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Sometime around 1844, an enslaved teenager named Anarcha was brought to a doctor in Montgomery, Alabama. She had recently given birth, a labor so prolonged and traumatic that the baby was delivered dead with forceps, and Anarcha was left with devastating internal injuries. Tears had formed between her vagina and bladder and between her vagina and rectum, a condition called vesicovaginal and rectovaginal fistula. It meant she had no control over her urine or feces. The wounds were open, constantly infected, and caused her unrelenting pain.
Her enslaver didn't bring her to a doctor out of concern for her suffering. He brought her because she could no longer work. The doctor was J. Marion Sims, a physician with no particular interest in women's reproductive health by his own admission. He had recently developed a new way of positioning surgical patients, and he believed he could repair fistulas in women like Anarcha within six months. He made arrangements with the enslavers of Anarcha and at least two other women, Betsey and Lucy, to lease them for the duration of the treatment. He built a small hospital behind his house and put them there.
He was wrong about the six months.
For the next four to five years, Sims operated on Anarcha, Betsey, Lucy, and at least nine other enslaved women, trying and failing and trying again. Anarcha alone underwent at least 30 operations. She was between 17 and 19 years old when the experiments began. The women were given opium as pain management in some procedures. Ether and chloroform were available during this period and were used in other medical settings. Sims chose not to use them. The prevailing belief among white physicians of the time was that Black people did not experience pain the way white people did. This was not medicine. It was a lie that made what he was doing easier to continue.
The women were not asked whether they wanted to participate. They had no legal standing to refuse. When other physicians grew tired of assisting and stopped coming, Sims trained Anarcha, Betsey, and Lucy to assist with the operations being performed on themselves and on each other.
In 1849, after introducing silver wire as a suture material, Sims successfully repaired Anarcha's fistula. He went on to publish a paper about his surgical technique, which became the first repeatable treatment for vesicovaginal fistula and formed the foundation of modern gynecology. The paper omitted any identifying characteristics of the women who had made it possible. Sims moved to New York, founded the first women's hospital in the United States, became president of the American Medical Association in 1875 and the American Gynecological Society in 1879, and was celebrated in his lifetime and long after as a pioneering figure in medicine. A statue of him stood in Central Park for over a century.
In 1856, a woman named Anarcha, aged around 32, appeared in Sims' records in New York, admitted to his women's hospital and discharged a month later as cured. Her enslaver at that point was listed as William Lewis Maury of the U.S. Navy. Recent research by writer J.C. Hallman, published in 2023, traced what is believed to be the same Anarcha forward in time. She appears to have eventually taken the name Anarcha Jackson, married a man named Lorenzo, and died in Virginia sometime around 1869 or 1870. A tombstone in King George County reads Annacay Jackson. She was somewhere in her early forties.
She left no written record. As an enslaved woman, she was almost certainly unable to read or write. What she endured, what she understood about what was happening to her, what she felt, remains entirely beyond recovery. The historical record belongs almost entirely to the man who operated on her.
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