Speaker 1: What what now? That's how we're starting the episode, Sophie,
Speaker 1: and then God bless you, and then this everything. Honestly,
Speaker 1: you've done way worse. So I'm like, cool with it.
Speaker 1: How are we doing the day? How's everybody? Who are we?
Speaker 1: Where are we? This is behind the bastards? And today
Speaker 1: fucking sucks? It is uh? Are you? Are you? When?
Speaker 1: When were you born? Are we? All? Was real older
Speaker 1: than all of us? Yeah, I'm not that old. Jesus man,
Speaker 1: I don't remember when my God, Yeah, yeah, I'm not
Speaker 1: that old. I'm I'm an eighties child, I'll put it
Speaker 1: that way. So, yeah, yeah, this is the first day
Speaker 1: of all of our lives that we're according this. It'll
Speaker 1: be coming out a bit later, but the day we're
Speaker 1: recording this is the first day of all of our
Speaker 1: lives that Rovie Wade is no longer a thing. I
Speaker 1: just looked up. I should have known that. Yeah, you
Speaker 1: thought you thought he was older than I get it.
Speaker 1: I don't know when when when? I don't remember when
Speaker 1: things medicine ages you. I'm a fucking rack. I get
Speaker 1: you're a doctor. That means apologize to doctor who as
Speaker 1: a doctor, which means he's an adult and all adults
Speaker 1: are the same age. Yeah, but we have feelings to Robert,
Speaker 1: I know, well you're just so you know what's really
Speaker 1: messed up? What's that? The history? Yes, yeah, that's what
Speaker 1: we're talking about today. Um, this is gonna be a
Speaker 1: rough one. Uh. I don't have anything else to say that.
Speaker 1: This is gonna be a rough one. What do you
Speaker 1: what do you know? What do you know about the
Speaker 1: how how gynecology started as a as a as a
Speaker 1: discipline in like western medical cannon. Okay, Um, this is
Speaker 1: this is gonna be hard on me. Uh, this is
Speaker 1: I'm not like above criticizing medical history. I mean, we
Speaker 1: have a very bad history everything thought. Yeah, but you
Speaker 1: you kind of higher hopes for medicine. Uh, and when
Speaker 1: you learn about some of the awful stuff in medicine,
Speaker 1: um it it's a little bit uh disappointing, maybe at
Speaker 1: least because you expect more. But there's a lot of
Speaker 1: bad people in the world of medicine did a lot
Speaker 1: of bad things. You've covered a lot of them, even
Speaker 1: recent ones. And uh, I'm sure it would be guine,
Speaker 1: like a lot of the other medical advances in medical
Speaker 1: fields has probably had some pretty awful characters in it.
Speaker 1: I think I have a sense of who we're talking
Speaker 1: about today. Uh if that's if that's what we're talking about. Yeah,
Speaker 1: today we are talking about Jay Mary and Sims. Um.
Speaker 1: And as a rule, when you google this guy, doctor
Speaker 1: j Mary and Sims. Although again, at the time he
Speaker 1: became a doctor, like I think there's like hairdressers who
Speaker 1: spend more time in school. Like, it wasn't it wasn't
Speaker 1: that hard at the time. You know, nobody was doing
Speaker 1: eight years in medical school. There's a lot of cocaine
Speaker 1: people and just a lot of knights in the hospitals.
Speaker 1: That was about it. I'm sure low're bar um. Yeah.
Speaker 1: So when you google Jay Mary and Sims, the thing
Speaker 1: you'll generally seem described at is the father of guy
Speaker 1: in ecology. Um, which is you would Oh, I thought
Speaker 1: you were gonna say, uh, Colin Firth, Stoppelganger. I mean,
Speaker 1: he does look a lot like Colin Firth. Listen, that's
Speaker 1: Mr Darby you're talking about. I have some respect. Well,
Speaker 1: I mean Jay Marry and Sims could have played Mr Darby. Um. Now,
Speaker 1: this is a tough one. It because this guy, unlike
Speaker 1: a lot of the doctor usually when we have a
Speaker 1: doctor on here, you're about to hear about them doing
Speaker 1: some very non doctor lee shit. Um. This guy was
Speaker 1: pretty competent at medicine. He I mean, he made his mistakes,
Speaker 1: but he was like kind of on the cutting edge,
Speaker 1: and he legitimately made some fair important breakthroughs in medical science. Um.
Speaker 1: He is not a medical grifter. Uh. And he was
Speaker 1: not full of shit. Um. What he was was a
Speaker 1: guy who used enslaved people as test dummies on which
Speaker 1: he could like cut at his will. Um. And that's
Speaker 1: what we're talking about today. I'm already sad. Yeah. UM.
Speaker 1: I do want to start though by because, like, because
Speaker 1: this guy gets called the father of gynecology a lot,
Speaker 1: I do feel like we should we should go back
Speaker 1: in time a little bit and talk about kind of
Speaker 1: what came before him, because, um, like, obviously this guy
Speaker 1: there's a degree of historical credit this guy should get.
Speaker 1: He invented some of the most basic tools that are
Speaker 1: still used today in the trade. Um, it's probably fair
Speaker 1: to say he was one of the first people to
Speaker 1: practice gynecology and a recognized modern way. Um. But in
Speaker 1: a larger sense saying that, like any person in the
Speaker 1: eighteen hundreds, let alone, a dude could be like the
Speaker 1: father of gynecology is like lunacy, because obviously people have
Speaker 1: heard about health and and those organs and that part
Speaker 1: of the body for forever, and they have been attempting
Speaker 1: to deal with it one way or the other, um,
Speaker 1: for forever. And I do want to start talking about that,
Speaker 1: just because I don't like limiting our discussion of medicine
Speaker 1: to like the eighteen hundreds when like ship was getting patented,
Speaker 1: because actually useful things were discovered before that period in time. UM,
Speaker 1: So obviously, UM, the it's you know, hard to say
Speaker 1: what the first medical practitioner would have been. It is
Speaker 1: certainly someone whose name has been lost to time, if
Speaker 1: indeed they had a name, right, Like, if you're really
Speaker 1: counting the very first people who figured out that there
Speaker 1: were different kind of plants or clays and soils, all
Speaker 1: of these were used in different kind of medical capacities
Speaker 1: by people in the past. Um, they may have even
Speaker 1: been people before like names were a thing that people had. UM.
Speaker 1: One of the reasons for this is that anthropologists suspect
Speaker 1: that a lot of our early understanding of like what
Speaker 1: herbs and plants and other things were medicinal came from
Speaker 1: people observing animals. There are animals that will seek out
Speaker 1: medicinal herbs in nature and use them to alleviate discomfort
Speaker 1: and aid in healing. This is how probably people learned
Speaker 1: about different things, including the plants that we get like
Speaker 1: ad villain stuff basically from um uh plants that like
Speaker 1: we get. I mean this is honestly where like d
Speaker 1: m T and ship comes from m al. Wise there's
Speaker 1: um like jaguars in the jungle, little seek out banister
Speaker 1: ops as cappy and whatnot. So like all of these,
Speaker 1: all these different like medicines. People probably started to find
Speaker 1: things that were useful in treating ailments by watching animals
Speaker 1: in the wild take them and kind of like documenting it. UM.
Speaker 1: It's also worth noting that this is probably not exclusive
Speaker 1: to humans. Anthropologists suspect that Neanderthal's had medical knowledge and
Speaker 1: presumably acquired it in the same way. UM. This also
Speaker 1: probably included basic knowledge about how to deal with wounds,
Speaker 1: because they would people. It's it's not hard to figure
Speaker 1: out that like putting pressure on a bleed can like
Speaker 1: help with the bleed. Right, we shouldn't assume that people
Speaker 1: thirty thousand years ago were too dumb to be like, oh,
Speaker 1: if you hold onto a bleeds sometimes they don't die. Um,
Speaker 1: you know, all that kind of stuff is probably early,
Speaker 1: early on, like medicine. The first documented medical tools in
Speaker 1: history are believed to be flint tipped drills and bowstrings
Speaker 1: used by Neolithic dentists in Balukastan around seven thousand BC. Um,
Speaker 1: which is pretty amazing. Blukastan. Are you making that up?
Speaker 1: Is this a place? No? No No, no, no no, but
Speaker 1: it's a let me let me double check because map
Speaker 1: stuff is always but I believe it's like, um, we're on.
Speaker 1: I'm going to be really pissed. I don't think it's
Speaker 1: far I mean Lucastan. Oh my god. Yeah, there is
Speaker 1: a Bulakistan. Yes, it's one of it's part of Pakistan Ta,
Speaker 1: so it's yeah, it's not far far enough, far far. Yeah,
Speaker 1: it's like yeah that kind of Indo Arean area. Um.
Speaker 1: So yeah, that's the first in the first medical tool.
