The Dose - On the Need to Reclaim Gynecology’s Troubled Legacy

Episode Date: April 19, 2024

Montgomery, Alabama’s capital, is known as the birthplace of gynecology. It’s a brutal history, as the field’s “founding father,” J. Marion Sims, advanced his work through the experimentation on enslaved women and babies. Artist and health care activist Michelle Browder has forced a reckoning with this legacy with one clear goal — we need to talk about the mothers. On the newest episode of The Dose podcast, host Joel Bervell talks to Browder about her efforts to honor Sims’s victims — the names of only three of whom we know today: Anarcha, Betsey, and Lucy. They also discuss Browder’s work to channel the painful legacy of the past into a healthier future for Black women and their babies, as she prepares to open a midwifery clinic and birthing center as well as a national education center for medical students.

The Dose is a production of the Commonwealth Fund, a foundation dedicated to healthcare for everyone. My guest today on The Dose is gynecology healthcare activist and clinic founder, Michelle Browder, who's using art to retell history. Michelle works in Montgomery, Alabama, where she's speaking to us from today. Place is crucial, especially in this episode of The Dose. Montgomery, Alabama is considered the birthplace of medical gynecology because of a 19th century physician named Dr. J. Marion Sims, who's been called the father of gynecology. Sims built a hospital, referred to as a surgical infirmary for Negroes, for enslaved

women whose owners brought them for treatment. It's thought to be the first women's hospital in history, and was the first hospital specifically for Black people in the United States. But at that facility in Montgomery, J. Marion Sims developed and performed dozens of experimental surgeries on enslaved women without their consent and without anesthesia to repair and reconstruct their organs. He had no training because there was no training at that time and no discipline. He even purchased one enslaved woman from her owner specifically with the intention of performing experimental surgeries on her. And while many of the names of these women are lost, three of the women he named in his journal are known, Anarka, Betsy, and Lucy. Each had vesicovaginal fistulas, a common condition of women who have many children. They're essentially tears in the vagina, which can

often be painful. It can cause leaking of urine and even feces, leading to tissue death. My guest today, Michelle Browder, has not only created a monument to the enslaved woman in Montgomery, which we'll talk about, but she's also now planning to open a local midwifery clinic, a national education center for maternal health, and ultimately a birthing center on the site of the former hospital for enslaved women. It's with great pleasure and a lot of awe that I welcome you to The Dose, Michelle Browder. Thank you so much for joining me for this conversation. Oh my God, thank you so much for having me. It's a privilege. Thank you. Yeah. So we've met before, but I have to tell everyone this because they can't see you,

but your glasses are always just incredible. And so today you're wearing these amazing bright red glasses, and I think it's just a testament to your fiery personality. But I really want to jump into and talk about your clinic. You've just broken ground on the clinic you plan to open in Montgomery. And I know you envision this as a place that serves women locally and more broadly acts as a national education center. Can you first tell me about the ground floor operation? Who's the clinic for and who will it give and get help for there? So basically it is, you know, I think that this is just amazing because I really admire all of the work that you're doing as a medical student transitioning into what would be someone's magnificent doctor. And so you understand

the history of, you know, gynecology and women's health. But right now, this space that I happened upon, okay, is already, it's a building that was built in 1862. It was used, it was a place that was used for the first open heart surgery. It's built on the site of where J. Marion Sims had the Negro Women's Hospital. And so what it means to me is that I feel like it was an ancestral call, right? And I feel like I'm on borrowed time in that, that this is something that needs to be done quickly with perfection and with, you know, precision. But I just really think that there's a mandate because of where we are with maternity care, maternal health and healthcare in general, how we treat people, our patients, the lack of

empathy, dignity, and respect. And so this space is used, well, will be used because of the language. You know, you have to be careful. So I am in what they would call the antebellum South still. You know, we in Montgomery, Alabama, it's in our city seal that we are the cradle of the Confederacy, but yet we're the birthplace of the civil rights movement. Right. So the space, 33 Perry, I'm going to open hopefully the beginning of next year. You will be here, hopefully. Oh, I'll be there. Yeah. But it's a clinical museum in that I'm an artist. I'm not a medical student. I've only learned what I've learned from Harriet Washington, you know, medical apartheid, whether it was Dorothy Roberts and Killing the black body or Cooper Owens.

And now this new book, Say Anarcha, it's like this is where I'm getting all of this information about these girls in today's time. But this space will be a clinical museum where I'm merging art, history, maternity care, and medicine. Oh, I love that so much. I think that's so important because often in science, we lose meaning of art, when in fact, like medicine is not all science. Much of it is art. And so to see what you're doing of merging these different disciplines together is so powerful.

