SHANKAR VEDANTAM, HOST:
This is HIDDEN BRAIN. I'm Shankar Vedantam.
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VEDANTAM: Throughout history, people have sought to create utopias - perfect societies free of defects. Of course, not everyone shares the same vision for a utopia. Different people have different priorities, but the wishes of those with power and prestige almost always take precedence.
Today, we tell the story of overzealous American scientists who believed creating a utopia for some would eventually lead to utopia for all. This is a story of people who believed they were doing the enlightened thing, even if it traumatized others.
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WENDY BLAIR, BYLINE: First of all, please tell me your name.
CARRIE BUCK: Carrie Elizabeth Detamore.
VEDANTAM: In 1980, an NPR reporter, Wendy Blair, took a trip to a one-room shack outside Charlottesville, Va. She'd come to interview a 78-year-old woman. Her married name was Detamore, but her given name was Carrie Buck.
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BUCK: You see, I was adopted when I was a little girl. I was adopted by the Dobbses here in Charlottesville.
VEDANTAM: This interview was one of the few that Carrie Buck ever gave. By this point, she had little to say. It was left to others to reconstruct her story. One of those who took up the task was historian and lawyer Paul Lombardo. He's the author of the book "Three Generations, No Imbeciles: Eugenics, The Supreme Court, And Buck V. Bell." Paul says the story of what happened to Carrie begins a few decades before her birth, with a scientist named Francis Galton.
PAUL LOMBARDO: He was looking a great deal at patterns of behavior and trying to figure out why it was that genius, the ability to think productively and other abilities - how these clustered in families. And so we see him very early in his career suggesting that there must be something that is biological about it, something that's inherent to the organism. And he proposes something you can think of as eugenics, which is a way of organizing people that will encourage the people who are prosperous and who are healthy and who are productive to marry other people of similar talents and then pass on their abilities to children and, at the same time, discourage people who are not successful and not productive, perhaps are poor, perhaps unwell. And over time, the negative ones will fall out of the population.
VEDANTAM: To be fair, lots of people pair up with others who are similar in education and social class. But Francis Galton, writing in the early 20th century, wanted the state to get involved.
KEVIN BEESLEY, BYLINE: (As Francis Galton, reading) I cannot doubt that our democracy will ultimately refuse consent to that liberty of propagating children which is now allowed to the undesirable classes. But the populace has yet to be taught the true state of things. A democracy cannot endure unless it be composed of able citizens. Therefore, it must, in self-defense, withstand the free introduction of degenerate stock.
VEDANTAM: These ideas coincided with a new movement in the United States. The progressive movement was an effort by social reformers to address the problems caused by industrialization. Progressives believed that education, science and social institutions could solve society's greatest problems. They launched anti-corruption efforts, a drive for women's suffrage. They also started the colony movement - institutions to care for and to detain people whom they viewed as disabled or deranged.
LOMBARDO: The primary motive was compassion. People who ran institutions realized that with a growing population, they had more and more people who were in need of care. So the colony movement begins as a movement out into the country and then later starts to take on the new ideas of eugenics - those ideas saying that people who are unfit, people who have mental or physical disabilities, people who are - to use the language of the time - feebleminded or morons or imbeciles should be separated and segregated from the general population not only because they can't survive in the city, but also because that will keep them from reproducing.
VEDANTAM: In 1911, Virginia opened its first colony just outside the small city of Lynchburg. Initially, the colony only took in people with epilepsy, but soon, new buildings went up to house people with mental, physical, even moral defects.
LOMBARDO: Women were often taken to colonies in the early years of the colony movement because they appeared to be sexually promiscuous or there were concerns that they were so unable to control themselves and so weak of mind and disposition that they needed to be protected and that the rest of the population needed to be protected from them.
VEDANTAM: I reached out to Virginia historian Lynn Rainville. She says it's impossible to disentangle the eugenics movement from the long history of men trying to regulate the behavior and bodies of women.
LYNN RAINVILLE: This was an attack against women. It's men making a plan of attack to deal with an issue that they have defined and targeting women, just the way the birth control discussion is today. It's always assumed that it's the woman's responsibility and that if something goes wrong, it's the woman's fault, and that if we have to control something, we've got to control women.
