On the Need to Reclaim Gynecology’s Troubled Legacy

JOEL BERVELL: My guest today on The Dose is gynecology health care activist and clinic founder, Michelle Browder, who’s using art to retell history. Michelle works in Montgomery, Alabama, where she’s speaking to us from today. Place is crucial, especially in this episode of The Dose. Montgomery, Alabama, is considered the birthplace of medical gynecology because of a 19th century physician named Dr. J. Marion Sims, who’s been called the “father of gynecology.” Sims built a hospital referred to as a surgical infirmary for Negroes, for enslaved women whose owners brought them for treatment. It’s thought to be the first women’s hospital in history and was the first hospital specifically for Black people in the United States.

But at that facility in Montgomery, J. Marion Sims developed and performed dozens of experimental surgeries on enslaved women, without their consent and without anesthesia, to repair and reconstruct their organs. He had no training because there was no training at that time, and no discipline. He even purchased one enslaved woman from her owner, specifically with the intention of performing experimental surgeries on her. And while many of the names of these women are lost, three of the women he named in his journal are known: Anarcha, Betsey, and Lucy. Each had vesicovaginal fistulas, a common condition of women who have many children. There are essentially tears in the vagina, which can often be painful. It can cause leaking of urine and even feces, leading to tissue death.

My guest today, Michelle Browder, has not only created a monument to the enslaved woman in Montgomery, which we’ll talk about, but she’s also now planning to open a local midwifery clinic, a national education center for maternal health, and ultimately a birthing center on the site of the former hospital for enslaved women.

It’s with great pleasure and a lot of awe that I welcome you to The Dose, Michelle Browder. Thank you so much for joining me for this conversation.

MICHELLE BROWDER: Oh my God, thank you so much for having me. It’s a privilege. Thank you.

JOEL BERVELL: Yeah. So we’ve met before, but I have to tell everyone this because they can’t see you, but your glasses are always just incredible. Today you’re wearing these amazing, bright red glasses, and I think it’s just a testament to your fiery personality. But I really want to jump into and talk about your clinic. You’ve just broken ground with the clinic you plan to open in Montgomery, and I know you envisioned this as a place that serves women locally and more broadly acts as a national education center. Can you first tell me about the ground floor operation? Who’s the clinic for, and who will it give and get help for there?

MICHELLE BROWDER: Basically, I think that this is just amazing because I really admire all of the work that you’re doing as a medical student transitioning into what would be someone’s magnificent doctor. And so you understand the history of gynecology and women’s health. But right now, this space that I happened upon, it’s a building that was built in 1862. It was a place that was used for the first open heart surgery. It’s built on the site of where J. Marion Sims had the Negro Women’s Hospital. And so what it means to me is that I feel like it was an ancestral call, and I feel like I’m on borrowed time, in that this is something that needs to be done quickly, with perfection and with precision. But I just really think that there’s a mandate because of where we are with maternity care, maternal health, and health care in general, how we treat people, our patients, the lack of empathy, dignity, and respect.

And so this space will be used because of the language. You have to be careful, Joel, in what they would call the antebellum South still. Montgomery, Alabama, it’s in our city seal that we are the cradle of the Confederacy, but yet we’re the birthplace of the civil rights movement. So the space, 33 Perry, I’m going to open hopefully the beginning of next year. You’ll be here hopefully.

JOEL BERVELL: Oh, I’ll be there.

MICHELLE BROWDER: You’ll be a part of that, yeah. But it’s a clinical museum in that I’m an artist. I’m not a medical student. I’ve only learned what I’ve learned from Harriet Washington, Medical Apartheid, whether it was Dorothy Roberts and Killing the Black Body or Deidre Cooper Owens. And now this new book, Say Anarcha, it’s like this is where I’m getting all of this information about these girls in today’s time. But this space will be a clinical museum where I’m merging art, history, maternity care, and medicine.