Speaker 1: And again these are just the first ones that we've
Speaker 1: probably the oldest tools that we have on record, right,
Speaker 1: which isn't to say that these were the first, but
Speaker 1: that's interesting to me always that like dental tools, although
Speaker 1: it makes sense like the consequences of fucking up with
Speaker 1: dental surgery or less than like heart surgery. So it
Speaker 1: makes sense that like people might have figured that out earlier, right, yeah, yeah, exactly,
Speaker 1: it's an easier access yeah yeah, and obviously, like tooth
Speaker 1: problems would have been all very common. Um. However, some
Speaker 1: researchers have recently argued convincingly that the very first recorded
Speaker 1: medical device and history came much earlier and was not
Speaker 1: a drill or any kind of surgical tool, but was
Speaker 1: actually the statuette commonly known as the Venus of Willendorff,
Speaker 1: found in Austria in nineteen o eight. If you've seen
Speaker 1: this artifact, and I think anyone who's gotten through grade
Speaker 1: school has seen it in a textbook, it is one
Speaker 1: of the most common pieces of ancient art that you'll see. Um.
Speaker 1: It dates back to about eight thousand years ago, give
Speaker 1: or take, and it depicts a rotund woman with substantial
Speaker 1: breasts and white hips. Uh. The guys who found this
Speaker 1: in Austria were like white Victorian due um, and they
Speaker 1: assumed immediately that this was pornography of some sort and
Speaker 1: that the venus descriptor was like the fact that they
Speaker 1: called it a venus was like them making fun of primitive, undeveloped,
Speaker 1: savage people, right, and like, oh, this is what they
Speaker 1: thought was hot, these weirdos in the past, Uh said,
Speaker 1: those weirdos in the past. So more recently, several groups
Speaker 1: of scholars have argued that the venus was in fact
Speaker 1: an obstetric aid used by women to track the progress
Speaker 1: of their pregnancies, the changes in their own bodies and
Speaker 1: the bodies of others over time during your pregnancy, and
Speaker 1: perhaps even as part of an attempt to figure out
Speaker 1: what body shapes were most likely to survive childbirth. Basically
Speaker 1: an attempt to document here's who what are members of
Speaker 1: are like tryb or clan or whatever look like in
Speaker 1: different stages of the pregnancies that we can know, Well,
Speaker 1: the women who look more like this have an easier
Speaker 1: time surviving the birthing process. Right, this is again wild. Yeah,
Speaker 1: I did not I did not know about that. I
Speaker 1: know about the statutes in like your rights in every
Speaker 1: textbook it's like you know, and like Michael Crichton books,
Speaker 1: it's in like a lot of like pop culture or
Speaker 1: when they this time travel thing, But like, I had
Speaker 1: no idea there's natural use for it. Yeah, one of
Speaker 1: the ways in which there's been a couple of papers
Speaker 1: on this at this point. And one of the things
Speaker 1: the first that I actually talked to one of the
Speaker 1: guys who did the first paper, one of the things
Speaker 1: they pointed out is that if you if you take
Speaker 1: pictures of the venus from the perspective of its head,
Speaker 1: like looking down at its breasts, looking to the side
Speaker 1: at its hips. Um. They compared that to pictures pregnant
Speaker 1: women took of themselves with the camera like facing where
Speaker 1: their eyes were, of the same parts of their body,
Speaker 1: and it looks like the depiction of a pregnant person
Speaker 1: that a pregnant person would make of their own body
Speaker 1: if they did not have access to like a mirror
Speaker 1: or something, if they were just looking down at themselves
Speaker 1: and trying to sculpture representation. UM. And further research was
Speaker 1: published and I'm gonna quote now from a write up
Speaker 1: and art critique about it. Quote published recently in Obesity,
Speaker 1: a scientific journal. Richard J. Johnson, Miguel al Lanaspa, and
Speaker 1: John W. Fox offered that variation in size amongst amongst
Speaker 1: venus sculptures was directly related to climate and proximity to
Speaker 1: glaciers because survival required sufficient nutrition for childbearing women. They write,
Speaker 1: we hypothesize that the overnourished woman became an ideal symbol
Speaker 1: of survival and beauty during episodes of starvation and climate
Speaker 1: change in Paleolithic Europe. The study further points out that
Speaker 1: the venus is often made out of mammoth. Mammoth ivory, stone,
Speaker 1: and horn were worn down in smooth likely result of
Speaker 1: being being handled, indicating that they were probably passed down
Speaker 1: through generations. The study proposes that the venuses could have
Speaker 1: been used as tools to teach women coming into their
Speaker 1: child bearing bearing years then increasing their own body fat
Speaker 1: would allow them to survive through difficult climates. It yeah,
Speaker 1: and I think it's yeah. It's obviously, um, it's unlikely
Speaker 1: that the venuses we have, any of them particularly, are
Speaker 1: the very first ones done. But but these go back
Speaker 1: very far, twenty three thousand years or so before the
Speaker 1: first dineral drills. Part of what that suggests is that
Speaker 1: maybe some of if not the very earliest people practicing
Speaker 1: medicine in anything that could be considered a kind of
Speaker 1: like um uh organized way would have been women either
Speaker 1: trying to survive pregnancy or trying to help other women
Speaker 1: survive pregnancy, right, which is also very logical if you
Speaker 1: think about, like, you know, how like the priorities people
Speaker 1: would have had back then. Um. I stayed all this
Speaker 1: because number one, we're about to talk about a very
Speaker 1: different period in the history of women's health when the
Speaker 1: only people who are allowed to study it were men
Speaker 1: um And I don't want to pretend because when you
Speaker 1: call somebody like Jay James Mary and Simms like the
Speaker 1: father of gynecology, it does kind of like insinuate that
Speaker 1: this is the start of like women's health as like
Speaker 1: a medical discipline, and it absolutely is not right. We
Speaker 1: people have been working and in a lot, in a
Speaker 1: lot of cases we could talk about, um, you know,
Speaker 1: midwives in Europe um and like a lot of how
Speaker 1: a lot of like honestly a lot of the best
Speaker 1: knowledge about childbirth and whatnot would have come from them
Speaker 1: rather than doctors from most of the history of medicine
Speaker 1: for reasons we're about to talk about. So just want
Speaker 1: to denote as we get into this really misogynistic and
Speaker 1: racist story, um, that the history of gynecology does not
Speaker 1: in fact begin with James Maryan Simms and kinnecology of stetrics.
Speaker 1: It's all kind of like woven together at this point
Speaker 1: because there's not a lot of specialization yet. Um when
Speaker 1: we talk about where we're talking about, which is the
Speaker 1: early eighteen hundreds. So I'm gonna I'm gonna move into
Speaker 1: the story now. James Marion Sims was born in Lancaster County,
Speaker 1: South Carolina, in eighteen thirteen. Most of the knowledge we
Speaker 1: have of his early life comes from his autobiography, The
Speaker 1: Story of My Life, which he wrote forty years after
Speaker 1: the experiments that are going to take up the bulk
Speaker 1: of our discussion today, to give you an idea of
Speaker 1: the sort of guy he was. The book opens with
Speaker 1: forty pages. He had someone else right about what a
Speaker 1: hero he was. I'm gonna the way to do it.
Speaker 1: I'm gonna I'm gonna do it. I'm gonna read you
Speaker 1: a sample passage for this fucking book. His mouth was
Speaker 1: admirably formed, the lips being of medium fullness to the
Speaker 1: lower lips somewhat fuller, indicating decision of character. His smile
Speaker 1: was one of kindly sweetness. His head was rather below
Speaker 1: than above the average size, and it's unusual height in
Speaker 1: proportion to its circumference pointed his Gaelic origin, for through
Speaker 1: his mother, the blood of the mcgregors of Mcalpan coursed
Speaker 1: full proof in the veins of their descendant. His tout
Speaker 1: ensemble suggested in all respects, Sir John Bell's ideal of
Speaker 1: the qualities necessary in a truly great surgeon, the brain
Speaker 1: of the apollo, the heart of a lion, the eye
Speaker 1: of an eagle, and the hand of a woman. Just
Speaker 1: so you know, this is classic academics. Classic academics is
Speaker 1: how it is. This is how it is to teach
Speaker 1: you go a male. This is everyone's like this classic
Speaker 1: beautiful Gaelic features. Yeah, beautiful feet in the hands of
Speaker 1: a woman. That's actually kind of a compliment that at least,
Speaker 1: at least that part of it's like, you know, like
Speaker 1: hands in the heart of a lion. He's perfect, He's
Speaker 1: a perfect man. Yeah, So, I mean, just as an
Speaker 1: idea of where this guy's ego ends up, that's like
Speaker 1: how that's that's what he has someone else right opening
Speaker 1: his fucking idol biography. Can I just asked you a question?
Speaker 1: Am I? Absolutely? At some point when he is forced
Speaker 1: to confront some of the bad stuff that he does,
Speaker 1: am I going to absolutely hate him for his responses,
Speaker 1: and when he looks back upon it in this book,
Speaker 1: yeah yeah, it's it's pretty weasily. It's one of mature
Speaker 1: is really going to hate it. So, following tens of
Speaker 1: thousands of words of effusive praise, the book opens with
Speaker 1: Sims explaining how a bunch of people just demanded he
Speaker 1: writes this autobiography. He's like, doctor's autobiographies aren't normally interesting,
Speaker 1: but the demand has been so intense that I must.
