The first serious challenge to Sims’s lionization came in a 1976 book by the historian G.J. Barker-Benfield titled The Horrors of the Half-Known. Barker-Benfield juxtaposed Sims’s “extremely active, adventurous policy of surgical interference with woman’s sexual organs” with his considerable ambition and self-interest. The man who once admitted “if there was anything I hated, it was investigating the organs of the female pelvis,” took to gynecology with a “monomania” once he realized it was his ticket to fame and fortune, writes Barker-Benfield.
In response, during the 1978 annual meeting of the American Gynecological Society, doctors took turns vigorously defending Sims against Barker-Benfield’s book. The most fervent of them was Lawrence I. Hester Jr., who said, “I rise not to reappraise J. Marion Sims, but to praise him.” He then announced that his institution, the Medical University of South Carolina, which Sims also attended, was raising $750,000 for an endowed chair named after J. Marion Sims.
Another doctor, Irwin Kaiser, in a more tempered defense asked the audience to consider how Sims ultimately helped the enslaved women he experimented upon. The surgery that he practiced on Lucy, Anarcha, Betsey, and the other enslaved women was to repair a vesicovaginal fistula—a devastating complication of prolonged labor. When a baby’s head presses for too long in the birth canal, tissue can die from lack of blood, forming a hole between the vagina and the bladder. The condition can be embarrassing, as women with it are unable to control urination. “Women with fistulas became social outcasts,” said Kaiser. “In the long run, they had reasons to be grateful that Sims had cured them of urinary leakage.” He concluded that Sims was “a product of his era.”
This did not quell criticisms, of course. Over the next few decades, scholars continued to criticize Sims’s practice of experimenting on enslaved women. The story became well-known enough to join a list of commonly cited examples—along with the Tuskegee experiments and Henrietta Lacks—of how the American medical system has exploited African Americans.
Medical textbooks, however, were slow to mention the controversy over Sims’s legacy. A 2011 study found that they continued to celebrate Sims’s achievement, often uncritically. “In contrast to the vigorous debate of Sims’s legacy in historical texts and even in the popular press, medical textbooks and journals have largely remained static in their portrayal of Sims as surgical innovator,” the authors wrote.
In recent years, one of the most prominent defenders of Sims’s legacy has been Lewis Wall, a surgeon and an anthropologist at Washington University in St. Louis. Wall has traveled to Africa to perform the vesicovaginal fistula surgery that Sims pioneered, and he has seen firsthand what a difference it makes in women’s lives. “Sims’s modern critics have discounted the enormous suffering experienced by fistula victims,” he wrote in a 2006 paper. “The evidence suggests that Sims’s original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time.” Wall also defended Sims on the charge that he refused to give anesthesia only to black patients. Anesthesia was not yet widespread in 1845, and physicians who trained without anesthesia sometimes preferred their patients to be awake.