 00:16:03,270 and opportunity and incidental findings. 301 00:16:03,270 --> 00:16:05,670 And George, being a keen and perceptive scientist, 302 00:16:05,670 --> 00:16:09,640 must have known the significance of what he has detected. 303 00:16:10,800 --> 00:16:12,270 NARRATOR: He would remember it as 304 00:16:12,270 --> 00:16:15,640 the single most thrilling experience of his career. 305 00:16:15,640 --> 00:16:18,300 At hand was a new technique 306 00:16:18,300 --> 00:16:22,300 that had the power to save millions of women's lives. 307 00:16:22,300 --> 00:16:24,840 And the fight Dr. Pap was now joining 308 00:16:24,840 --> 00:16:27,800 could not have been more urgent. 309 00:16:27,800 --> 00:16:32,840 ♪ ♪ 310 00:16:34,740 --> 00:16:37,070 GROSS: Cancer was deeply feared at this time. 311 00:16:37,070 --> 00:16:40,600 It was known as the dread disease. 312 00:16:40,600 --> 00:16:42,440 Often doctors wouldn't even use the word cancer 313 00:16:42,440 --> 00:16:43,740 giving you a diagnosis. 314 00:16:45,440 --> 00:16:49,400 COOPER OWENS: Cervical cancer patients suffered in pain. 315 00:16:49,400 --> 00:16:51,340 By the time 316 00:16:51,340 --> 00:16:53,070 they found out that it was cancer, 317 00:16:53,070 --> 00:16:56,040 it was too late, so it was certainly a death sentence. 318 00:16:57,470 --> 00:17:01,000 NARRATOR: By the late 1920s, cancer was on the rise. 319 00:17:01,000 --> 00:17:03,700 And it seemed to be killing mostly women-- 320 00:17:03,700 --> 00:17:06,240 some 40,000 a year. 321 00:17:07,270 --> 00:17:08,640 A new organization, 322 00:17:08,640 --> 00:17:11,670 the American Society for the Control of Cancer, 323 00:17:11,670 --> 00:17:14,400 had recently been created to get the word out. 324 00:17:15,900 --> 00:17:17,670 Now, for its first 30 years, 325 00:17:17,670 --> 00:17:20,170 it was sort of a mom and pop shop. 326 00:17:20,170 --> 00:17:22,670 So the money that they did raise mostly 327 00:17:22,670 --> 00:17:25,040 went to people with cancer. 328 00:17:25,040 --> 00:17:28,870 It was almost a bit like a charity organization. 329 00:17:28,870 --> 00:17:32,370 NARRATOR: The society occasionally printed pamphlets, 330 00:17:32,370 --> 00:17:35,500 like "What Every Woman Should Do About Cancer." 331 00:17:35,500 --> 00:17:38,500 But that was the full extent of their campaign. 332 00:17:39,600 --> 00:17:44,070 LERNER: The notion of trying to find a cervical cancer early 333 00:17:44,070 --> 00:17:46,040 wasn't on anyone's radar screen, 334 00:17:46,040 --> 00:17:48,870 because nobody had thought of it before, 335 00:17:48,870 --> 00:17:51,070 and nobody thought there was a way to do that. 336 00:17:52,900 --> 00:17:55,070 (dog barking) 337 00:17:56,870 --> 00:17:59,870 NARRATOR: In early January 1928, 338 00:17:59,870 --> 00:18:02,370 armed with his new cancer detection method, 339 00:18:02,370 --> 00:18:05,870 Dr. Pap traveled to Battle Creek, Michigan, 340 00:18:05,870 --> 00:18:08,400 excited to tell his colleagues about his discovery. 341 00:18:09,570 --> 00:18:13,700 It was called the "Race Betterment Conference," 342 00:18:13,700 --> 00:18:16,800 a high-profile event sponsored by prominent members 343 00:18:16,800 --> 00:18:18,640 of the eugenics movement. 344 00:18:20,740 --> 00:18:24,000 It is a who's who of the academic world. 345 00:18:24,000 --> 00:18:27,270 It's a who's who of the scientific world. 346 00:18:27,270 --> 00:18:30,800 You had a number of prominent thinkers 347 00:18:30,800 --> 00:18:35,570 who were invested in these racist ideas. 348 00:18:37,200 --> 00:18:39,900 ♪ ♪ 349 00:18:39,900 --> 00:18:41,940 LERNER: It was very common 350 00:18:41,940 --> 00:18:44,570 for mainstream scientists not doing eugenic research 351 00:18:44,570 --> 00:18:46,540 to present at these conferences. 352 00:18:46,540 --> 00:18:49,340 Dr. Pap didn't see his research particularly 353 00:18:49,340 --> 00:18:51,440 as promoting the eugenics cause, 354 00:18:51,440 --> 00:18:53,600 but it was reproductive research. 355 00:18:53,600 --> 00:18:56,940 So he took the chance and decided to present there. 356 00:18:57,940 --> 00:19:01,470 NARRATOR: On the third day, Papanicolaou took the stage 357 00:19:01,470 --> 00:19:04,840 and launched into an explainer of his new technique. 358 00:19:06,170 --> 00:19:09,700 GARDNER: It was a disastrous presentation. 359 00:19:09,700 --> 00:19:11,670 The first problem was his slides, 360 00:19:11,670 --> 00:19:13,800 by all accounts, were terrible. 361 00:19:13,800 --> 00:19:17,970 (slides clicking) 362 00:19:17,970 --> 00:19:20,540 So if you're making a presentation 363 00:19:20,540 --> 00:19:22,700 where you're trying to argue that the key 364 00:19:22,700 --> 00:19:24,800 to identifying irregular cells 365 00:19:24,800 --> 00:19:27,770 is so that you can create these classifications... 366 00:19:27,770 --> 00:19:29,340 (slide clicking) 367 00:19:29,340 --> 00:19:31,600 ...and then your slides are some of the worst that anyone 368 00:19:31,600 --> 00:19:36,670 has seen at the conference, it's just not that convincing. 369 00:19:36,670 --> 00:19:39,440 Two: the gold standard was the biopsy. 370 00:19:39,440 --> 00:19:42,200 NARRATOR: The biopsy involved an operation 371 00:19:42,200 --> 00:19:44,800 to collect tissue from within a tumor. 372 00:19:44,800 --> 00:19:48,870 It was effective, but often painful. 373 00:19:48,870 --> 00:19:52,170 HAZARD: So doctors at this betterment conference, 374 00:19:52,170 --> 00:19:54,870 they don't understand why it would be appealing 375 00:19:54,870 --> 00:19:58,470 to switch from the biopsy, 376 00:19:58,470 --> 00:20:00,840 a painful, invasive diagnostic, 377 00:20:00,840 --> 00:20:05,500 to one that was arguably uncomfortable, but not painful. 378 00:20:05,500 --> 00:20:07,470 There probably wasn't really a recognition 379 00:20:07,470 --> 00:20:10,100 that the woman's comfort and the patient's preference 380 00:20:10,100 --> 00:20:13,440 would be in any way a deciding factor. 381 00:20:13,440 --> 00:20:16,940 ♪ ♪ 382 00:20:16,940 --> 00:20:19,870 NARRATOR: When journalists caught wind of Papanicolaou's findings, 383 00:20:19,870 --> 00:20:22,140 it made national headlines. 384 00:20:22,140 --> 00:20:25,440 ♪ ♪ 385 00:20:25,440 --> 00:20:27,940 But as Dr. Pap himself would note, 386 00:20:27,940 --> 00:20:29,870 "I failed to convince my colleagues 387 00:20:29,870 --> 00:20:32,140 of the practicability of the procedure." 