JOEL BERVELL: Oh, I love that so much. I think that’s so important because often in science, we lose meaning of art when in fact, medicine is not all science. Much of it is art. And so to see what you’re doing of merging these different disciplines together is so powerful. And can you tell us about what’s upstairs, the education missions of your center?

MICHELLE BROWDER: Yeah. Upstairs there will be a space for medical students to come to learn. We’re changing the curriculum in health care, so there would be a space for students to come in, not just students, but doctors and other medical practitioners, psychiatrists, right? Everyone needs to know what this legacy of slavery, what it has done to the body as it relates to trauma. And so there’s a space there equipped with AI and equipped with the actual equipment to teach medical students how to administer empathy, dignity, and respect while they practice.

So we’re curating a curriculum that will help teach all of us, not just the medical procedures and what they should do in a time when there’s someone in a distressed situation, but also how do we really care for folks? And I think that’s what we need today.

JOEL BERVELL: Absolutely. And how is this work tied to the current maternal health crisis in America for Black women?

MICHELLE BROWDER: Oh, my gosh. Well, we’re not listened to, right? We’re not taken seriously. There’s this stereotype, a generalization of Black women and Black girls. And I have to say that there are the statistics or the generalization that Black women don’t feel pain or we experience pain differently. That was from the 19th century. Well, it still plays out today. You look at women like Serena Williams and/or the woman that died during COVID, Dr. Susan Moore — they weren’t believed. And so I think that it’s playing out today as just teaching us a different way to administer health care in this country. And whether it’s maternity care or just health care in general, we need to do better. And so hopefully, this space will give credence to that and open doors for a more courageous conversation on how we do better.

JOEL BERVELL: And I think about this site, I said in the opening that location is so important, Alabama being a red state, and while Montgomery itself isn’t a maternity desert, much of the surrounding state is. And I know even in the post-Dobbs world right now, there’ve been a lot of talk from potentially future ob-gyns not wanting to go to the South, or especially the need for more Medicaid expansion for those that haven’t been able to access health care too. How do you see the policy tying in with the work that you’re doing here?

MICHELLE BROWDER: Well, the policy right now in Alabama is that the IVFs, we’re having this issue with . . . even though we don’t have autonomy over our bodies, we are a red state where we do not believe that a woman should have a right to choose. And so now with the whole IVF legislation, it’s just shining a light on where we’re headed in terms of autonomy and bodily care.

JOEL BERVELL: Absolutely. Can you talk about each of the three named and known women who received treatment at this site your clinic is going to be at in the 1860s to 1880s, so Anarcha, Lucy, and Betsey?

MICHELLE BROWDER: Yeah. So it’s interesting because we talk about the women, but they were really girls. They were girls ages 17, 16, 18 years old, and they basically were sexually trafficked. They were raped. One of their main duties was that they were to breed. You know, 1808, transatlantic slave trade is outlawed. And so basically in the United States, you had to breed in order to replenish your stock. So Anarcha, 17 years old, was enslaved here in Montgomery County at the time of her first fistula. It was J. Marion Sims who was her practitioner, her doctor, her enslaver. The Westcotts took her to him because he claimed that he could fix this fistula, that he could heal her from this. And these are women that J. Marion Sims himself spoke about in his memoir, Stories of My Life [sic]. And basically, he described them as subjects that were in need of repair, but historically, they weren’t fit for duty as the incomparable Dr. Joy DeGruy points out in Post Traumatic Slave Syndrome, that they weren’t able to perform their duties.

And so it was customary for Sims, who saw where this could be profitable for his business, started accepting these women. Lucy, at the time of her experimentation, 18 years old, was from Macon County, home of the notorious syphilis studies. And then Betsey from Lowndes County was 16 years old at the time of her experimentation and the fistula, giving birth. And so basically, I wanted to honor these three women who were enslaved in Alabama, and then talk more about the history and the duties of these trafficked enslaved bodies and these girls. And that’s one thing, we talk about the women, but they were girls. And so that’s what I try to really uplift and amplify, and it’s still happening today. We still have a sex trafficking problem.

