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http://www.medscape.com/viewarticle/479809

" Diagnostic Imaging and Vascular Embolization for Uterine Leiomyomas "

by Gisela C. Mueller, M.D.; ph J. Gemmete, M.D.; Ruth C. , M.D.,

M.S.

Semin Reprod Med 22(2):131-142, 2004. Posted 8 June 2004

http://www.medscape.com/viewarticle/479892

" J. n Sims, the Father of Gynecology: Hero or Villain? "

S. Sartin, MD

South Med J 97(5):500-505, 2004.

http://www.medscape.com/viewarticle/480354

" Symptom Patterns May Suggest Ovarian Cancer "

Laurie Barclay, MD

Vega, MD, FAAFP

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>

> http://www.medscape.com/viewarticle/479892

> " J. n Sims, the Father of Gynecology: Hero or Villain? "

> S. Sartin, MD

> South Med J 97(5):500-505, 2004.

" Though modern critics may not wish to remove Sims' monuments from

their current homes, they would not be remiss in asking to have

monuments erected beside them to Lucy, Betsey and Anarcha. "

I couldn't agree more with this closing statement. After plowing

through much of Sims's life works from his writings and his biography,

I came to the conclusion long ago that he was " ...a typical man of

southern times... " . However, I don't exactly see this as a positive

statement.

Sims fled the south during the Civil War and practiced in Europe to

escape it all -- to the point of fearing he wouldn't be allowed to

return to America when all was said and done. He disagreed vehemently

with the freeing of slaves and wrote in great detail in " The Story of

My Life " of his many travels and years abroad to escape the war.

" My sentiments I can not help, for I lived forty years of my life at

the South. The companions of my youth are the leaders of the great

Southern rebellion. My father, now seventy-three years of age, is one

of its soldiers; our whole family are in arms; your father and mother,

my mother, and one of our beloved children have graves on Southern

soil, and how under heaven could we be otherwise than we are, unless

lost to all sense of humanity. "

His wife and children often stayed behind, for the most part, and also

exemplified his patriarchal perspective of their role in his life.

Regardless of how loving he wrote of his wife, it would seem he was

forever leaving her behind to tend to their children while he

journeyed long and far to further his name and both capitalize upon

AND escape his legacy of experimentation on the slaves of the south.

He became famous for the procedures he perfected while the suffering

slaves he toiled on were all but forgotten. In 1862, he relocated his

family to Europe to escape the civil war entirely and build his

practice in safer environs.

His resignation from the Women's Charity Hospital he created was all

about his ego. His experimentations and show-off surgeries were

deemed, by the women's board who helped him to build that facility, as

unethical. While he is credited with developing the first Women's

Hospital of its kind -- the truth is that he did so only because of

jealousy and competition and exclusion from other hospitals of the

time. And, if it were not for society WOMEN who came to his aid in

making the idea a reality, it would never have happened with Sims at

the helm.

Sims' career was built on the backside of women in more ways than

simply those which Lucy, Betsey, and Anarcha represent. His thanks to

ANY of these women is nonexistent in his writings or his legacy. In

fact, the only woman he seemed to have any respect for whatsoever was

simply his wife.

From MY perspective, the statues of Sims and great honors placed upon

him in the annals of gynecology are overblown and represent a manner

of embracement by the male gynecological community, over the years,

that is wholly unhealthy in it's perspective of women. Women of

color. Women who are without means. Women are are WITH means.

Simply women. It is a glorification of the unethical treatment of

women that many gynecologists take to heart and proceed with that

legacy in their work today, as well.

Buried within a tribute to Dr. Sims upon his death are the following

words of Dr. W. O. Baldwin:

**********************

" Gentlemen, there is one page in the life of this great man, one scene

in the living panorama of which he constituted a part, that I would

fain not disturb, and one on which I would prefer to drop the mantle

of oblivion, were it not that it is already a matter of history, and

perhaps it is due to the memory of Dr. Sims that I should refer to it.

I alluded to the night when, as one of the surgeons, he last met the

governors of the Woman's Hospital, and which closed forever his

connection with that institution.

It is said that republics are ungrateful, and it therefore should not

be surprising if even the governors of charitable institutions should

sometimes forget their greatest benefactors, and smite the cheek of

him whose hand was chiefly instrumental in calling them into

existence. The Woman's Hospital was Dr. Sims's bantling. The

creation of its germ and the conception of its possibilites were the

outgrowth of those discoveries which emanated from his brain alone,

and its final success was due to his untiring exertions. He was proud

of his work; he was proud of the child of his own life, and when the

Woman's Hospital was completed he regarded it as the largest pearl in

all his greatness--the central jewel in his crown of glory. But while

it was the glory of his life it was its humiliation too!