388 00:20:33,500 --> 00:20:36,340 KEAN: George just sort of shrunk back and took the criticism. 389 00:20:37,700 --> 00:20:39,640 And he didn't really give 390 00:20:39,640 --> 00:20:41,140 up on the work, 391 00:20:41,140 --> 00:20:43,040 he just wasn't pushing for it. 392 00:20:43,040 --> 00:20:45,440 He wasn't that assertive of a person. 393 00:20:47,170 --> 00:20:48,470 NARRATOR: Little did George know, 394 00:20:48,470 --> 00:20:52,000 the war on cancer was just beginning. 395 00:20:52,000 --> 00:20:53,940 And new voices, 396 00:20:53,940 --> 00:20:56,900 and new faces, were about to change 397 00:20:56,900 --> 00:20:59,000 the nature of the fight. 398 00:21:00,100 --> 00:21:02,940 ♪ ♪ 399 00:21:08,170 --> 00:21:12,270 FILM NARRATOR (archival): Cancer challenges every man and woman. 400 00:21:12,270 --> 00:21:16,400 It is a test of our civilization's ability 401 00:21:16,400 --> 00:21:19,570 to organize for health and happiness. 402 00:21:21,540 --> 00:21:23,540 NARRATOR: The Women's Field Army, 403 00:21:23,540 --> 00:21:24,970 an offshoot of the American Society 404 00:21:24,970 --> 00:21:26,570 for the Control of Cancer, 405 00:21:26,570 --> 00:21:28,340 was determined to make cancer 406 00:21:28,340 --> 00:21:31,200 a part of the national conversation. 407 00:21:31,200 --> 00:21:34,640 And soon, their message seemed to be everywhere. 408 00:21:38,240 --> 00:21:39,900 GARDNER: The idea is they are going 409 00:21:39,900 --> 00:21:41,640 to invade American homes 410 00:21:41,640 --> 00:21:43,700 with knowledge about cancer. 411 00:21:43,700 --> 00:21:45,870 And whether that means knocking on doors 412 00:21:45,870 --> 00:21:48,740 and giving out pamphlets, 413 00:21:48,740 --> 00:21:50,370 getting placards in the subway, 414 00:21:50,370 --> 00:21:54,000 going to fairs and setting up a health booth, 415 00:21:54,000 --> 00:21:55,940 these women were going to do it. 416 00:21:55,940 --> 00:21:58,500 NARRATOR: By 1938, 417 00:21:58,500 --> 00:22:01,600 the Women's Field Army had even successfully lobbied Congress 418 00:22:01,600 --> 00:22:04,500 to make April "Cancer Control Month." 419 00:22:06,170 --> 00:22:08,600 ♪ ♪ 420 00:22:08,600 --> 00:22:10,470 GARDNER: What begins to happen 421 00:22:10,470 --> 00:22:13,640 is women carving out an identity for themselves 422 00:22:13,640 --> 00:22:15,400 really as public health activists. 423 00:22:17,400 --> 00:22:20,140 We might not be the MDs who have these theories, 424 00:22:20,140 --> 00:22:22,100 but we can certainly be the educators 425 00:22:22,100 --> 00:22:24,400 who translate these theories to the public, 426 00:22:24,400 --> 00:22:26,670 so that they can be more effective. 427 00:22:27,870 --> 00:22:31,470 NARRATOR: But the outreach, as groundbreaking as it was, 428 00:22:31,470 --> 00:22:35,300 mostly ignored the plight of large swaths of the population. 429 00:22:35,300 --> 00:22:38,200 AMEENAH SHAKIR: The Women's Field Army, 430 00:22:38,200 --> 00:22:41,640 documenting some of these cases in white women patients, 431 00:22:41,640 --> 00:22:44,770 there was not as much of a focus on 432 00:22:44,770 --> 00:22:47,770 how uterine and ovarian cancer were actually 433 00:22:47,770 --> 00:22:49,770 impacting Black women. 434 00:22:49,770 --> 00:22:52,900 The perception at the time was that 435 00:22:52,900 --> 00:22:57,200 African Americans did not live long enough to get cancer, 436 00:22:57,200 --> 00:23:00,540 were not civilized enough to get cancer. 437 00:23:00,540 --> 00:23:04,370 Cancer was considered to be a disease of the elite. 438 00:23:04,370 --> 00:23:06,900 ♪ ♪ 439 00:23:06,900 --> 00:23:09,600 NARRATOR: An hour south of the Field Army's Manhattan headquarters, 440 00:23:09,600 --> 00:23:12,970 down in Philadelphia, a young doctor was about 441 00:23:12,970 --> 00:23:17,070 to discover a very different reality. 442 00:23:17,070 --> 00:23:20,500 Her name was Helen Dickens. 443 00:23:20,500 --> 00:23:22,540 Born in Dayton, Ohio, 444 00:23:22,540 --> 00:23:26,070 to parents Daisy and Charles Dickens, 445 00:23:26,070 --> 00:23:29,300 her father had escaped from slavery in Kentucky. 446 00:23:30,340 --> 00:23:32,840 He'd taught himself to read, and took the name 447 00:23:32,840 --> 00:23:35,840 Charles Dickens, whose writings he loved. 448 00:23:36,940 --> 00:23:39,300 Tragically, he'd died when his daughter 449 00:23:39,300 --> 00:23:41,100 was just eight years old. 450 00:23:42,640 --> 00:23:45,000 HELEN DICKENS (archival): He always wanted me to be a nurse. 451 00:23:45,000 --> 00:23:47,040 But somewhere along the way, 452 00:23:47,040 --> 00:23:49,000 I decided that if I was going to be a nurse, 453 00:23:49,000 --> 00:23:51,000 I might as well be a doctor. 454 00:23:51,000 --> 00:23:54,370 I had never seen a woman doctor, either Black or white. 455 00:23:54,370 --> 00:23:56,400 It never occurred to me there was a barrier. 456 00:23:57,600 --> 00:23:59,870 JAYNE HENDERSON BROWN: Oh, my mother loved school. 457 00:24:01,500 --> 00:24:03,540 She wanted to know so much, 458 00:24:03,540 --> 00:24:04,570 and learn so much 459 00:24:04,570 --> 00:24:07,040 and that was what she was about. 460 00:24:07,040 --> 00:24:11,200 NARRATOR: At 17, Dickens graduated from high school, 461 00:24:11,200 --> 00:24:15,770 taking night classes and summer school to finish early. 462 00:24:15,770 --> 00:24:17,070 Three years later, 463 00:24:17,070 --> 00:24:18,840 she was accepted to medical school 464 00:24:18,840 --> 00:24:20,200 at the University of Illinois, 465 00:24:20,200 --> 00:24:24,370 where she was the only Black woman in her class. 466 00:24:24,370 --> 00:24:25,700 GROSS: In medical school, 467 00:24:25,700 --> 00:24:28,770 students would taunt her, use slurs and gestures. 468 00:24:28,770 --> 00:24:31,570 And she said her strategy for avoiding them was always 469 00:24:31,570 --> 00:24:33,070 to sit in the front row of the class 470 00:24:33,070 --> 00:24:34,740 where she couldn't see them, 471 00:24:34,740 --> 00:24:36,340 and if anyone else wanted a good view, 472 00:24:36,340 --> 00:24:38,240 they had to sit next to her. 473 00:24:39,700 --> 00:24:41,740 NARRATOR: By June 1934, 474 00:24:41,740 --> 00:24:44,600 the medical school had a new graduating class. 475 00:24:46,270 --> 00:24:48,870 And there was Helen Dickens. 476 00:24:50,600 --> 00:24:53,440 COOPER OWENS: Helen Dickens was Black and a woman. 