Part One: The Father of Gynecology

Robert is joined by Dr. Kaveh Hoda to discuss the history of gynecology. 

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Episode Transcript

Speaker 1 (00:03):
What what now? That's how we're starting the episode, Sophie,
and then God bless you, and then this everything. Honestly,
you've done way worse. So I'm like, cool with it.
How are we doing the day? How's everybody? Who are we?
Where are we? This is behind the bastards? And today
fucking sucks? It is uh? Are you? Are you? When?

(00:27):
When were you born? Are we? All? Was real older
than all of us? Yeah, I'm not that old. Jesus man,
I don't remember when my God, Yeah, yeah, I'm not
that old. I'm I'm an eighties child, I'll put it
that way. So, yeah, yeah, this is the first day
of all of our lives that we're according this. It'll
be coming out a bit later, but the day we're
recording this is the first day of all of our
lives that Rovie Wade is no longer a thing. I

(00:51):
just looked up. I should have known that. Yeah, you
thought you thought he was older than I get it.
I don't know when when when? I don't remember when
things medicine ages you. I'm a fucking rack. I get
you're a doctor. That means apologize to doctor who as

(01:13):
a doctor, which means he's an adult and all adults
are the same age. Yeah, but we have feelings to Robert,
I know, well you're just so you know what's really
messed up? What's that? The history? Yes, yeah, that's what
we're talking about today. Um, this is gonna be a

(01:35):
rough one. Uh. I don't have anything else to say that.
This is gonna be a rough one. What do you
what do you know? What do you know about the
how how gynecology started as a as a as a
discipline in like western medical cannon. Okay, Um, this is

(01:57):
this is gonna be hard on me. Uh, this is
I'm not like above criticizing medical history. I mean, we
have a very bad history everything thought. Yeah, but you
you kind of higher hopes for medicine. Uh, and when
you learn about some of the awful stuff in medicine,
um it it's a little bit uh disappointing, maybe at

(02:20):
least because you expect more. But there's a lot of
bad people in the world of medicine did a lot
of bad things. You've covered a lot of them, even
recent ones. And uh, I'm sure it would be guine,
like a lot of the other medical advances in medical
fields has probably had some pretty awful characters in it.

(02:41):
I think I have a sense of who we're talking
about today. Uh if that's if that's what we're talking about. Yeah,
today we are talking about Jay Mary and Sims. Um.
And as a rule, when you google this guy, doctor
j Mary and Sims. Although again, at the time he
became a doctor, like I think there's like hairdressers who

(03:01):
spend more time in school. Like, it wasn't it wasn't
that hard at the time. You know, nobody was doing
eight years in medical school. There's a lot of cocaine
people and just a lot of knights in the hospitals.
That was about it. I'm sure low're bar um. Yeah.
So when you google Jay Mary and Sims, the thing
you'll generally seem described at is the father of guy

(03:23):
in ecology. Um, which is you would Oh, I thought
you were gonna say, uh, Colin Firth, Stoppelganger. I mean,
he does look a lot like Colin Firth. Listen, that's
Mr Darby you're talking about. I have some respect. Well,
I mean Jay Marry and Sims could have played Mr Darby. Um. Now,
this is a tough one. It because this guy, unlike

(03:43):
a lot of the doctor usually when we have a
doctor on here, you're about to hear about them doing
some very non doctor lee shit. Um. This guy was
pretty competent at medicine. He I mean, he made his mistakes,
but he was like kind of on the cutting edge,
and he legitimately made some fair important breakthroughs in medical science. Um.
He is not a medical grifter. Uh. And he was

(04:06):
not full of shit. Um. What he was was a
guy who used enslaved people as test dummies on which
he could like cut at his will. Um. And that's
what we're talking about today. I'm already sad. Yeah. UM.
I do want to start though by because, like, because
this guy gets called the father of gynecology a lot,

(04:28):
I do feel like we should we should go back
in time a little bit and talk about kind of
what came before him, because, um, like, obviously this guy
there's a degree of historical credit this guy should get.
He invented some of the most basic tools that are
still used today in the trade. Um, it's probably fair
to say he was one of the first people to
practice gynecology and a recognized modern way. Um. But in

(04:51):
a larger sense saying that, like any person in the
eighteen hundreds, let alone, a dude could be like the
father of gynecology is like lunacy, because obviously people have
heard about health and and those organs and that part
of the body for forever, and they have been attempting
to deal with it one way or the other, um,
for forever. And I do want to start talking about that,

(05:11):
just because I don't like limiting our discussion of medicine
to like the eighteen hundreds when like ship was getting patented,
because actually useful things were discovered before that period in time. UM,
So obviously, UM, the it's you know, hard to say
what the first medical practitioner would have been. It is

(05:32):
certainly someone whose name has been lost to time, if
indeed they had a name, right, Like, if you're really
counting the very first people who figured out that there
were different kind of plants or clays and soils, all
of these were used in different kind of medical capacities
by people in the past. Um, they may have even
been people before like names were a thing that people had. UM.
One of the reasons for this is that anthropologists suspect

(05:54):
that a lot of our early understanding of like what
herbs and plants and other things were medicinal came from
people observing animals. There are animals that will seek out
medicinal herbs in nature and use them to alleviate discomfort
and aid in healing. This is how probably people learned
about different things, including the plants that we get like
ad villain stuff basically from um uh plants that like

(06:16):
we get. I mean this is honestly where like d
m T and ship comes from m al. Wise there's
um like jaguars in the jungle, little seek out banister
ops as cappy and whatnot. So like all of these,
all these different like medicines. People probably started to find
things that were useful in treating ailments by watching animals
in the wild take them and kind of like documenting it. UM.

(06:37):
It's also worth noting that this is probably not exclusive
to humans. Anthropologists suspect that Neanderthal's had medical knowledge and
presumably acquired it in the same way. UM. This also
probably included basic knowledge about how to deal with wounds,
because they would people. It's it's not hard to figure
out that like putting pressure on a bleed can like
help with the bleed. Right, we shouldn't assume that people
thirty thousand years ago were too dumb to be like, oh,

(06:58):
if you hold onto a bleeds sometimes they don't die. Um,
you know, all that kind of stuff is probably early,
early on, like medicine. The first documented medical tools in
history are believed to be flint tipped drills and bowstrings
used by Neolithic dentists in Balukastan around seven thousand BC. Um,

(07:20):
which is pretty amazing. Blukastan. Are you making that up?
Is this a place? No? No No, no, no no, but
it's a let me let me double check because map
stuff is always but I believe it's like, um, we're on.
I'm going to be really pissed. I don't think it's
far I mean Lucastan. Oh my god. Yeah, there is
a Bulakistan. Yes, it's one of it's part of Pakistan Ta,

(07:44):
so it's yeah, it's not far far enough, far far. Yeah,
it's like yeah that kind of Indo Arean area. Um.
So yeah, that's the first in the first medical tool.
And again these are just the first ones that we've
probably the oldest tools that we have on record, right,
which isn't to say that these were the first, but
that's interesting to me always that like dental tools, although
it makes sense like the consequences of fucking up with

(08:04):
dental surgery or less than like heart surgery. So it
makes sense that like people might have figured that out earlier, right, yeah, yeah, exactly,
it's an easier access yeah yeah, and obviously, like tooth
problems would have been all very common. Um. However, some
researchers have recently argued convincingly that the very first recorded

(08:26):
medical device and history came much earlier and was not
a drill or any kind of surgical tool, but was
actually the statuette commonly known as the Venus of Willendorff,
found in Austria in nineteen o eight. If you've seen
this artifact, and I think anyone who's gotten through grade
school has seen it in a textbook, it is one
of the most common pieces of ancient art that you'll see. Um.