VEDANTAM: When the Virginia colony first opened, demand for admission was high. At the time, people suffering from mental and physical disabilities were often shunted off to the poorhouse or to a local jail. The colony seemed like a far more humane option. Paul Lombardo says the superintendent of the colony, Dr. Albert Priddy, took his mission seriously.
LOMBARDO: Dr. Priddy believed that it was his prerogative as a physician - and especially a physician paid by the state - to take care of the social problems that were generated by the individuals who came to the Virginia colony. And Dr. Priddy thought the best way to do that was, first of all, by segregating them away from society and away from each other. They couldn't have children if they couldn't have sex. But secondly and more radically, he was one of the early people to propose surgical sterilization.
VEDANTAM: The idea of forced sterilizations sounds shocking today. It was also shocking to many people in the early 20th century. Dissenters fought eugenics on religious and legal grounds. But it also appealed to many ordinary citizens.
LOMBARDO: The majority of people in the country, at least up until 1920, had grown up on farms, and people who lived on farms understood that you culled the herd of the weaker members. You got rid of the plant that was rotting in the field. You weeded your garden so as to get rid of the kinds of organisms that would ruin the whole plot.
VEDANTAM: Gradually, states began enacting eugenics laws. In 1907, Indiana passed the country's first compulsory sterilization law. It applied to institutionalized criminals, rapists, idiots and imbeciles. Thirty-one states followed with their own laws. Diseases that might qualify a person for sterilization included syphilis, alcoholism, moral or sexual perversion and feeblemindedness. Virginia was not one of the early states to pass a eugenics law. Nonetheless, around 1915, Dr. Albert Priddy began to sterilize some of his patients. He felt he had the authority based on a number of Virginia laws.
LOMBARDO: Which had fairly vague language in them giving the directive to physicians who worked in state institutions the power to do whatever was necessary for the medical health of the patient. He sterilized quite a number of them - over a dozen. And then he was suddenly met with a lawsuit by a family of a man from the eastern part of Virginia whose wife and two daughters had been taken to the colony while he was out of town.
VEDANTAM: The man bringing the lawsuit was George Mallory.
LOMBARDO: George was working on a sawmill in a little town outside of Richmond and was gone from home for several weeks at a time. He had a fairly large family, with several daughters and a wife. And when he came back from work one weekend, some of his children had been sent to foster care, and his wife and two of his daughters had been taken to the Virginia colony. Turns out that the social workers and the police had been watching their home, and they made the allegation that the Mallory family was running a house of ill repute or a brothel. And that's why they broke the family up while George was gone. George went and found a local lawyer, told him his story, and that lawyer brought a case against Dr. Priddy.
VEDANTAM: Albert Priddy was furious. Here he was, a man of science and reason, being challenged by someone who was not his social or intellectual equal.
LOMBARDO: He never quite got over the fact that he'd been dragged into the court by this poor man when he thought he was doing the best thing, both for the state and for those women whom he sterilized.
VEDANTAM: A jury refused to award damages to George Mallory, but the trial judge sternly warned the doctor to stop what he was doing. Current Virginia law, the judge said, was not in the superintendent's favor. Eugenics was still illegal in Virginia.
Albert Priddy's response - he decided to change that. He began to campaign for a Virginia law that would explicitly allow for the sterilization of defective people. Among other things, he argued such a law could save taxpayer money. Instead of confining people to the colony, sterilized people could be sent back to communities.
In 1924, his efforts paid off. Virginia passed a broad sterilization law. It gave eugenicists the green light. But Albert Priddy and others feared that even this wasn't enough. What if someone challenged the law, tried to overturn it? They wanted something watertight. They wanted not just a law, but a law that was sure to survive legal challenge.
So they came up with an unusual strategy. They decided to find a test case that they were absolutely sure to win - a case where, in effect, they would get to play both prosecution and defense. How to find such a case? Dr. Albert Priddy had just the person in mind. Her name was Carrie Buck. Stay with us. You're listening to HIDDEN BRAIN from NPR.