Speaker 1: I'm gonna tell you I know how this happened. Because
Speaker 1: when you're a doctor and you're being followed around by
Speaker 1: like a big group of medical students, you have them
Speaker 1: at your you have to that their grades, their lives,
Speaker 1: the future careers are in your hands. And I've never
Speaker 1: gotten more fake laughs than when I like have medical
Speaker 1: students with me. I'm like very sensitive to it, like
Speaker 1: a dream. It's you think, but at some point kind
Speaker 1: of drives you crazy because you're, wait, was that, don't
Speaker 1: don't give me a courtesy laugh? I want you don't
Speaker 1: have to do that. And that's what's happening to this guy,
Speaker 1: because all these students being, oh my god, you're so amazing.
Speaker 1: Please tell us how you have to write a book, sir, sir,
Speaker 1: you have to write a book. You have predicted this,
Speaker 1: because he starts to hospitals. So, yes, that's absolutely the
Speaker 1: case here. I know I know this guy, Yeah, I
Speaker 1: know him. So um. He notes that his uh yeah.
Speaker 1: He gives through some interminable family history before he starts
Speaker 1: talking about his own birth. He notes that his parents
Speaker 1: were descended from English colonists in Virginia, that his family
Speaker 1: had come to North America in seventeen forty, and that
Speaker 1: his grandfather served in the Revolutionary War. Quote, when I
Speaker 1: was ten or twelve or eleven years old, he showed
Speaker 1: me a document with Washington's name signed to it. But
Speaker 1: I did not have enough sense to appreciate it or
Speaker 1: to care to know what it was. Um, who knows
Speaker 1: if that's true. Might have been might have just been
Speaker 1: something he said, because it was kind of invoked in
Speaker 1: this period of time if you were a certain kind
Speaker 1: of white dude to be like, oh, yeah, my I
Speaker 1: had a grandpa or a dad who knew George Washington
Speaker 1: for share. Um. Now, his grandfather lived to age ninety five,
Speaker 1: which is insane in that that's pretty good now, Like
Speaker 1: in the eight hundreds, like that is the toughest son
Speaker 1: of a bitch in several counties, UM. And what he
Speaker 1: talks a lot about how the men and his family
Speaker 1: live long lives. And then he spends several pages whining
Speaker 1: that his dad died at age seventy eight, which is
Speaker 1: again pretty good for the era. Now again is still
Speaker 1: above average UM. And he spends a long time listing
Speaker 1: all of the things his dad could have done to
Speaker 1: have lived longer, because he was supposed to live to
Speaker 1: be over a hundred UM. And then, after he spends
Speaker 1: all this time complaining about his father dying early at
Speaker 1: seventy eight, he notes, off handedly, my mother died at
Speaker 1: the age of forty of common bilious remittent fever, the
Speaker 1: disease that is cured now with the greatest facility, but
Speaker 1: at the time was attended with great mortality because they
Speaker 1: were ignorant of the method of care. That's it. That's
Speaker 1: all for mom. That's all for mom. Oh, this was
Speaker 1: an amazing time to be alive. Share was dad only
Speaker 1: lived a seventy eight? What a tragedy if he'd you know,
Speaker 1: avoided this and taken this and done this that I
Speaker 1: told him, Oh, yeah, mom dropped at forty, but whatever. Yeah,
Speaker 1: she didn't have his lips. Did you see in my
Speaker 1: father's lips. They were my father's beautiful full lips. They
Speaker 1: were beautiful. Uh, it's it's great. So Mary and Simms
Speaker 1: was educated from a young age, as his father had
Speaker 1: not really gotten an education. It was kind of insecure
Speaker 1: about it. Right. So he wants his kid, which is normal, right,
Speaker 1: wants his kid to have a better life than he did.
Speaker 1: The family owned a store in so most mornings, five
Speaker 1: year old Marian would hike a mile to the local school,
Speaker 1: which was run by a Scotsman. He is the kind
Speaker 1: of autobiographer who always lets you know the race of
Speaker 1: everybody who comes up in the book. It is very
Speaker 1: important you know this guy was a Scotsman and you
Speaker 1: know the Irishman are Irish, and the Germans or Germans. Yeah,
Speaker 1: he's he's real, real insistent on that. Um. Now, since
Speaker 1: he was six at the time, sim says that he
Speaker 1: remember there is little of this period, which is fair.
Speaker 1: I don't remember a whole lot about being six, but
Speaker 1: he does note that quote the teacher flogged the boys
Speaker 1: occasionally very severely and stood some of them up in
Speaker 1: the corner with a fool's cap on um, which is
Speaker 1: probably not weird for the time, but always funny to
Speaker 1: read about kids getting hit in old timey schools. So,
Speaker 1: school in this part of the United States, and this
Speaker 1: time was often summer term only. That was actually kind
Speaker 1: of the norm back in the day. You would go
Speaker 1: to school during the summer because like there's no planting
Speaker 1: or anything, or in the summer, right, you plant and
Speaker 1: like the spring and you harvest and kind of like
Speaker 1: the fall summer, there's not really much for the kids
Speaker 1: to do, so that's like the best time in winter.
Speaker 1: It's usually like YouTube, is he not dying of freezing
Speaker 1: to death to go do much in the winter, So
Speaker 1: kids would go to school in the summer. Um. Now,
Speaker 1: the elder Simms didn't like the idea of his son
Speaker 1: only receiving a couple of months of schooling per year,
Speaker 1: so he spent a significant amount of money to send
Speaker 1: his boy, now age six, to a boarding school in
Speaker 1: eighteen nineteen. Adults, Simms lets us know that this teacher
Speaker 1: was an irishman who was badly pockmarked from small po
Speaker 1: This again critical detail from his childhood for you. Um.
Speaker 1: He was quote a rigid, disciplinarian, altogether, very tyrannical. And
Speaker 1: I was very unhappy at his house because I think
Speaker 1: he's living with the teacher. That's the kind of weird
Speaker 1: boarding school. It's not like a big boarding school. I
Speaker 1: think it's like this guy runs a school in a town,
Speaker 1: and people who live in rural communities will like send
Speaker 1: their kids to live with them for a few months
Speaker 1: to do school. I love so much weird ship from
Speaker 1: your show man. Yeah, it's we I think this is
Speaker 1: pretty common for the period cases. It's so great though.
Speaker 1: I learned so many little facts I get to drop
Speaker 1: on on other people. Yet, imagine how much that would suck.
Speaker 1: It's like, you gotta go live with your math teacher now,
Speaker 1: so that's the only way for you to learn things.
Speaker 1: Oh what a bad youth set would be. Um, I
Speaker 1: love that spods the weirdest ship for ship, but it's
Speaker 1: great love. I would not choose for that to be
Speaker 1: how my childhood. But you know what I would choose
Speaker 1: for someone's childhood. I bet you. I bet you you
Speaker 1: would choose them the delightful UH products and services that
Speaker 1: are funding this program. I believe that children have the
Speaker 1: right to engage in projects and services, and more than anything,
Speaker 1: I believe that children have the right to be put
Speaker 1: on child hunting island where they can become part of
Speaker 1: the economy. That's what always gets bleeped out. That is,
Speaker 1: that's what always gets bleeped out. Now you know it,
Speaker 1: but no one else gets access to. We're back, uh kava.
Speaker 1: You know we would probably talk about something. Obviously, the
Speaker 1: f d A just banned jewels to protect the kids. Um.
Speaker 1: I think you know, youth smoking youth vaping have actually
Speaker 1: both been dropping for a while. My opinion is that
Speaker 1: we ought to do the thing where you just force
Speaker 1: kids to smoke when they're in grade school, right, because
Speaker 1: what's the one way to make not consuming tobacco cool
Speaker 1: something kids do with like they'll hang out and they
Speaker 1: won't smoke. Force him to smoke at school. Yeah, this
Speaker 1: was This was proven a long time ago in a
Speaker 1: documentary about Donald duck Um where he forced Hughie, Dewey
Speaker 1: and Louie to smoke a carton of cigarettes and they
Speaker 1: got so sick that they never wanted to smoke again. Um.
Speaker 1: I think that makes a lot of sense that And
Speaker 1: if you at home have an argument, I want you
Speaker 1: to think to yourself, has Donald Duck ever been wrong?