(08:48):
It dates back to about eight thousand years ago, give
or take, and it depicts a rotund woman with substantial
breasts and white hips. Uh. The guys who found this
in Austria were like white Victorian due um, and they
assumed immediately that this was pornography of some sort and
that the venus descriptor was like the fact that they
called it a venus was like them making fun of primitive, undeveloped,

(09:10):
savage people, right, and like, oh, this is what they
thought was hot, these weirdos in the past, Uh said,
those weirdos in the past. So more recently, several groups
of scholars have argued that the venus was in fact
an obstetric aid used by women to track the progress
of their pregnancies, the changes in their own bodies and
the bodies of others over time during your pregnancy, and

(09:31):
perhaps even as part of an attempt to figure out
what body shapes were most likely to survive childbirth. Basically
an attempt to document here's who what are members of
are like tryb or clan or whatever look like in
different stages of the pregnancies that we can know, Well,
the women who look more like this have an easier
time surviving the birthing process. Right, this is again wild. Yeah,
I did not I did not know about that. I

(09:51):
know about the statutes in like your rights in every
textbook it's like you know, and like Michael Crichton books,
it's in like a lot of like pop culture or
when they this time travel thing, But like, I had
no idea there's natural use for it. Yeah, one of
the ways in which there's been a couple of papers
on this at this point. And one of the things
the first that I actually talked to one of the
guys who did the first paper, one of the things

(10:12):
they pointed out is that if you if you take
pictures of the venus from the perspective of its head,
like looking down at its breasts, looking to the side
at its hips. Um. They compared that to pictures pregnant
women took of themselves with the camera like facing where
their eyes were, of the same parts of their body,
and it looks like the depiction of a pregnant person
that a pregnant person would make of their own body

(10:34):
if they did not have access to like a mirror
or something, if they were just looking down at themselves
and trying to sculpture representation. UM. And further research was
published and I'm gonna quote now from a write up
and art critique about it. Quote published recently in Obesity,
a scientific journal. Richard J. Johnson, Miguel al Lanaspa, and
John W. Fox offered that variation in size amongst amongst

(10:55):
venus sculptures was directly related to climate and proximity to
glaciers because survival required sufficient nutrition for childbearing women. They write,
we hypothesize that the overnourished woman became an ideal symbol
of survival and beauty during episodes of starvation and climate
change in Paleolithic Europe. The study further points out that
the venus is often made out of mammoth. Mammoth ivory, stone,

(11:15):
and horn were worn down in smooth likely result of
being being handled, indicating that they were probably passed down
through generations. The study proposes that the venuses could have
been used as tools to teach women coming into their
child bearing bearing years then increasing their own body fat
would allow them to survive through difficult climates. It yeah,
and I think it's yeah. It's obviously, um, it's unlikely

(11:38):
that the venuses we have, any of them particularly, are
the very first ones done. But but these go back
very far, twenty three thousand years or so before the
first dineral drills. Part of what that suggests is that
maybe some of if not the very earliest people practicing
medicine in anything that could be considered a kind of
like um uh organized way would have been women either

(12:00):
trying to survive pregnancy or trying to help other women
survive pregnancy, right, which is also very logical if you
think about, like, you know, how like the priorities people
would have had back then. Um. I stayed all this
because number one, we're about to talk about a very
different period in the history of women's health when the
only people who are allowed to study it were men

(12:21):
um And I don't want to pretend because when you
call somebody like Jay James Mary and Simms like the
father of gynecology, it does kind of like insinuate that
this is the start of like women's health as like
a medical discipline, and it absolutely is not right. We
people have been working and in a lot, in a
lot of cases we could talk about, um, you know,

(12:42):
midwives in Europe um and like a lot of how
a lot of like honestly a lot of the best
knowledge about childbirth and whatnot would have come from them
rather than doctors from most of the history of medicine
for reasons we're about to talk about. So just want
to denote as we get into this really misogynistic and
racist story, um, that the history of gynecology does not
in fact begin with James Maryan Simms and kinnecology of stetrics.

(13:06):
It's all kind of like woven together at this point
because there's not a lot of specialization yet. Um when
we talk about where we're talking about, which is the
early eighteen hundreds. So I'm gonna I'm gonna move into
the story now. James Marion Sims was born in Lancaster County,
South Carolina, in eighteen thirteen. Most of the knowledge we
have of his early life comes from his autobiography, The

(13:27):
Story of My Life, which he wrote forty years after
the experiments that are going to take up the bulk
of our discussion today, to give you an idea of
the sort of guy he was. The book opens with
forty pages. He had someone else right about what a
hero he was. I'm gonna the way to do it.
I'm gonna I'm gonna do it. I'm gonna read you
a sample passage for this fucking book. His mouth was

(13:50):
admirably formed, the lips being of medium fullness to the
lower lips somewhat fuller, indicating decision of character. His smile
was one of kindly sweetness. His head was rather below
than above the average size, and it's unusual height in
proportion to its circumference pointed his Gaelic origin, for through
his mother, the blood of the mcgregors of Mcalpan coursed

(14:11):
full proof in the veins of their descendant. His tout
ensemble suggested in all respects, Sir John Bell's ideal of
the qualities necessary in a truly great surgeon, the brain
of the apollo, the heart of a lion, the eye
of an eagle, and the hand of a woman. Just
so you know, this is classic academics. Classic academics is
how it is. This is how it is to teach

(14:33):
you go a male. This is everyone's like this classic
beautiful Gaelic features. Yeah, beautiful feet in the hands of
a woman. That's actually kind of a compliment that at least,
at least that part of it's like, you know, like
hands in the heart of a lion. He's perfect, He's
a perfect man. Yeah, So, I mean, just as an

(14:53):
idea of where this guy's ego ends up, that's like
how that's that's what he has someone else right opening
his fucking idol biography. Can I just asked you a question?
Am I? Absolutely? At some point when he is forced
to confront some of the bad stuff that he does,
am I going to absolutely hate him for his responses,
and when he looks back upon it in this book,
yeah yeah, it's it's pretty weasily. It's one of mature

(15:18):
is really going to hate it. So, following tens of
thousands of words of effusive praise, the book opens with
Sims explaining how a bunch of people just demanded he
writes this autobiography. He's like, doctor's autobiographies aren't normally interesting,
but the demand has been so intense that I must.
I'm gonna tell you I know how this happened. Because
when you're a doctor and you're being followed around by

(15:39):
like a big group of medical students, you have them
at your you have to that their grades, their lives,
the future careers are in your hands. And I've never
gotten more fake laughs than when I like have medical
students with me. I'm like very sensitive to it, like
a dream. It's you think, but at some point kind
of drives you crazy because you're, wait, was that, don't

(16:01):
don't give me a courtesy laugh? I want you don't
have to do that. And that's what's happening to this guy,
because all these students being, oh my god, you're so amazing.
Please tell us how you have to write a book, sir, sir,
you have to write a book. You have predicted this,
because he starts to hospitals. So, yes, that's absolutely the
case here. I know I know this guy, Yeah, I
know him. So um. He notes that his uh yeah.