And can you tell us about what's upstairs, the education missions of your center? Yeah. So upstairs, there will be a space for medical students to come to learn. We're changing the curriculum in healthcare. So there will be a space for students to come in, not just students, but doctors and other medical practitioners, psychiatrists, right? Everyone needs to know what this legacy of slavery, what it has done to the body as it relates to trauma. And so there's a space there equipped with AI and equipped with the actual equipment to teach medical students how to administer empathy, dignity, and respect while they practice. And so, yeah, so we're curating a curriculum that will help teach all of us, you know, not just the medical procedures and what they should do

in a time when, you know, there's someone in a distressed situation, but also how do we really care for folks? And I think that's what we need today. Absolutely. And how is this work tied to the current maternal health crisis in America for Black women? Oh, my gosh. Well, we're not listened to, right? We're not taken seriously. There's a stereotype, a generalization of Black women and Black girls. And I have to say that there are, you know, the statistics or the generalization that Black women don't feel pain or we experience pain differently. That was from, you know, the 19th century. Well, it still plays out today.

You look at women like Serena Williams and or the woman that died during COVID, Dr. Susan Moore, you know, they weren't believed, right? And so I think that it's playing out today as just teaching us a different way to administer healthcare in this country. And, you know, whether it's maternity care or just healthcare in general, we need to do better. And so hopefully this space will give credence to that and open doors for a more courageous conversation on how we do better. And I think about this site, I said in the opening that location is so important, Alabama being a red state. And while Montgomery itself isn't a maternity desert, much of the surrounding state is. And I know even in like the post-Dobbs kind of world right now, there've been a lot of talk from potentially future OBGYNs not wanting to go to the South, or especially the need for more Medicaid expansion

for those that haven't been able to access healthcare too. How do you see kind of the policy tying in with the work that you're doing here? Well, the policy right now in Alabama is that, you know, the IVFs, we're having this issue with, you know, even though we don't have autonomy over our bodies, we are a red state where we do not believe that a woman should have a right to choose. And so now with the whole IVF legislation, it's just shining a light on where we're headed, right? In terms of autonomy and bodily care. Absolutely. Can you talk about each of the three named and known women who received treatment at the site your clinic is going to be at in the 1860s to 1880s? So Anarka, Lucy, and they basically were sexually trafficked. They were raped. One of their main duties was that they were to breed. You know, 1808, transatlantic slave trade is outlawed. And so basically in the United States, you know, you had to breed in order to replenish your stock. So Anarka, 17 years old, was enslaved here in Montgomery County.

At the time of her first fistula, it was J. Marion Sims, who was her practitioner, her doctor, her enslaver, the Westcots, you know, took her to him because he claimed that he could fix this fistula, that he could heal her from this. And and these are women that J. Marion Sims himself spoke about in his memoir, Stories of My Life. And basically he described them as subjects, you know, that that were in need of repair. But historically, they weren't fit for duty. As the incomparable Dr. Joy DeGruy points out in Post-Traumatic Slave Syndrome, that they weren't able to perform their duties.

And so it was customary for Sims, who saw where this could be profitable for his business, started accepting these women. Lucy, at the time of her experimentation, 18 years old, was from Macon County, home of the notorious syphilis studies, right? And then Betsy from Lowndes County was 16 years old at the time of her experimentation and, you know, the fistula giving birth. And so basically I wanted to honor these three women who were enslaved in Alabama and then, you know, talk more about the history and the duties of these trafficked enslaved bodies and these girls, you know, and that's one thing, you know,

we talk about the women, but they were girls, you know? And so that's what I tried to really uplift and amplify. And it's still happening today. We still have a sex trafficking problem. Absolutely. Can you tell talks a little bit more about Anarcha. And she basically went on to have six children. She went on to get married. And so they've recently found one of her descendants from the married side. And I don't know if you know about this, but she's- I don't know. Yeah. They found the descendant and also where she's buried. Wow. Yeah. And it's in the new book. It's in a new book.

And so basically, Anarka, you know, she went on to be a nurse. Jamie and Sims actually loaned her out to be a nurse where she would take care of, you know, traveling, you know, six sick passengers as they would come through Montgomery, Alabama. And so basically there's a little bit more about her, more so than the other two, because Betsy and Lucy, those names were very common. But with Anarcha, the A-N-A-R-C-H-A, she was easily recognizable in the census, but the other two are not. And so that's basically all that we know of her. And so there's more information in this book, if you all would like to go and check it out. But again, it's important to lift them up because Sims imposed upon them, right? He tortured these girls, but yet he talked about them, right? so basically, we're trying to shine that light on them specifically.