This is HIDDEN BRAIN. I'm Shankar Vedantam. In 1924, lawmakers in Virginia passed a broad eugenics law that would allow for the sterilization of people deemed to be defective. One of the champions of that law was Albert Priddy. He ran the Virginia State Colony for Epileptics and the Feebleminded. And even though the law was on his side, he feared that sterilization laws could be overturned.
So he began to scheme. He had the idea of creating a test case that would protect sterilization from legal challenge. The person he found to accomplish that goal was Carrie Buck. She was born in 1906 to Emma Buck, a woman who had fallen on hard times.
LOMBARDO: Someone who, from time to time, was homeless, someone who was suspected of being a drug abuser.
VEDANTAM: This is historian Paul Lombardo. Paul says that when Carrie was about 4, local authorities removed her from Emma's care and placed her in a foster home.
LOMBARDO: The family that became her foster parents were the Dobbs. And the Dobbs were also a very modest crew. They took her in, partially because she could provide services as a household worker and also because they got a bit of a supplement from the state for taking care of her.
VEDANTAM: Carrie lived with John and Alice Dobbs for more than a decade. She attended school, and school records show she was good at her lessons.
LOMBARDO: But she left school after the sixth grade, and she spent her time as a domestic servant there in the Dobbs family.
VEDANTAM: At 16, Carrie became pregnant. Her account of what happened never wavered. She says Alice Dobbs had left town to care for a sick relative.
LOMBARDO: And at that point, a young man named Clarence Garland appeared.
VEDANTAM: He was a nephew of Alice Dobbs.
LOMBARDO: Carrie said, Clarence took advantage of me. He promised me he would marry me. He forced himself on me, and then he left.
VEDANTAM: It was a huge scandal. Alice Dobbs knew that having an unmarried pregnant girl in the house looked very bad. It would jeopardize the family's chances of getting other foster placements. So she set about finding a way to have Carrie removed.
LOMBARDO: And she asked the local social worker and the nurse and some doctors if they could have her committed to the Virginia Colony for the Epileptic and the Feebleminded because that's often where girls like Carrie, who were in trouble, went. The moral overlay in the late 19th and early 20th century having to do with sex is just impossible to escape. The people who set up the colonies who thought that they could isolate people who were sexually promiscuous or, for that matter, who were somehow sexually unorthodox in other ways - they really focused on the necessity of getting those people out of society.
VEDANTAM: Carrie was allowed to remain in Charlottesville until she gave birth. Alice and John Dobbs agreed to take in the baby, a little girl named Vivian. Carrie was taken to the colony. Now, this is the point in the story where the plot takes a very strange turn. You see, Carrie's mother was already living at the same colony. Emma had been brought there a few years earlier. The stage was set for the tragedy that was about to unfold.
LOMBARDO: Well, when Carrie arrived at the colony, Dr. Priddy was quite excited because he had the records of Carrie's analysis and an examination by a Red Cross nurse who was living in Charlottesville. And he knew the records of Carrie's mother, Emma. And so all of the cluster of problems that Emma exhibited fit into Dr. Priddy's idea of the kinds of traits - the kind of negative traits that were hereditary. A woman who was sexually promiscuous, who had problems with her own inhibitions, who couldn't control her intake of things like alcohol and drugs and who didn't take care of her children - he thought that these were characteristics that were likely to be passed down. So when Carrie appeared as a new resident of the colony and he connected the two people, it seemed to him that there might be good evidence here of a hereditary connection.
VEDANTAM: Albert Priddy knew that two generations with genetic flaws presented a strong case for sterilization. But three generations - that would seal the deal. The third generation was Carrie's daughter Vivian, whom he automatically assumed was feebleminded. The eugenicists had their case. They ignored facts that didn't fit, like Carrie's normal school record. Carrie was given a rudimentary IQ test, which came back suspiciously low.
LOMBARDO: The IQ number they assigned to her was something in the 50s. If 70 is the cutoff for someone we would call developmentally disabled or they might call a moron, she was 20 points below that.