(16:23):
He gives through some interminable family history before he starts
talking about his own birth. He notes that his parents
were descended from English colonists in Virginia, that his family
had come to North America in seventeen forty, and that
his grandfather served in the Revolutionary War. Quote, when I
was ten or twelve or eleven years old, he showed
me a document with Washington's name signed to it. But
I did not have enough sense to appreciate it or

(16:43):
to care to know what it was. Um, who knows
if that's true. Might have been might have just been
something he said, because it was kind of invoked in
this period of time if you were a certain kind
of white dude to be like, oh, yeah, my I
had a grandpa or a dad who knew George Washington
for share. Um. Now, his grandfather lived to age ninety five,
which is insane in that that's pretty good now, Like

(17:06):
in the eight hundreds, like that is the toughest son
of a bitch in several counties, UM. And what he
talks a lot about how the men and his family
live long lives. And then he spends several pages whining
that his dad died at age seventy eight, which is
again pretty good for the era. Now again is still

(17:27):
above average UM. And he spends a long time listing
all of the things his dad could have done to
have lived longer, because he was supposed to live to
be over a hundred UM. And then, after he spends
all this time complaining about his father dying early at
seventy eight, he notes, off handedly, my mother died at
the age of forty of common bilious remittent fever, the

(17:49):
disease that is cured now with the greatest facility, but
at the time was attended with great mortality because they
were ignorant of the method of care. That's it. That's
all for mom. That's all for mom. Oh, this was
an amazing time to be alive. Share was dad only
lived a seventy eight? What a tragedy if he'd you know,

(18:09):
avoided this and taken this and done this that I
told him, Oh, yeah, mom dropped at forty, but whatever. Yeah,
she didn't have his lips. Did you see in my
father's lips. They were my father's beautiful full lips. They
were beautiful. Uh, it's it's great. So Mary and Simms
was educated from a young age, as his father had
not really gotten an education. It was kind of insecure
about it. Right. So he wants his kid, which is normal, right,

(18:31):
wants his kid to have a better life than he did.
The family owned a store in so most mornings, five
year old Marian would hike a mile to the local school,
which was run by a Scotsman. He is the kind
of autobiographer who always lets you know the race of
everybody who comes up in the book. It is very
important you know this guy was a Scotsman and you
know the Irishman are Irish, and the Germans or Germans. Yeah,

(18:52):
he's he's real, real insistent on that. Um. Now, since
he was six at the time, sim says that he
remember there is little of this period, which is fair.
I don't remember a whole lot about being six, but
he does note that quote the teacher flogged the boys
occasionally very severely and stood some of them up in
the corner with a fool's cap on um, which is

(19:12):
probably not weird for the time, but always funny to
read about kids getting hit in old timey schools. So,
school in this part of the United States, and this
time was often summer term only. That was actually kind
of the norm back in the day. You would go
to school during the summer because like there's no planting
or anything, or in the summer, right, you plant and
like the spring and you harvest and kind of like
the fall summer, there's not really much for the kids

(19:33):
to do, so that's like the best time in winter.
It's usually like YouTube, is he not dying of freezing
to death to go do much in the winter, So
kids would go to school in the summer. Um. Now,
the elder Simms didn't like the idea of his son
only receiving a couple of months of schooling per year,
so he spent a significant amount of money to send
his boy, now age six, to a boarding school in
eighteen nineteen. Adults, Simms lets us know that this teacher

(19:56):
was an irishman who was badly pockmarked from small po
This again critical detail from his childhood for you. Um.
He was quote a rigid, disciplinarian, altogether, very tyrannical. And
I was very unhappy at his house because I think
he's living with the teacher. That's the kind of weird
boarding school. It's not like a big boarding school. I
think it's like this guy runs a school in a town,

(20:19):
and people who live in rural communities will like send
their kids to live with them for a few months
to do school. I love so much weird ship from
your show man. Yeah, it's we I think this is
pretty common for the period cases. It's so great though.
I learned so many little facts I get to drop
on on other people. Yet, imagine how much that would suck.
It's like, you gotta go live with your math teacher now,

(20:41):
so that's the only way for you to learn things.
Oh what a bad youth set would be. Um, I
love that spods the weirdest ship for ship, but it's
great love. I would not choose for that to be
how my childhood. But you know what I would choose

(21:01):
for someone's childhood. I bet you. I bet you you
would choose them the delightful UH products and services that
are funding this program. I believe that children have the
right to engage in projects and services, and more than anything,
I believe that children have the right to be put
on child hunting island where they can become part of

(21:25):
the economy. That's what always gets bleeped out. That is,
that's what always gets bleeped out. Now you know it,
but no one else gets access to. We're back, uh kava.
You know we would probably talk about something. Obviously, the

(21:48):
f d A just banned jewels to protect the kids. Um.
I think you know, youth smoking youth vaping have actually
both been dropping for a while. My opinion is that
we ought to do the thing where you just force
kids to smoke when they're in grade school, right, because
what's the one way to make not consuming tobacco cool

(22:09):
something kids do with like they'll hang out and they
won't smoke. Force him to smoke at school. Yeah, this
was This was proven a long time ago in a
documentary about Donald duck Um where he forced Hughie, Dewey
and Louie to smoke a carton of cigarettes and they
got so sick that they never wanted to smoke again. Um.
I think that makes a lot of sense that And

(22:32):
if you at home have an argument, I want you
to think to yourself, has Donald Duck ever been wrong?
And the answer is no, no, And we shouldn't wear pants,
and we shouldn't wear pants. We shouldn't wear pants. Shirt
cock it give your kids cigarettes, make them smoke at school. Anyway,
back to the podcast, So, so he goes to this
boarding school with this uh irishman who is, yeah, a

(22:54):
tyrannical guy. He's going to live at his house. He
clearly finds found the experience somewhat traumatizing, because he writes,
pointed Lee in his autobiography quote, my convictions now are
that the best place for a child under ten years
of ages with his mother? And it's it does say
a lot both about the experience he had that like
as a as a guy who does not talk about