JOEL BERVELL: Absolutely. Can you tell us a little bit about their lives beyond their lives as just specimens, beyond experiments by J. Marion Sims?

MICHELLE BROWDER: There’s not much that I have found other than this new book, Say Anarcha, that talks a little bit more about Anarcha. And she basically went on to have six children. She went on to get married. And so they’ve recently found one of her descendants from the married side. And I don’t know if you know about this, but she’s . . .

JOEL BERVELL: I don’t, no.

MICHELLE BROWDER: Yeah, they found the descendant and also where she’s buried.

JOEL BERVELL: Wow.

MICHELLE BROWDER: Yeah. And it’s in the new book. It’s in the new book. And so basically, Anarcha, she went on to be a nurse. J. Marion Sims actually loaned her out to be a nurse where she would take care of traveling sick passengers as they would come through Montgomery, Alabama. And so basically, there’s a little bit more about her, more so than the other two, because Betsey and Lucy, those names were very common. But with Anarcha, the A-N-A-R-C-H-A, she was easily recognizable in the census, but the other two are not. And so that’s basically all that we know of her.

And so there’s more information in this book if you all would like to go and check it out. But again, it’s important to lift them up because Sims imposed upon them. He tortured these girls, but yet he talked about them. And so basically, we’re trying to shine that light on them specifically.

JOEL BERVELL: Absolutely. Can you talk about if these women were acknowledged, compensated, or otherwise credited at all for the use of their bodies or their literal physical material?

MICHELLE BROWDER: No, they were not. They were not given their just due. As a matter of fact, in the state of Alabama and Montgomery in particular, there is a statue that sits at our state’s Capitol. And the Capitol was built by enslaved African people and their descendants. And there’s no recognition, there’s no posts and/or iconography to talk about those people that were enslaved. And neither was there until 2001 that talked about Anarcha, Lucy, and Betsey. However, Sims is known as the “father of gynecology,” and I would often drive by that marker that sits at our state’s Capitol. This man did nothing in terms of legislation, but the MASA, the Medical Association for the State of Alabama, deemed him worthy to erect a monument. And I thought to myself, “Well, where are the mothers? If he’s a father, there must be a mother somewhere.” And so from there, the research continued. So our goal is to just make sure we tell their stories.

JOEL BERVELL: And that’s such a beautiful line right there, “Where are the mothers? If there’s a father, there has to be a mother.” And it’s so true in the sense that we overlook women, mothers so much and focus so much on the male perspective. That’s why I think the work you’re doing is so important. Can you tell us a little bit more, you’ve mentioned some, about the kinds of experimentation that the patients of Dr. Marion Sims were subjected to?

MICHELLE BROWDER: Oh my gosh. So it wasn’t just women. It wasn’t just girls. There were babies. There were men with lockjaw and drop foot, and he killed a lot of his subjects, because that’s what they were known as. They weren’t humanized. So he killed a lot of these victims. And there’s one in particular that’s spoken about in this book about the lockjaw and the babies whom he murdered for simply trying to close the cranium, that little soft spot in the baby’s head. He literally would experiment on trying to formulate and/or shape the cranium, causing the child’s death. When Sims left Montgomery, Nathan Bozeman, this doctor was given his space to continue some work, and he was a critic of J. Marion Sims because of how he conducted his work.

But many of subjects that he killed, and I say that in that way because these were actually human, but again, in his view, they were just subjects, they were just easily discarded.

JOEL BERVELL: And I know the site that you are building this monument on already has a statue there that you’ve built. Can you describe the Mothers of Gynecology statue?

MICHELLE BROWDER: So can I tell you how I first heard of them though?

JOEL BERVELL: Yes, please, please.

