14 Feb The Mothers of Gynecology

I’m grateful to the writer J.C. Hallman for the details below, from his excellent article in The Forum, a publication of the African American Policy Forum, founded by Kimberlé Crenshaw.

I’ve written on this subject before, but never in the following detail. It’s the story of women hideously victimized by the so-called “father of gynecology,” J. Marion Sims. As Hallman writes, Sims enjoyed an unquestioned “reputation as a pathbreaking researcher and experimenter in American medicine. His actual career–built on gruesome experimental surgeries performed on enslaved women, without anesthesia–was doubly insulated from serious public scrutiny. First, he benefited from a culture of impunity that dehumanized Black women on grounds of both sex and race. Then, as a pivotal figure in the professionalization of American medicine, he claimed uncontested patriarchal authority to abridge the Hippocratic canons of western medicine in the service of a “scientific” inquiry that would eventually enable routine medical atrocities. This meant that his medical reputation was near unassailable–until very recently.”

After the infamous 2017 Unite the Right March of white nationalists in Charlottesville Va., protesters and counter-protesters feuded over a statue of Robert E. Lee. A week later, four women in East Harlem put on bloody hospital gowns for a picture taken in front of a statue of Sims that had stood in New York for 130 years. The image went viral. The Sims monument was removed eight months later, even before the Lee statue was finally taken down. Although Sims had many critics in his own lifetime, by the early 20th century a campaign of sanctifying him via laudatory articles by doctors from all over the country had silenced them. This makeover paralleled the rise of apartheid Jim Crow regimes in the American South.

Sims had opened Women’s Hospital in New York in 1855, with the express purpose of founding a larger version of his backyard “Negro Hospital” in Alabama. He wanted to monetize his procedure for the cure of “vesicovaginal fistula,” which he had performed in years of experiments on Black women in downtown Montgomery. The new hospital in the North would create a venue for additional experiments, including those to be conducted on Irish immigrant women who, though not enslaved, were another vulnerable population, having recently fled Ireland’s great famine on “coffin ships.” Sims ran the new hospital for six years, left for Europe during the Civil War, returned in 1868, and didn’t perform surgery again at Women’s Hospital until 1872.

A lot had changed, and Sims was highly displeased. Prior to the Civil War, the Women’s Hospital “board of lady managers” had remained a mostly ceremonial board, easily manipulated by Sims. But now some of the “ladies,” emboldened by battlefield medical experiences, became more assertive. They initiated an investigation into growing mortality rates at the hospital, and enforced rules about the number of visitors invited to observe vaginal surgeries. Sims’ second tenure at Women’s Hospital lasted two years, ending with a confrontation at an organizational gala in 1874. It was a study of mortality rates that got him ejected from his own hospital: the lady managers had concluded he was killing too many women.

Still, his expulsion became a national scandal, because he was by then world famous. The American Medical Association (AMA) catapulted him to the presidency, in an election that even his worshipful biographers were forced to acknowledge amounted to the male medical establishment’s disparagement of the female managers at Women’s Hospital. Sims gave speeches against medical ethics, which he described as “an engine of torture” victimizing innovative physicians. He built his reputation in the service of fame, wealth, and the erection of more Sims statues in Alabama and South Carolina.

The first stirrings of reappraisal began in the late 1960s, with dissertations becoming books by such scholars as G. Jay Barker-Benfield and Deborah Kuhn McGregor, who took aim at the matricide committed by these newly named gynecologists who, all male, had ejected women from the practice of midwifery. Then, in 2007, Harriet Washington’s award-winning book Medical Apartheid documented a long history of medical experiments on African Americans. People finally noticed. In East Harlem, a woman named Viola Plummer, inspired by the book, began handing out flyers questioning the presence of a statue that had gone unnoticed for decades on the outer wall of Central Park. A group called East Harlem Preservation took up the cause, and soon was joined by community organizations calling for removal of the monument. Women marched up Fifth Avenue chanting Say her name Anarcha say her name Betsy say her name Lucy!—references to Sims’ earliest experimental subjects. New York’s initial response was to delay, spread lies, and chuckle. Activists forced a public meeting, to which Harriet Washington was noticeably not invited. Years of stalemate ensued.

Hallman began researching Sims in 2015, setting out to find hard evidence of the existence and later life of Anarcha–the most consequential of Sims’ experimental victims–and he was eventually, intrepidly able to recreate most of her life story, using primary source documents to track her movement from the Montgomery plantation where she was born to the lonely forest in Virginia where she’s buried. (Hallman, author of six books and a Knight Fellowship and Guggenheim recipient, will publish his new book, Anarcha, with Holt in 2023.) The toxic nature of the Sims story became apparent, he writes, as soon as Hillman began his research: the New York Academy of Medicine, among other organizations, indulged in a cover-up about Sims’ 1857 prestigious annual address, and in 1870, he was tried and convicted by the Academy’s special committee on ethical violations. Nonetheless, after he died, the Academy played a role in the erection of his statue.

The stalemate persisted until 2017, when Confederate monuments began to fall across the South. Hallman’s work revealed that Sims had acted as a spy in Paris on behalf of the Confederacy during the Civil War, but by then such damning information was no longer needed to convict him in the court of public opinion. Mayor Bill de Blasio created a special commission to reconsider the city’s policy on public art of all kinds. With the 2018 de-installation of the Sims monument, New York took an unprecedented step in metropolitan history: a statue could now be removed because of public concerns over the person or the values it represented.

This left the country’s elite medical institutions in quite a quandry. Sims had served terms as president of the AMA and the American Gynecological Association, and had been a founder and officer of the Medical Association of the state of Alabama. Less than a month after the removal of the Sims monument in New York, the Medical Association of the state of Alabama issued a half- hearted, sorry-not-sorry statement on Sims. This foot dragging proceduralism is characteristic of the efforts of high profile institutions to dodge accountability in owning up to an ugly racial past. It should be clear in these controversies over monuments that they represent values, not history.

In the medical world, the learning curve on these issues remains frighteningly steep. In 2021 the American Medical Association became embroiled in scandal when its official publication, the journal of the AMA, JAMA, released a podcast and supporting tweet suggesting that structural racism was impossible in healthcare, at precisely the same moment another wing of the AMA was preparing to release a three-year strategic plan to address racial justice and advance HealthEquity. In 2020 the American Gynecological Society published its own factually challenged statement claiming that Sims’ experiments had led to “successful treatment of vesicovaginal fistula.” This ignores multiple fistula cures that predated Sims, and skirts the specifics of his method, which was challenged and abandoned only four years after he published it.

More to the point, the American College of Obstetricians and Gynecologists in 2021 followed with a substantive suggestion to rectify the ugly legacies of Sims, and proposed that the dates of February 28th to March 1st be dedicated to Anarcha, Lucy, and Betsy, and state measures endorsing Anarcha, Lucy, and Betsy Days have since passed in Connecticut and Alabama.

Among the efforts to honor them has been Michelle Browder’s “Mothers of Gynecology Monument” erected in Montgomery in September 2021, and this year Browders’ More Up campus will host an “inaugural day of reckoning conference” on Anarcha, Lucy, and Betsy Days.

Long, long past due.