Speaker 1: And the answer is no, no, And we shouldn't wear pants,
Speaker 1: and we shouldn't wear pants. We shouldn't wear pants. Shirt
Speaker 1: cock it give your kids cigarettes, make them smoke at school. Anyway,
Speaker 1: back to the podcast, So, so he goes to this
Speaker 1: boarding school with this uh irishman who is, yeah, a
Speaker 1: tyrannical guy. He's going to live at his house. He
Speaker 1: clearly finds found the experience somewhat traumatizing, because he writes,
Speaker 1: pointed Lee in his autobiography quote, my convictions now are
Speaker 1: that the best place for a child under ten years
Speaker 1: of ages with his mother? And it's it does say
Speaker 1: a lot both about the experience he had that like
Speaker 1: as a as a guy who does not talk about
Speaker 1: his feelings, he wants to note this decades later, like
Speaker 1: I think that points to this being pretty traumatizing to him,
Speaker 1: and also it points to kind of what was going
Speaker 1: on at the time that he also felt the need
Speaker 1: to tell other readers in the late eighteen hundreds, like
Speaker 1: don't separate small children from their parents. That was probably
Speaker 1: crazy at the time. Yeah, what this guy is supergressive
Speaker 1: soft now from this very early age. Simms was extremely
Speaker 1: competitive against his peers. The school had a daily challenge
Speaker 1: where if you got like kudos or something, you know,
Speaker 1: if you basically you got like a praise from the teacher,
Speaker 1: if you were the first kid who got to class,
Speaker 1: you got to sit in a special seat. Um and
Speaker 1: Sims wound up in a rivalry. There was this ten
Speaker 1: year old who was always the first kid in class, Um,
Speaker 1: whose name he remembered like eighty years later. Uh, and
Speaker 1: he gets into like a competition with this kid over
Speaker 1: who can get to school fastest. Quote. And this kid's
Speaker 1: name is James Graham, So this is him writing. However,
Speaker 1: the boy that got ahead of James Graham had to
Speaker 1: rise very early in the morning. I remember getting up
Speaker 1: one morning, long before daybreak. The dread of my young
Speaker 1: life was Mad Dogs and Runaway inwards. I started off
Speaker 1: for the schoolhouse on a trot an hour before day,
Speaker 1: looking anxiously from side to side and before and behind,
Speaker 1: fearing all the time for those two great bugbears of
Speaker 1: my young life vise mad Dogs and runaway in words
Speaker 1: with which the minds of the young were so often
Speaker 1: demoralized by Negro stories. So, uh really hate this guy
Speaker 1: and he is he is. He is talking here about
Speaker 1: runaway slaves, right, which is a book like kids get
Speaker 1: warned like, hey, if you wander off the path, you
Speaker 1: go into the woods, like there are runaway slaves, they'll
Speaker 1: murder you, right, Like it's a it's a thing white
Speaker 1: people tell their kids, you know. Um, that's what he's
Speaker 1: referring to, right, is these stories he would have been
Speaker 1: told of a kid of like runaway slaves hiding in
Speaker 1: the woods that he has to watch out for. Obviously,
Speaker 1: nothing ever happens, um, But the fact that he refers
Speaker 1: to them that way, and he does not use that
Speaker 1: polite term um, should be a hint as to this
Speaker 1: fellow's attitudes on racism. Um. Yeah, although I again as racist,
Speaker 1: says he says, I do want to note like he
Speaker 1: is totally normal for his time, because it is the
Speaker 1: United States in the early eighteen hundreds. So you know, um,
Speaker 1: he is he is growing up deep within like slavery, um,
Speaker 1: and there is nothing about it that he finds unsettling
Speaker 1: other than the thought that he might get hurt by
Speaker 1: a freed slave, right or an escaped slave. Right. Um.
Speaker 1: So in second grade, his teacher had one remarkable peculiarity,
Speaker 1: which was that quote, it made no odds whether a
Speaker 1: boy was good or bad. He invariably got a flogging
Speaker 1: on the first day. So one of his teachers in
Speaker 1: second grade is like, first time a new kid comes in,
Speaker 1: I'm on a weapon. It's like gang initiation. It's the
Speaker 1: worst school. I bring this up because he goes on
Speaker 1: to tell the story of a seventh grade who got
Speaker 1: seventh or a seven year old who got flogged because
Speaker 1: he had to spend a single day in their class.
Speaker 1: And the kid wasn't a student, his brothers were, and
Speaker 1: his mom had to go into town, so she dropped
Speaker 1: him off at the school because she didn't want to
Speaker 1: leave him at home. Quote with the negroes again, this
Speaker 1: is like, these are the people who are raising him.
Speaker 1: These are the adults in his culture. Right, We're taking
Speaker 1: you somewhere safe, son, to the floor. We don't want
Speaker 1: you to hang out around the slaves. Let's take you
Speaker 1: to go get beaten with a whip bite. Teacher. Your seven,
Speaker 1: you can handle it. So I think you're getting an
Speaker 1: idea of how this kid's early life went right and
Speaker 1: and kind of the culture that raises him and its values.
Speaker 1: Um when Marian was like twelve. His dad is elected
Speaker 1: shiriff of Lancaster Village, which most sources will note. Who
Speaker 1: was north of Hanging Rock Creek. You can probably guess
Speaker 1: who tended to get hung there and why. Um. Once
Speaker 1: his dad was established in a prominent position, he was
Speaker 1: able to send his son to Franklin Academy, where he
Speaker 1: studied for two years before earning admission to South Carolina College. Um.
Speaker 1: So he starts college at fourteen, which is not abnormal
Speaker 1: at the time. Right Again, in this same period of time,
Speaker 1: if you're in Germany, if you're most of like the
Speaker 1: western world, at age fourteen, you're legally an adult in
Speaker 1: a lot of the West, right like you're you're starting
Speaker 1: to do a man's work in that period of time.
Speaker 1: So it's not wild that he's going to college at
Speaker 1: age fourteen. Um. He does well in college, he's quickly
Speaker 1: admitted to the Euphratean Society, which is a literary fraternity
Speaker 1: for nerds. Um. The Euphratean Society existed as a result
Speaker 1: of a split with an older fraternity, and for whatever
Speaker 1: it's worth, the one Marion joined was the less less
Speaker 1: famous of the two. Because their sister fraternity. The Clariosophic
Speaker 1: Society counted a bunch of famous people as members, including
Speaker 1: John C. Calhoun UM. So, yeah, by this point he
Speaker 1: had decided to become a doctor, and while he was
Speaker 1: at South Carolina College, he basically interns with a local doctor.
Speaker 1: Right in this period of time, medicine it's still this
Speaker 1: kind of hybrid of the way it had existed pretty
Speaker 1: much forever, which is, you find a doctor and you
Speaker 1: like become their helper and that's how you learn a
Speaker 1: lot of the tools of the trade. But there's also
Speaker 1: a school. There's also medical schools, and you can get like,
Speaker 1: you know, a degree and stuff. But kind of both
Speaker 1: things are common and which is not like today, you know,
Speaker 1: you have like your your what do you call it,
Speaker 1: residency and stuff. But in this period of time, he
Speaker 1: kind of starts his residency at the same time as
Speaker 1: he's starting to go to medical school, and medical school
Speaker 1: is not nearly as formal, so his medical schooling starts
Speaker 1: his formal medical cooling starts with a three month course
Speaker 1: at a medical college at Charleston UM, but he finds
Speaker 1: that too hard, so he quits. Uh, he goes to
Speaker 1: Philly and he gets joins the worse medical school. Uh,
Speaker 1: that's what I wanted. Three month course, which just too intense. Well,
Speaker 1: you know the old joke. You know what they call
Speaker 1: the doctor who quits his medical school after three months
Speaker 1: and goes to a worse medical school and graduates at
Speaker 1: the bottom of that medical school. You know what, they
Speaker 1: call him a doctor. That's right, classic joke. Good stuff.
Speaker 1: I mean, like three months now, you couldn't. You can't
Speaker 1: become a paramedic in three months, right, isn't that like
Speaker 1: a year or so? Three months would be like one
Speaker 1: rotation in like yeah, yeah, it's it's very little in
Speaker 1: today's standards. Um. But he does eventually get into a
Speaker 1: worse medical school. He graduates in eighteen thirty five and is,
Speaker 1: in his words quote, a lackluster student who showed little ambition.
Speaker 1: He noted in his memoirs, I felt no particular interest
Speaker 1: in my profession at the beginning of it, apart from
Speaker 1: making a living. I was really ready, at any time
Speaker 1: and in any moment, to take up anything that offered
Speaker 1: or held out any inducement of fortune, because I knew
Speaker 1: that I could never make a fortune out of the
Speaker 1: practice of medicine. I didn't really feel passionate about my
Speaker 1: work until I realized I could really make people suffer. Yeah,
Speaker 1: until I learned how to get fucking rich, I didn't
Speaker 1: care about being a doctor. So he is a graduated
Speaker 1: doctor at age twenty two, which, man, I don't know
Speaker 1: that I think twenty two year old should be driving cars.
