NOEL KING, HOST:
Puerto Rico has had a hard couple of years. It's still recovering from Hurricane Maria. The governor recently stepped down after popular protests, and the territory has huge amounts of debt. Puerto Rico is an unincorporated territory of the United States. It has been since 1898. And its recent difficulties have raised a really old question, one that's been asked for years. What should the relationship between Puerto Rico and the United States mainland be? How connected should they be? NPR's history podcast Throughline took a look at the U.S.-Puerto Rico relationship in a recent episode. And I'm here now with one of the show's hosts, Ramtin Arablouei. Hey, Ramtin.
RAMTIN ARABLOUEI, BYLINE: Hi, Noel.
KING: So this relationship, in short, between the U.S. and PR is super complicated. Why? What happened?
ARABLOUEI: Yeah. It's a story that most Americans don't know because it wasn't really reported much here at the time, but it's a story that looms large for many Puerto Ricans. It even galvanized Puerto Rico's Nationalist movement to push for independence from the U.S. And the story starts with another hurricane.
KING: When was this?
ARABLOUEI: 1928. Hurricane San Felipe was the name of the hurricane, and the storm killed hundreds, left hundreds of thousands homeless and devastated their economy. And it coincided with a big public health crisis. In the early 1930s, the Rockefeller Foundation stepped in and sent a bunch of doctors to Puerto Rico. One of those doctors was a man named Cornelius Packard Rhoads.
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DANIEL IMMERWAHR: Yeah. Cornelius Packard Rhoads - Dusty to his friends, Dusty Rhoads, you know. And there'd been doctors who'd come down from the mainland to Puerto Rico before, and they'd behaved like doctors, right? You know, they made sure to preserve the health of the patients above all else. Cornelius Packard Rhoads took a different tack.
RUND ABDELFATAH: This is Daniel Immerwahr. He's the author of...
IMMERWAHR: "How To Hide An Empire: A History Of The Greater United States."
LAURA BRIGGS: And he's a colorful character who people either like or don't like.
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BRIGGS: And somebody strips his car. He's furious.
ARABLOUEI: That's Laura Briggs. She's a professor at the University of Massachusetts.
IMMERWAHR: And then he wrote a letter. He sat down, and he wrote one of the most extraordinary letters in U.S. history - at least that I have read as a historian.
BRIGGS: He writes this letter to a friend saying, so I have this opportunity to get an appointment here, which would be a very good opportunity for me.
IMMERWAHR: (Reading) And I'm tempted to take it. It would be ideal except for the Puerto Ricans. They are beyond doubt the dirtiest, laziest, most degenerate and feverish race of men ever inhabiting this sphere. It makes you sick to inhabit the same island with them. They are even lower than Italians. What this island needs is not public health work but a tidal wave or something to totally exterminate the population. It might then be livable. I've done my best to further the process of extermination by killing off eight and transplanting cancer into several more. The latter has not resulted in any fatalities so far. The matter of consideration for the patients' welfare plays no role here. In fact, all physicians take delight in the abuse and torture of the unfortunate subjects. Do let me know if you hear any more news. Sincerely, Dusty.
ABDELFATAH: Cornelius Rhoads finishes writing and walks away.
IMMERWAHR: And he left the letter out, and the Puerto Rican staff of the hospital found it, and they were horrified.
ABDELFATAH: He finds out that a lab tech has the letter.
IMMERWAHR: He tried to get the letter back.
IMMERWAHR: He couldn't do it. They wouldn't let him have it.
ABDELFATAH: Soon after...
BRIGGS: He sends a letter saying he's gone home. He has a health crisis. He has to see his uncle and he has to run home.
ARABLOUEI: Cornelius P. Rhoads never steps foot in Puerto Rico again, but his letter makes its way into all the Puerto Rican newspapers, and Puerto Ricans are...
BRIGGS: Completely freaked out. What does this mean? What are Rockefeller doctors doing?
IMMERWAHR: So the governor, the appointed governor - the mainland appointed governor, even he deems this a confession of murder, and there is an investigation.
BRIGGS: The Rockefeller Foundation sends its people down, and the Puerto Rican medical establishment also tries to figure out what happened.
ARABLOUEI: Here's what they find.
IMMERWAHR: He refused treatment in some of his patients to see what would happen. He also sought to induce disease in other of his patients, and he referred to those patients to his colleagues as experimental animals.
ABDELFATAH: Nonetheless, the investigation can't find evidence of murder, and in the few cases where there's news coverage in the mainland American media, it doesn't exactly make waves.
BRIGGS: The U.S. press kept reporting that this was just a joke letter.
ABDELFATAH: Maybe you're wondering, what happened to Cornelius Rhoads in the following years?
BRIGGS: Absolutely nothing. It's an excellent example of how little Puerto Rico mattered in the U.S. national imaginary.
IMMERWAHR: He goes back to New York - what happens in San Juan stays in San Juan - confesses to having murdered eight people and doesn't lose his job. And he continues to work his way up in status in the medical establishment, and he becomes one doctor among others who realizes that mustard agents might actually be used to fight cancer. And he becomes also simultaneously the first head of the Sloan Kettering Institute, and he used his position to test chemical after chemical on a whole hospital full of patients who were dying of cancer. And he becomes, in doing this, one of the pioneers of chemotherapy. He's on the cover of Time magazine, "Cornelius Rhoads, Cancer Fighter." And the American Association for Cancer Research, for more than 20 years, gives a prestigious award out called the Cornelius Rhoads Award to promising young cancer researchers. That goes on for more than 20 years. Cornelius Rhoads' hope that he could just get away with it, that's true. He does get away with it.
BRIGGS: I think if you stopped 10 people on the street in Puerto Rico today, you would find that probably half of them know about Cornelius Rhoads. People remember him as an agent of U.S. colonialism and as possibly a murderer - a never-disproved murder - who acted on behalf of the Rockefeller Foundation and implicitly the U.S. state.
KING: That is an incredible story. So in Puerto Rico, this guy is remembered as possibly a murderer. And here in the United States, he's a medical hero.
ARABLOUEI: Right. In Puerto Rico, Rhoads' letter became evidence in the argument that the U.S. was only interested in treating Puerto Rico as a colony. And that distrust and the mainland's forgetting feed the relationship between the U.S. and Puerto Rico to this day.
KING: Ramtin Arablouei from NPR's Througline podcast, thanks so much for telling us this story.
ARABLOUEI: Thanks for having me.
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