MICHELLE BROWDER: I first was introduced to Anarcha, Lucy, and Betsey when I was 18 years old at the Art Institute of Atlanta. I studied visual communications and graphic design. And I’m in one of my classes, my figurative drawing class, and there’s a poster . . . it wasn’t a poster, it was a postcard that was sitting on the desk of my professor, and it’s that infamous one by Robert Thom, who created “45 Moments of Medicine.” [sic] He was commissioned by Parke-Davis, which is now Pfizer, to create this art. And it depicts Sims standing with a speculum, Anarcha on the table, it’s a very famous one, and the two girls peering behind the sheet with these two white men.

And so I went to my professor. Now, my family, we’re very Black power, right? We know all about the Black history. We know all about what happened historically as it relates to the transatlantic slave trade, but nobody told me about Black girls and Black bodies and how they were sexually trafficked and raped. And so I went to my professor and I was like, “What does this postcard mean? Tell me more about it.” And he looked at me and he said in a dismissive manner, “You go figure it out.”

JOEL BERVELL: Oh, wow.

MICHELLE BROWDER: And I did. So over my summer break, I went to what is called the Shrine of the Black Madonna in Atlanta, Georgia. And I told them what I saw, and they immediately knew exactly what I was talking about. They told me about it, but these girls haunted me because they were just girls. And I can remember going back to my college and creating my whole portfolio to honor Anarcha, Lucy, and Betsey. And it is beautiful. I still have some of my pieces today.

JOEL BERVELL: Wow.

MICHELLE BROWDER: And my portfolio presentation, my professor looked at it and said, “It’s too Black.”

JOEL BERVELL: Wow.

MICHELLE BROWDER: “You need to diversify.” And at a young age, I was given a dilemma by my father. My father is the first Black prison chaplain that was appointed by George Wallace. And he said to me, “Michelle, if you don’t learn how to channel your energy, you’ll be in prison.” So he gave me an ultimatum at 13: prison or art.

JOEL BERVELL: Wow.

MICHELLE BROWDER: And so at that time when my professor said, “I’m not going to let you go further because your portfolio is talking about these three enslaved girls,” I chose to drop out of college, and I just started my own business. So during COVID, here we are, some 30 years later, I’m just thinking of Anarcha, Lucy, and Betsey, and I said, “Now is the time for me to erect a monument.” And then the timing is right. So my whole goal was to honor them, to amplify their voice, and to change the narrative.

And so that’s why the property that they sit on is literally a mile from where Anarcha was enslaved, the Westcott Plantation. It’s literally two blocks from the church that her owner, Eliza Westcott, owned and formed this church in Montgomery, Alabama, and they split it off and had the Negro Church for Black enslaved folks to attend. And the monument sits literally, what? Six blocks from where they were enslaved and tortured at the hospital.

But they’re made of discarded metal. There’s bicycle chains, scissors, gynecological tools, the Sims retractor, the speculum, the knees are scuffed up for the Sims position. There’s nothing in the medical field and/or as it relates to instruments that speak to these girls. I think there’s a push for “the Lucy.” Someone’s pushing to call one of the retractors “the Lucy.” I think it’s a speculum.

So yeah. So I wanted to make sure that these girls, this monument showed the type of trauma that they went through. So there’s perforated metal with the holes in it that represents the poking and the prodding. There’s also a serving platter that adorns Lucy’s chest with the adinkra symbol. I wanted all of them to have an adinkra symbol. And the Ghanaian language of God is supreme, the tongue and teeth, which is the friendship for Lucy, and then the emblem for strength adorns the body of Betsey. So it’s mixed with some African ancestry and language, and I wanted to honor the Maasai tribe on Lucy. So her dormant is made up of this beautiful glass and cowrie shells that shows the African diaspora.