VEDANTAM: For Albert Priddy, the path was obvious. The first step under the new Virginia law was to petition the colony board for authorization to sterilize Carrie. He argued that she was incurable, had a mental age of a 9-year-old and had given birth to a child born out of wedlock who was, quote, "mentally defective." The board agreed that sterilizing Carrie was the right course.
The next step to building a watertight case for sterilization was to have the board's decision challenged in the courts. The idea was to mount a legal challenge against eugenics where the eugenicists could play both attack and defense. They would defeat the challenge and thus establish a legal precedent.
So Albert Priddy recruited a friendly lawyer, a personal confidante who would sue him on Carrie's behalf. The lawyer was himself a proponent of eugenics. He filed the appeal in Carrie's name but never really represented her. She was just a prop.
LOMBARDO: We really have no contemporaneous record of Carrie's thoughts. We have a picture of her taken the day before her trial, which tells us a little bit. It tells us that she was a 17-year-old girl who seemed to be fairly uncomfortable and clearly in distress. She'd had a baby taken from her only a few months earlier. She was taken out of her home and sent away to a place she'd never been. She was surrounded by doctors and lawyers and other people who were prodding her and questioning her.
VEDANTAM: During the first trial, at the Amherst County Courthouse, the Buck family was excoriated. Emma Buck was accused of living in the worst neighborhoods and functioning like a 12-year-old. A welfare worker who'd never met Carrie testified that she didn't seem to be a bright girl. Another social worker offered her assessment of Carrie's 7-month-old daughter Vivian. She said, there's a look about it that's not quite normal, but just what it is, I can't tell. Finally, Albert Priddy testified that sterilizing women like Carrie might, quote, "tame them down."
The trial took less than five hours. The county court upheld the sterilization order. But it wasn't enough for the eugenicists. They wanted the Supreme Court to also uphold the sterilization order.
LOMBARDO: Because if the Supreme Court didn't endorse sterilization, then it was still possible for someone to challenge the lower court law. And so they ended up, in 1926, filing papers in the United States Supreme Court on behalf of Carrie, challenging the case and allowing the Supreme Court to take a look at all the evidence that had been gathered at the steps below.
VEDANTAM: On May 2, 1927, in an 8-1 decision, the court ruled that Carrie Buck could be sterilized. The opinion was written by Justice Oliver Wendell Holmes Jr.
LOMBARDO: He described the Buck family - this family with cascading problems generation to generation, a series of people who've had illegitimate children, a series of people who seemed to be mentally compromised and morally degraded - mother, child and then grandchild all somehow touched with mental defect.
And Holmes wraps this all up into one package and says, it's better for all the world if, instead of waiting for degenerate offspring to die from starvation or for criminals to be executed for their crimes, that we stop this line before it goes on - better that those people not be born at all. And he describes the Buck family in his opinion and draws a line under it and says, here we have three people, three generations, a whole household full of defect. Three generations of imbeciles are enough.
VEDANTAM: Three generations of imbeciles are enough. This phrase was to become the rallying cry of the eugenics movement. On October 19, 1927, Carrie Buck was taken from her room at the Virginia Colony and brought to the infirmary. Dr. John Bell was waiting for her. Carrie received anesthesia and drugs to keep her from vomiting.
When reporter Wendy Blair interviewed Carrie in 1980, she asked her about that day and whether her doctor had told her what was happening.
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BUCK: Well, he only said that if I wanted to live - said that I would have to go through the operation. But I didn't want the operation. I kicked against it.
VEDANTAM: But it was useless. Everyone - the state, the country, even the Supreme Court - said Carrie's opinion about what happened to her own body mattered less than the opinions of doctors, politicians and judges.
LOMBARDO: Dr. Bell, having prepared Carrie for surgery, makes an incision in her abdomen which exposes her fallopian tubes. He then cuts the tubes, ties them together and sews her up. It takes several days for her to recover because this is, after all, major surgery. When she's recovered, she realizes that she's had the surgical operation that would make her sterile.
VEDANTAM: Carrie was 21 years old.
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BLAIR: Do you remember how you felt?
BUCK: I didn't feel too good over it.
BLAIR: Were you very sad?
BUCK: Yeah, I was sad 'cause I - see, I wanted to have children.
