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There are three statues of Dr. James Marion Sims on public display in the United States. Dr. Sims is known to some as the father of modern American gynecology for reportedly developing the first successful and reproducible surgical technique for vesicovaginal fistulas and for opening the first public hospital for women dedicated to repairing inuries from pregnancy and childbirth. Sims achieved his reputation because of experimentation on enslaved women and the whole sordid history of Sims has tragically been rewritten. This is what I know about Sims from reading multiple journals and textbooks from the 1800s (both before and after Sims infamy), his autobiography and the autobiography of Dr. Emmet, as well as the work of modern historians and ethicists and if you are defending anything to do with Sims you should know it as well. 

Vaginal fistulas are connections between the bladder and the vagina or the rectum and vagina and the most common cause in Sims’ day was a long, obstructed labor with days of a fetal head sitting low inside the vagina reducing blood flow until the tissues died and sloughed off leaving gaping holes resulting in constant drainage of urine and/or feces through the vagina. The skin on the vulva and around the anus develops an intense irritant reaction from the constant bath of urine and/or feces and the odor, even with modern sanitation and absorbent garments, can be unbearable. In Sims’ era fistulas were more common among the poor, the result of nutritional deficiencies and lack of access to health care. Women who were enslaved were at highest risk as many had contracted pelvises due to rickets and more likely to have obstructed labors.

Dr. James Marion Sims, by his own admission, was a below average medical student who didn’t really want to be a doctor it was simply a way to make a living. At one point, long before his infamy, he thought of leaving medicine to go into a merchant clothing business. “What is the use of my struggling here always, for two thousand or three thousand dollars a year…” he wrote. In his autobiography he writes of actively seeking wealthy clients and Jews as they could pay. He also writes of disbelieving a nurse that a young baby was ill. When the baby died he claimed he was more upset than the parents because the bad outcome could end his practice. It’s not a crime to want to make money but it is sickening to read about it page after page from the man who is supposed to be the father of gynecology.

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Image: Di Jus10y – Opera propria, CC0, https://commons.wikimedia.org/w/index.php?curid=14803838

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