Those governors, who were in fact but little more than figureheads so

far as the privileges and duties of the surgeons were concerned, had

taken upon themselves the privilege of regulating the affairs of the

operating-room, and of saying to the surgeons that only fifteen guests

or spectators should be permitted to be present at any one operation.

Dr. Sims took this occasion for telling them that he had not obeyed

this order of theirs, and would not, and that if they insisted on

enforcing this rule his resignation was at their disposal. He claimed

the right to invite such numbers as his own judgment and inclination

might dictate.

Their action in assuming to restrict his privileges, in this respect,

he regarded as without authority. To a man of honor their action must

have been offensive.

In effect it accused him of being ignorant of the surgeon's duties in

the sick-room, and of wanting in a proper regard for the feelings and

sensibilities of his patients. All this made it insulting and galling

to him, and especially as he knew it to be an unauthorized invasion of

his own prerogatives, inherent to the office which he held, and

altogether outside of their accredited duties.

All the world over, the creed of common courtesy which exists between

the laity and profession makes the physician the autocrat of the

sick-chamber, and the privilege of the surgeon, as to whom he will

invite to his operating table or room, has never before been

restricted. If it was wrong to invite all who desired to attend, or

all whom the surgeon might wish to witness his operation, why invite

fifteen? It was not necessary to invite any! The hospital service

afforded all necessary assistance. If it would not offend the

sensibilities of a woman to have fifteen guests present, would it

shock her modesty very greatly to have eighteen, or twenty, or fifty,

or a hundred, or any number that the room could accommodate

conveniently? Besides, it is well known that the patients in this

hospital are rarely ever seen by the spectators until after they have

been placed upon the operating-table and under the influence of an

anaesthetic, when the the table is rolled into position. Another and

even stronger reason exists against this restriction. To serve all

the purposes in the interest of woman of which his hospital was

capable, it was doubtless intended, or in contemplation by Dr. Sims

from the first, that it should be used as a school, so far as

possible, for teaching physicians from the country, or city, or other

cities, or from other States or nations, who might temporarily be in

New York for the purpose of studying that class of diseases, and would

like to see these operations.

But suppose these governors could find nothing in all these facts to

make them retrace their steps, could they find nothing in the fact

that Dr. Sims thought they were in error, and wished them to

reconsider their unjust and unwise action? Could they not have

conceded something to the opinions of the man who had created the

hospital, who had devoted fifteen or twenty of the best years of his

life to its service, who had passed many weary days and sleepless

nights in the promotion of its interest, and had carried it upon his

heart as none of them had ever done? They knew he had placed himself

in a position, in relation to the order which they had issued, from

which he could not recede without loss of dignity or even honor; they

knew he did not wish to sever his connectin with the hospital, and

they knew he did not wish his resignation accepted, and yet, with a

heartless and cruel inflexibility, they refused to abolish their

miserable order and accepted his resignation; thus stabbing him in the

most vital spot of his life, and mortifying him as nothing else had

ever done.

In this difficulty Dr. Sims had the sympathy of a large portion of the

medical men of American. And, as an expression of their sentiments in

this direction, the American Medical Association, at its very next

meeting, unanimously elected him its president. "

************

Believe it or not, this is wholly representative of similar political

antics being carried on today. One of ACOG's most recent presidents

was the former chair of Duke University's gynecology department. He

was elected after his battle with interventional radiologists over

fibroid embolization at Duke erupted publicly with his writing a

scathing letter to an IR which proclaimed that Duke's gyn department

would NEVER refer a woman for fibroid embolization.

If it were not for the women governors overseeing The Woman's Hospital

attempting to force a consideration of ethics in medicine over the

likes of Sims, precisely where would we be today? I shudder to think

of it. As it stands, far too many gynecologists are walking, talking

emulations of Sims' attitude and behaviors towards women.

Yes, it's time we balanced the picture of history with honoring those

women who sacrificed greatly for all of us.

Lucy, Betsey and Anarcha deserve more than simply a mention in Sims'

biography. So do the women governors who helped to build The Woman's

Hospital and then later reigned in Sims with a voice of ethical

considerations for the patients they served there.

It's time for balancing the weight of medical history with the

development of a memorial to these women. And, it's simply the right

thing to do.

Carla Dionne

Executive Director

National Uterine Fibroids Foundation