Introduction
A Better Phantom
In August 2017, in the wake of the deadly Confederate monument protests in Charlottesville, Virginia, a consortium of local community boards and activist groups in New York City staged an event at the site of the Central Park statue of J. Marion Sims, the so-called Father of Gynecology. In less than twenty-four hours, an image from the protest was shared on social media more than 250,000 times.
J. Marion Sims was infamous for a yearslong series of experimental vaginal surgeries—begun in 1846 and conducted without the use of anesthesia—on approximately ten enslaved women in his backyard “Negro Hospital” in Montgomery, Alabama. The most consequential of Sims’s experimental subjects was a young woman who has come to be known as Anarcha.
Sims was attempting to cure obstetric fistula, a horrific condition that is the result of prolonged obstructed labor. His true motive in this effort is one of the subjects of this book. More important, however, is Anarcha. Anarcha was the first woman that Sims saw, and she was subjected to upward of thirty experiments. After Sims claimed to have cured her, in 1849, medical text after medical text cited Anarcha as representing a crucial moment in the history of medicine and surgery. It was the birth of modern gynecology.
Criticism of Sims began with his contemporaries—his greatest critics were his assistants—but for decades after his death, in 1883, these voices were drowned out by enthused hagiographers who hailed Sims as a “savior of women.” It wasn’t until the late 1960s that a reevaluation of Sims’s legacy began to creep into the mainstream. Activists, scholars, historians, artists, poets, playwrights, and journalists chipped away at his biographical facade. By 2017, Sims’s legacy had become intertwined with broader reevaluations of the role of white supremacy in American history; with a long overdue indictment of the causes of racial health disparities, particularly in regard to maternal mortality;* with efforts to unwind vestiges of racist southern culture preserved in public monuments; and with tragic histories of medical experimentation performed on people of African descent.†
At the time of the protest of Sims’s monument in New York, I had been immersed in a search for Anarcha—and in the Sims story—for almost two years. In 2016, I sold an article to Harper’s Magazine about Sims’s New York statue (one of a number of statues, busts, markers, and paintings created to commemorate him), and—I admit it—I wanted to cancel him. I delivered the piece in early 2017, and it remained in queue for publication at Harper’s until Sims went viral. Almost immediately, New York mayor Bill de Blasio announced the formation of a ninety-day commission tasked with reconsidering the city’s official policy on statues and monuments. This left just enough time to fact-check the article and publish it before the commission handed down its decision. The piece played a small backup role to the work of the community organizers and protesters who had been objecting to the monument for the better part of a decade, often with city officials working behind the scenes to tamp down enthusiasm for removing Sims’s statue—or any statue.
It didn’t work. The vote to remove the Sims monument was unanimous, and the statue came down in April 2018. By then, I was poring through the thousands of documents I had collected so as to enable a telling of Anarcha’s story. In addition, I had spent ten weeks in Ethiopia, Nigeria, and Uganda to bear witness to the modern legacy of the Alabama fistula experiments. This legacy is described in full in the afterword of this book, but suffice it to say that Sims did nothing to ensure that a fistula cure reached the population that had provided him with his experimental fodder. A patient-centered model of care sparked by Anarcha and the Alabama fistula experiments—a model of care that has improved the lives of hundreds of thousands of African women—owes nothing to Sims. It is the accidental by-product of his lifelong effort to enrich himself. The treatment of obstetric fistula today is based almost entirely on fistula sufferers living communally, acquiring skills as they care for one another. This model was spontaneously devised by a group of enslaved women—teenagers, really—in a tiny clinic in Alabama in the 1840s. Today, hundreds of fistula survivors have followed in their footsteps to become nurses, nurse aides, doctors, activists, and community organizers.
The daughters of Anarcha are legion.
* * *
Say Anarcha is a book about a ghost—a ghost who has undergone periodic revision.
The first version of the ghost of Anarcha was Sims’s own. He told the tale of his fistula experiments over and over; Anarcha’s story was the pivotal anecdote in a fanciful narrative that brought him fame and fortune. For her part, Anarcha vanished: no record of her appeared to have survived, yet her memory was tugged along behind Sims’s ascent into the medical firmament. For 170 years, the only evidence of Anarcha’s existence was Sims’s own suspect writings.
Somewhere along the line—it’s unclear when—she became “Anarcha Westcott.” Sims’s autobiography indicates that he first saw Anarcha on the “Wescott” plantation, a mile from his office in downtown Montgomery. But he never called her “Anarcha Westcott”; the application of her enslaver’s surname to Anarcha did not appear in print until the second half of the twentieth century. It has since appeared, without caveat or comment, in numerous peer-reviewed articles debating Sims’s legacy, in books of poetry that have given voice to her life, and in reputable media sources.
However, there was never anyone named “Anarcha Westcott.” There is no document to suggest that Anarcha took the name of her former enslaver. “Anarcha Westcott” was another ghost, a name for a hole in history, the title of a story that could not be told.
Copyright © 2023 by J. C. Hallman