VEDANTAM: Carrie was released from the Virginia Colony soon after her sterilization. She married twice. Her first marriage lasted 25 years until her husband died. She was still married to her second husband and living in a nursing facility when Paul Lombardo finally spoke with her in December 1982.
LOMBARDO: She was quite near death. It wasn't clear that she was going to die, but she did about three weeks later. She was very weak, and she wasn't very talkative. So we really didn't talk about the details of her surgery. We did talk about her recollection of the time. And she made it obvious to me that she felt that she had been wronged because the young man who had forced himself upon her, as she said, disappeared. She was left alone. No one protected her, and no one defended her.
VEDANTAM: No one protected Carrie Buck's younger sister, either. Her name was Doris. She'd also been brought to the colony on grounds that, quote, "sooner or later, she will become the mother of illegitimate children." She was 12. She was registered as inmate 1968. Doris was sterilized about a year and a half later. Medical staff only told the child that she needed to have her appendix removed.
NPR's Wendy Blair tracked down Doris and her husband, Matthew Figgins, for her report. Doris said that for decades, she hadn't understood what had been done to her.
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DORIS FIGGINS: I just loved children, and I wanted one.
MATTHEW FIGGINS: We wanted children so bad. And...
BLAIR: Doris and Matthew Figgins, who tried all their married life to have children, are both in their 60s now, living in the country in western Virginia. They visited many doctors before one told them, not very clearly, that Doris probably couldn't have a child.
M FIGGINS: Dr. Hansbury (ph) had found scar tissue that she wouldn't be able to have a child. He didn't know - he didn't say that she had been sterile or anything.
BLAIR: And today, the Figgins still feel their disappointment.
D FIGGINS: I just felt empty. That's all.
VEDANTAM: It wasn't until 1979 that Doris learned that she had been sterilized. The person who told her the news was the director of the colony at the time. His name was K. Ray Nelson.
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K RAY NELSON: I felt that she had a right to know. And, basically, that was my motive. She had a right to know.
BLAIR: What is your understanding now about why they did that to you back then in 1928?
D FIGGINS: I couldn't tell you. I don't know why - they were experimenting on us or what - guinea pigs.
VEDANTAM: And what of Vivian, Carrie's daughter? She'd been adopted by John and Alice Dobbs. According to the Supreme Court, she was the third generation of imbeciles in the Buck family.
LOMBARDO: Vivian went to school. She went to the first grade and did passably well. She went to the second grade. That summer, she got the measles, apparently developed some kind of secondary infection and died when she was only 8 years old. So her story was pretty much buried for the better part of 50 years until the larger story of Buck v. Bell became public.
VEDANTAM: Before she died, Vivian, the child who was deemed to be not quite normal, had been on the honor roll.
After the Supreme Court decision, the nation embraced forced sterilizations for decades. The last of the country's eugenics laws were repealed only in the 1970s. By then, some 65,000 Americans had been sterilized. The targets were almost always the least powerful - Native American and African American women; immigrants; the physically and mentally ill; and, of course, the poor. As Paul puts it, if you want to know who was going to get sterilized during the reign of the eugenicists, you just had to look at the social ladder and see who was at the bottom.
When we come back, we consider the painful legacy of the Virginia State Colony for Epileptics and Feebleminded and how far we've really come.
MOLLY MCCULLY BROWN: People would come up to my parents, and they would say, what happened to her? They would say, can she talk? They would say, what's wrong with her?
VEDANTAM: You're listening to HIDDEN BRAIN from NPR.
This is HIDDEN BRAIN. I'm Shankar Vedantam. The Virginia State Colony was built on a vast tract of farmland overlooking the James River. It's a beautiful spot in the foothills of the Blue Ridge Mountains. It's the kind of country that imprints itself on a person, becomes part of who you are. Molly McCully Brown grew up just 15 miles from the Virginia colony.
MCCULLY BROWN: I can tell - if I'm driving, I can always tell the minute I hit that part of Virginia sort of - no matter if I can see a sign or not. The landscape starts to look familiar, and my heartbeat settles down. And I feel like, oh, this is what the world is supposed to look like. And that's a really nice artifact, I think, of having been raised someplace, of knowing where I'm from.
