Say Anarcha: A Young Woman, a Devious Surgeon, and the Harrowing Birth of Modern Women's Health

Image of Say Anarcha: A Young Woman, a Devious Surgeon, and the Harrowing Birth of Modern Women's Health
Release Date: 
June 6, 2023
Henry Holt and Co.
Reviewed by: 

“J. C. Hallman explores the problems with historical conscience in Say Anarcha, the story of Dr. James Marion Sims of Montgomery, a founder of modern gynecology who experimented on enslaved women.”

In an age of counter-culture, kicking ghosts, and coming to terms with the past, the truth inconveniently creates situations in conflict with our real and imagined modern ideals. Dividing everyone between either on the cross or driving in the nails is complicated by facts, honesty, and reality. The story of Dr. James Marion Sims represents a special example of this struggle with finding historical justice.

J. C. Hallman explores the problems with historical conscience in Say Anarcha, the story of Dr. James Marion Sims of Montgomery, a pioneer of modern gynecology who experimented on enslaved women. Sims was celebrated internationally for his work but not for the circumstances in which he conducted his experiments. The facts are not in dispute, but what they mean proves complicated and controversial.

The story of the experiments on Anarcha and other enslaved women has become, Hallman writes, “intertwined with broader reevaluations of the role of white supremacy in American history.” Sims’ legacy became involved in “a long overdue indictment of the causes of racial health disparities, especially in regard to maternal mortality.”

Hallman explains that Sims’s most famous work was more than 30 operations on the enslaved African American Anarcha that began in 1846—all without anesthesia. Criticism began in his own time, notably from his assistants, and, since the 1960s, has overwhelmed any positive notoriety of his work.

Sims’ prominent statue in New York City came down in April 2018, despite his work there in the city’s Women’s Hospital. In his lifetime, he was also reprimanded, on other matters, by the New York Academy of Medicine.

Truman Capote referred to works like Say Anarcha as nonfiction novels. Hallman uses that material and much more to write a broad if complicated narrative rich in detail about the times and world in which Sims lived.

Sims’ writings provide a rare detailed account of life growing up in the white antebellum South Carolina middle class. He described the people who encouraged his quest for exploration and knowledge, even before the great era of innovation in the 1850s. Ironically, Anarcha also had medical experience, from the healers among the plantation people. She treated Dr. Sims for malaria long before he experimented on her.

Hallman explains that Sims had exposure and training in the first conflicted efforts in modern gynecology and also in the use of painkillers. “The [medical] profession Sims learned was [also] beginning to suffer from the beginnings of so-called medical ethics.” These issues cloud modern efforts to fairly judge the morality of these experiments and their practitioner.

Sims, the author tells, recognized the quackery common in his profession in those years and worked against it, when he could, at least to find cures. His revolutionary work on Black and white patients received publication. “if Sims could contrive a cure for fistula on a slave, the gains would be immeasurable” and for women everywhere.

Sims did his groundbreaking experiments in his clinic for African Americans that he opened in Montgomery, Alabama, but he initially wanted nothing to do with women’s pelvis operations. Anarcha and other suffering patients, however, needed his help!

The enslaved “cursed women” granted him permission for his work and served as his assistants in his work. “The only hope for a cure required a slave who wanted to be cured.” Anarcha became their leader and combined Sims’s work with folk cures taught to her. “Dr. Sims’s first experiments did not succeed, and sometimes they went horribly wrong.”

Readers could sometimes find this work difficult to follow. Hallman argues, for example, “that Sims did nothing to ensure that a fistula cure reached the population that had provided him with his experimental fodder” in places like modern East Africa. The author uses the meteor shower of 1833, the comet of 1835, and other astronomical events as metaphors.

Similarly, breeding enslaved women in a way does connect with Sims’ experiments that often had also been tried earlier by other physicians. Hallman connects that fact to the horrors of selling people in bondage and to infanticide committed against African American children.

Anarcha is a ghost, hardly any record of her exists beyond Sims’ writings. Hallman’s research has turned up much of what else survives with the rest coming from guesswork and presumption to tell a story around the lives of the real Anarcha and Sims.

This work has no annotation or index, but it does have an extensive bibliography. The author includes “A complete list of the formerly enslaved persons whose narratives contributed to the re-creation of Anarcha’s story.” The list runs to more than three pages.

Hallman refers the reader to a series of videos at In that very different video book, he again tells the story of Anarcha.