477 00:24:53,440 --> 00:24:55,600 And because she exists in one body 478 00:24:55,600 --> 00:24:57,670 with those intersecting identities, 479 00:24:57,670 --> 00:24:59,170 it was a challenge. 480 00:24:59,170 --> 00:25:02,000 And yet, here she rose to the top, 481 00:25:02,000 --> 00:25:03,600 to become an MD. 482 00:25:04,800 --> 00:25:06,840 NARRATOR: Now, age 26, 483 00:25:06,840 --> 00:25:10,540 Dickens had taken a job in North Philadelphia, 484 00:25:10,540 --> 00:25:12,000 working with a doctor 485 00:25:12,000 --> 00:25:14,540 who would change the course of her career. 486 00:25:14,540 --> 00:25:18,800 SHAKIR: Virginia Alexander, African-American woman physician 487 00:25:18,800 --> 00:25:21,200 who had something called the Aspiranto Health Home. 488 00:25:22,200 --> 00:25:24,270 This was similar to what we would now call 489 00:25:24,270 --> 00:25:26,540 a birthing home. 490 00:25:26,540 --> 00:25:29,470 DICKENS (archival): The patients came to us. 491 00:25:29,470 --> 00:25:33,170 She had two rooms in her house for patients 492 00:25:33,170 --> 00:25:36,000 and one little room where you delivered patients. 493 00:25:36,000 --> 00:25:37,900 Oh, it was different. 494 00:25:37,900 --> 00:25:41,170 The O.B. patients stayed in nine days. 495 00:25:42,970 --> 00:25:44,370 Most of them were poor. 496 00:25:44,370 --> 00:25:46,670 People weren't able to pay, 497 00:25:46,670 --> 00:25:49,100 they weren't expected to pay a lot. 498 00:25:50,170 --> 00:25:52,870 NARRATOR: Aspiranto was a world unto itself 499 00:25:52,870 --> 00:25:55,900 in a segregated society. 500 00:25:55,900 --> 00:25:59,240 COOPER OWENS: It's not as if Black people can just go 501 00:25:59,240 --> 00:26:00,600 to the county hospital. 502 00:26:00,600 --> 00:26:03,570 You have to go to the hospital for the Negro. 503 00:26:04,600 --> 00:26:06,570 And oftentimes they're underfunded, 504 00:26:06,570 --> 00:26:08,670 they're understaffed. 505 00:26:08,670 --> 00:26:11,840 The chief physicians tend to be white men, 506 00:26:11,840 --> 00:26:14,970 and there is a condescension that goes on, 507 00:26:14,970 --> 00:26:16,740 a kind of patronizing attitude. 508 00:26:18,440 --> 00:26:20,440 SHAKIR: So Dickens and Alexander 509 00:26:20,440 --> 00:26:22,540 really provides this alternative. 510 00:26:22,540 --> 00:26:28,100 Alexander helped Dickens to formulate a consciousness around 511 00:26:28,100 --> 00:26:30,840 how healthcare could be used as a site of activism. 512 00:26:32,840 --> 00:26:35,870 NARRATOR: Beyond the walls of the Aspiranto Health Home, 513 00:26:35,870 --> 00:26:40,270 Dr. Dickens was working more and more out in the community. 514 00:26:40,270 --> 00:26:41,870 DICKENS: Going in the middle of the night, 515 00:26:41,870 --> 00:26:44,070 and you were going into all kinds of communities. 516 00:26:44,070 --> 00:26:45,400 You were going into the homes, 517 00:26:45,400 --> 00:26:47,170 you were seeing all these people. 518 00:26:47,170 --> 00:26:51,940 You were taking responsibility for care of people. 519 00:26:53,170 --> 00:26:55,640 BROWN: The more she was in it with the women she came across, 520 00:26:55,640 --> 00:26:57,800 the more she knew about 521 00:26:57,800 --> 00:26:59,970 what their struggles and concerns were health-wise. 522 00:27:01,400 --> 00:27:04,300 NARRATOR: One of the things that Dickens saw again and again 523 00:27:04,300 --> 00:27:05,840 was cancer. 524 00:27:05,840 --> 00:27:08,840 Her patients were dying, 525 00:27:08,840 --> 00:27:10,740 and she now knew that the perception 526 00:27:10,740 --> 00:27:13,740 that Black people didn't get cancer was a lie. 527 00:27:14,970 --> 00:27:18,640 Dickens was determined to document cancer's deadly toll, 528 00:27:18,640 --> 00:27:23,300 and to tell Black women what they so urgently needed to know. 529 00:27:24,770 --> 00:27:27,600 (trolley bell ringing, car horn honking) 530 00:27:27,600 --> 00:27:30,940 (motorcycle revving) 531 00:27:30,940 --> 00:27:33,940 ♪ ♪ 532 00:27:35,740 --> 00:27:38,940 NARRATOR: Back in New York, in 1939, 533 00:27:38,940 --> 00:27:42,240 Dr. Papanicolaou had had 11 years to stew about 534 00:27:42,240 --> 00:27:44,240 the failure of his smear technique 535 00:27:44,240 --> 00:27:47,770 to pique the interest of the medical community. 536 00:27:47,770 --> 00:27:50,700 He'd moved on to other research, 537 00:27:50,700 --> 00:27:53,140 but he and Mary had always carried on 538 00:27:53,140 --> 00:27:55,400 with the daily smears. 539 00:27:55,400 --> 00:27:56,800 He stayed in the same lab. 540 00:27:56,800 --> 00:27:58,240 He stayed in similar work. 541 00:27:59,600 --> 00:28:02,640 He always had his wife next to him. 542 00:28:02,640 --> 00:28:05,240 That was probably incredibly comforting 543 00:28:05,240 --> 00:28:08,100 while he continued with his work. 544 00:28:12,040 --> 00:28:13,840 NARRATOR: There's a saying in science 545 00:28:13,840 --> 00:28:16,240 that luck comes to the prepared. 546 00:28:16,240 --> 00:28:19,470 Death, of course, comes for us all. 547 00:28:19,470 --> 00:28:23,900 Both came to the Cornell Medical College that April. 548 00:28:23,900 --> 00:28:27,370 Charles Stockard, Papanicolaou's boss, 549 00:28:27,370 --> 00:28:30,040 had died, age 60, 550 00:28:30,040 --> 00:28:34,070 and he was replaced by one Dr. Joseph Hinsey. 551 00:28:34,070 --> 00:28:35,740 KEAN: George's new boss, 552 00:28:35,740 --> 00:28:38,200 he understood how deadly cervical cancer was 553 00:28:38,200 --> 00:28:40,200 and he wanted to help women. 554 00:28:40,200 --> 00:28:43,470 Coincidentally, George had been rethinking his work, 555 00:28:43,470 --> 00:28:46,400 because before he was looking at tumors 556 00:28:46,400 --> 00:28:48,200 when they were already pretty advanced, 557 00:28:48,200 --> 00:28:49,940 and at that point, fairly deadly. 558 00:28:49,940 --> 00:28:51,600 But he started thinking, 559 00:28:51,600 --> 00:28:55,600 maybe we could look at cells on their way to becoming cancer. 560 00:28:58,300 --> 00:29:01,500 NARRATOR: If he was to try to detect cancers earlier, 561 00:29:01,500 --> 00:29:03,800 Papanicolaou needed new subjects. 562 00:29:03,800 --> 00:29:05,640 And by October, he had them. 563 00:29:07,000 --> 00:29:10,400 The top brass at New York Hospital had decreed 564 00:29:10,400 --> 00:29:13,070 that every woman admitted to the gynecological unit 565 00:29:13,070 --> 00:29:15,870 would now be required to have a smear. 