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Honoring Black History in Healthcare: Week 4 – Enslaved Women and Modern Gynecology

Throughout February, NOAH will share and honor Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history in healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. To do that, we will look at where we have been, what we have accomplished, and how we will collectively achieve this goal.

Enslaved Women and Modern Gynecology

By By Jennifer Perry, MD, PGY-3

Dr. James Marion Sims has been named the “father of modern gynecology” for his contribution of tools, such as the speculum, and surgical techniques related to women’s health. He was named president of the American Medical Association in 1876 and president of the American Gynecological Society in 1880. However, Dr. Sims’ success has overshadowed the suffering of enslaved women that contributed to his work.

Seven women participated in Dr. Sims’ experimentation over a four-year period. Lucy, an 18-year-old who was unable to control her bladder after a traumatic birth, was his first subject. She had a vesicovaginal fistula, a connection between the bladder and uterus which wasn’t uncommon for women who endured traumatic deliveries in the 19th century. Dr. Sims placed naked Lucy on her knees and elbows with her head in her hands for the procedure while several male doctors watched. The entire surgery was conducted without anesthesia. As imagined, Lucy experienced extreme pain as Dr. Sims operated. A sponge was placed in Lucy’s bladder to drain the urine, which led to severe infection. Lucy almost lost her life, but this did not stop Dr. Sims from performing a similar procedure on six other enslaved women.

Enslaved women were considered property and did not need to give their consent for medical procedures. Dr. Sims performed more than 30 surgeries on one woman, Anarcha, without anesthesia. Despite reports of displayed agony, including screaming, it was believed that Black people did not experience pain like White people, so anesthesia was not utilized. However, once Dr. Sims perfected his technique, he performed surgery on White women under anesthesia.

Statues of Dr. Sims have been erected in Central Park and Philadelphia in dedication to his contribution to medicine. Those statues have sparked many protests because of the controversy of honoring a man who performed non-consensual medical experiments on Black women. The New York City statue was moved out of Central Park in 2018, and to Dr. Sims gravesite in Brooklyn, NY. In the same year, the monument in Philadelphia was removed and replaced by a plaque that educates the public of the origins of the monument and the Black females whose bodies were used for the advancement of medicine.

To learn more about the medical ethics involved with this story, read this article from the Journal of Medical Ethics.

Read our other Black History in Healthcare stories:

Week 1: The Innovations of Dr. Charles Richard Drew

Week 2: Understanding the Tuskegee Study

Week 3: The Lasting Impact of Henrietta Lacks

Honoring Black History in Healthcare: Week 3 – The Lasting Impact of Henrietta Lacks

Throughout February, NOAH will share and honor Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history and healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. To do that, we will look at where we have been, what we have accomplished, and how we will collectively achieve this goal.

The Lasting Impact of Henrietta Lacks

By Monica Chaung, MD, PGY-3

In 1951, Henrietta Lacks, a young mother of five, was diagnosed with cervical cancer. Doctors at Johns Hopkins collected some of her cancer cells during her biopsy to diagnose the cancer. Some of these cells were sent to Dr. George Grey’s research lab, as was common with many other patients at this time.

The sample cells from other patients Dr. Grey collected and studied quickly died. Henrietta Lacks’ cells, however, were different. Instead of dying, Henrietta’s cells doubled every 20-24 hours. These remarkable cells, named “HeLa” cells after her first and last name, became the first immortal human cell line.  

To this day, researchers continue to use HeLa cells to make scientific and medical discoveries. They have allowed scientists to study the human genome, test the effects of drugs and toxins on human cells, learn more about cancer cells and viruses, and even create the Polio vaccine; all without having to experiment on humans. HeLa cells also have been used to improve our understanding of diseases like tuberculosis and HIV.

Despite her enormous contribution to medicine, however, the way in which Henrietta’s cells were used raised ethical questions. In the 1950s, it was common for extra biopsy samples to be shared and used for research without gaining consent from patients. Standardized informed consent was not common practice.

When Henrietta Lacks consented to the diagnosis and treatment of her cervical cancer, she was not informed that her cells could be collected and used for ongoing research. Additionally, there were no regulations on the use of human cells for research and patients did not have access to their medical records. The ethical concerns surrounding the use of Henrietta Lacks’ cell line have guided policies that now protect patients. These include informed consent, research approval through an Institutional Review Board (IRB) and improving patients’ access to their medical records. 

Henrietta Lacks died at the age of 31, within a short time of her cancer diagnosis. Although her life ended early, Henrietta Lacks’ legacy lives on through her HeLa cells, the impact of her story, and on research and medical ethics.

More on her story can be found in Rebecca Skloots’ book: The Immortal Life of Henrietta Lacks

Read our other Black History Month snapshots:

Week 1: The Innovations of Dr. Charles Richard Drew

Week 2: Understanding the Tuskegee Study

Week 4: Enslaved Women and Modern Gynecology

Honoring Black History in our Healthcare: Week 2 – Understanding the Tuskegee Study

Throughout February, NOAH will share and honor Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history and healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. It is well-established that blacks and other minority groups in the U.S. experience more illness, worse outcomes, and premature death compared with whites. To change that, we will look at where we have been, what we have accomplished, and how we will collectively achieve these goals.