Speaker 1: But yeah, it's a for a time, you know, it
Speaker 1: is a different, very far off, and there's a lot
Speaker 1: less medicine to learn, right, Uh, there's much less medicine
Speaker 1: to learn. So if you even go back now, like
Speaker 1: ten years, like ten fifteen years, Like the books we
Speaker 1: took for our step one training test, they were like
Speaker 1: maybe a quarter inch thick. Now over the years they're
Speaker 1: like two to three inches thick of all the stuff
Speaker 1: you have to learn just in that one for that
Speaker 1: one test. So in the last it's been a little
Speaker 1: bit more exponential in terms of what we have to
Speaker 1: learn in terms of the sciences. But uh, yeah, I
Speaker 1: imagine back then it was like maybe a pamphlet in
Speaker 1: life pay attention. If you condensed all of the good
Speaker 1: medical information you could have fitted into a zine. Um
Speaker 1: mostly it would have been washhands underlying bu. They were
Speaker 1: pretty far from that, Yeah, that is a that is
Speaker 1: a contentious debate at the time. People are getting stabbed
Speaker 1: with four steps over it. That's exactly right. Yeah. Um,
Speaker 1: so you know he's a doctor. Twenty two, he goes
Speaker 1: back to his hometown. Um. Now he has no actual
Speaker 1: clinical experience. He had never worked in a hospital. He basically,
Speaker 1: like kind of by his own admission, didn't know how
Speaker 1: to do anything. His first two patients are newborn babies,
Speaker 1: and both of them die instantly. Um. This makes him
Speaker 1: sad for reasons that I think are understandable, and to
Speaker 1: be fair, with the best medical knowledge at the time,
Speaker 1: there's pretty good chance he wouldn't have saved those babies
Speaker 1: because it is eight thirty five. Yeah. Um, So he
Speaker 1: gets very sad and he flees to Alabama. Um. He
Speaker 1: lives there in a disreputable boomtown, presumably drinking too much
Speaker 1: due to the fact that he described it his quote
Speaker 1: nothing but a pile of gin houses, stables, blacksmith shops,
Speaker 1: grog shops, taverns, and stores thrown together in one promiscuous huddle.
Speaker 1: You will know that three of the six business types
Speaker 1: he describes are just different types of bars. We had
Speaker 1: the house house, so in eighteen thirty six home from Alabama,
Speaker 1: he marries a woman named Teresa, and in eighteen thirty
Speaker 1: seven he and his new bride moved to Macon County
Speaker 1: to get simms first real job, which is working as
Speaker 1: a plantation physician. So, as you probably have guessed, his
Speaker 1: primary patients there are not plantation owners. They probably hired
Speaker 1: better doctors because he's not very good at this point. Um,
Speaker 1: his patients are enslaved people, right, Um, Now, in some
Speaker 1: ways this is not an inherently evil job, because like,
Speaker 1: slavery is wrong, but like it's not wrong to provide
Speaker 1: medical care to enslaved people obviously. Uh. And he did
Speaker 1: a lot of operations on club feed, cleft palates, crossed eyes, like,
Speaker 1: and that's like, even if you're working for a plantation owner,
Speaker 1: if you are carrying out medical procedures on people who
Speaker 1: are enslaved, it's like good to do that. Um. So
Speaker 1: this is not like a job that is nest necessarily
Speaker 1: the worst thing you could be doing at this time
Speaker 1: if you're interfacing with the slave economy. However, the job
Speaker 1: of plantation doctor does not just mean being paid to
Speaker 1: take care of enslaved people. Um. It is fully integrated
Speaker 1: into the machinery of slaveholding and the South's budding human
Speaker 1: trafficking business. See The foreign importation of slaves had been
Speaker 1: banned in eighteen o eight, which meant the growing demand
Speaker 1: for enslaved black people in the United States was served
Speaker 1: primariably by forcing enslaved people to make babies and then
Speaker 1: selling those babies. Right, you cannot import more enslave people
Speaker 1: after eighteen o eight. The way that the slave economy
Speaker 1: keeps going is they force enslave people to have children,
Speaker 1: and then they steal those children and sell them. Right,
Speaker 1: that is how it works. Doctors are a critical part
Speaker 1: of this because again, not the easiest thing to keep
Speaker 1: mothers and babies alive in this period of time. Um now,
Speaker 1: I want to quote now from a write up by
Speaker 1: Monica Cronin quote. Enslave women were not only expected to reproduce,
Speaker 1: but it seems reproduce often. As Dorothy Roberts wrote, slave
Speaker 1: women's childbearing replenty to the slave labor force. Black women
Speaker 1: bore children who belonged to the slave owner from the
Speaker 1: moment of their conception. Thomas Jefferson, third President of the
Speaker 1: United States of America, acknowledged that a woman who brings
Speaker 1: a child every two years is more profitable than the
Speaker 1: best man of the farm. So so they're part of
Speaker 1: this machine to keep slavery going, this economy of it.
Speaker 1: And they are arguably a critical part of the most
Speaker 1: profitable part of this machine, because the slave owners themselves
Speaker 1: will argue that keeping enslaved women breeding is more profitable
Speaker 1: than any individual labor laborer. Right. Um, so Simms's work
Speaker 1: was very much critical in maintaining the profitability of his
Speaker 1: employer's slave empires, and he was not an insignificant part
Speaker 1: of this machinery in the state of Georgia. This right
Speaker 1: up from history that goes into more detail. According to
Speaker 1: Vanessa Gamble, University Professor of Medical Humanities at George Washington University,
Speaker 1: Sims's practice was deeply rooted in the trade for enslaved people.
Speaker 1: Sim's built an eight person hospital in the heart of
Speaker 1: the trading district in Montgomery. While most healthcare took place
Speaker 1: on the plantation, some stubborn cases were brought to physicians
Speaker 1: like Sims, who patched up in slave workers so they
Speaker 1: could produce and reproduce for their masters. Again, otherwise they
Speaker 1: were useless to their owners. This brings up the concept
Speaker 1: of soundness, says Gamble, being sound meant they produce for
Speaker 1: men and women and reproduce for for women. Right, So
Speaker 1: this is like, yeah, this is the thing. Now, we
Speaker 1: are somewhat reliant upon Sims here for information on the
Speaker 1: size and scope of his practice. But his claim is
Speaker 1: that his practice was not merely one among many, but
Speaker 1: the largest surgical practice, but the largest surgical practice in Alabama,
Speaker 1: and the largest practice any doctor in Montgomery had ever
Speaker 1: had up to that point. Again, he is a narcissist.
Speaker 1: This may be untrue. That's I'm not saying that to
Speaker 1: like mitigate his crimes. It's just like he's not an
Speaker 1: entirely reliable narrator here. And and the fact that he's
Speaker 1: just like I had the most racist medical progression. I
Speaker 1: was the biggest racist and the greatest racist dr you've
Speaker 1: ever seen. Yeah. But and also it is entirely possible
Speaker 1: he was the biggest you know, that's not an impossible
Speaker 1: thing here. He's certainly a significant part of this. And
Speaker 1: it's also, as you said, worth noting that he's like
Speaker 1: I was the most important of the racism doctors. Yeah. Um,
Speaker 1: And again he he has so many patients because he
Speaker 1: provided an economic like a cost effective way for slave
Speaker 1: owners to keep their human assets productive. In in that sense,
Speaker 1: um as a doctor, Sims had to treat female patients
Speaker 1: regularly and he hated this. Uh No doctors at the
Speaker 1: time liked working on women. Um, this is going to
Speaker 1: be gnarly, so buckle up. One of Sims's major critics,
Speaker 1: Direnda Januga, explained it this way in her article for
Speaker 1: the Journal of Medical Ethics. Quote. To complicate the situation
Speaker 1: even more, the medical specialty of gynecology did not exist.
Speaker 1: The practice of examining the female organs was considered repugnant
Speaker 1: by doctors, who were almost all males. In fact, in
Speaker 1: American medical schools, obstetrics and child delivery were taught by
Speaker 1: the use of dummies, and often it was not until
Speaker 1: the doctor was in practice that he actually delivered a baby.
Speaker 1: According to Words and Words nine, young doctors rarely had
Speaker 1: any clinical training and what the theory of birth mint
Speaker 1: In practice, Many arrived at a birth with only lectures
Speaker 1: and book learning to guide them. If they and the
Speaker 1: laboring patients were fortunate, they had an older, experienced doctor
Speaker 1: or attending woman to explain what was natural in what
Speaker 1: was not. Many young men were less lucky and were embarrassed, confused,
Speaker 1: and frightened by the appearances of labor and birth. So
Speaker 1: most doctors know almost nothing about labor about again, this
Speaker 1: is part of why, like, you're in better hands a
Speaker 1: lot of times with a midwife here than you're like
Speaker 1: going to a doctor for this. Um. And if I
Speaker 1: could be fair for a second, there was very few
Speaker 1: things in medicine that scared me when I was doing
Speaker 1: my medical school training, but childbirth was one of them.
Speaker 1: Like it was, I found it terrifying. The risks were
Speaker 1: the scared holding babies exactly. I mean, like, I just
Speaker 1: you don't want to suck it up so mad it was.
Speaker 1: It can be so stressful. Um, I mean that's not
Speaker 1: I don't think that's quite the issue that all these
Speaker 1: people are facing at the time. But I'm just gonna
Speaker 1: say it's it is a really tough field. I have
Speaker 1: a lot of respect for obi gaians. I mean, so
Speaker 1: one field, of course, it's like the one field of
Speaker 1: medicine where you're not just avoiding death, you're actually bringing
Speaker 1: life into the world. So it's kind of like cool
Speaker 1: in that that way, but it's also very high risk,
Speaker 1: high reward sort of thing, and there's like the loads
Speaker 1: can be so low it's like soul crushing if it happens,
Speaker 1: you know, and one has to assume, You have to assume.