566 00:29:19,270 --> 00:29:20,870 The results were better 567 00:29:20,870 --> 00:29:23,200 than even Dr. Pap could have expected. 568 00:29:25,170 --> 00:29:28,140 The smear was able to identify suspicious cells 569 00:29:28,140 --> 00:29:31,340 some ten years before they developed into cancer. 570 00:29:34,200 --> 00:29:36,570 GROSS: His research was already a game-changer, 571 00:29:36,570 --> 00:29:40,540 to be able to find cancer when there are no outward signs, 572 00:29:40,540 --> 00:29:41,700 but now, 573 00:29:41,700 --> 00:29:43,940 he also realizes that you can find cancer 574 00:29:43,940 --> 00:29:45,770 before it technically exists, 575 00:29:45,770 --> 00:29:48,570 so that really is unprecedented. 576 00:29:50,600 --> 00:29:52,970 NARRATOR: Remembering his disastrous slides 577 00:29:52,970 --> 00:29:54,670 at the Race Betterment Conference, 578 00:29:54,670 --> 00:29:57,370 this time, Papanicolaou was determined 579 00:29:57,370 --> 00:29:59,870 to launch the smear the right way. 580 00:29:59,870 --> 00:30:02,400 And he knew that to do so, 581 00:30:02,400 --> 00:30:04,700 he would need some help. 582 00:30:06,270 --> 00:30:09,340 ♪ ♪ 583 00:30:09,340 --> 00:30:12,640 NARRATOR: Scientific illustrator Hashime Murayama 584 00:30:12,640 --> 00:30:15,570 wasn't just down the hall anymore. 585 00:30:15,570 --> 00:30:16,970 Back in 1921, 586 00:30:16,970 --> 00:30:19,200 he'd been offered his dream job 587 00:30:19,200 --> 00:30:23,370 as a staff illustrator at the National Geographic Society, 588 00:30:23,370 --> 00:30:27,940 and had moved his family down to Washington, D.C. 589 00:30:27,940 --> 00:30:30,600 Murayama and his wife Nao had kept in touch 590 00:30:30,600 --> 00:30:32,670 with the Papanicolaous over the years. 591 00:30:34,670 --> 00:30:37,970 There'd been the usual pleasant exchange of Christmas cards, 592 00:30:37,970 --> 00:30:40,370 and family news. 593 00:30:41,740 --> 00:30:46,070 In January 1941, Murayama was retiring 594 00:30:46,070 --> 00:30:48,640 from a remarkable 20-year career 595 00:30:48,640 --> 00:30:50,840 during which his attention to detail 596 00:30:50,840 --> 00:30:56,170 had become as famous as his drawings of fish and fowl. 597 00:30:56,170 --> 00:30:59,670 ♪ ♪ 598 00:31:10,070 --> 00:31:12,440 HAZARD: The pictures are absolutely stunning. 599 00:31:13,440 --> 00:31:14,800 Colors are rich, 600 00:31:14,800 --> 00:31:17,100 the attention to detail is immaculate. 601 00:31:18,470 --> 00:31:21,770 KEAN: There were famous stories of him counting all the scales 602 00:31:21,770 --> 00:31:23,770 on the fish that he would draw, 603 00:31:23,770 --> 00:31:26,570 because he wanted to make sure he got things exactly right. 604 00:31:26,570 --> 00:31:28,640 He was a really nice combination of 605 00:31:28,640 --> 00:31:30,200 meticulous attention to detail, 606 00:31:30,200 --> 00:31:31,540 but also bringing things to life. 607 00:31:31,540 --> 00:31:33,300 ♪ ♪ 608 00:31:33,300 --> 00:31:35,470 NARRATOR: Murayama once explained that 609 00:31:35,470 --> 00:31:39,470 "Art is the expression of feeling without reason, 610 00:31:39,470 --> 00:31:43,840 "science the expression of reason without feeling. 611 00:31:43,840 --> 00:31:47,840 "Mine is the task of depicting scientific facts 612 00:31:47,840 --> 00:31:51,370 "so that they shall have both human and artistic interest." 613 00:31:52,740 --> 00:31:56,670 GROSS: Scientific illustrators are science communicators. 614 00:31:56,670 --> 00:31:59,600 There's a million tiny judgments about what to leave out 615 00:31:59,600 --> 00:32:01,870 and what to enhance and what will be 616 00:32:01,870 --> 00:32:05,100 the most useful, but also visually compelling, 617 00:32:05,100 --> 00:32:07,600 and what will get people's attention. 618 00:32:11,100 --> 00:32:13,470 NARRATOR: In New York, Dr. Pap and Mary 619 00:32:13,470 --> 00:32:15,040 were in the midst of putting together 620 00:32:15,040 --> 00:32:16,670 a definitive book 621 00:32:16,670 --> 00:32:19,800 about their revolutionary diagnostic tool. 622 00:32:19,800 --> 00:32:21,070 Knowing what a difference 623 00:32:21,070 --> 00:32:23,500 Murayama's illustrations could make, 624 00:32:23,500 --> 00:32:25,540 George wrote to his old friend, 625 00:32:25,540 --> 00:32:27,200 and by October 1, 626 00:32:27,200 --> 00:32:30,440 Murayama had taken on the massive project 627 00:32:30,440 --> 00:32:32,740 of illustrating the progression of cancer 628 00:32:32,740 --> 00:32:35,070 across cervical cells. 629 00:32:35,070 --> 00:32:37,040 GARDNER: So, when you're drawing 630 00:32:37,040 --> 00:32:39,340 these small little parts of the cell, 631 00:32:39,340 --> 00:32:41,970 he would spend an agonizing amount of time 632 00:32:41,970 --> 00:32:44,100 getting them correct. 633 00:32:44,100 --> 00:32:46,170 He used colors in a way 634 00:32:46,170 --> 00:32:48,970 that made differences in the cells 635 00:32:48,970 --> 00:32:50,900 much easier to identify-- 636 00:32:50,900 --> 00:32:53,740 they were very rich and they were very defined. 637 00:32:55,900 --> 00:32:58,400 NARRATOR: Murayama had been on the project for only two months 638 00:32:58,400 --> 00:33:00,340 when everything changed. 639 00:33:00,340 --> 00:33:03,840 (muffled horn blaring) 640 00:33:06,470 --> 00:33:09,040 ♪ ♪ 641 00:33:12,240 --> 00:33:15,640 Soon after the United States declared war on Japan, 642 00:33:15,640 --> 00:33:17,740 Murayama was arrested, 643 00:33:17,740 --> 00:33:20,600 his house back in D.C. ransacked. 644 00:33:22,640 --> 00:33:24,500 Murayama faced a lot of discrimination 645 00:33:24,500 --> 00:33:25,740 because of his ethnicity. 646 00:33:27,300 --> 00:33:29,300 At this time, there was widespread 647 00:33:29,300 --> 00:33:30,740 anti-Japanese hysteria. 648 00:33:30,740 --> 00:33:33,570 ♪ ♪ 649 00:33:35,040 --> 00:33:37,840 J. EDGAR HOOVER: We ask every citizen to immediately report 650 00:33:37,840 --> 00:33:41,700 any information regarding espionage, sabotage, 651 00:33:41,700 --> 00:33:43,300 or un-American activities 652 00:33:43,300 --> 00:33:45,800 to the Federal Bureau of Investigation. 