Understanding the Tuskegee Study

By Jennifer Perry, MD, PGY-3

Frequently cited as one of the original causes of mistrust and discord between the African American community and the U.S. Department of Health and its branches is the “Tuskegee Study of Untreated Syphilis in the Negro Male.” This study was intended to examine the progression of syphilis in humans. After the promise of free medical care, 600 Black men in Alabama registered for the study in 1932. The details of the study were not disclosed to the men who registered. Of the 600 participants, 399 had the disease while the remaining 201 served as the control group.

Researchers only told the men they were being treated for “bad blood,” a local term used during that time to describe several different ailments. However, the men in the study were all given a placebo (a pill or treatment with no medical effect) such as aspirin and mineral supplements. Healthcare workers continued to monitor the participants and provide ineffective treatments. Although the study was intended to be six months, it continued for 40 years. The men suffering from the disease continued to receive placebos, even after penicillin became an effective treatment for syphilis in 1947, 15 years into the study.

The men in the study paid the ultimate price of blindness, insanity, and death as their disease progressed unnecessarily for the sake of scientific analysis. Later research found nothing to show the men were given the option to leave the study once effective treatment had become available.

In the mid-1960’s, Peter Buxton, a venereal disease investigator raised concerns about the ethics of “The Tuskegee Syphilis Study” as it became known, and a committee was formed to review it. Ultimately, the committee elected to allow the experiment to continue, and recommended concluding only once all participants had died, autopsies had been performed, and the data analyzed.

Buxton decided to leak the story. He sent the information to Associated Press reporter Jean Heller, who published the findings. When the story broke in 1972, it was met with public outrage. By that time, 128 participants had died from the disease or related complications, while at least 40 spouses had been infected, and 19 children had contracted syphilis in-utero. After the conclusion of Congressional hearings, the living participants and their families collectively reached an out-of-court settlement of $9 million, and new guidelines were issued to protect future participants of human studies. As part of the settlement, the U.S. government promised participants (later extended to spouses and their offspring) lifetime medical benefits offered through the Tuskegee Health Benefit Program.

Although the government has attempted to make amends, including an apology from President Bill Clinton in 1997, suspicion of the government and healthcare services continue to plague the Black community. Even with the COVID-19 vaccine in 2021 there is still caution, distrust, and wariness as a result of events in our history like “The Tuskegee Syphilis Study” and other disparities in healthcare for Black Americans.

To learn more, watch The Tuskegee Study video by Black History in Two Minutes or read The Tuskegee Study Timeline by the CDC.  

Read our other Black History Month snapshots:

Week 1: The Innovations of Dr. Charles Richard Drew

Week 3: The Lasting Impact of Henrietta Lacks

Week 4: Enslaved Women and Modern Gynecology

Honoring Black History in Healthcare: Week 1 – The Innovations of Dr. Charles Richard Drew

Throughout February, NOAH will share and honor Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history and healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. To do that, we will look at where we have been, what we have accomplished, and how we will collectively achieve these goals.

Week 1: The Innovations of Dr. Charles Richard Drew

By Karina Luera, DO, PGY-1

Dr. Charles Richard Drew, an African American surgeon born in 1904, is known as the “Father of Blood Banking” for his significant contributions to the process of blood plasma preservation.

Dr. Drew attended medical school at McGill University in Montreal, Canada and became interested in blood transfusion during his residency work in fluid resuscitation for shock. Later, he was awarded a Rockefeller fellowship at Columbia University where he wrote his thesis “Banked Blood: A Study in Blood Preservation” for his Doctorate in Medical Science. His research led to an appointment as the Medical Director of the Blood for Britain Project (BFB) during World War II, a program in which he implemented a uniform procedure for collecting and processing blood and plasma, successfully collecting over 14,000 blood donations.

Shortly after completing his work with the BFB, he was appointed assistant director of a national blood banking program in the US, sponsored by the American Red Cross where he developed one of his greatest innovations, mobile blood donation units. His work paved the way for the development of modern blood storage and transfusions.

Dr. Drew faced several racial barriers throughout his life, including being denied training and research opportunities. Most ironically, he was unable to donate blood to the very programs he helped establish at the American Red Cross due to their policies preventing Black people from donating blood. The policy was later modified but still required blood donations from Black and White people to be stored separately.  

In response to the policies of the American Red Cross, he resigned from his position and began teaching at Howard University as the Head of the Department of Surgery while also serving as the Chief of Surgery at Freedmen’s Hospital. His mission was to train young African American surgeons to the highest standards. He was the first Black person to be appointed an examiner for the American Board of Surgery. Additionally, he continued to campaign against the exclusion of Black physicians from local and national medical organizations, including the American Medical Association.

Dr. Drew died tragically in a car accident at the age of 46. In his short lifetime, he broke through many racial barriers and made significant contributions to the fields of science and medicine.

Read our other Black History Month snapshots:

Week 2: Understanding the Tuskegee Study

Week 3: The Lasting Impact of Henrietta Lacks

Week 4: Enslaved Women and Modern Gynecology