(23:15):
his feelings, he wants to note this decades later, like
I think that points to this being pretty traumatizing to him,
and also it points to kind of what was going
on at the time that he also felt the need
to tell other readers in the late eighteen hundreds, like
don't separate small children from their parents. That was probably
crazy at the time. Yeah, what this guy is supergressive

(23:38):
soft now from this very early age. Simms was extremely
competitive against his peers. The school had a daily challenge
where if you got like kudos or something, you know,
if you basically you got like a praise from the teacher,
if you were the first kid who got to class,
you got to sit in a special seat. Um and
Sims wound up in a rivalry. There was this ten

(23:58):
year old who was always the first kid in class, Um,
whose name he remembered like eighty years later. Uh, and
he gets into like a competition with this kid over
who can get to school fastest. Quote. And this kid's
name is James Graham, So this is him writing. However,
the boy that got ahead of James Graham had to
rise very early in the morning. I remember getting up
one morning, long before daybreak. The dread of my young

(24:19):
life was Mad Dogs and Runaway inwards. I started off
for the schoolhouse on a trot an hour before day,
looking anxiously from side to side and before and behind,
fearing all the time for those two great bugbears of
my young life vise mad Dogs and runaway in words
with which the minds of the young were so often
demoralized by Negro stories. So, uh really hate this guy

(24:41):
and he is he is. He is talking here about
runaway slaves, right, which is a book like kids get
warned like, hey, if you wander off the path, you
go into the woods, like there are runaway slaves, they'll
murder you, right, Like it's a it's a thing white
people tell their kids, you know. Um, that's what he's
referring to, right, is these stories he would have been
told of a kid of like runaway slaves hiding in
the woods that he has to watch out for. Obviously,
nothing ever happens, um, But the fact that he refers

(25:05):
to them that way, and he does not use that
polite term um, should be a hint as to this
fellow's attitudes on racism. Um. Yeah, although I again as racist,
says he says, I do want to note like he
is totally normal for his time, because it is the
United States in the early eighteen hundreds. So you know, um,
he is he is growing up deep within like slavery, um,

(25:29):
and there is nothing about it that he finds unsettling
other than the thought that he might get hurt by
a freed slave, right or an escaped slave. Right. Um.
So in second grade, his teacher had one remarkable peculiarity,
which was that quote, it made no odds whether a
boy was good or bad. He invariably got a flogging
on the first day. So one of his teachers in

(25:51):
second grade is like, first time a new kid comes in,
I'm on a weapon. It's like gang initiation. It's the
worst school. I bring this up because he goes on
to tell the story of a seventh grade who got
seventh or a seven year old who got flogged because
he had to spend a single day in their class.
And the kid wasn't a student, his brothers were, and
his mom had to go into town, so she dropped

(26:11):
him off at the school because she didn't want to
leave him at home. Quote with the negroes again, this
is like, these are the people who are raising him.
These are the adults in his culture. Right, We're taking
you somewhere safe, son, to the floor. We don't want
you to hang out around the slaves. Let's take you
to go get beaten with a whip bite. Teacher. Your seven,
you can handle it. So I think you're getting an

(26:33):
idea of how this kid's early life went right and
and kind of the culture that raises him and its values.
Um when Marian was like twelve. His dad is elected
shiriff of Lancaster Village, which most sources will note. Who
was north of Hanging Rock Creek. You can probably guess
who tended to get hung there and why. Um. Once
his dad was established in a prominent position, he was

(26:54):
able to send his son to Franklin Academy, where he
studied for two years before earning admission to South Carolina College. Um.
So he starts college at fourteen, which is not abnormal
at the time. Right Again, in this same period of time,
if you're in Germany, if you're most of like the
western world, at age fourteen, you're legally an adult in
a lot of the West, right like you're you're starting

(27:16):
to do a man's work in that period of time.
So it's not wild that he's going to college at
age fourteen. Um. He does well in college, he's quickly
admitted to the Euphratean Society, which is a literary fraternity
for nerds. Um. The Euphratean Society existed as a result
of a split with an older fraternity, and for whatever
it's worth, the one Marion joined was the less less

(27:38):
famous of the two. Because their sister fraternity. The Clariosophic
Society counted a bunch of famous people as members, including
John C. Calhoun UM. So, yeah, by this point he
had decided to become a doctor, and while he was
at South Carolina College, he basically interns with a local doctor.
Right in this period of time, medicine it's still this
kind of hybrid of the way it had existed pretty

(28:00):
much forever, which is, you find a doctor and you
like become their helper and that's how you learn a
lot of the tools of the trade. But there's also
a school. There's also medical schools, and you can get like,
you know, a degree and stuff. But kind of both
things are common and which is not like today, you know,
you have like your your what do you call it,
residency and stuff. But in this period of time, he
kind of starts his residency at the same time as

(28:23):
he's starting to go to medical school, and medical school
is not nearly as formal, so his medical schooling starts
his formal medical cooling starts with a three month course
at a medical college at Charleston UM, but he finds
that too hard, so he quits. Uh, he goes to
Philly and he gets joins the worse medical school. Uh,

(28:43):
that's what I wanted. Three month course, which just too intense. Well,
you know the old joke. You know what they call
the doctor who quits his medical school after three months
and goes to a worse medical school and graduates at
the bottom of that medical school. You know what, they
call him a doctor. That's right, classic joke. Good stuff.
I mean, like three months now, you couldn't. You can't

(29:04):
become a paramedic in three months, right, isn't that like
a year or so? Three months would be like one
rotation in like yeah, yeah, it's it's very little in
today's standards. Um. But he does eventually get into a
worse medical school. He graduates in eighteen thirty five and is,
in his words quote, a lackluster student who showed little ambition.

(29:26):
He noted in his memoirs, I felt no particular interest
in my profession at the beginning of it, apart from
making a living. I was really ready, at any time
and in any moment, to take up anything that offered
or held out any inducement of fortune, because I knew
that I could never make a fortune out of the
practice of medicine. I didn't really feel passionate about my
work until I realized I could really make people suffer. Yeah,
until I learned how to get fucking rich, I didn't

(29:48):
care about being a doctor. So he is a graduated
doctor at age twenty two, which, man, I don't know
that I think twenty two year old should be driving cars.
But yeah, it's a for a time, you know, it
is a different, very far off, and there's a lot
less medicine to learn, right, Uh, there's much less medicine
to learn. So if you even go back now, like

(30:10):
ten years, like ten fifteen years, Like the books we
took for our step one training test, they were like
maybe a quarter inch thick. Now over the years they're
like two to three inches thick of all the stuff
you have to learn just in that one for that
one test. So in the last it's been a little
bit more exponential in terms of what we have to
learn in terms of the sciences. But uh, yeah, I

(30:32):
imagine back then it was like maybe a pamphlet in
life pay attention. If you condensed all of the good
medical information you could have fitted into a zine. Um
mostly it would have been washhands underlying bu. They were
pretty far from that, Yeah, that is a that is
a contentious debate at the time. People are getting stabbed