653 00:33:45,800 --> 00:33:48,970 NARRATOR: On March 26, 1943, 654 00:33:48,970 --> 00:33:51,070 the Enemy Alien Hearing Board-- 655 00:33:51,070 --> 00:33:53,740 a citizen-led Department of Justice project 656 00:33:53,740 --> 00:33:56,740 that decided the fate of each Japanese, Italian, 657 00:33:56,740 --> 00:33:58,340 or German immigrant-- 658 00:33:58,340 --> 00:34:01,200 placed Murayama in an internment camp 659 00:34:01,200 --> 00:34:02,870 on Ellis Island. 660 00:34:04,900 --> 00:34:07,400 It was used as a detention camp 661 00:34:07,400 --> 00:34:09,040 for people who were like Murayama, 662 00:34:09,040 --> 00:34:10,240 who'd done nothing wrong 663 00:34:10,240 --> 00:34:12,170 besides being born in Japan. 664 00:34:13,240 --> 00:34:16,200 ♪ ♪ 665 00:34:16,200 --> 00:34:19,300 NARRATOR: Every professional acquaintance of Murayama's was interviewed, 666 00:34:19,300 --> 00:34:23,700 and asked to give a written statement about his loyalties. 667 00:34:26,070 --> 00:34:29,500 A file was prepared for Hoover and the FBI. 668 00:34:29,500 --> 00:34:31,700 The Murayama case, 669 00:34:31,700 --> 00:34:35,100 like so many tens of thousands of others, 670 00:34:35,100 --> 00:34:38,340 grew to include masses on masses of documents, 671 00:34:38,340 --> 00:34:41,870 a sea of paper chasing a crime that simply wasn't there. 672 00:34:44,070 --> 00:34:48,400 ♪ ♪ 673 00:34:48,400 --> 00:34:52,570 Papanicolaou tried to argue on his collaborator's behalf, 674 00:34:52,570 --> 00:34:55,300 writing to the board that "Murayama's work 675 00:34:55,300 --> 00:34:57,770 "could not well be duplicated by anyone 676 00:34:57,770 --> 00:34:59,240 not having his talent." 677 00:35:00,300 --> 00:35:02,170 In mid-June, 678 00:35:02,170 --> 00:35:04,440 in a letter three pages long, 679 00:35:04,440 --> 00:35:07,100 Murayama himself wrote: 680 00:35:07,100 --> 00:35:09,640 "I am 64 years old, 681 00:35:09,640 --> 00:35:13,400 "having lived here for more than a half of my life, 682 00:35:13,400 --> 00:35:16,570 "I have no intention to return to Japan. 683 00:35:16,570 --> 00:35:18,340 "I intend to remain here, 684 00:35:18,340 --> 00:35:21,170 "and to devote the remainder of my life 685 00:35:21,170 --> 00:35:23,340 "to the precious work which would contribute 686 00:35:23,340 --> 00:35:25,770 toward saving American women's lives." 687 00:35:29,270 --> 00:35:31,170 Then, on August 9, 688 00:35:31,170 --> 00:35:33,770 some four months after his arrest, 689 00:35:33,770 --> 00:35:35,840 something remarkable happened. 690 00:35:37,100 --> 00:35:40,470 KEAN: The attorney general of the United States, Francis Biddle, 691 00:35:40,470 --> 00:35:44,440 intervenes on behalf of Murayama. 692 00:35:44,440 --> 00:35:46,100 Biddle knows about the work 693 00:35:46,100 --> 00:35:49,140 that Papanicolaou is doing on cancer screening. 694 00:35:49,140 --> 00:35:52,470 And Biddle considers this of vital national importance. 695 00:35:53,900 --> 00:35:55,470 NARRATOR: As luck would have it, 696 00:35:55,470 --> 00:35:57,800 the man in the attorney general's office 697 00:35:57,800 --> 00:35:59,300 had long harbored doubts 698 00:35:59,300 --> 00:36:02,200 about the country's policy of internment. 699 00:36:02,200 --> 00:36:03,700 FRANCIS BIDDLE (archival): We must remember 700 00:36:03,700 --> 00:36:08,170 our grandparents or our great-grandparents 701 00:36:08,170 --> 00:36:11,500 all were aliens in their day. 702 00:36:12,500 --> 00:36:14,770 NARRATOR: But behind Biddle's decision, 703 00:36:14,770 --> 00:36:17,670 there was also proof of something else. 704 00:36:17,670 --> 00:36:21,070 HAZARD: The fact that Murayama was released from Ellis Island 705 00:36:21,070 --> 00:36:23,670 shows just how seriously the government 706 00:36:23,670 --> 00:36:26,200 took this threat of cervical cancer, 707 00:36:26,200 --> 00:36:30,100 and consequently, the value of George's research 708 00:36:30,100 --> 00:36:31,740 and Murayama's role in it. 709 00:36:33,370 --> 00:36:37,870 ♪ ♪ 710 00:36:50,340 --> 00:36:53,500 NARRATOR: As the Papanicolaous and the Murayamas 711 00:36:53,500 --> 00:36:55,840 celebrated his release that summer, 712 00:36:55,840 --> 00:36:57,870 the book that they had all been working on 713 00:36:57,870 --> 00:36:59,900 was finally published. 714 00:37:01,170 --> 00:37:03,300 It was the result of 715 00:37:03,300 --> 00:37:05,200 untold hours at the microscope. 716 00:37:05,200 --> 00:37:08,370 3,014 women had given the smears 717 00:37:08,370 --> 00:37:10,540 that made it all possible. 718 00:37:11,970 --> 00:37:13,870 But it was Murayama's illustrations 719 00:37:13,870 --> 00:37:16,000 that made it a sensation. 720 00:37:18,470 --> 00:37:21,640 HAZARD: Science really is nothing without our ability 721 00:37:21,640 --> 00:37:23,500 to communicate it to the rest of the world. 722 00:37:24,670 --> 00:37:30,040 To have accurate, powerful illustrations of those cells 723 00:37:30,040 --> 00:37:33,240 was completely fundamental to the success of George's work. 724 00:37:33,240 --> 00:37:35,640 ♪ ♪ 725 00:37:35,640 --> 00:37:38,040 GARDNER: What those visual images did 726 00:37:38,040 --> 00:37:41,840 is they allowed the public to imagine 727 00:37:41,840 --> 00:37:46,370 how you could categorize cancerous cells. 728 00:37:46,370 --> 00:37:48,870 If you have an epiphany at your desk 729 00:37:48,870 --> 00:37:50,370 and then you have no support for it, 730 00:37:50,370 --> 00:37:51,740 it's not going to go anywhere. 731 00:37:52,900 --> 00:37:55,600 So these moments of change and innovation, 732 00:37:55,600 --> 00:37:57,700 they're part of a network. 733 00:38:00,800 --> 00:38:03,570 ♪ ♪ 734 00:38:04,700 --> 00:38:06,970 (crowd cheering, horns honking) 735 00:38:06,970 --> 00:38:08,800 GROSS: There's this period right after World War II 736 00:38:08,800 --> 00:38:10,640 where there's a lot of 737 00:38:10,640 --> 00:38:12,240 faith in technology 738 00:38:12,240 --> 00:38:14,170 as the thing that helped us win the war. 739 00:38:14,170 --> 00:38:17,400 ♪ ♪ 740 00:38:17,400 --> 00:38:20,170 And it's now being applied to medicine. 741 00:38:21,970 --> 00:38:24,840 NARRATOR: Nowhere were the postwar changes more evident 742 00:38:24,840 --> 00:38:28,840 than at the American Society for the Control of Cancer. 743 00:38:28,840 --> 00:38:32,140 Newly renamed and fully rebranded, 744 00:38:32,140 --> 00:38:34,870 the American Cancer Society had become 745 00:38:34,870 --> 00:38:37,440 a completely different organization. 746 00:38:37,440 --> 00:38:38,900 Its transformation 747 00:38:38,900 --> 00:38:41,770 had been led by the will of one woman. 