VEDANTAM: The Virginia colony was part of the landscape of her childhood. Molly says that when she and her mother would drive past it on their way to shop at Lynchburg, she would press her nose to the window and stare at the red brick buildings. They looked haunted.
MCCULLY BROWN: I knew that it had this complicated history tangled up with Appalachia and the Great Depression and people with disabilities. And I knew that it was still a residential facility for adults with really severe disabilities, but I didn't know much else beyond that.
VEDANTAM: In time, she learned about the institution's troubled history. For Molly, the story of Carrie and Doris Buck came with a special kind of pain. When she looked at her own body, when she thought of the way strangers looked at her, she knew deep down the colony was meant to house people just like her. Molly has cerebral palsy.
MCCULLY BROWN: I have impaired balance, and I walk with a kind of crouched gait.
VEDANTAM: She often uses a wheelchair. Molly has lived all her life knowing what it's like to be viewed, as Albert Priddy might say, as unfit.
MCCULLY BROWN: People would come up to my parents, and they would say, what happened to her? They would say, can she talk? They would say, what's wrong with her? And I think, mostly, those questions didn't come out of any kind of malice. They came out of discomfort and curiosity and a lack of understanding. But I understood, because of things like that - from a very early age, I understood my body as something strange and othered and defective, and that people were encountering it in that way and then assuming that I was othered and defective and strange.
VEDANTAM: Defective and strange - words so similar to those once used to describe the residents of the colony. Molly felt the connection. And one summer, when she was home on college break, she decided to visit the colony grounds.
MCCULLY BROWN: When I was there, I was just really struck by the place. I drove to the cemetery, you know, which had gravestones from the very early 1900s up to, you know, just a few years prior to when I was there. And I drove through the facility itself, which still had standing on it all of the buildings that were the original colony buildings that had just been sort of abandoned and moved out of. And then beside them, there were these newer, functional buildings that were the current facility.
And that combination of this place which was both a functioning residential facility and also a kind of ghost town of everything that it had been was really evocative for me. And I just remember thinking, oh, if I'd been born in the same part of the world even six years earlier, like, I might well have been a prime candidate to be a colony patient. And that is a kind of amazing - that was an amazing realization for me.
VEDANTAM: Slowly, the idea for a book emerged - a book of poems. She called it "The Virginia Colony For Epileptics And Feebleminded." Here's Molly reading the first poem in the collection, inspired by those drives she took as a child.
MCCULLY BROWN: (Reading) Whatever it is - home or hospital, graveyard or asylum, government facility or a great tract of land slowly seeding itself back to dust - its church is a low-slung brick box with a single window, a white piece of plywood labeled chapel and a locked door.
Whatever it is, my mother and I ride along its red roads in February with the windows down. This place looks lived in. That one has stiff, gray curtains in the window, a roof caving in. We see a small group moving in the channel between one building and the next, bowing in an absent wind. He's in a wheelchair. She is stumbling, pushing a pram from decades ago, coal-black and wrong. There is no way it holds a baby. Behind them, a few more shuffling bodies in coats.
I am my own kind of damaged there, looking out the right-hand window - spastic, palsied and off-balance. I'm taking crooked notes about this place. It is the land where he is buried, the place she spent her whole life, the room where they made it impossible for her to have children. It is the colony where he did not learn to read but did paint every single slat of fence you see that shade of yellow, the place she didn't want to leave when she finally could because she'd lived there 50 years and couldn't drive a car or remember the outside or trust anyone to touch her gently. And by some accident of luck or grace, some window less than half a century wide, it is my backyard, but not what happened to my body.
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VEDANTAM: While campaigns of mass sterilization are in our past, the ideas that inspired those campaigns live on. Dozens of women were sterilized without their consent in the California prison system between 2005 and 2011. In 2017, a judge in Tennessee offered reduced jail time to inmates who agreed to be sterilized in order to, quote, "break a vicious cycle of repeat drug offenders with children."
The eugenicists were convinced that they were doing hard but necessary things. So, too, was the man whose story we'll hear next - a story from an earlier era in American history.
