We Didn't Know Any BetterLists about the pre-historic, ancient, medieval, olden, and not-that-long-ago days of medicine, when doctors made bizarre assumptions and prescribed totally insane treatments that made sense at the time...
Modern doctors are governed by a system of medical ethics developed over the past century. But how should we assess the reputations of earlier doctors who violated those now deeply held ethical standards? That's the question facing people looking at the record of J. Marion Sims, an important medical figure who experimented on slave women without anesthesia.
Like other brutal human experiments, Sims's operations were horrifically painful. For example, he operated on one slave woman 30 times. Records state another woman screamed for an hour while Sims experimented. But those experiments earned Sims his reputation as the "Father of Modern Gynecology," commemorated in statues displayed in several states.
Should we understand Sims as a product of his time, when nearly all doctors assumed Black people were inferior and couldn't feel pain? Or is Sims's work more akin to the Tuskegee syphilis experiment, which medical professionals wholly condemn? In April 2018, New York City decided to take down the J. Marion Sims statue in Central Park, drawing comparisons with the controversy over Confederate statues. The complicated history of J. Marion Sims is a stark reminder of the debate over how to memorialize historical figures.
The case of J. Marion Sims encourages contemporary thinkers to grapple with a difficult question: How do we properly reckon with the legacy of someone who made huge contributions that still benefit people when they gleaned those contributions from brutal research conducted on the disenfranchised?
He Was Long Held In Esteem For Inventing Much Of The Foundation For Modern Gynecology
For over a century, J. Marion Sims boasted a sterling reputation. Born in 1813 in South Carolina, Sims opened one of the first women's hospitals in history, invented the speculum, published the first textbook on gynecological surgery, and earned the title "Father of Modern Gynecology." Sims also served as president of the American Medical Association, was the personal doctor of an empress, and gave expert medical advice after President James A. Garfield was shot.
In the late 20th and early 21st centuries, though, medical professionals and historians began to question the ethics of Sims's experiments, which placed slave women under the knife without anesthesia, even after it was widely available.
In His Writing, Sims Documented The Pain He Caused His Slave Patients
While Sims has been memorialized with numerous statues, his descriptions of medical experiments on slave women, performed without anesthesia, are difficult to read. In his first surgical case, Sims operated on a young slave named Lucy. He wrote:
That was before the days of anesthetics, and the poor girl [Lucy], on her knees, bore the operation with great heroism and bravery. I had about a dozen doctors there to witness the series of experiments I expected to perform... At the end of five days [Lucy] was very ill. She had fever, frequent pulse, and real blood-poisoning, but we did not know what to call it at that day and time.
During the operation, Sims intentionally left a sponge in Lucy's bladder, but it became dangerously infected. Sims recalled, "Lucy's agony was extreme... I thought she was going to die."
Lucy, Betsey, and Anarcha, Sims's Three Recorded Slave Patients, Endured A Great Deal Of Pain Many Benefit From Today
Sims operated on many enslaved women, but we only know three of their names: Lucy, Anarcha, and Betsey. Records state that during an hourlong operation without anesthesia, 18-year-old Lucy screamed and cried out in pain. Sims first experimented with a speculum on Betsey, using the bent handle of a spoon to examine her.
And Anarcha was just 17 years old when Sims first operated on her; she underwent a total of 30 operations, all without painkillers, over a four-year period. Sims was also experimenting with closing surgical cuts after his procedures. It took 30 operations on Anarcha before he perfected the technique. For years, Sims gave heavy doses of opium to his patients after surgery, with the goal of inducing constipation while their stitches healed.
Sims Invented The Speculum Using A Bent Spoon On A Slave Patient Named Betsey
Sims invented the vaginal speculum, an important tool used by gynecologists to this day. He came up with the idea when a white patient visited Sims after falling off a horse, which caused a prolapsed uterus. After repairing the problem, Sims decided to take a closer look at one of his patients, a slave named Betsey.
Sims realized that by using the bent handle of a pewter spoon, he could better diagnose Betsey's medical problem. Sims later wrote that he told his patient, "'Betsey, I told you that I would send you home this afternoon, but before you go I want to make one more examination of your case.' She willingly consented." Using the spoon, Sims diagnosed Betsey with a fistula. He also reported, "I saw everything, as no man had ever seen before."
For A Long Time, The Medical Profession Praised Sims, Even While Acknowledging The Issues With His Work
For decades, the medical profession praised Sims for his groundbreaking research, even while acknowledging the ethical problems with the way he conducted that research. As Dr. Tatiana M. Gellein found in her research, the first critiques of Sims's work did not emerge until the civil rights movement.
Even in 1978, the American Journal of Obstetrics & Gynecology published an article that concluded, "[Sims's] original three subjects might never have tolerated the pain and misery of the repeated operations had they not been slaves. In the long run, they had reason to be grateful to Sims."
At The Heart Of The Issue Is Sims Using Anesthesia On White Patients While Denying It To Black Patients
The Sims debate often comes down to the anesthesia question. Was Sims wrongfully denying anesthesia to women undergoing surgical procedures, which would be tantamount to torture? Or was he simply skeptical of a new medical tool that was still not in widespread use?
Sims's defenders point out that the first successful use of anesthesia in surgery only occurred in 1846 - the year after Sims began experimenting on Black women. The practice was not widespread in the 1840s, and some doctors preferred operating on awake patients. However, Sims's critics point out that when the doctor expanded his perfected surgical techniques to white patients, he gave them anesthesia. Some suggest Sims decided not to use anesthesia when experimenting on Black women because he subscribed to the racist and incorrect view that Black people didn't feel pain as strongly as white people.
