Author and journalist J.C. Hallman was researching an article about hedge funds when he came across a company bio of a woman who’d worked on the problem of vesicovaginal fistula (VVF) in Africa. “I had no idea what that was,” he recalls.

He soon learned it’s a catastrophic effect of obstructed labor in which a woman is left with a hole between the bladder and vagina, resulting in a life of incapacity and degradation. Today, the condition is mostly seen among young mothers in nations ravaged by poverty and poor healthcare. But VVF was for a long time prevalent among enslaved women in America, too. In the mid-19th century, an Alabama doctor named J. Marion Sims claimed to cure VVF and was hailed a hero. However, growing awareness that he developed his technique by experimenting on enslaved sufferers — and without anesthesia — caused an outcry, resulting in a statue of Sims being removed from Central Park in 2018. 

By that time, Hallman had already been to Africa to report on the VVF crisis and saw there a plaque in a fistula hospital in memory of Sims. “That’s when I realized the two stories — Sims and the sisterhood of survivors — were connected,” says Hallman. Named for one of Sims’ enslaved patients, Say Anarcha: A Young Woman, a Devious Surgeon, and the Harrowing Birth of Modern Women’s Health is what the author calls a work of “speculative nonfiction,” although it also reveals little-known aspects of the (in)famous physician, including his possible espionage on behalf of the Confederacy during the Civil War.

Sims has long been called the “father of gynecology,” but that phrase does not appear in your book.

Part of the backlash against Sims has been to celebrate Anarcha and [his other patients] as the “mothers of gynecology,” but I didn’t use that phrase, either. Still, these two lives were inextricably bound. Each story needed the other to be fully understood. In my version of Anarcha’s story, she’s a symbol of the women who suffered alongside her, the many women who have been experimented on by other doctors, and the women who continue to suffer today from this condition. The larger point is that Sims’ version of events, long taken as undisputed fact, was fraudulent fiction.

Fraudulent in what way?

People say over and over that Sims developed important tools based on his Alabama experiments. Looking at everything that was credited to Sims, I realized that he was either stealing things from other doctors and taking credit or he was proposing surgeries that were debunked in his lifetime — even his cure for fistula, the “clamp suture.” He said he cured Anarcha in 1849. He wrote about it in 1852, and by 1856, that technique was completely abandoned. There was no specific clinical advance that came from Sims’ efforts. 

None of these women were cured? 

His methods worked about half the time.

Do you know for a fact that Sims did not use anesthesia on his enslaved patients?

He never talked about using anything. His biographer Seale Harris said that he gave [an enslaved woman] in advance of the first experiment a few drops of laudanum. But that is not cited. Harris might have been thinking about a case just a few weeks before, when Sims used a manual chainsaw to remove the entirety of a young enslaved man’s jaw. He gave 60 drops of laudanum before strapping him to a board. He didn’t wait for that medicine to take effect before he started, and it did not seem to take effect until he was done. 

What do you mean when you call Say Anarcha a work of speculative nonfiction?

The telling of Sims’ story was relatively straightforward using the rules and protocols of traditional history and biography, which were designed for people like him: the well-heeled and the wealthy, who could leave behind a documentary record. I had to approach Anarcha’s story in a different way because all I had was this primary-source scaffold of census records and stray references in people’s letters or diaries. I had to give her life a sense of presence and atmosphere. The complexities of the story were best explored by dramatizing it.

What was your calculus for staying on the nonfiction side of the line?

I looked to the hard sciences, like archaeology. You walk into the Museum of Natural History and you see the skeleton of the T-Rex. You think, “Wow, this is what it’s like to be in the presence of this animal 90 million years ago.” But you’re really looking at composite casts which have been created from parts of different animals from, say, Manitoba and Colorado and the Gobi Desert. Paleontologists say that since we have 40 percent, we can guess at the rest. And then they arrange it in this ferocious posture. We don’t walk in and say, “Well, that’s fiction.” 

In lieu of an index and end notes, you created an online illustrated bibliography, “The Anarcha Archive.” Why?

Partly so I could include everything — all 5,000 citations, 8,000 images. I didn’t have to just give cryptic CMA-style abbreviated citations. It’s also more interactive and gives people the opportunity to scrutinize my choices in real time. Jefferson Medical College has accepted the archive as a donation and agreed to maintain it. 

Did you feel a need to hyper-annotate because you were contradicting an entrenched narrative and deconstructing Sims’ cult of personality? 

Annette Gordon-Reed has talked about how particular histories, because of implicit bias in society, are required to clear a much higher threshold of certainty than others. I was saying that I found Anarcha. This is the first time anybody had ever seen anything about her that did not come from Sims himself or his apologists, who were outright propagandists. I was also correcting earnest but calcified errors on the other side of the debate, mainly by Sims’ antagonists, which were exaggerated over time like a game of telephone. 

For example?

Take the “Black women don’t feel pain” trope. For a long time, people have attributed this statement to Sims. But you can’t find him saying that. In fact, he describes Black women in excruciating pain. It’s possible that he felt that Black women feel less pain than white women, but it doesn’t comport with the sources we have. That quote can be traced back to [biographer] Harris not in the 1850s, but in the 1950s. He’s the same guy who erected the monument to Sims on the capitol lawn in Montgomery, Alabama. Incidentally, there are still two statues of J. Marion Sims standing. Sims is medical history’s version of the Lost Cause.

What are you working on now?

I have another short novel that I hope will find a home [and] a few different podcasts that are getting shopped. There are a couple of stories about Thurgood Marshall I’m keen to tell of his traveling to Korea to defend Black soldiers accused of cowardice. There were 250 oral histories that were never transcribed, and the cassettes were thought to be lost, but I found them in an archive. And I’m about to release a set of YouTube videos which covers Sims’ experiments on another 19 enslaved women between 1849 and 1858. Besides creating another way for people to engage with the story, I want to inspire them to keep looking for even more material on Anarcha. There’s bound to be more out there.

[Photo by Laura Migliorinio.]

Laura Fisher Kaiser is a journalist, editor, and author based in Washington, DC. She is working on a group biography about a family haunted by generational suicide. 

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