748 00:38:41,770 --> 00:38:44,770 MARY LASKER (archival): I have some pictures here by Cézanne, 749 00:38:44,770 --> 00:38:47,770 and Manet, and Renoir. 750 00:38:47,770 --> 00:38:49,670 Van Gogh. 751 00:38:49,670 --> 00:38:52,840 LERNER: Mary Lasker was a philanthropist, 752 00:38:52,840 --> 00:38:58,070 and she had a housekeeper who had died of cancer. 753 00:38:58,070 --> 00:39:00,140 She was surprised to learn 754 00:39:00,140 --> 00:39:02,900 how little was being done 755 00:39:02,900 --> 00:39:05,070 to prevent these cancers and treat these cancers. 756 00:39:05,070 --> 00:39:09,140 So Lasker made it her goal to modernize 757 00:39:09,140 --> 00:39:11,870 the American Society for the Control of Cancer, 758 00:39:11,870 --> 00:39:13,670 and that's what she did. 759 00:39:13,670 --> 00:39:14,970 LASKER (archival): The amount of money 760 00:39:14,970 --> 00:39:17,470 that's being spent for medical research is... 761 00:39:17,470 --> 00:39:18,800 well, it's just piddling. 762 00:39:18,800 --> 00:39:21,700 Less is spent on, on cancer research 763 00:39:21,700 --> 00:39:23,540 than we spend on chewing gum! 764 00:39:24,700 --> 00:39:28,500 NARRATOR: Lasker's new fundraising tactics soon paid off, 765 00:39:28,500 --> 00:39:30,800 and in no time, the society's annual budget 766 00:39:30,800 --> 00:39:34,500 had grown over a hundredfold. 767 00:39:34,500 --> 00:39:36,670 Now, what the ACS really needed 768 00:39:36,670 --> 00:39:38,840 was a big, ambitious project-- 769 00:39:38,840 --> 00:39:42,340 something to show the public that cancer was a disease 770 00:39:42,340 --> 00:39:44,100 that you could actually do something about. 771 00:39:46,070 --> 00:39:49,070 The Pap smear was the perfect tool for the job, 772 00:39:49,070 --> 00:39:50,900 but its roll out would introduce 773 00:39:50,900 --> 00:39:53,670 an entirely new set of challenges. 774 00:39:53,670 --> 00:39:56,470 PAPANICOLAOU (archival): A trained and skilled cytotechnician 775 00:39:56,470 --> 00:39:59,070 cannot examine more than 776 00:39:59,070 --> 00:40:01,070 12 specimens a day. 777 00:40:01,070 --> 00:40:02,740 That is about 60 a week 778 00:40:02,740 --> 00:40:04,670 or 3,000 a year. 779 00:40:04,670 --> 00:40:05,800 You can figure out how many 780 00:40:05,800 --> 00:40:08,140 technicians are needed 781 00:40:08,140 --> 00:40:10,600 to study the specimens 782 00:40:10,600 --> 00:40:12,000 from the population of the United States. 783 00:40:12,000 --> 00:40:15,470 ♪ ♪ 784 00:40:15,470 --> 00:40:20,700 NARRATOR: Recently, Papanicolaou's lab had become a teaching center, 785 00:40:20,700 --> 00:40:23,340 a place where the next generation of cytologists 786 00:40:23,340 --> 00:40:24,670 could be trained. 787 00:40:25,870 --> 00:40:28,670 At the heart of the classes and the instruction 788 00:40:28,670 --> 00:40:30,940 was, more often than not, 789 00:40:30,940 --> 00:40:32,470 Mary Pap herself. 790 00:40:34,240 --> 00:40:36,370 GARDNER: Every technician that came in there, 791 00:40:36,370 --> 00:40:38,000 she sat down and she worked with them 792 00:40:38,000 --> 00:40:40,270 in terms of how we stain the slides, 793 00:40:40,270 --> 00:40:43,000 how we identify the slides. 794 00:40:43,000 --> 00:40:45,200 NARRATOR: Mary would later explain 795 00:40:45,200 --> 00:40:48,670 that she believed that people are born scientists. 796 00:40:48,670 --> 00:40:52,570 She'd been the one who'd decided they wouldn't have children, 797 00:40:52,570 --> 00:40:55,940 so that they could keep working together, always. 798 00:40:57,040 --> 00:41:00,100 "There was no other option for me," she'd say, 799 00:41:00,100 --> 00:41:02,940 "but to follow him inside the lab, 800 00:41:02,940 --> 00:41:05,600 making his way of life mine." 801 00:41:06,640 --> 00:41:08,040 For 21 years, 802 00:41:08,040 --> 00:41:09,840 she'd had a smear every day. 803 00:41:09,840 --> 00:41:14,770 Some 7,665 smears in all. 804 00:41:15,870 --> 00:41:19,270 You can just imagine what that was like... 805 00:41:19,270 --> 00:41:20,300 or can you? I mean, 806 00:41:20,300 --> 00:41:21,500 none of us have submitted to 807 00:41:21,500 --> 00:41:23,140 such a kind of long-term 808 00:41:23,140 --> 00:41:26,500 invasive campaign of personal investigation. 809 00:41:27,970 --> 00:41:31,500 To involve your body, and your life, 810 00:41:31,500 --> 00:41:34,040 to that extent in your partner's work 811 00:41:34,040 --> 00:41:35,840 is really remarkable. 812 00:41:35,840 --> 00:41:38,340 And I think to describe her as an equal partner 813 00:41:38,340 --> 00:41:39,540 in George's work 814 00:41:39,540 --> 00:41:42,100 is almost even to do her a discredit, 815 00:41:42,100 --> 00:41:44,940 because she immersed herself in it, 816 00:41:44,940 --> 00:41:46,970 body and soul. 817 00:41:46,970 --> 00:41:50,970 NARRATOR: Mary Papanicolaou had made the smear possible. 818 00:41:50,970 --> 00:41:53,970 But there were limits to what even she could do. 819 00:41:55,840 --> 00:41:57,600 HAZARD: It would've been really challenging 820 00:41:57,600 --> 00:42:00,970 to win hearts and minds, especially in the '50s. 821 00:42:00,970 --> 00:42:03,000 You know, to be invited in for a screening program 822 00:42:03,000 --> 00:42:05,170 where you have to lift your dress and open your legs 823 00:42:05,170 --> 00:42:07,470 would not have been an easy sell. 824 00:42:09,170 --> 00:42:11,670 NARRATOR: As both George and Mary well knew, 825 00:42:11,670 --> 00:42:15,200 there were millions of women in America. 826 00:42:15,200 --> 00:42:18,170 Every single one of them needed to hear 827 00:42:18,170 --> 00:42:20,440 how the Pap could save their life. 828 00:42:22,040 --> 00:42:24,700 And for that, what was really needed 829 00:42:24,700 --> 00:42:26,440 were people on the ground. 830 00:42:28,470 --> 00:42:31,370 ♪ ♪ 831 00:42:31,370 --> 00:42:33,670 In Philadelphia, in 1948, 832 00:42:33,670 --> 00:42:36,600 Helen Dickens was busier than ever. 833 00:42:38,000 --> 00:42:40,940 SHAKIR: She would do workshops like "Cancer in Women," 834 00:42:40,940 --> 00:42:42,800 "Cancer in the Uterus." 835 00:42:42,800 --> 00:42:45,040 But also working specifically 836 00:42:45,040 --> 00:42:47,340 with these club women's groups in Philadelphia, 837 00:42:47,340 --> 00:42:49,100 like the Pyramid Club, 838 00:42:49,100 --> 00:42:53,170 the Junior Business and Professional League. 