Speaker 1: There are the odd like shining examples here of like
Speaker 1: male doctors who actually give a shit about this, but
Speaker 1: they are very few and far between, and for the
Speaker 1: most part, like doctors are scared of this and don't
Speaker 1: know much about it. Um And part of this is
Speaker 1: based on the very again Victorian attitudes towards like sex
Speaker 1: and sexuality at the time. So to give you an
Speaker 1: idea of how fucked up this is. When Sims was
Speaker 1: trained as a doctor, the standard medical procedure for doing
Speaker 1: a pedic pelvic exam was to look directly in the
Speaker 1: eyes of the patient and nowhere else because actually looking
Speaker 1: at their genitals would have been inappropriate, really creepy. Yeah,
Speaker 1: you are staring in their eyes, not looking at what
Speaker 1: your hands are doing. Yeah, this is very uncomfortable. It
Speaker 1: makes me very uncomfortable. Probably seems like it is hard
Speaker 1: to do good medicine that way, not an O, B,
Speaker 1: G U, I N. But I assume that makes it
Speaker 1: more difficult. Um. So again, I stayed a list to that. Like,
Speaker 1: given both just kind of the the the limitations of
Speaker 1: science and the cultural limitations placed on doctors and the
Speaker 1: doctors placed on themselves in this period, it is was
Speaker 1: basically impossible to solve what was probably the worst pregnancy
Speaker 1: related illness of the day, which was vaginal and rectal fistulus. Now,
Speaker 1: these can be deeply unpleasant things to deal with. Uh.
Speaker 1: The gist of the issue is that a whole develops. Uh.
Speaker 1: And this is like a thing that happens due to
Speaker 1: getting that baby out of their trauma. Yeah. Yeah, a
Speaker 1: whole develops between a woman's bladder and vagina um. This
Speaker 1: can lead to constant, uncomfortable and uncontrollable urinarian continents, and
Speaker 1: worse versions of the condition lead to uncontrollable fecal incontinence too.
Speaker 1: I probably don't need to be labor what an issue
Speaker 1: this would be for anyone suffering from it, and what
Speaker 1: kind of impact this would have on their life? Right? Um,
Speaker 1: people with these fistial is cannot safely carry additional children
Speaker 1: to term, so if they are enslaved people. Um, number one,
Speaker 1: you can't really work with this, right, It gets in
Speaker 1: the way of you being able to labor and be
Speaker 1: a productive economic unit, and you also cannot bear additional
Speaker 1: children's So in the minds of a slave holder, this
Speaker 1: health issue turns a woman into a complete financial loss, right,
Speaker 1: which is how they think about these women, right, These
Speaker 1: human beings are purely financial instruments for them. You know,
Speaker 1: they look at them as like battle almost like not
Speaker 1: they're non They're not looking at them they would look
Speaker 1: at a normal patient. Right. So, from the perspective of
Speaker 1: the people who own slaves, this is a major financial issue,
Speaker 1: and obviously from the perspective of both enslaved women and
Speaker 1: free women, this is also just like a horrific health
Speaker 1: problem that there is no cure for, right, because this
Speaker 1: this affects everybody, um, and it's I mean, I don't
Speaker 1: again feel like I don't have to believe it, like
Speaker 1: why everyone would want there to be a cure for this.
Speaker 1: I just feel the need to point out that the
Speaker 1: people who are paying Jay Marry and Sims, who's going
Speaker 1: to work on this problem, want it cured specifically for
Speaker 1: financial reasons. Right. Um Now, Jay Mary and Simms was
Speaker 1: going to be the guy who fixes this problem, which
Speaker 1: is sort of surprising because up until his thirties, women's
Speaker 1: health was pretty much just an afterthought for him, as
Speaker 1: he wrote, quote, I never pretended to treat any of
Speaker 1: the diseases of women, And if any women came to
Speaker 1: consult me on account of any functional derangement of the
Speaker 1: uterine system, I immediately replied, this is out of my line.
Speaker 1: I do not know anything about it. Practically, he advised
Speaker 1: them to see He advised them to seek help with
Speaker 1: a different physician. But all this changed one day, a
Speaker 1: few years into his practice, when he was called to
Speaker 1: work on a woman who had fallen off a horse
Speaker 1: and was in pain around her back in pelvis. He
Speaker 1: assumed he she dislocated her uterus, which I guess is
Speaker 1: a thing that can happen. Um. He probably he was
Speaker 1: probably a hip or something, Yeah, he said, he she
Speaker 1: he thought she had dislocated her uterus right. Um, Now,
Speaker 1: without going into too much detail here, he like gets
Speaker 1: his hands up in there, and he kind of by
Speaker 1: accident relieves her pain without meaning to. He like pushes
Speaker 1: a bunch of air into the vagina, which dilates it,
Speaker 1: and in his words, pushes it back in its normal place.
Speaker 1: I'm not entirely certain what he's talking about here. But
Speaker 1: the end result of this is that while he's kind
Speaker 1: of rooting around in there, because of the stuff that
Speaker 1: he does, he's able to get a good This woman
Speaker 1: also has a fistula, which had been an untreatable problem
Speaker 1: for her, and because of what he's doing down there,
Speaker 1: because of the dilation of the vagina, he's able to
Speaker 1: see this fistual and be what he thinks is probably
Speaker 1: like one of the first doctors to get a good
Speaker 1: look at it. Um. And he's close enough to it.
Speaker 1: He can't quite see it enough, but he's he sees
Speaker 1: enough of it, he's close enough to seeing that he's like,
Speaker 1: I feel like I know how I could get a
Speaker 1: better look at this thing. And obviously, again he's not
Speaker 1: actually an incompetent doctor. He quite rationally is like, well, look,
Speaker 1: I'm really close to seeing this thing. If I can
Speaker 1: get the right tools so that I can actually get
Speaker 1: a good look at this thing, I can figure out
Speaker 1: how to treat them right, um, which is perfectly reasonable
Speaker 1: medical logic at this point. Um. Now, the only issue
Speaker 1: is that the right tools did not exist um today,
Speaker 1: doctors who work on this un thing. One of the
Speaker 1: tools that would use is called a speculum um, and
Speaker 1: Dr Sims is the one who invents the precursor to
Speaker 1: the speculum um. He does it by buying a pewter spoon. Uh.
Speaker 1: He grabs two medical students, and he goes back to
Speaker 1: his patient. He writes, quote, I got a table about
Speaker 1: three ft long and put a coverlet upon it and
Speaker 1: mounted her on the table on her knees, with her
Speaker 1: head resting on the palm of our hands. I placed
Speaker 1: the two students, one on each side of the pelvis,
Speaker 1: and they laid hold of the needs and pulled them open.
Speaker 1: Before I could get the bent spoon handle into the vagina,
Speaker 1: the air rushed in with a puffing noise, dilating the
Speaker 1: vagina to its foolish extent. Introducing the bent handle of
Speaker 1: the spoon, I saw everything as no man had ever
Speaker 1: seen before. So it is yeah, you know, and we
Speaker 1: I'm sure a lot of people are familiar with the
Speaker 1: concept of a speculum. I'm I don't actually know. I'd
Speaker 1: be curious to see some pictures, but I assume these
Speaker 1: are much we we now we think about the sort
Speaker 1: of disposable bivalve plastic, you know, vaginal speculum. I'm assuming
Speaker 1: this was some sort of came out looking like some
Speaker 1: sort of medieval horror device. It probably looked unsettling, yes, yeah, um,
Speaker 1: but this is like this starts the process that leads
Speaker 1: to the modern medical speculum. Right like he is and
Speaker 1: this is this is like good. So far everything we've
Speaker 1: talked about in this moment is like this good medicine.
Speaker 1: I would I would say he's doing something, he's doing something.
Speaker 1: He's yeah, he's he's following logically, he's trying to relieve
Speaker 1: a persons you know, suffering. Um. And he realizes that
Speaker 1: he can see the fistula and he's got enough working
Speaker 1: room to experiment with surgical treatments for it. Now, this
Speaker 1: is a big moment, right um, a big moment and
Speaker 1: just like medicine. Um. But after this point things take
Speaker 1: a much darker turn because this patient he's got, she's
Speaker 1: a woman who has some means. She's not going to
Speaker 1: let him experiment on her on like surgically experiment on here.
Speaker 1: Because again it shouldn't be surprising to people, experimenting on
Speaker 1: fistuli surgery is nightmarishly painful and dangerous for reasons that
Speaker 1: should be very obvious. Because it is the eighteen thirties. Um,
Speaker 1: this is part of why so little progress had been
Speaker 1: made on the problem. But as George but as an
Speaker 1: Alabama's largest plantation, Doctor Mary and Simms had a massive,
Speaker 1: basically unlimited supply of women with fistulas, women whose consent
Speaker 1: was immaterial, and their owners had no reason not to
Speaker 1: send them off with Dr Sims, because, as we've discussed,
Speaker 1: a slave who cannot give birth, your work is nothing
Speaker 1: but a money sync. And so Marian starts to make
Speaker 1: deals with slave owners. They will give him their slaves
Speaker 1: for as long as he would need them as test subjects.