JOEL BERVELL: There is so much power in what you just said, of the recognition of the history, of the legacies of these girls, of the intentionality. And at the top of this conversation, you talked about feeling this ancestral drive to be able to create this monument for them. And I love how you’ve also connected it back to them and their ancestral roots as well. I encourage anyone that’s listening, please, please, please go look this up online if you’re not able. But if you can, go to Montgomery and see this in person, because it is a beautiful statue that I think when you just look at it, you get chills. And I remember when I created the video about J. Marion Sims being the “father of gynecology” and how we need to focus on the mothers of gynecology. I put that monument image in there because I thought it was so powerful just for someone seeing it for the first time, and it’s beautiful.

But I really want to ask about your mission. Your mission is, in part, health-related. Right now that’s a primary focus with the clinic just breaking ground. When you look ahead, what do you see in the horizon for this region? As you are, we’ve discussed that the state has so much farther to go in terms of things like Medicaid expansion, living in a post-Dobbs world, now the IVF decision — what do you see on the horizon for the region?

MICHELLE BROWDER: It’s grim. It’s grim. We have people in office and in position that just do not care, and there’s no other way to say it. You can’t pussyfoot around it. You can’t pattycake with it. These people do not care about health care. You just mentioned the Medicaid expansion. We are going to lose another hospital in Alabama if we don’t expand Medicaid. How is that? Right now, we’re going to these maternity care deserts. There’s 25 of them, but there’s 43 counties that don’t have obstetrics and/or a gynecologist.

What’s ahead of us is that I decided I wanted to really buy a mobile clinic. I priced it out. It’s $131,000. Didn’t make sense to invest that type of money when we’re trying to finish this clinic, open it up and finish it. So I thought, “Well, why can’t I just buy a camper and convert a camper over to a wellness pod?” So we did that last year. We unveiled it on Mother’s Day, and we’ve seen over 213 women and girls who do not have maternity care in these Black Belt counties. And a Black Belt county in Alabama are these spaces where historically is known for the cotton fields, Black Belt, the soil. They’re also some of the poorest counties in the state of Alabama. They don’t have maternity care.

So we’ve been going to these people. Our motto is, “We’re coming to see about you.” We’ve been going, talking to them, taking them, whether it’s lactation care, just education in general, whether it’s contraceptives. The first thing people asked us in Selma was, “Do you have any contraceptives, contraceptive care?” And so we’re taking Pampers, whatever they need, including food. We’re learning now that, okay, so a mother was walking up the street in 100-degree weather and she was contemplating whether or not she’s going to buy diapers and/or food.

And so that’s what we’re doing. We see what’s ahead of us as it relates to the state and the leadership. And so we’re trying to get ahead of it, and we’re taking matters into our own hands, and we’re going to these spaces and offering care and support to women in these maternity care deserts or what the March of Dimes would say is a maternity desert. And it is, it is. And the food insecurity, the children and hopefully supplying some support for job placement.

It’s a holistic approach that we’re trying to do with people in our state. And so that’s what I say that it’s grim as it relates to leadership, but I’m very hopeful of the charge that we have to keep, which is to reach out and to go find these people, link them with a midwife, a doula, and/or an ob-gyn, and that’s what we’re doing.

JOEL BERVELL: That’s incredible. Michelle, I want to say thank you for choosing to channel your power into art, for being the voice for the voiceless, and for continuing to challenge us and the assumptions that we all hold. I’m so honored to have had you here on The Dose. Thank you.

MICHELLE BROWDER: Thank you.

JOEL BERVELL: This episode of The Dose was produced by Jody Becker, Mickey Capper, and Bethanne Fox. Special thanks to Barry Scholl for editing, Jen Wilson and Rose Wong for art and design, and Paul Frame for web support. Our theme music is “Arizona Moon” by Blue Dot Sessions. If you want to check us out online, visit thedose.show. There, you’ll be able to learn more about today’s episode and explore other resources. That’s it for The Dose. I’m Joel Bervell, and thank you for listening.