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VEDANTAM: Five hours south of the Virginia state colony, in Columbia, S.C., there's a statue honoring J. Marion Sims. He's known today as the father of modern gynecology. The inscription on the statue reads, the first surgeon of the ages in ministry to women, treating alike empress and slave.
VANESSA NORTHINGTON GAMBLE: J. Marion Sims was a physician who was born in South Carolina in 1813.
VEDANTAM: This is Vanessa Northington Gamble. She's a physician and medical historian at the George Washington University. We asked her to come in to tell us the story of J. Marion Sims.
NORTHINGTON GAMBLE: He started a clinic in Montgomery, Ala. And at the time, in order to survive financially, he also was a plantation physician, where he took care of the enslaved on plantations.
VEDANTAM: This is where the story of Sims becomes complicated because, yes, the inscription on a statue in South Carolina is true. He did invent techniques that help women to this day. He treated slaves, as well as high society. He once treated Empress Eugenie of France. But there is something not mentioned on the inscriptions on the statues.
NORTHINGTON GAMBLE: Starting in 1845, he started to conduct experiments on enslaved women. And why we talk about Sims today and why that statue was there is that he perfected a technique to repair a condition called vesico-vaginal fistula. And let me tell you what that means. It basically means that there is an opening between the vagina and, also, the bladder or the vagina and the rectum, which usually comes after traumatic childbirth. And Sims started in 1845, 1846, according to some sources, a series of experiments to repair these fistulas.
VEDANTAM: This condition was highly stigmatized and dangerous for these women. There was no treatment. So on the one hand, you could say Sims was doing what doctors are supposed to do by taking these women on as patients. But there's another side to what Sims did. He wanted to be a trailblazing researcher. And these women - their bodies became props in his journey of scientific discovery.
NORTHINGTON GAMBLE: These women were property. These women could not consent. These women also had value to the slave holders for production and reproduction - how much work they could do in the fields, how many enslaved children they could produce. And by having these fistulas, they could not continue with childbirth and also have difficulty working.
VEDANTAM: There are 10 slave women central to the story. Three are named by Sims in his writing. These women were brought to him by their owners. The first woman was named Anarcha.
NORTHINGTON GAMBLE: Anarcha was a 17-year-old enslaved woman who had just undergone a very traumatic delivery. Some sources say that she was in labor for three days. At first, he did not want to treat her. He was not interested in treating women. But then what he started to do from a period from 1845 to 1849 - he did a series of experimental surgeries on these women, and he uses sutures to try to close up this opening.
VEDANTAM: Now, presumably, this would have been painful.
NORTHINGTON GAMBLE: It was very painful. And he talks about how Lucy, one of the three women, almost felt as if she were going to die, that she cried out in pain so much because of these surgeries. But at the same time, he writes that the women wanted the surgery because they did not want to have the condition anymore.
VEDANTAM: Surgical anesthesia was first used in Boston in 1846, so it's possible Marion Sims, working in the South, was unaware of it or unable to access it. But Vanessa says the surgeries he performed on enslaved women were also informed by a persistent bias about African Americans.
NORTHINGTON GAMBLE: There was a belief at the time that black people did not feel pain in the same way. They were not vulnerable to pain, especially black women. So that they had suffered pain in other parts of their lives - and their pain was ignored.
VEDANTAM: As Sims' reputation as a researcher grew, he began to invite other physicians to come watch as he performed the surgeries.
NORTHINGTON GAMBLE: So this surgery was done where black women were naked. So when we think about it, I think we think about pain. We also need to think about how these women's dignity were also taken away from them.
VEDANTAM: For a long time, the surgeries didn't work.
NORTHINGTON GAMBLE: No, he's not successful at the beginning. That's why these surgeries went on from 1846 to 1849. And finally, after 30 surgeries on one woman, he was finally able to perfect his technique.
VEDANTAM: That woman was Anarcha. The two others who are named in Sims' papers are Betsey and Lucy. I asked Vanessa Gamble whether there was any way to know if these women actually wanted the surgeries.