Speaker 1: He will pay for their food, which he did complain
Speaker 1: about constantly in his memoirs, and the slave owners would
Speaker 1: cover the tax that he had to pay, and he
Speaker 1: would use them as experimental test subjects. Oh my god, yeah,
Speaker 1: I will say, I don't. I won't belabor it. And
Speaker 1: also it's not my wheelhouse. I'm not no beguine, but
Speaker 1: my dad is, so you know. Dinner conversations in the
Speaker 1: Yodah family growing up were very different than yours probably,
Speaker 1: and this procedure is requires a high level of skill
Speaker 1: these days, anesthesia with either general or like talking about that, Yes,
Speaker 1: and and are very tough things to do and I
Speaker 1: think we take probably like an hour to do. So
Speaker 1: they're not like quick things in and out. They're like
Speaker 1: lengthy procedures, um surgeries because you have to dissect them
Speaker 1: micoso playing and so it's really, um, it's it's pretty okay.
Speaker 1: I'm just I'm just trying to get myself ready. No,
Speaker 1: I mean, and that's the thing again, we'll be talking
Speaker 1: about this later. This guy is legitimately good at what
Speaker 1: he does. Like the actual he is not a quack.
Speaker 1: The actual thing he comes up with is an important thing. Um.
Speaker 1: We're going to talk about some other aspects of that
Speaker 1: that make this even more morally questionable. But like what
Speaker 1: he's what he's doing, he's not he's not bad at
Speaker 1: the medical side of it. It's the ethics side of
Speaker 1: it that where things become problematic. Um. But you know
Speaker 1: what else is problematic? Not sure? First, not having products
Speaker 1: and services exactly. Not engaging with these products and these
Speaker 1: services is the ultimate way to be problematic. Um, Because
Speaker 1: if you're not engaging with these products and services, are
Speaker 1: you really alive or American? Exactly? Damn? Oh oh, merry Christmas. Um,
Speaker 1: it's not Christmas. It's nowhere near Christmas. It's I thought
Speaker 1: Paul had murdered you, Santa Claus. He did, he did.
Speaker 1: Paul Schaeffer shot Santa Claus in a ditch. And today
Speaker 1: we're going to shoot our fun recollection of residencies and
Speaker 1: the medical training or something like that. We're certainly gonna complicated.
Speaker 1: Um so um. He gets these a number of slave
Speaker 1: owners to agree to hand over enslaved women to him.
Speaker 1: He is effectively their owner during this period of time
Speaker 1: in a legal sense of the word. He begins his
Speaker 1: experiments in eighteen forty five. He is thirty three years old.
Speaker 1: Most historians writing about this will note that he had
Speaker 1: three patients, Lucy, Anarca, and Betsy. And I had not
Speaker 1: heard the name in Arca before this dope ass name
Speaker 1: spelled like you'd think it is. Uh. And this is
Speaker 1: where we get to the root of why Dr Simms
Speaker 1: has been canceled by modern critics. Um. They alleged that
Speaker 1: what he did was human experimentation without consent, because true
Speaker 1: informed consent is impossible from a person who is enslaved,
Speaker 1: like you can't consent to be experimented upon if you
Speaker 1: are owned by the person doing the experimenting. Now, I
Speaker 1: don't think the ethics they're complicated like um, like you
Speaker 1: know autonomy, it's likely of medical ethics you have to
Speaker 1: have informed consent and you have to have some control
Speaker 1: over one's body exactly, exactly, um. Now, there are a
Speaker 1: number of people who are detractors to this idea, and
Speaker 1: the most notable of them is Dr L. L. Wall Um.
Speaker 1: We will be talking about this guy quite a bit,
Speaker 1: you know, on this show we occasionally will have like
Speaker 1: defenders of weird fucked up things. Often it will be
Speaker 1: like we're talking about some British empire motherfucker, and like
Speaker 1: his biographer who thinks he was he's the Bee's Knees
Speaker 1: and like writes a long things defending him massacreing people
Speaker 1: in Africa or whatever. This is a bit different. Dr L. O.
Speaker 1: Wall I think is very very wrong and some of
Speaker 1: his arguments are pretty messed up. That said, from what
Speaker 1: I can tell, he's spent a lot of his career
Speaker 1: flying to impoverished parts of the world and performing surgeries
Speaker 1: on people with fistula's. I think his he's passionate about
Speaker 1: this because he's dedicated his career to dealing with this
Speaker 1: specific health issue, and SIMS is the guy who, like
Speaker 1: most fixed it again l O Wall is wrong here,
Speaker 1: but he's not the same as like some dude whose
Speaker 1: job is to professionally defend the British Empire, because it
Speaker 1: does seem like his day job is helping people for
Speaker 1: free with a serious medical issue, which is nice. Um. Anyway,
Speaker 1: I wanted to provide that context because we will be
Speaker 1: tearing apart some of these guy. This guy's arguments in
Speaker 1: a little bit here. Um, I'm sorry, he's uh modern doctor.
Speaker 1: L yeah, yeah, he's he's around right now. Uh he
Speaker 1: has yes. Um, I think his arguments are bad, but
Speaker 1: here is one he made in a rite up in
Speaker 1: the Journal of Medical Ethics. This is an ongoing series
Speaker 1: of arguments that that other people have had with him. Quote.
Speaker 1: The first assertion was that it was unethical by any
Speaker 1: standard to perform experimental surgical operations on slaves because slaves
Speaker 1: by definition, could not have given voluntary, informed consent for surgery.
Speaker 1: Underlying this assertion is the hidden presumption presupposition that enslaved
Speaker 1: women with fishtalists did not want surgical care for their condition,
Speaker 1: and that they were therefore coerced into having unwanted and
Speaker 1: perhaps unnecessary surgery. Now, I would argue that that's not
Speaker 1: actually a hidden presupposition, because like we're not saying they
Speaker 1: don't want surgical care. We're saying they can't give informed
Speaker 1: consent to be experimented upon, which is different. Right. Obviously,
Speaker 1: anyone who has a medical condition wants it to be treated, um,
Speaker 1: But that doesn't mean you want to be a test subject,
Speaker 1: you know, in a medical experiment. Um. His argument then,
Speaker 1: is that this particular medical problem is such a nightmare
Speaker 1: that these women were basically beating down Simms's door to
Speaker 1: get treatment. In his memoire, Sims claims that he received
Speaker 1: enthusiastic consent from Lucy, Anarca and Betsy. We have no
Speaker 1: actual levi of this. This is something he writes down later.
Speaker 1: None of these women, as far as we know, could
Speaker 1: read or write. They have left us absolutely no written
Speaker 1: documentation of their consent. Calls absolute this guy. But by
Speaker 1: the way, I'm so sorry. I know I shouldn't do
Speaker 1: this because you're giving me all the information right now,
Speaker 1: but I just google. That's come so fascinating to know
Speaker 1: that there's like a modern day like enthusiast of Dr
Speaker 1: Sims and there is this article in the Journal of
Speaker 1: Medical Ethics by L. L. Wall, The medical ethics of
Speaker 1: Dr J. Mary and Sims a fresh a fresh look
Speaker 1: at the historical record. That one of the things that
Speaker 1: we're quoting from here is that, Yeah, in his conclusions,
Speaker 1: he says, Uh, in conclusion, it's difficult to make a
Speaker 1: fair assessment of the medical ethics of past practitioners. Yeah,
Speaker 1: I don't think it is here, buddy, seems pretty open.
Speaker 1: I think who knows it's gonna get it's gonna open
Speaker 1: up further. Um So again, uh, number one, Obviously, outside
Speaker 1: of what I just said, even if you ask a
Speaker 1: person that you legally own if they consent to surgical
Speaker 1: experimentation and they say yes, that still doesn't count as consent,
Speaker 1: right for a variety of things. I think what should
Speaker 1: be obvious reasons, right because you own them legally, and like, again,
Speaker 1: they don't like if their consent is immaterial, Um, then
Speaker 1: I don't know that. I like, I don't think they
Speaker 1: can consent. And that's current like medical ethics, is that
Speaker 1: they cannot consent to respect autonomy, they be given all
Speaker 1: the tools to make their own informed decision. And I'm
Speaker 1: certain that was not happening. Yeah, but but I mean,
Speaker 1: even outside of that number one, we have no evidence
Speaker 1: other than Sims's words that they told him that they consented.
Speaker 1: And I want to quote from that right up by
Speaker 1: Monica Cronan. Again, she notes that Sims published as memoirs
Speaker 1: well after the end of slavery in the United States,
Speaker 1: and that he may consciously have wanted to put himself
Speaker 1: in a positive light by claiming that these women had
Speaker 1: consented to his experiments. Quote. Sims is memoires is likely
Speaker 1: to be a reflection of changing attitudes towards formerly enslaved
Speaker 1: people and self conscious image making, as it is to
Speaker 1: be an accurate portrayal of events. Now. L. L. Wall's
Speaker 1: argument is that it's pretty obvious the women would have
Speaker 1: consented because a fistula is such a horrible thing to endure.