(30:56):
with four steps over it. That's exactly right. Yeah. Um,
so you know he's a doctor. Twenty two, he goes
back to his hometown. Um. Now he has no actual
clinical experience. He had never worked in a hospital. He basically,
like kind of by his own admission, didn't know how
to do anything. His first two patients are newborn babies,
and both of them die instantly. Um. This makes him

(31:19):
sad for reasons that I think are understandable, and to
be fair, with the best medical knowledge at the time,
there's pretty good chance he wouldn't have saved those babies
because it is eight thirty five. Yeah. Um, So he
gets very sad and he flees to Alabama. Um. He
lives there in a disreputable boomtown, presumably drinking too much
due to the fact that he described it his quote

(31:39):
nothing but a pile of gin houses, stables, blacksmith shops,
grog shops, taverns, and stores thrown together in one promiscuous huddle.
You will know that three of the six business types
he describes are just different types of bars. We had
the house house, so in eighteen thirty six home from Alabama,

(32:05):
he marries a woman named Teresa, and in eighteen thirty
seven he and his new bride moved to Macon County
to get simms first real job, which is working as
a plantation physician. So, as you probably have guessed, his
primary patients there are not plantation owners. They probably hired
better doctors because he's not very good at this point. Um,

(32:27):
his patients are enslaved people, right, Um, Now, in some
ways this is not an inherently evil job, because like,
slavery is wrong, but like it's not wrong to provide
medical care to enslaved people obviously. Uh. And he did
a lot of operations on club feed, cleft palates, crossed eyes, like,
and that's like, even if you're working for a plantation owner,

(32:49):
if you are carrying out medical procedures on people who
are enslaved, it's like good to do that. Um. So
this is not like a job that is nest necessarily
the worst thing you could be doing at this time
if you're interfacing with the slave economy. However, the job
of plantation doctor does not just mean being paid to
take care of enslaved people. Um. It is fully integrated

(33:12):
into the machinery of slaveholding and the South's budding human
trafficking business. See The foreign importation of slaves had been
banned in eighteen o eight, which meant the growing demand
for enslaved black people in the United States was served
primariably by forcing enslaved people to make babies and then
selling those babies. Right, you cannot import more enslave people
after eighteen o eight. The way that the slave economy

(33:34):
keeps going is they force enslave people to have children,
and then they steal those children and sell them. Right,
that is how it works. Doctors are a critical part
of this because again, not the easiest thing to keep
mothers and babies alive in this period of time. Um now,
I want to quote now from a write up by
Monica Cronin quote. Enslave women were not only expected to reproduce,

(33:54):
but it seems reproduce often. As Dorothy Roberts wrote, slave
women's childbearing replenty to the slave labor force. Black women
bore children who belonged to the slave owner from the
moment of their conception. Thomas Jefferson, third President of the
United States of America, acknowledged that a woman who brings
a child every two years is more profitable than the
best man of the farm. So so they're part of

(34:15):
this machine to keep slavery going, this economy of it.
And they are arguably a critical part of the most
profitable part of this machine, because the slave owners themselves
will argue that keeping enslaved women breeding is more profitable
than any individual labor laborer. Right. Um, so Simms's work

(34:35):
was very much critical in maintaining the profitability of his
employer's slave empires, and he was not an insignificant part
of this machinery in the state of Georgia. This right
up from history that goes into more detail. According to
Vanessa Gamble, University Professor of Medical Humanities at George Washington University,
Sims's practice was deeply rooted in the trade for enslaved people.
Sim's built an eight person hospital in the heart of

(34:56):
the trading district in Montgomery. While most healthcare took place
on the plantation, some stubborn cases were brought to physicians
like Sims, who patched up in slave workers so they
could produce and reproduce for their masters. Again, otherwise they
were useless to their owners. This brings up the concept
of soundness, says Gamble, being sound meant they produce for
men and women and reproduce for for women. Right, So

(35:18):
this is like, yeah, this is the thing. Now, we
are somewhat reliant upon Sims here for information on the
size and scope of his practice. But his claim is
that his practice was not merely one among many, but
the largest surgical practice, but the largest surgical practice in Alabama,
and the largest practice any doctor in Montgomery had ever

(35:40):
had up to that point. Again, he is a narcissist.
This may be untrue. That's I'm not saying that to
like mitigate his crimes. It's just like he's not an
entirely reliable narrator here. And and the fact that he's
just like I had the most racist medical progression. I
was the biggest racist and the greatest racist dr you've
ever seen. Yeah. But and also it is entirely possible

(36:02):
he was the biggest you know, that's not an impossible
thing here. He's certainly a significant part of this. And
it's also, as you said, worth noting that he's like
I was the most important of the racism doctors. Yeah. Um,
And again he he has so many patients because he
provided an economic like a cost effective way for slave
owners to keep their human assets productive. In in that sense,

(36:25):
um as a doctor, Sims had to treat female patients
regularly and he hated this. Uh No doctors at the
time liked working on women. Um, this is going to
be gnarly, so buckle up. One of Sims's major critics,
Direnda Januga, explained it this way in her article for
the Journal of Medical Ethics. Quote. To complicate the situation

(36:46):
even more, the medical specialty of gynecology did not exist.
The practice of examining the female organs was considered repugnant
by doctors, who were almost all males. In fact, in
American medical schools, obstetrics and child delivery were taught by
the use of dummies, and often it was not until
the doctor was in practice that he actually delivered a baby.
According to Words and Words nine, young doctors rarely had

(37:07):
any clinical training and what the theory of birth mint
In practice, Many arrived at a birth with only lectures
and book learning to guide them. If they and the
laboring patients were fortunate, they had an older, experienced doctor
or attending woman to explain what was natural in what
was not. Many young men were less lucky and were embarrassed, confused,
and frightened by the appearances of labor and birth. So

(37:28):
most doctors know almost nothing about labor about again, this
is part of why, like, you're in better hands a
lot of times with a midwife here than you're like
going to a doctor for this. Um. And if I
could be fair for a second, there was very few
things in medicine that scared me when I was doing
my medical school training, but childbirth was one of them.

(37:49):
Like it was, I found it terrifying. The risks were
the scared holding babies exactly. I mean, like, I just
you don't want to suck it up so mad it was.
It can be so stressful. Um, I mean that's not
I don't think that's quite the issue that all these
people are facing at the time. But I'm just gonna
say it's it is a really tough field. I have

(38:10):
a lot of respect for obi gaians. I mean, so
one field, of course, it's like the one field of
medicine where you're not just avoiding death, you're actually bringing
life into the world. So it's kind of like cool
in that that way, but it's also very high risk,
high reward sort of thing, and there's like the loads
can be so low it's like soul crushing if it happens,
you know, and one has to assume, You have to assume.

