Honouring the Mothers of Gynecology
This blog was written after hearing Shankar Vendantam’s excellent
podcast from the NPR Hidden Brain series on the mothers of gynecology.
The history of healthcare, the history of the noble profession,
doctors, nurses, scientists and others has an underbelly of unethicality and
double standards. This is often justified by the rationale that the practices
were compatible with the ‘standards of the time’. That is one of the
fundamental issues, the wrong question is whether it was compatible with the
standards of the time, a possibly right question would be whether it was
compatible with some of the eternal principles of medical practice. We will
find again and again that actions of many of our predecessors in modern
healthcare were not compatible with eternal ethical principles of healthcare.
An infamous example of an individual was the American physician J Marion Sims, who acquired black women slaves for the purpose of experimental
surgery to resolve vesico-vaginal fistula. He operated on them without
anaesthesia when anaesthesia was available and he operated on white women with
the same condition only when he had completed his experimental surgery on black
slave women after his technique was perfected on these black women. Who were
these black women? It seems there were 14 of them; we do not even know their
names except three of them. Anarcha, Betsy and Lucy.
In the NPR podcast historian Vanessa Gamble alludes to some
potential motives. The women with vesico-vaginal (abnormal connections between
urinary bladder and vagina) and recto-vaginal (abnormal connections between
rectum and vagina) fistulas that happened after traumatic childbirth, meant
that these enslaved women could not work for their ‘masters’ and could not
reproduce creating more enslaved people to benefit their ‘owners’. So, it seems
that it might not have simply been the desire to progress the frontiers of
surgical science that was the primary motivator for Sims to have acted
unethically. The view that he might have acted unethically is not just from
retrospection, he was challenged about it even within his time.
Vanessa Gamble and Bettina Judd (a poet) talk in the NPR podcast
about how these women whose life, living and bodies were used without consent
could be recognised; there is some talk on statues along with the one that
exists for Sims. Recognising and honouring these women is not tokenism, it is a
fundamental for progress of humanity. Statues will act as symbols but they will
have the constraints of geography and history whereas Sims will continue to
have universality.
The mothers of gynecology should have universality (while Sims
would become a lesser part of history). With that in mind I propose the
following:
1)
Anarcha
should be referred to as the mother of gynecology.
2)
The
vaginal speculum currently known as Sims and its variants should from now be
known as the Betsy speculum
3)
The
surgical procedure to repair vesico-vaginal fistula should be called the Lucy’s
repair.
While these three are important, it is also important to stop
referring to Sims as the father of gynecology.
These suggestions stem from the principle where an immoral or
unethical person is disassociated from any glory that is derived from the
outcome of such person’s activity. The new world demands a new kind of
approach, the sins, crimes and injustices of the past will remain – the
benefits from those should not. The ignominy suffered by these women must be
honoured by making them the main story; Sims of course needs a place on the
page which he will have as an incidental footnote in the history of gynecology.
Success in Healthcare demands these actions, we cannot allow healthcare to fail
by not giving the mothers of gynecology their rightful place.
Organisations and persons working for equality and justice should
lobby the gynaecological profession to adopt these changes so that they become
the norm.
M. HEMADRI
Links
PS: I started writing a blog called ‘What are the nasties in
healthcare we may regret in the future?’ and intended to use the mothers of
gynecology as an example. Once I started writing it I realised that it will be
yet another injustice if the mothers of gynecology did not have their own place
in these blog pages.
©M HEMADRI
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