The Dark Knife ... Surgeon, Researcher, Or Racial Sadist?

Throughout history, official memory has often edged out narratives that tend to tarnish the reputations of people and events that society holds dear. Monuments usually commemorate only good or heroic deeds.

In the case of James Marion Sims, the putative “Father of Gynecology,” the widespread usefulness of his contributions to medicine has overshadowed the ethically-questionable means he used to achieve his success. A monument to him in South Carolina reads: “He founded the science of gynecology, was honored in all lands, and died with the benediction of mankind.”

This is one version of his story. But there is another, which no monument tells.

J. Marion Sims (1813-83) is perhaps the most famous American surgeon of the 19th century. Born in South Carolina, he was a pioneer in the field of women’s health and the first physician in the United States to have a statue erected in his honor (there are now three of him, one each in his home state of South Carolina, New York, and Alabama, which also added him to its Hall of Fame). He founded the nation’s first women’s hospital in New York City. After pioneering vaginal surgery, Sims went on to other accomplishments, such as the first gall bladder surgery and the introduction of antisepsis in the operating room. He treated an empress and a duchess in Europe. At various times in his life, he was president of the American Medical Association, the International Medical Congress, and the American Gynecological Society.

Sims was a man of many accomplishments. But he made a name for himself by discovering the method for fixing vesicovaginal fistulas — a grave clinical condition in women. (Fistulas are a rip between the vagina and the bladder, which result in a continuous, infected stream of urine or feces to run through the vagina.) They can be devastating to women afflicted by them, at many levels — damaging their body image and self-esteem, impairing their fertility as well as being searingly painful.

Sims’s therapeutic method brought relief to millions of women worldwide. But what is lesser known is that Sims used African-American slave women from Alabama, as human guinea pigs to perfect his technique. His first patients were Betsey, Anarcha, and Lucy. He rented them from plantation owners, who were only too happy to be rid of them, since their fistulas rendered them unfit for work. The women he performed experiments on (eventually, he had a pool of 17) were in great distress and in need of a physician’s — Sims’s — help. They needed a doctor. But what they got instead, was a researcher who only saw their ethnic roots, not their humanity.

Sims was a vigorous supporter of slavery, which by extension, raises questions about the willingness of his subjects to volunteer for his medical procedures. The ability of these women to give informed consent to his medical treatment (or research) is highly questionable, given that they were the property of slaveholders with no legal or political rights, and could not make informed decisions about their well-being. They had to submit to others’ wills and do what was asked of them—free of cost.

Moreover, Sims knew that he could not test his technique on white women. Given the social practice of the day, male doctors did not look directly into a woman’s vagina, but discerned ailments by their sense of touch. With African-American female slaves however, it was different. Sims made them undress completely and kneel on all fours. This way, he and other physicians took turns to examine them and do, in Sims’s words, “everything [that] no man had [done] before.”

Also, Sims wielded his inquiring scalpel on fully-awake subjects, inflicting excruciating pain on them. Anarcha alone underwent 30 operations. Though word of ether’s narcotic effects had been circulating since the early 1840s, Sims believed that Africans had a higher tolerance for pain than whites, whom he would later, anesthetize when performing the perfected procedure. Doctors who had initially assisted Sims abandoned him within a year, no longer able to tolerate the women’s obvious pain. At that point, Sims simply forced his female subjects to restrain each other.

When criticized by his own brother-in-law for his experiments, Sims replied cryptically that he had a “mission of divine origin.” Sims writes in his autobiography and journal articles that his slaves “clamored” for the operations, and that they willingly tolerated the pain. However, in the absence of any testimony from his slaves, that claim is debatable.

While Sims did much to further the study of women’s health, we must not forget his racial attitude toward those with whom he conducted his work. His monument in South Carolina states that he treated “alike, empress and slave.”

But while the “empress” and the millions of women who benefited from his techniques had the power to consent to or refuse the surgery, Anarcha, Betsey, and Lucy, so deserving of their own monuments—did not.

About author: Eric Trump is a researcher at New York University.