(38:31):
There are the odd like shining examples here of like
male doctors who actually give a shit about this, but
they are very few and far between, and for the
most part, like doctors are scared of this and don't
know much about it. Um And part of this is
based on the very again Victorian attitudes towards like sex

(38:52):
and sexuality at the time. So to give you an
idea of how fucked up this is. When Sims was
trained as a doctor, the standard medical procedure for doing
a pedic pelvic exam was to look directly in the
eyes of the patient and nowhere else because actually looking
at their genitals would have been inappropriate, really creepy. Yeah,
you are staring in their eyes, not looking at what

(39:14):
your hands are doing. Yeah, this is very uncomfortable. It
makes me very uncomfortable. Probably seems like it is hard
to do good medicine that way, not an O, B,
G U, I N. But I assume that makes it
more difficult. Um. So again, I stayed a list to that. Like,
given both just kind of the the the limitations of

(39:37):
science and the cultural limitations placed on doctors and the
doctors placed on themselves in this period, it is was
basically impossible to solve what was probably the worst pregnancy
related illness of the day, which was vaginal and rectal fistulus. Now,
these can be deeply unpleasant things to deal with. Uh.
The gist of the issue is that a whole develops. Uh.

(39:59):
And this is like a thing that happens due to
getting that baby out of their trauma. Yeah. Yeah, a
whole develops between a woman's bladder and vagina um. This
can lead to constant, uncomfortable and uncontrollable urinarian continents, and
worse versions of the condition lead to uncontrollable fecal incontinence too.
I probably don't need to be labor what an issue

(40:20):
this would be for anyone suffering from it, and what
kind of impact this would have on their life? Right? Um,
people with these fistial is cannot safely carry additional children
to term, so if they are enslaved people. Um, number one,
you can't really work with this, right, It gets in
the way of you being able to labor and be
a productive economic unit, and you also cannot bear additional

(40:42):
children's So in the minds of a slave holder, this
health issue turns a woman into a complete financial loss, right,
which is how they think about these women, right, These
human beings are purely financial instruments for them. You know,
they look at them as like battle almost like not
they're non They're not looking at them they would look

(41:03):
at a normal patient. Right. So, from the perspective of
the people who own slaves, this is a major financial issue,
and obviously from the perspective of both enslaved women and
free women, this is also just like a horrific health
problem that there is no cure for, right, because this
this affects everybody, um, and it's I mean, I don't
again feel like I don't have to believe it, like

(41:23):
why everyone would want there to be a cure for this.
I just feel the need to point out that the
people who are paying Jay Marry and Sims, who's going
to work on this problem, want it cured specifically for
financial reasons. Right. Um Now, Jay Mary and Simms was
going to be the guy who fixes this problem, which
is sort of surprising because up until his thirties, women's

(41:44):
health was pretty much just an afterthought for him, as
he wrote, quote, I never pretended to treat any of
the diseases of women, And if any women came to
consult me on account of any functional derangement of the
uterine system, I immediately replied, this is out of my line.
I do not know anything about it. Practically, he advised
them to see He advised them to seek help with
a different physician. But all this changed one day, a

(42:06):
few years into his practice, when he was called to
work on a woman who had fallen off a horse
and was in pain around her back in pelvis. He
assumed he she dislocated her uterus, which I guess is
a thing that can happen. Um. He probably he was
probably a hip or something, Yeah, he said, he she
he thought she had dislocated her uterus right. Um, Now,

(42:27):
without going into too much detail here, he like gets
his hands up in there, and he kind of by
accident relieves her pain without meaning to. He like pushes
a bunch of air into the vagina, which dilates it,
and in his words, pushes it back in its normal place.
I'm not entirely certain what he's talking about here. But
the end result of this is that while he's kind
of rooting around in there, because of the stuff that

(42:49):
he does, he's able to get a good This woman
also has a fistula, which had been an untreatable problem
for her, and because of what he's doing down there,
because of the dilation of the vagina, he's able to
see this fistual and be what he thinks is probably
like one of the first doctors to get a good
look at it. Um. And he's close enough to it.
He can't quite see it enough, but he's he sees

(43:10):
enough of it, he's close enough to seeing that he's like,
I feel like I know how I could get a
better look at this thing. And obviously, again he's not
actually an incompetent doctor. He quite rationally is like, well, look,
I'm really close to seeing this thing. If I can
get the right tools so that I can actually get
a good look at this thing, I can figure out
how to treat them right, um, which is perfectly reasonable

(43:32):
medical logic at this point. Um. Now, the only issue
is that the right tools did not exist um today,
doctors who work on this un thing. One of the
tools that would use is called a speculum um, and
Dr Sims is the one who invents the precursor to
the speculum um. He does it by buying a pewter spoon. Uh.
He grabs two medical students, and he goes back to
his patient. He writes, quote, I got a table about

(43:54):
three ft long and put a coverlet upon it and
mounted her on the table on her knees, with her
head resting on the palm of our hands. I placed
the two students, one on each side of the pelvis,
and they laid hold of the needs and pulled them open.
Before I could get the bent spoon handle into the vagina,
the air rushed in with a puffing noise, dilating the
vagina to its foolish extent. Introducing the bent handle of
the spoon, I saw everything as no man had ever

(44:16):
seen before. So it is yeah, you know, and we
I'm sure a lot of people are familiar with the
concept of a speculum. I'm I don't actually know. I'd
be curious to see some pictures, but I assume these
are much we we now we think about the sort
of disposable bivalve plastic, you know, vaginal speculum. I'm assuming
this was some sort of came out looking like some

(44:37):
sort of medieval horror device. It probably looked unsettling, yes, yeah, um,
but this is like this starts the process that leads
to the modern medical speculum. Right like he is and
this is this is like good. So far everything we've
talked about in this moment is like this good medicine.
I would I would say he's doing something, he's doing something.
He's yeah, he's he's following logically, he's trying to relieve

(44:59):
a persons you know, suffering. Um. And he realizes that
he can see the fistula and he's got enough working
room to experiment with surgical treatments for it. Now, this
is a big moment, right um, a big moment and
just like medicine. Um. But after this point things take
a much darker turn because this patient he's got, she's
a woman who has some means. She's not going to

(45:21):
let him experiment on her on like surgically experiment on here.
Because again it shouldn't be surprising to people, experimenting on
fistuli surgery is nightmarishly painful and dangerous for reasons that
should be very obvious. Because it is the eighteen thirties. Um,
this is part of why so little progress had been

(45:41):
made on the problem. But as George but as an
Alabama's largest plantation, Doctor Mary and Simms had a massive,
basically unlimited supply of women with fistulas, women whose consent
was immaterial, and their owners had no reason not to
send them off with Dr Sims, because, as we've discussed,
a slave who cannot give birth, your work is nothing

(46:03):
but a money sync. And so Marian starts to make
deals with slave owners. They will give him their slaves
for as long as he would need them as test subjects.
He will pay for their food, which he did complain
about constantly in his memoirs, and the slave owners would
cover the tax that he had to pay, and he
would use them as experimental test subjects. Oh my god, yeah,

