Sims, who founded the country’s first women’s hospital in New York in 1855, developed his method of treating vesicovaginal fistula over three years of experimental surgeries, operating on 11 slave women in Alabama who suffered from the condition, from 1846 to 1849, sometimes in front of observers to whom he wished to demonstrate his methods. The condition was considered incurable at the time. “I made this proposition to the owners of the negroes,” Sims wrote in his autobiography, The Story of My Life. “If you will give me Anarcha and Betsey for experiment, I agree to perform no experiment or operation on either of them to endanger their lives, and will not charge a cent for keeping them, but you must pay their taxes and clothe them.”
Sparing them pain was not a part of the agreement. “Lucy’s agony was extreme,” Sims wrote of one patient, from whom he had to remove a sponge after failing to create a proper catheter to prevent her urine from seeping into her vagina. “It was a very stupid thing for me to do … she was much prostrated, and I thought she was going to die.” Lucy did recover after Sims removed the sponge, and the operation he performed on her, Sims wrote, was the basis of more successful surgeries. Sims’s progress came from excruciating repetition of trial and error. “His first operation, on a female slave, was unsuccessful,” The New York Times noted in an 1894 article on the dedication of statue, which was spearheaded and financed by the contributions of fellow surgeons. “He operated again and again on the same subject, and finally, in his thirtieth trial, he was successful.”
“James Marion Sims is an important figure in the history of experimentation with African Americans because he so well embodies the dual face of American medicine to which racial health disparities owe so much,” Harriet A. Washington wrote in Medical Apartheid. “Slaves did not have to be recruited, persuaded, and cajoled to endure pain and indignity; they could not refuse.”
In his autobiography, Sims emphasized his desire to help his enslaved subjects, and insisted that they voluntarily agreed to be operated on—whatever that could mean for the enslaved. But he also must have known, despite his conviction that blacks were inferior, that his use of human experimentation on enslaved people was immoral.
“In Alabama, Sims’s vigorous defense of the slavery system had been liberally seasoned with ‘nigger,’” Washington wrote. “However, once up north, he hid the ethnicity of his subjects, portraying them as white in the illustrations that accompanied his accounts of the surgery.” Contrary to the defense that Sims was merely a man of his time, Washington notes, he had contemporary critics—physicians white and black—who attacked his methods as barbaric. His 1883 obituary in The New York Times mentions his development of a treatment for vesicovaginal fistula, but nothing of the captive women he experimented on. It might have been a simple matter for a white reporter to ignore the descendants of the enslaved in 1883; in 2018, they will be heard.