Absolutely. Can you talk about if these women were acknowledged, compensated, or otherwise credited at all for the use of their bodies or their literal physical material? No, they were not. They were not given their just due. As a matter of fact, in the state of Alabama and Montgomery in particular, there is a statue that sits at our state's capital. And the capital was built by enslaved African people and their descendants. And there's no recognition, there's no post and or iconography to talk about those people that were enslaved and neither was there until 2001 that talked about

Anarcha, Lucy, and Betsy. However, Sims is known as the father of gynecology. And I would often drive by that marker that sits at our state's Capitol. This man did nothing in terms of legislation, but the MASA, the Medical Association for the State of Alabama, deemed him worthy to erect a monument. And I thought to myself, well, where are the mothers? Yeah. If he's a father, there must be a mother somewhere. And so from there, you know, the research continued. So our goal is to just make sure we tell their stories.

And that's such a beautiful line right there. Where are the mothers? If there's a father, there has to be a mother. And it's so true in the sense that we overlook women, mothers so much and focus so much on the male perspective. That's why I think the work you're doing is so important. Can you tell us a little bit more? You've mentioned some about the kinds of experimentation

that the patients of Dr. Marion Sims were subjected to. Oh my gosh. So it wasn't just women. It wasn't just girls. There were babies. There were men with lockjaw and drop foot, and he killed a lot of his subjects because that's what they were known. They weren't humanized. Right. So he killed a lot of these victims. And there's one in particular that's spoken about in this book about the lockjaw and the babies whom he murdered for simply trying to, you know, close little soft spot in the baby's head, he literally would experiment on trying to formulate and or shape the cranium causing the child's death. When Sims left Montgomery, Nathan Bozeman, this doctor, was given his space to continue some work. And he was a critic of J. Marion Sims because of how he conducted his work. And so, yeah, but many of subjects that he built, and I say that in that way because these were actually human, but again, in his view, they were just subjects. They were just, you know, easily discarded. Yeah. And I know the site that you

are building this monument on already has a statue there that you've built. Can you describe the Mothers of Gynecology statue? So can I tell you how I first heard of them though? Yes, please, please. I first was introduced to Anarcha, Lucy, and Betsy when I was 18 years old at the Art Institute of Atlanta. I studied visual communications and graphic design. And I'm in one of my classes, my figurative drawing class, and there's a poster. It wasn't a poster. It was a postcard that was sitting on the desk of my professor. And it's that infamous one by Robert

Tom, who created 45 Moments of Medicine, right? He was commissioned by Park Davis, which is now Pfizer, to create this art. And it depicts Sims standing with a speculum and Arca on the table. It's a very famous one, right? And the two girls appearing behind the sheet with these two white men. And so I went to my professor. Now, my family, we're very, you know, Black power, right? We know all about the Black history. We know all about, you know, what happened, right? We know all about the black history. We know all about, all about, you know, what happened historically as it relates to transatlantic slave trade, but nobody told me about black girls and black bodies and how they were, you know, sexually trafficked and raped. And so I went, I went to my professor and I was like, what does

this postcard mean? Tell me more about it. And he looked at me and he said, in a dismissive manner, you go figure it out. Oh, wow. And I did. So over my summer break, I went to what is called the Shrine of the Black Madonna in Atlanta, Georgia, and told them, I told them what I saw. And they immediately knew exactly what I was talking about. They told me about it, but these girls haunted me because they were just girls. And I can remember going back to my college and creating my whole portfolio to honor Anarka, Lucy, and Betsy. And it's beautiful. I still have some of my pieces today. And my portfolio presentation, my professor looked at it and said, it's too Black.

Wow. You need to diversify. And at a young age, I was given a dilemma by my father. My father is the first Black prison chaplain that was appointed by George Wallace. And he said to me, Michelle, if you don't learn how to channel your energy, you'll be in prison. So he gave me an ultimatum at 13, prison or art. Wow. And so at that time when my professor said,

I'm not going to let you go further because your portfolio is talking about these three enslaved girls, I chose to drop out of college and I just started my own business, right? So during COVID, here we are some 30 years later, I'm just thinking of Anarcha, Lucy, and Betsy. And I said, now is the time for me to erect a monument. And then the timing is right, right?