839 00:42:53,170 --> 00:42:56,200 But Dickens doesn't just work with those societies. 840 00:42:56,200 --> 00:43:01,040 She also would do workshops for hairdressers. 841 00:43:01,040 --> 00:43:03,340 People kept calling on her 842 00:43:03,340 --> 00:43:04,770 to speak here and there. 843 00:43:04,770 --> 00:43:07,140 The more she did, 844 00:43:07,140 --> 00:43:08,870 the more people heard about her. 845 00:43:08,870 --> 00:43:11,040 Word spread, quickly. 846 00:43:11,040 --> 00:43:15,700 NARRATOR: Now, Dr. Dickens was in a new position of power. 847 00:43:15,700 --> 00:43:17,570 After passing her boards 848 00:43:17,570 --> 00:43:22,000 to become the only Black female OB-GYN in all of Philadelphia, 849 00:43:22,000 --> 00:43:23,370 she'd taken a job 850 00:43:23,370 --> 00:43:27,170 as the head of the department at Mercy Hospital. 851 00:43:27,170 --> 00:43:30,500 BROWN: She didn't leave the office and come home. 852 00:43:30,500 --> 00:43:31,940 She didn't do that. 853 00:43:31,940 --> 00:43:33,900 There were phone calls at home. 854 00:43:33,900 --> 00:43:35,840 She called patients back. 855 00:43:35,840 --> 00:43:38,400 She was interested in their families. 856 00:43:38,400 --> 00:43:41,270 Many of them became friends. 857 00:43:41,270 --> 00:43:44,240 In retrospect, I get it. 858 00:43:44,240 --> 00:43:45,400 As a kid, I was like, 859 00:43:45,400 --> 00:43:48,440 "Oh my goodness." (laughs) 860 00:43:48,440 --> 00:43:50,870 She was gone. 861 00:43:50,870 --> 00:43:53,740 She was there for them. 862 00:43:53,740 --> 00:43:56,700 NARRATOR: Always on the lookout for any cutting-edge medical tool 863 00:43:56,700 --> 00:43:58,270 that could help her patients, 864 00:43:58,270 --> 00:44:01,970 when a publication about the smear came across her desk, 865 00:44:01,970 --> 00:44:05,440 Dickens saw its potential at once. 866 00:44:05,440 --> 00:44:10,670 BROWN: She did study what Dr. Papanicolaou was doing, 867 00:44:10,670 --> 00:44:12,940 and thought that if she could just spread that technique, 868 00:44:12,940 --> 00:44:14,970 it was lifesaving. 869 00:44:14,970 --> 00:44:17,800 But it was an uphill battle. 870 00:44:19,370 --> 00:44:21,440 ♪ ♪ 871 00:44:21,440 --> 00:44:23,770 NARRATOR: Since its very beginnings, 872 00:44:23,770 --> 00:44:27,170 the practice of gynecology in America had been tied to-- 873 00:44:27,170 --> 00:44:30,770 and made possible by-- the institution of slavery. 874 00:44:33,100 --> 00:44:35,640 Surgeons like James Marion Sims, 875 00:44:35,640 --> 00:44:38,270 the man behind the modern speculum, 876 00:44:38,270 --> 00:44:40,170 had developed the field 877 00:44:40,170 --> 00:44:42,970 without any ethical restraints whatsoever. 878 00:44:44,200 --> 00:44:47,440 COOPER OWENS: James Marion Sims founds the first hospital 879 00:44:47,440 --> 00:44:52,900 dedicated to women's conditions in the 1840s 880 00:44:52,900 --> 00:44:54,740 in Montgomery, Alabama. 881 00:44:54,740 --> 00:44:57,470 And it's essentially a hospital for enslaved women. 882 00:44:57,470 --> 00:45:01,000 ♪ ♪ 883 00:45:01,000 --> 00:45:02,100 They are experimented on 884 00:45:02,100 --> 00:45:04,140 for a number of years. 885 00:45:07,470 --> 00:45:09,770 one young woman, Anarcha, 886 00:45:09,770 --> 00:45:13,200 she was experimented on almost 30 times. 887 00:45:17,200 --> 00:45:19,100 Without anesthesia. 888 00:45:22,300 --> 00:45:24,870 NARRATOR: With the rise of the eugenics movement, 889 00:45:24,870 --> 00:45:28,470 certain doctors had advocated for-- and performed-- 890 00:45:28,470 --> 00:45:31,800 sterilizations on women of color. 891 00:45:31,800 --> 00:45:33,600 ♪ ♪ 892 00:45:33,600 --> 00:45:36,140 COOPER OWENS: It was considered "Mississippi appendectomy." 893 00:45:36,140 --> 00:45:38,140 Oftentimes, that's what the doctors 894 00:45:38,140 --> 00:45:39,640 would tell these patients. 895 00:45:39,640 --> 00:45:41,140 And they would go in, 896 00:45:41,140 --> 00:45:44,170 and perform hysterectomies on very young Black women. 897 00:45:46,540 --> 00:45:51,000 The long-term effect of those sterilization surgeries 898 00:45:51,000 --> 00:45:54,300 is that you have a community of people 899 00:45:54,300 --> 00:45:57,800 who do not trust doctors, 900 00:45:57,800 --> 00:46:00,370 particularly when it comes to reproduction. 901 00:46:01,540 --> 00:46:02,900 NARRATOR: For years, 902 00:46:02,900 --> 00:46:06,140 Dickens had worked to gain her patients' trust. 903 00:46:06,140 --> 00:46:09,370 And now, she was going to need it. 904 00:46:09,370 --> 00:46:11,200 SHAKIR: With the Pap smear, 905 00:46:11,200 --> 00:46:12,970 what she's really concerned about 906 00:46:12,970 --> 00:46:14,800 educating the public about, 907 00:46:14,800 --> 00:46:17,900 "This is not a form of sterilization, 908 00:46:17,900 --> 00:46:19,800 but it in fact will help to prevent you 909 00:46:19,800 --> 00:46:21,070 from getting cancer." 910 00:46:22,240 --> 00:46:25,700 COOPER OWENS: She understands some of the trepidation, 911 00:46:25,700 --> 00:46:27,740 and she's saying, "Look, I'm a product of this, 912 00:46:27,740 --> 00:46:30,300 and I'm telling you that you can trust me." 913 00:46:31,300 --> 00:46:33,040 NARRATOR: In 1953, 914 00:46:33,040 --> 00:46:34,500 a new cancer center opened 915 00:46:34,500 --> 00:46:37,240 under Dickens' direction at Mercy Hospital. 916 00:46:38,270 --> 00:46:39,940 It would finally document 917 00:46:39,940 --> 00:46:41,900 the instances of reproductive cancer 918 00:46:41,900 --> 00:46:44,540 in the Black community. 919 00:46:44,540 --> 00:46:46,700 As Dickens would argue, 920 00:46:46,700 --> 00:46:50,300 "No woman need die from cervical cancer." 921 00:46:50,300 --> 00:46:52,800 But it remained an open question. 922 00:46:52,800 --> 00:46:56,140 When those clinics opened, would women go? 923 00:46:57,370 --> 00:46:59,970 (indistinct chatter) 924 00:47:05,200 --> 00:47:08,040 HAZARD: The first wide-scale screening program 925 00:47:08,040 --> 00:47:11,800 that involved the Pap smear took place in Tennessee. 926 00:47:13,000 --> 00:47:14,740 KEAN: A lot of this work was done at clinics, 927 00:47:14,740 --> 00:47:16,140 but they also used 928 00:47:16,140 --> 00:47:19,640 what they called Pap stations that would pop up-- 929 00:47:19,640 --> 00:47:21,640 small, mobile clinics 930 00:47:21,640 --> 00:47:24,370 at schools, businesses. 