(46:23):
I will say, I don't. I won't belabor it. And
also it's not my wheelhouse. I'm not no beguine, but
my dad is, so you know. Dinner conversations in the
Yodah family growing up were very different than yours probably,
and this procedure is requires a high level of skill
these days, anesthesia with either general or like talking about that, Yes,

(46:46):
and and are very tough things to do and I
think we take probably like an hour to do. So
they're not like quick things in and out. They're like
lengthy procedures, um surgeries because you have to dissect them
micoso playing and so it's really, um, it's it's pretty okay.
I'm just I'm just trying to get myself ready. No,
I mean, and that's the thing again, we'll be talking

(47:08):
about this later. This guy is legitimately good at what
he does. Like the actual he is not a quack.
The actual thing he comes up with is an important thing. Um.
We're going to talk about some other aspects of that
that make this even more morally questionable. But like what
he's what he's doing, he's not he's not bad at
the medical side of it. It's the ethics side of

(47:29):
it that where things become problematic. Um. But you know
what else is problematic? Not sure? First, not having products
and services exactly. Not engaging with these products and these
services is the ultimate way to be problematic. Um, Because
if you're not engaging with these products and services, are

(47:51):
you really alive or American? Exactly? Damn? Oh oh, merry Christmas. Um,
it's not Christmas. It's nowhere near Christmas. It's I thought
Paul had murdered you, Santa Claus. He did, he did.

(48:12):
Paul Schaeffer shot Santa Claus in a ditch. And today
we're going to shoot our fun recollection of residencies and
the medical training or something like that. We're certainly gonna complicated.
Um so um. He gets these a number of slave

(48:35):
owners to agree to hand over enslaved women to him.
He is effectively their owner during this period of time
in a legal sense of the word. He begins his
experiments in eighteen forty five. He is thirty three years old.
Most historians writing about this will note that he had
three patients, Lucy, Anarca, and Betsy. And I had not

(48:55):
heard the name in Arca before this dope ass name
spelled like you'd think it is. Uh. And this is
where we get to the root of why Dr Simms
has been canceled by modern critics. Um. They alleged that
what he did was human experimentation without consent, because true
informed consent is impossible from a person who is enslaved,
like you can't consent to be experimented upon if you

(49:17):
are owned by the person doing the experimenting. Now, I
don't think the ethics they're complicated like um, like you
know autonomy, it's likely of medical ethics you have to
have informed consent and you have to have some control
over one's body exactly, exactly, um. Now, there are a

(49:38):
number of people who are detractors to this idea, and
the most notable of them is Dr L. L. Wall Um.
We will be talking about this guy quite a bit,
you know, on this show we occasionally will have like
defenders of weird fucked up things. Often it will be
like we're talking about some British empire motherfucker, and like
his biographer who thinks he was he's the Bee's Knees
and like writes a long things defending him massacreing people

(49:59):
in Africa or whatever. This is a bit different. Dr L. O.
Wall I think is very very wrong and some of
his arguments are pretty messed up. That said, from what
I can tell, he's spent a lot of his career
flying to impoverished parts of the world and performing surgeries
on people with fistula's. I think his he's passionate about
this because he's dedicated his career to dealing with this

(50:20):
specific health issue, and SIMS is the guy who, like
most fixed it again l O Wall is wrong here,
but he's not the same as like some dude whose
job is to professionally defend the British Empire, because it
does seem like his day job is helping people for
free with a serious medical issue, which is nice. Um. Anyway,
I wanted to provide that context because we will be

(50:41):
tearing apart some of these guy. This guy's arguments in
a little bit here. Um, I'm sorry, he's uh modern doctor.
L yeah, yeah, he's he's around right now. Uh he
has yes. Um, I think his arguments are bad, but
here is one he made in a rite up in
the Journal of Medical Ethics. This is an ongoing series
of arguments that that other people have had with him. Quote.

(51:01):
The first assertion was that it was unethical by any
standard to perform experimental surgical operations on slaves because slaves
by definition, could not have given voluntary, informed consent for surgery.
Underlying this assertion is the hidden presumption presupposition that enslaved
women with fishtalists did not want surgical care for their condition,
and that they were therefore coerced into having unwanted and
perhaps unnecessary surgery. Now, I would argue that that's not

(51:24):
actually a hidden presupposition, because like we're not saying they
don't want surgical care. We're saying they can't give informed
consent to be experimented upon, which is different. Right. Obviously,
anyone who has a medical condition wants it to be treated, um,
But that doesn't mean you want to be a test subject,
you know, in a medical experiment. Um. His argument then,

(51:46):
is that this particular medical problem is such a nightmare
that these women were basically beating down Simms's door to
get treatment. In his memoire, Sims claims that he received
enthusiastic consent from Lucy, Anarca and Betsy. We have no
actual levi of this. This is something he writes down later.
None of these women, as far as we know, could
read or write. They have left us absolutely no written

(52:09):
documentation of their consent. Calls absolute this guy. But by
the way, I'm so sorry. I know I shouldn't do
this because you're giving me all the information right now,
but I just google. That's come so fascinating to know
that there's like a modern day like enthusiast of Dr
Sims and there is this article in the Journal of
Medical Ethics by L. L. Wall, The medical ethics of

(52:30):
Dr J. Mary and Sims a fresh a fresh look
at the historical record. That one of the things that
we're quoting from here is that, Yeah, in his conclusions,
he says, Uh, in conclusion, it's difficult to make a
fair assessment of the medical ethics of past practitioners. Yeah,
I don't think it is here, buddy, seems pretty open.

(52:52):
I think who knows it's gonna get it's gonna open
up further. Um So again, uh, number one, Obviously, outside
of what I just said, even if you ask a
person that you legally own if they consent to surgical
experimentation and they say yes, that still doesn't count as consent,
right for a variety of things. I think what should

(53:14):
be obvious reasons, right because you own them legally, and like, again,
they don't like if their consent is immaterial, Um, then
I don't know that. I like, I don't think they
can consent. And that's current like medical ethics, is that
they cannot consent to respect autonomy, they be given all
the tools to make their own informed decision. And I'm

(53:35):
certain that was not happening. Yeah, but but I mean,
even outside of that number one, we have no evidence
other than Sims's words that they told him that they consented.
And I want to quote from that right up by
Monica Cronan. Again, she notes that Sims published as memoirs
well after the end of slavery in the United States,
and that he may consciously have wanted to put himself
in a positive light by claiming that these women had

(53:55):
consented to his experiments. Quote. Sims is memoires is likely
to be a reflection of changing attitudes towards formerly enslaved
people and self conscious image making, as it is to
be an accurate portrayal of events. Now. L. L. Wall's
argument is that it's pretty obvious the women would have
consented because a fistula is such a horrible thing to endure.
He goes into some detail here quote. In addition to

(54:16):
the continuous stream of urine and sometimes fecies to which
they are subjected, these victims of prolonged obstructed labor also
often suffer from secondary and fertility. Loss of vaginal function
due to extensive scarring of the birth canal damage to
the pubic bones, contractors of the lower extremities from neur
muscular damage, recurring pelvic and urinary tract infections, horribly diminished
self esteem, damaged body image, and not infrequently severe depression,