So my whole goal was to honor them, to amplify their voice, and it changed the narrative. And so that's why the property that they sit on is literally a mile from where Anarcha was enslaved. The Westcott Plantation, it's literally two blocks from the church that her owner, Eliza Westcott, owned and formed this church in Montgomery, Alabama. And they split it off and had the Negro church for black enslaved folks to attend. And the monument sits literally what's six blocks from where they were enslaved and tortured

the hospital, but they're made of discarded metal. There's bicycle chains, scissors, gynecological tools, the Sims retractor, the speculum, the knees are scuffed up for the Sims position. You know, no, there's nothing in the medical field and or as it relates to instruments that speak to these girls. You know, I think there is a push for the Lucy. You know, someone's pushing to call one of the retractors the Lucy. I think it's a speculum. So, yeah. So I wanted to make sure that these girls, this monument showed the type of trauma that they went through. So there's perforated metal, right, with the holes in it that represent the poking and the prodding. There's also a serving platter that adorns Lucy's chest have an Adinkra symbol and the Guinean language of, you know, God is supreme.

The tongue and teeth, which is the friendship with for Lucy. And then the emblem for strength adorns the body of Betsy. So it's, you know, it's mixed with some African ancestry and language. And I wanted to honor the Maasai tribe on Lucy. So her adornment is made up of this beautiful glass and powery shells that shows the African diaspora. There is so much power in what you just said of the recognition of the history, of the legacies of these girls, of the intentionality. And at the top of this conversation, you talked about feeling this ancestral drive to be able to create this monument for them.

And I love how you've also connected it back to them and their ancestral roots as well. I encourage anyone that's listening, please, please, please go look this up online if you're not able. If you can, go to Montgomery and see this in person because it is a beautiful statue that I think when you just look at it, you get chills. And I remember when I created the video about J. Marion Sims being the father of gynecology and how we need to focus on the mothers of gynecology.

I put that monument image in there because I thought it was so powerful just for someone to see it for the first time. And it's beautiful. But I really want to ask about your mission. Your mission is in part health-related. Right now, that's a primary focus with the clinic just breaking ground. When you look ahead, what do you see in the horizon for this region? As you are, we've discussed that the state has so much farther to go in terms of things like Medicaid expansion, living in a post-op world, now the IVF decision. What do you see on the horizon for the region? It's grim. It's grim. We have people in

office and in position that just do not care. And there's no other way to say it. You can't, you know, pussyfoot around it. You can't patty cake with it. These people do not care about healthcare. You just mentioned the Medicaid expansion. We're going to lose another hospital in Alabama if we don't expand Medicaid. How is that? Right now we're going to these maternity care deserts. There's 25 of them, but there's 43 counties that don't have obstetrics and or a gynecologist. We just, we, you know, what's ahead of us is that we, I decided I wanted to really buy a mobile clinic, right? I priced it out. It's $131,000. Didn't make sense to invest that type of money when, you know, we're trying to finish this clinic, open it up and finish it. So I thought, well, why can't I

just buy a camper and convert the camper over to a wellness pod, right? So we did that last year. We unveiled it on Mother's Day and we've seen over 213 women and girls who do not have maternity care in these black belt counties. And the black belt county in Alabama are these spaces where historically is known for the cotton fields, right? Black belt, the soil. They're also some of the poorest counties in the state of Alabama. They don't have maternity care. So we've been going to these people. Our motto is, you know, we're coming to see about you. We've been going, talking to them, taking them, you them, whether it's lactation care, just education in general, whether it's contraceptives. The first thing people asked us in Selma was, do you have any contraceptives, right? Contraceptive care.

And so, you know, so we're taking Pampers, you know, whatever they need, including food. We're learning now that, okay, so a mother was walking up the street in a hundred degree weather and she was contemplating whether or not she's going to buy diapers and or food, you know? And so that's what we're doing. We see what's ahead of us as it relates to the state and the leadership. And so we're trying to get ahead of it and we're taking matters into our own hands and we're going to these spaces and, you know, offering care and support to women in these maternity care deserts or what the March of Dimes would say is a maternity desert. And it is. It is. And the food insecurity with the children, you know, and hopefully, you know, supplying some support for, you know, job placement. It's a holistic approach that we're trying to, you know, to do with people in our state. And so that's what I say that it's grim as it relates to leadership.

But I'm very hopeful of the charge that we have to keep, which is to reach out and to go find these people, link them with a midwife, a doula, and or an OBGYN. And that's what we're doing. That's incredible. Michelle, I want to say thank you for choosing to channel your power into art, for being the voice for the voiceless, and for continuing to challenge us and the assumptions that we all hold. I'm so honored to have had you here on The Dose. Thank you.

Thank you. Thank you. This episode of The Dose was produced by Jodi Becker, Mickey Kapper, and Bethann Fox. Special thanks to Barry Scholl for editing, Jen Wilson and Rose Wong for art and design, and Paul Frame for web support. Our theme music is Arizona Moon by Blue Dot Sessions. If you want to check us out online,

visit thedose.show. There, you'll be able to learn more about today's episode and explore other resources. That's it for The Dose. I'm Joel Brevelle, and thank you for listening.