931 00:47:24,370 --> 00:47:28,940 NARRATOR: It was called the Memphis Cancer Survey Project. 932 00:47:28,940 --> 00:47:34,340 Over five years, from 1952 to 1957, 933 00:47:34,340 --> 00:47:37,670 it would enroll hundreds of thousands of women, 934 00:47:37,670 --> 00:47:41,670 and become the first real-world test of the Pap smear. 935 00:47:43,770 --> 00:47:46,500 ♪ ♪ 936 00:47:46,500 --> 00:47:48,500 Meanwhile, across the country, 937 00:47:48,500 --> 00:47:52,700 the American Cancer Society was funding the training 938 00:47:52,700 --> 00:47:55,700 of an entirely new labor force. 939 00:47:55,700 --> 00:47:57,900 And it was an army of women. 940 00:48:04,070 --> 00:48:05,470 HAZARD: There's a story about how 941 00:48:05,470 --> 00:48:07,740 these women were looking at these cell samples, 942 00:48:07,740 --> 00:48:10,700 and on the wall they had Murayama's paintings. 943 00:48:12,170 --> 00:48:14,140 ♪ ♪ 944 00:48:14,140 --> 00:48:16,240 And so if they were looking at a slide and, 945 00:48:16,240 --> 00:48:18,500 "Oh, I'm not quite sure. Does that look normal?" 946 00:48:18,500 --> 00:48:20,840 they could look at this amazing reference point 947 00:48:20,840 --> 00:48:22,200 and go, "Oh, yeah. Okay. 948 00:48:22,200 --> 00:48:23,800 "That's what I should be looking for. 949 00:48:23,800 --> 00:48:25,940 This is cancer," or "This isn't cancer." 950 00:48:27,800 --> 00:48:30,670 NARRATOR: Hashime Murayama, by this time, 951 00:48:30,670 --> 00:48:33,640 was well and truly retired. 952 00:48:33,640 --> 00:48:35,340 But there was no question that 953 00:48:35,340 --> 00:48:36,840 he'd delivered on his promise. 954 00:48:38,200 --> 00:48:40,340 He'd devoted his considerable skill 955 00:48:40,340 --> 00:48:43,470 to helping save American women's lives. 956 00:48:45,840 --> 00:48:48,970 ♪ ♪ 957 00:48:48,970 --> 00:48:53,270 GROSS: Mass trials in Tennessee reveal that this test 958 00:48:53,270 --> 00:48:58,070 is 98% or more effective at detecting cancer. 959 00:48:58,070 --> 00:48:59,800 And that's really 960 00:48:59,800 --> 00:49:01,900 the kind of confirmation that you need 961 00:49:01,900 --> 00:49:03,740 to start spreading this as a medical tool. 962 00:49:04,940 --> 00:49:06,600 NARRATOR: In Philadelphia, 963 00:49:06,600 --> 00:49:09,340 Dr. Helen Dickens was leading the charge. 964 00:49:09,340 --> 00:49:11,640 She'd gone out and taught the technique 965 00:49:11,640 --> 00:49:14,740 to as many other Black doctors as possible, 966 00:49:14,740 --> 00:49:17,670 and soon had grown her army of one 967 00:49:17,670 --> 00:49:19,940 into a force more than 200 strong. 968 00:49:21,100 --> 00:49:24,000 DICKENS (archival): You took a van and went out 969 00:49:24,000 --> 00:49:25,840 to the churches in various places, 970 00:49:25,840 --> 00:49:28,440 and invited women in 971 00:49:28,440 --> 00:49:31,570 to have a Pap smear done. 972 00:49:31,570 --> 00:49:33,300 She really made it her mission 973 00:49:33,300 --> 00:49:36,400 to use any means available to her 974 00:49:36,400 --> 00:49:37,640 to get the word out. 975 00:49:37,640 --> 00:49:39,870 She would recommend that families 976 00:49:39,870 --> 00:49:41,300 appoint a female representative 977 00:49:41,300 --> 00:49:43,000 who made sure every woman in the family 978 00:49:43,000 --> 00:49:44,300 got their Pap smear. 979 00:49:46,300 --> 00:49:47,840 NARRATOR: In the end, 980 00:49:47,840 --> 00:49:52,000 Dr. Dickens had simply refused to wait for people to come. 981 00:49:52,000 --> 00:49:54,370 She'd gone to them. 982 00:49:54,370 --> 00:49:57,500 SHAKIR: She's always thinking of herself as a worker, 983 00:49:57,500 --> 00:50:00,740 and for her, work means the liberation of Black people 984 00:50:00,740 --> 00:50:02,270 through medical activism. 985 00:50:02,270 --> 00:50:07,800 BROWN: Her legacy is the gift she gave of healthcare 986 00:50:07,800 --> 00:50:10,400 to every woman who came, you know, 987 00:50:10,400 --> 00:50:11,600 within ten feet of her. 988 00:50:12,940 --> 00:50:14,800 DICKENS (archival): The care of women, the dealing with women. 989 00:50:14,800 --> 00:50:16,740 That was the specialty I liked. 990 00:50:19,070 --> 00:50:23,740 NARRATOR: By 1958, the Pap smear was triumphant, 991 00:50:23,740 --> 00:50:27,870 and both George and Mary were invited to the White House, 992 00:50:27,870 --> 00:50:30,000 where they dined with Eisenhower 993 00:50:30,000 --> 00:50:32,500 and the queen of Greece. 994 00:50:32,500 --> 00:50:37,200 Their simple test for cancer had long since left the lab 995 00:50:37,200 --> 00:50:40,770 to become a vital part of women's lives. 996 00:50:41,800 --> 00:50:44,900 LERNER: The Pap test helped de-stigmatize cancer. 997 00:50:44,900 --> 00:50:46,840 By the late 1960s, 998 00:50:46,840 --> 00:50:49,140 you could go to the public and say, 999 00:50:49,140 --> 00:50:51,240 "Go get this test at your doctor. 1000 00:50:51,240 --> 00:50:52,840 "Sure, we might find cancer, 1001 00:50:52,840 --> 00:50:54,200 but we have something to do about it." 1002 00:50:54,200 --> 00:50:55,870 "Let's get cancer out of the closet. 1003 00:50:55,870 --> 00:50:58,940 Let's make this a disease that everybody can talk about." 1004 00:50:58,940 --> 00:51:00,170 WOMAN: I have an appointment 1005 00:51:00,170 --> 00:51:02,340 that I make once a year for my checkup. 1006 00:51:02,340 --> 00:51:04,870 Of course I go for a Pap test, every lady should. 1007 00:51:04,870 --> 00:51:08,040 My daughter went for a Pap test and she's fine. 1008 00:51:08,040 --> 00:51:12,370 COOPER OWENS: The ways that this medical discovery 1009 00:51:12,370 --> 00:51:16,500 literally changed the globe is incredible. 1010 00:51:16,500 --> 00:51:20,700 The Pap smear educated people about medicine, 1011 00:51:20,700 --> 00:51:22,540 and preventative healthcare. 1012 00:51:22,540 --> 00:51:23,640 And more importantly, 1013 00:51:23,640 --> 00:51:25,640 it saved people's lives. 1014 00:51:25,640 --> 00:51:28,400 HAZARD: The Pap smear changed the landscape 1015 00:51:28,400 --> 00:51:30,870 for cancer, for its detection, 1016 00:51:30,870 --> 00:51:32,870 its diagnosis, management, and treatment. 1017 00:51:32,870 --> 00:51:34,340 Suddenly we could envision a time 1018 00:51:34,340 --> 00:51:36,470 when we could screen healthy people, 1019 00:51:36,470 --> 00:51:39,840 and we could all be thriving in a new and quite exciting way.