Savior, Sadist, and a Legacy of Lies

The "Father" of American Gynecology was a celebrated hero for generations. Why did he hide his methods?

The first thing I noticed about the terrifying, final scene in the cult classic film The Stepford Wives was its quiet bloodlessness. The terror is ultimately not in a knife, a jump scare, or an onscreen murder. The scene centers simply around a conversation between a man, who has power, and a woman, who does not.

When Joanna Eberhart arrives in Stepford, CT in the 1975 film The Stepford Wives, she finds a serene town of happy, smiling women and contented families. Over the course of the film, she starts to put together the cost of this “peace”. But it’s too late for her, and she only discovers the master plan to replace the women with submissive robots when it is her turn for her body to be quietly, methodically taken from her, and destroyed.

She is face to face with the engineer responsible for this body snatching and this town. And like so many of us, facing a deeply cruel or unjust thing, Joanna asks “Why?”

“Why?” Dale, the brilliant, devious man replies.

“Because we can.”

In Chapter 2 of Harriet Washington’s Medical Apartheid, titled “Profitable Wonders”, we are reintroduced to the famous Dr. James Marion Sims.

Hailed as the father of American gynecology, a savior to American women, and the doctor who treated everyone from the French empress to the enslaved, Dr. Sims has enjoyed a decorated legacy.

In his life and in his death, he enjoyed dinners in his honor, statues that stand today, and a prominent place as a celebrated doctor of society. His work and research were well documented and he published numerous writings about his life, his work, and his groundbreaking discoveries that forever changed how vesicovaginal fistulas and vaginismus were treated and cared for. He opened the first “Hospital for Women” on prime NYC real estate, carefully treating the society ladies and healing royalty.

The picture of Dr. Sims and as he described “the indomitable courage of long-suffering women” rising out from the unbearable and agonizing pain of vaginal tears in childbirth -and the aftermath that would plague women being treated in a world where doctors were still not washing hands, using sutures that could cause horrific infections, and unaware of some of the labor difficulties women faced - with his medical discoveries from careful, ethical research stuck.

The reality was much more complicated and dark.

At this point, it would be hard for us to be all that shocked that that picture is deeply incomplete and duplicitous. Dr. Sims’ success and the legacy of American gynecology actually rests on the three young women Anarcha, Lucy, and Betsey, and their bodies, experiences, and pain. These young women lived in a racist system that allowed them to be “gifted” or sent to this doctor for medical experimentation. Their pregnancies, their fistulas, and their exploited and tortured bodies were the forced birthsite of all Dr. Sims’ innovations in sutures, treatments, and surgeries.

The shock of this chapter is the laying bare of the absolutely illogical thinking of physicians like Dr. Sims, and how his many, documented choices in both how he medically experimented on and treated women he purchased or owned were not made out of some logically held scientific belief, an obligation for care, or basic humanity, but out of a desire for absolute control. Often times in trying to understand why certain obviously illogical decisions were made, some obvious injustice excused, or an outright lie is believed, we try too hard to excuse the decision maker. We believe the first illogical excuse or try to understand the unreasonable, racist claim. Today, people ask that we withhold judgment, for the doctors didn’t know better, the ethical standards were different at the time, or the science had yet to catch up with the establishment.

This chapter not only deftly punctures all those excuses, but sketches out the ideas of this time, and how doctors claimed that Africans were so impossibly different from Europeans but immediately used any treatment that worked on enslaved people on the enslavers. Long after morphine and anesthetics were readily available, doctors withheld them from patients and test subjects and kept careful records of the pain they felt, flying directly against their claims to the public that Africans had less emotional and physical pain than Europeans. When African community members suggested cures and treatments that worked and were time tested across Africa, doctors aggressively and physically fought the advances and resented attempts to normalize and spread the cures. When public outcry about using enslaved women for forced experimentation spread, Sims went underground, revising their papers, using sketches of White women, and entirely contradicting his initial records of the pain he inflicted and witnessed. He purposely obscured to the community what really went on in their backyard “hospital” where enslaved women had no choice or agency in what was done to them. Many assistants quit working with Sims because they could not hear the screams of the women over and over again. Sims and his colleagues would randomly blame the issues the women faces on their imagined lack of morality, instead of the forced conditions of the slave huts, the chronic malnutrition, and the intense physical labor the pregnant women endured. This willful blindness was all part of the practice.

When looking at the record of Dr. Sims, who alongside an entire society of doctors, threw out common modesty, decency, and care in a rush to profit financially and academically and find humane, painless treatment for people believed to be White at the expense of human guinea pigs believed to be Black, we see a man who consistently valued control and unfettered access to the bodies of women he owned over careful medical treatment or a body of collected empirical research. The cruelty, carelessness, and pain inflicted by doctors like Sims were so widespread that African Americans across the nation harbored further fear of the medical establishment.

With medical racism, Washington’s research demonstrates that there was and is no scientifically sound or logical reasoning behind it. Copious papers by the doctors themselves, meant to only be seen by their colleagues, show again and again that they knew exactly what they were doing and not doing to their forced test subjects. The capricious, scattered experimentation did not need to adhere to careful form as there was always another body to purchase to start over and the health of the subject was secondary. Doctors like Sims did what was allowed to them, by a wider society that had already decided that enslaved women and poor immigrant women (other, later test subjects) pain existed but did not matter.

Anarcha, Betsey, and Lucy and their experiences are finally starting to be honored, and Dr. Sims and others are critically reexamined. Their pain and lives are connected to today, as more women are speaking out and sharing about the present-day lack of care for their pain that remains in gynecological practices across the US. Harriet Washington’s other notable research heavily centers medical ethics today with experiments, and this chapter is a reminder for all of us to consider not only the costs of our care but who is asked to pay for them.