NORTHINGTON GAMBLE: One of the things in this story that's missing are the words and voices of the women themselves not being translated by Sims. The only thing we know is that Sims said that these women - one of the women clamorously wanted to have the surgery. They wanted to be cured.
VEDANTAM: Sims, of course, has a self-interested reason to say that the women wanted what he was trying to do to them.
NORTHINGTON GAMBLE: Of course he has an interest. And one of the interests is that it mutes the story of slavery in his work, that it mutes the story that the foundations of modern gynecology are based on the body and the pain of enslaved black women.
VEDANTAM: The statue in South Carolina that says that Sims treated empress and slave women alike...
NORTHINGTON GAMBLE: Yes.
VEDANTAM: Is that true? Was he treating white women the same way?
NORTHINGTON GAMBLE: He did treat white women, but he treated white women with anesthesia. Sims left - in the 1850s, he left Alabama and moved to New York City for health reasons, and he started a women's hospital in 1855 there. He gained a reputation as an excellent surgeon. And so that - he did treat white women, but the technique had been perfected on the bodies of black women.
VEDANTAM: When you hear about a story that took place 150 years ago, there is a part of us that says, that was pretty awful, but that was then and this is now. But a lot of your work has actually tried to broaden that idea and said, yes, that was then, but some of what was then is also with us now.
NORTHINGTON GAMBLE: Right. I mean, one of the things that - I teach a course on the history of race and racism in American medicine. And one of the things that I try to get across to my students is that racism is a very flexible, very adaptive concept - that, yes, black people are not thrown out of hospitals these days because they are black or not excluded from hospitals because they are black. But our focus today is on what happens once one gets into the hospital.
VEDANTAM: It's striking as you say this because I feel like I've read studies in the last few years looking at disparities in how people of color get treated for pain in the late 20th century and the early 21st century. It feels like there is a thread between what happened 150 years ago and what's happening today.
NORTHINGTON GAMBLE: Right. I agree with you because I think part of the story has to deal with how black bodies are conceptualized by the medical profession. There is a video that Johns Hopkins put out about people with sickle cell disease. And in this video, this woman says when I go to the hospital, even though I'm in pain, I make sure I get dressed up because if I get dressed up, maybe I will be treated better and not be seen as somebody who is seeking drugs. So it still is there in terms of how the medical profession views black people and black bodies.
VEDANTAM: Since I first spoke with Vanessa, a statue of Marion Sims in New York City's Central Park has been relocated. It's now in a less prominent spot at the site of his grave in Brooklyn. I asked Vanessa what she thought should be done with statues of people like Sims.
NORTHINGTON GAMBLE: It's one of those things where I'm conflicted. Last summer, I went to Liverpool, and Liverpool has a remarkable international museum of slavery because Liverpool was at the center of the trans-Atlantic slave trade. And on an art deco building, there was an image of Neptune, and underneath Neptune, there were two black children who were in chains. And the tour guide, who was an 80-plus-year-old black gentleman, asked us, do you think this should be taken down? And most people said yes. And he says, I think it should stay. And he said, I think it should stay because I don't want people to forget it happened. And so I think that we need to do something to commemorate the women to add something to say, yes, Sims did this, but what about Anarcha? What about Lucy? What about Betsey?
VEDANTAM: If you could build a memorial to Anarcha, Betsey and Lucy, what would the memorial say?
NORTHINGTON GAMBLE: The statue would not be of the experiments because I think that it's important not just to think of them as victims of these experiments. It might be with the three of them together or it might be with their - holding children, that they were mothers, that they were women. So that would be part of it. So it would not be their prostrate on the altar of science. I think what the inscription would say is Betsey, Anarcha and Lucy, the mothers of modern gynecology.
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VEDANTAM: Professor Vanessa Northington Gamble is a physician and medical historian at the George Washington University.
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VEDANTAM: This week's show was produced by Jenny Schmidt, Thomas Lu and Maggie Penman. It was edited by Parth Shah and Tara Boyle. Our team includes Laura Kwerel and Rhaina Cohen. You can listen to more of our stories by searching for HIDDEN BRAIN on your favorite podcast app. I'm Shankar Vedantam. See you next week.
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