(54:39):
even suicide. The cumulative devastation brought by this process can
be appalling. It is hardly the relatively minor condition referred
to by historian Deborah Coon McGregor, and he does have
a point there. I think it's probably a bad call
to refer to this as a relatively minor condition um.
But then L. L. Wall extends his argument and what
I think is a real fockd up place quote in

(55:00):
alleging that it is unethical for slaves to participate in
any form of medical experimentation, O Januga and the other
writers seem to imply that they wouldn't, that it would
never have been appropriate for slaves to undergo innovative surgical operations,
no matter what their problems might have been. Critics of
this stripe conveniently ignore the differences between non therapeutic and
therapeutic medical experimentation. In the former case, participants can have

(55:22):
no reasonable expectation of obtaining direct personal benefit from whatever
is done, But in the case of therapeutic experimentation. Research
participants may gain direct and sometimes substantial medical relief as
a result of their participation in a clinical trial. At
the time Sims began as experiments to repair the fistual
as affecting afflicting his African American slave patients, there was
no effective therapy for vestico vaginal fistula. Many surgeons in

(55:45):
different countries had made repeated but unsuccessful attempts to close
veso vaginal fistulas and put it into the tormenting loss
of urine that these suffering women experienced. With rare exceptions,
all such attempts failed. Now, one of the key points
against this argument that he's making is that that last
part is not true. Right and again, if there were
doctors who had successfully provided therapeutic treatments for fistula and

(56:08):
had done it without experimenting on enslaved people, then it's
reasonable too. It's even more reasonable to say that doctor
Sims was engaging in unnecessary human experimentation on enslaved people.
And several doctors had treated fistula successfully as far back
as sixteen seventy five. John Paul Mattower of Virginia had
successfully treated one in eighteen forty and by eighteen fifty

(56:29):
five had repeated this feat twenty seven times. George Hayward
had closed his first fistula in eighteen thirty nine. Now,
this techniques that doctor Sims is going to develop are
more repeatable and and and are an important, really important
part in figuring out a better and kind of more
mainstream treatment for this um. And he was probably the
most tenacious doctor in his field attempting to figure out

(56:51):
a replicable treatment. But the fact that multiple other doctors
were working successfully on fistula in the same period without
and experimenting on enslaved people further makes the case that
Dr Sims was not experimenting on these women because there
was no other way, nor was he doing it primarily
for their benefit. He did it because it was easier. Um.
That's that's pretty key to me. Um. Yeah, I mean,

(57:13):
I guess, on one hand, you know, it's fine to
make this argument that you know, prior to like ninety four,
with like the National Research Act, in the Belmont Report,
all that stuff that came after the Tuskegee experiment, Like
it's fair to say that before that there was no
framework of like you know, I R. B. S. Studies

(57:35):
that you need that that that's a fair argument, but
you can't get around the fact that even at the time,
I'm sure it was widely considered unethical. And then yeah,
I'm assuming he's doing these without anesthesia, but is he not?
But ansthesia was around from like I think eighteen forty

(57:56):
six SAT. Seven. I think the anstegia was around at
point right. Yeah, Um, we are going to uh, we'll
be talking about that a lot in part two. Um no, no, no,
we will be That's that's important. You will be getting
into the um. But yeah, it's it's also worth noting

(58:17):
that like um and this is also very important. While
Mary and Sims does make sure to claim that the
three women who are named in his book gave their consent,
he also introduces quite blithely that there were multiple other
enslaved women he used as test subjects. By some accounts,
like seven. He doesn't even give their names. Uh, he
makes vague comments that they wanted his help. There is

(58:39):
no claim that like these people uh even consented to
the extent that like the others did, which again is
not really consent. But like that's part that offer that
gets ignored by l l Wall. It gets ignored by
a lot of people because it's like, well, he names
he gives the names of three of them, but there
were a lot of he because why would he bother right,
like they're not people to him. Um. And again later

(59:01):
in his memoir, despite these this like single vague claim
he makes about consent, he also makes this note quite
and this is how he introduces that there were other
women he experimented on who are not named. I got
three or four more to experiment on, and there was
never a time that I could not at any day
have had a subject for an operation. Again, he's very
clear about what he's doing here. Yeah, I mean he

(59:24):
he's he sees them as test subjects, not as humans. Um.
I mean again, the very basics of like medical ethics,
like even I know, and I'm not like an expert
in medical ethics by any means. Non malfeasance, autonomy, justice,
all these like basic concepts that are again very basic.

(59:46):
They're not all modern and stuff are not being adhered
to in the slightest here. Yeah, and that's I mean,
that's what we're gonna leave it for part one. We
get into part two, it's it's actually even worse than
that Covic. But you know what's not worse than that
uh podcast, that's right. I actually now not host two.

(01:00:08):
The first one is of the House of Pod. It's
a sort of humor adjacent medical podcast. I have on
lots of great guests. We have doctors, we have musicians,
we have Roberts, we have sophies come on the show
and we uh we talked about medical stuff, science stuff.
It's fun and that you can find anywhere you find

(01:00:29):
your podcast. It is thank you. It's a it's a
good time and you might learn something very very stuff
And we kind of cover if you like these same
sorts of topics that you guys cover here you we'll
cover a lot of similar stuff. And then, um, there's
a new show I'm doing with Rebecca Watson, who is awesome,
amazing of skep chic and we it's called Girls on Boys.

(01:00:52):
It is a podcast where we uh talk about take
deep dives on the show The Boys, which I find
immensely entertained and I think it is one of the
best satires show. Also, man Eric Kripkey knows how to
do gore. Some of the best television gore I've seen
any ever. We we should talk about exploding penises at
some point. Man, that's a good scene. It was. I mean,

(01:01:16):
the whole prostate anatomy is there's a question there with that.
But I'm not surprised. Yeah, but the show is amazing
and and it impresses, it surprises me in the most
fun ways. So I think it's a smart show. We
talk about it. That's Girls on Boys. It's a podcast.
You can find it at iTunes. Yeah, check that out. Um.
I have a book called After the Revolution. If you

(01:01:37):
want to buy it and you're looking where you can
get it an indie bookstore in your area. You can
check out this thing I just learned about called bookshop
dot org. If you get a bookshop dot org type
and After the Revolution you can find my book. There's
a couple of dollar discount on it. Now. You can
also just go to a k press After the Revolution
just google that and you'll find it. So I love
that book. But it's a great book. It's really good,

(01:01:58):
it's really enjoyed. Great. Thank you working on the sequel. Um,
you can get it everywhere else to wherever the funk
you find a book. But someone told me bookshop dot
org helps out indie bookstores, So maybe try that out. Yeah,
go to cools on media dot com to see the
rest of the stuff we're working on. Check out you know,
Ghost Churchard, politics, cool people, cool stuff's check it all out,

(01:02:22):
come on or else fucker's