Speaker 1: He goes into some detail here quote. In addition to
Speaker 1: the continuous stream of urine and sometimes fecies to which
Speaker 1: they are subjected, these victims of prolonged obstructed labor also
Speaker 1: often suffer from secondary and fertility. Loss of vaginal function
Speaker 1: due to extensive scarring of the birth canal damage to
Speaker 1: the pubic bones, contractors of the lower extremities from neur
Speaker 1: muscular damage, recurring pelvic and urinary tract infections, horribly diminished
Speaker 1: self esteem, damaged body image, and not infrequently severe depression,
Speaker 1: even suicide. The cumulative devastation brought by this process can
Speaker 1: be appalling. It is hardly the relatively minor condition referred
Speaker 1: to by historian Deborah Coon McGregor, and he does have
Speaker 1: a point there. I think it's probably a bad call
Speaker 1: to refer to this as a relatively minor condition um.
Speaker 1: But then L. L. Wall extends his argument and what
Speaker 1: I think is a real fockd up place quote in
Speaker 1: alleging that it is unethical for slaves to participate in
Speaker 1: any form of medical experimentation, O Januga and the other
Speaker 1: writers seem to imply that they wouldn't, that it would
Speaker 1: never have been appropriate for slaves to undergo innovative surgical operations,
Speaker 1: no matter what their problems might have been. Critics of
Speaker 1: this stripe conveniently ignore the differences between non therapeutic and
Speaker 1: therapeutic medical experimentation. In the former case, participants can have
Speaker 1: no reasonable expectation of obtaining direct personal benefit from whatever
Speaker 1: is done, But in the case of therapeutic experimentation. Research
Speaker 1: participants may gain direct and sometimes substantial medical relief as
Speaker 1: a result of their participation in a clinical trial. At
Speaker 1: the time Sims began as experiments to repair the fistual
Speaker 1: as affecting afflicting his African American slave patients, there was
Speaker 1: no effective therapy for vestico vaginal fistula. Many surgeons in
Speaker 1: different countries had made repeated but unsuccessful attempts to close
Speaker 1: veso vaginal fistulas and put it into the tormenting loss
Speaker 1: of urine that these suffering women experienced. With rare exceptions,
Speaker 1: all such attempts failed. Now, one of the key points
Speaker 1: against this argument that he's making is that that last
Speaker 1: part is not true. Right and again, if there were
Speaker 1: doctors who had successfully provided therapeutic treatments for fistula and
Speaker 1: had done it without experimenting on enslaved people, then it's
Speaker 1: reasonable too. It's even more reasonable to say that doctor
Speaker 1: Sims was engaging in unnecessary human experimentation on enslaved people.
Speaker 1: And several doctors had treated fistula successfully as far back
Speaker 1: as sixteen seventy five. John Paul Mattower of Virginia had
Speaker 1: successfully treated one in eighteen forty and by eighteen fifty
Speaker 1: five had repeated this feat twenty seven times. George Hayward
Speaker 1: had closed his first fistula in eighteen thirty nine. Now,
Speaker 1: this techniques that doctor Sims is going to develop are
Speaker 1: more repeatable and and and are an important, really important
Speaker 1: part in figuring out a better and kind of more
Speaker 1: mainstream treatment for this um. And he was probably the
Speaker 1: most tenacious doctor in his field attempting to figure out
Speaker 1: a replicable treatment. But the fact that multiple other doctors
Speaker 1: were working successfully on fistula in the same period without
Speaker 1: and experimenting on enslaved people further makes the case that
Speaker 1: Dr Sims was not experimenting on these women because there
Speaker 1: was no other way, nor was he doing it primarily
Speaker 1: for their benefit. He did it because it was easier. Um.
Speaker 1: That's that's pretty key to me. Um. Yeah, I mean,
Speaker 1: I guess, on one hand, you know, it's fine to
Speaker 1: make this argument that you know, prior to like ninety four,
Speaker 1: with like the National Research Act, in the Belmont Report,
Speaker 1: all that stuff that came after the Tuskegee experiment, Like
Speaker 1: it's fair to say that before that there was no
Speaker 1: framework of like you know, I R. B. S. Studies
Speaker 1: that you need that that that's a fair argument, but
Speaker 1: you can't get around the fact that even at the time,
Speaker 1: I'm sure it was widely considered unethical. And then yeah,
Speaker 1: I'm assuming he's doing these without anesthesia, but is he not?
Speaker 1: But ansthesia was around from like I think eighteen forty
Speaker 1: six SAT. Seven. I think the anstegia was around at
Speaker 1: point right. Yeah, Um, we are going to uh, we'll
Speaker 1: be talking about that a lot in part two. Um no, no, no,
Speaker 1: we will be That's that's important. You will be getting
Speaker 1: into the um. But yeah, it's it's also worth noting
Speaker 1: that like um and this is also very important. While
Speaker 1: Mary and Sims does make sure to claim that the
Speaker 1: three women who are named in his book gave their consent,
Speaker 1: he also introduces quite blithely that there were multiple other
Speaker 1: enslaved women he used as test subjects. By some accounts,
Speaker 1: like seven. He doesn't even give their names. Uh, he
Speaker 1: makes vague comments that they wanted his help. There is
Speaker 1: no claim that like these people uh even consented to
Speaker 1: the extent that like the others did, which again is
Speaker 1: not really consent. But like that's part that offer that
Speaker 1: gets ignored by l l Wall. It gets ignored by
Speaker 1: a lot of people because it's like, well, he names
Speaker 1: he gives the names of three of them, but there
Speaker 1: were a lot of he because why would he bother right,
Speaker 1: like they're not people to him. Um. And again later
Speaker 1: in his memoir, despite these this like single vague claim
Speaker 1: he makes about consent, he also makes this note quite
Speaker 1: and this is how he introduces that there were other
Speaker 1: women he experimented on who are not named. I got
Speaker 1: three or four more to experiment on, and there was
Speaker 1: never a time that I could not at any day
Speaker 1: have had a subject for an operation. Again, he's very
Speaker 1: clear about what he's doing here. Yeah, I mean he
Speaker 1: he's he sees them as test subjects, not as humans. Um.
Speaker 1: I mean again, the very basics of like medical ethics,
Speaker 1: like even I know, and I'm not like an expert
Speaker 1: in medical ethics by any means. Non malfeasance, autonomy, justice,
Speaker 1: all these like basic concepts that are again very basic.
Speaker 1: They're not all modern and stuff are not being adhered
Speaker 1: to in the slightest here. Yeah, and that's I mean,
Speaker 1: that's what we're gonna leave it for part one. We
Speaker 1: get into part two, it's it's actually even worse than
Speaker 1: that Covic. But you know what's not worse than that
Speaker 1: uh podcast, that's right. I actually now not host two.
Speaker 1: The first one is of the House of Pod. It's
Speaker 1: a sort of humor adjacent medical podcast. I have on
Speaker 1: lots of great guests. We have doctors, we have musicians,
Speaker 1: we have Roberts, we have sophies come on the show
Speaker 1: and we uh we talked about medical stuff, science stuff.
Speaker 1: It's fun and that you can find anywhere you find
Speaker 1: your podcast. It is thank you. It's a it's a
Speaker 1: good time and you might learn something very very stuff
Speaker 1: And we kind of cover if you like these same
Speaker 1: sorts of topics that you guys cover here you we'll
Speaker 1: cover a lot of similar stuff. And then, um, there's
Speaker 1: a new show I'm doing with Rebecca Watson, who is awesome,
Speaker 1: amazing of skep chic and we it's called Girls on Boys.
Speaker 1: It is a podcast where we uh talk about take
Speaker 1: deep dives on the show The Boys, which I find
Speaker 1: immensely entertained and I think it is one of the
Speaker 1: best satires show. Also, man Eric Kripkey knows how to
Speaker 1: do gore. Some of the best television gore I've seen
Speaker 1: any ever. We we should talk about exploding penises at
Speaker 1: some point. Man, that's a good scene. It was. I mean,
Speaker 1: the whole prostate anatomy is there's a question there with that.
Speaker 1: But I'm not surprised. Yeah, but the show is amazing
Speaker 1: and and it impresses, it surprises me in the most
Speaker 1: fun ways. So I think it's a smart show. We
Speaker 1: talk about it. That's Girls on Boys. It's a podcast.
Speaker 1: You can find it at iTunes. Yeah, check that out. Um.
Speaker 1: I have a book called After the Revolution. If you
Speaker 1: want to buy it and you're looking where you can
Speaker 1: get it an indie bookstore in your area. You can
Speaker 1: check out this thing I just learned about called bookshop
Speaker 1: dot org. If you get a bookshop dot org type
Speaker 1: and After the Revolution you can find my book. There's
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Speaker 1: just google that and you'll find it. So I love
Speaker 1: that book. But it's a great book. It's really good,
Speaker 1: it's really enjoyed. Great. Thank you working on the sequel. Um,
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Speaker 1: go to cools on media dot com to see the
Speaker 1: rest of the stuff we're working on. Check out you know,
Speaker 1: Ghost Churchard, politics, cool people, cool stuff's check it all out,
Speaker 1: come on or else fucker's