Lombardo Finds Relevancy in the Echoes of History

Matlock, the plain-spoken lawyer played by Andy Griffith on the eponymous TV show, worked out of the Flatiron Building on Peachtree Street. Depending on whom you talk to, he was based on noted north Georgia attorney Bobby Lee Cook. But the legacy Cook has created in downtown Atlanta is far from fictitious.

Created in 2006, the Bobby Lee Cook Endowed Professorship has brought one of the world’s foremost minds on health and legal issues to the Georgia State University College of Law.

Paul A. Lombardo has served on a presidential bioethics commission and the faculties of both the law school and medical school at the University of Virginia, and he’s done exhaustive historical research into discredited medical practices such as eugenics and forced sterilization. That work has guided both state and federal governments in their responses to these controversies. At Georgia State, he’s helping to grow the Center for Law, Health & Society into one of the nation’s foremost resources for insight into the complicated interplay between the law and health care — and sharing that insight with new generations of legal minds.

Lombardo says he’s grateful both for the Cook Professorship and “the opportunity to get in on the ground floor of the health law center. It had been established when I came, but it wasn’t fully populated yet. In the last few years, it’s been filled with people from various disciplines in law that relate to health and medicine. So the attraction to Georgia State, for me, was to be a part of a growing center in a really hot area of law — and one I’d worked in for 20 years.”

Echoes of History

Lombardo readily admits that people tend to take a step back when he tells them much of his scholarly work is tied to eugenics, a practice most people associate with Adolf Hitler and the Third Reich. “I have a shelf in my office that’s six feet high and it’s full of old books about eugenics,” Lombardo says. “I used to have a little note on it, kind of as a joke — it said, ‘If I die, tell them that I didn’t believe this stuff.’ You’d go through those books and you’d think, ‘That guy’s really weird.’”

Lombardo’s interest in eugenics, though, is that of a historian, not legal practictioner. And the uncomfortable truth he’s discovered in his historical research is that for many years, mainstream American medicine included practices shockingly similar to those Hitler hoped to use to create a “master race.”

“We associate eugenics with the Nazis, and that’s accurate,” Lombardo explains, “but we should also remember that in this country, for 50 years, we had laws that allowed for immigration exclusion based on eugenics, racial separation based on eugenics, forced sterilization based on eugenics, even laws about who you could or couldn’t marry. So this was a part of our policy for most of the 20th century. The reason for that is not because we were all Nazis, but because there was a base of understanding in the early 20th century that said eugenics was the key to a hopeful future in which you could eliminate conditions like crime and poverty and disease.”

As well-intentioned as some of the American eugenicists might have been, though, their practices paved the way for acts that today provoke outrage. In Virginia, for example, thousands of mentally ill or impaired people were sterilized without consent at state asylums; when the General Assembly formally apologized for Virginia’s role in the eugenics movement in 2001, Lombardo helped write the bill. In 2007 he played the same role in Georgia’s eugenics apology. He also served as a historical consultant for “The Lynchburg Story,” a 1993 Discovery Channel documentary, and for “Nuovomondo,” an award-winning 2006 feature film that explored the impact of eugenic screening on immigrants arriving at Ellis Island. He’s recently been acknowledged by prize-winning author Laura Hildenbrand for helping her understand eugenic history in preparation for her best-selling book Unbroken, upon which Angelina Jolie’s Oscar-nominated 2014 film was based.

“Eugenics was bizarre, and it is something people draw back from, but we don’t have the luxury of ignoring it,” he says. “It’s too much a part of our own national fabric.”

Where the Patient, the Doctor and the State Collide

Lombardo’s scholarship is more than mere curiosity, though. Issues such as eugenics and coercive medicine, he says, inform hot-button issues that are being debated at various levels of government as we speak.

“It’s relevant to the same types of things that are going on today, where people want to be free to accept or refuse treatment and, in many ways, want to draw boundaries around what states can do to them,” he says. “It’s not a good guys/bad guys thing; it comes up when there’s a crisis, like when people contract a contagious disease — what do we do with them? People say, ‘Leave us alone,’ while the politicians say, ‘Well, we can’t just leave you alone, that’s not an option.’ There are personal expectations and personal values having to do with bodily integrity, there’s the state’s need to maintain order, and there’s the medical profession’s need to have appropriate input into the practices that will allow the state to do its job most effectively.”

The struggle between those forces continues to play out today, in everything from the debate over the 2010 Patient Protection and Affordable Care Act to the government’s response to epidemics such as AIDS and Ebola. The struggle naturally attracts controversy — sometimes in unexpected ways. In his capacity as a senior advisor to the Presidential Commission for the Study of Bioethical Issues, for example, Lombardo helped unearth extensive evidence that then Surgeon General Thomas Parran Jr. endorsed experiments in the late 1940s in which U.S. doctors infected hundreds of Guatemalans with syphilis without their knowledge.

“When you’re doing research in medicine and you find material from the past that casts institutions or individuals in a bad light, people get very upset,” Lombardo says. “They say you’re just digging up dirt from the past that they don’t want to talk about. You’re taking heroes off their pedestals.”

But Lombardo continues to see great value and relevance in “discovering material that was historically hidden, writing about that in a scholarly sense, cooperating with people in the world of media and journalism to make the stories known to a broader public, and then participating in a conversation with legislators to ask, ‘How should we remember this unpleasant history? How should we keep it from being buried again, and how should it inform the way we treat patients now?’ It’s about shedding a little bit of light on our past so that we can at least have our eyes open as we go forward.”

‘Superstars’ at Georgia State

As complex as Lombardo’s scholarly interests may be, he says he’s fortunate to be surrounded by like-minded individuals at the College of Law’s Center for Law, Health & Society. “To be here, to have great students and colleagues around me who are interested in the same issues I am, is as good as it gets,” he says. “Beyond Atlanta, the Cook Professorship is a scholar’s ticket to the world, and it’s allowed me to do the kinds of things I’ve always wanted to do.”

That includes exhibiting Georgia State’s collected expertise at conferences and presentations as far away as New York or Karachi, Moscow or Rome. And not only has Lombardo been able to expand the university’s reputation around the globe, his position has enabled him to bring knowledge and expertise back for the benefit of Georgia State students and faculty.

Of all the many facets to his job — research, teaching, writing, presenting — Lombardo says one of the most rewarding is serving “not just as a teacher of students but also as a mentor to younger legal scholars.” He’s been grateful for the opportunity to help to attract new minds to Georgia State and watch their energy and ideas continue the school’s development into a globally respected knowledge resource.

“One of the most exciting things for me is helping to recruit people of a younger generation here, then take a role in supporting their careers,” he says. “Long after guys like me are gone, there will be superstars at this school for sure.”