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Instrumentalized Images: The Trouble with Representation, Truth, and Affective Power in Histories of American Gynecology

Thanks to crucial scholarship and committed activism, recent years have witnessed increased reporting and public-facing writing about the histories of racialized violence at the crux of gynecology’s emergence in the United States. Much of this writing centers the figure of J. Marion Sims. In a media landscape that seems to demand visual accompaniment, authors and news outlets frequently illustrate their articles with a reproduction of Robert Thom’s painting J. Marion Sims: Gynecologic Surgeon (figure 1).[i] Thom’s image has appeared alongside national reporting, local stories, and more focused historical coverage alike. Often, authors include a caption indicating that Thom’s is the only known representation of Lucy, Anarcha, and Betsey—three of the enslaved women Sims is known to have abused—phrasing that suggests a direct or even affective connection between Thom’s image and these women’s lives. Yet within the copy of these stories, the painting repeatedly remains largely or wholly unacknowledged. Authors thereby seem to present Thom’s image as a—or even the—window onto the world of Sims’ nineteenth-century surgery.

Figure 1. Robert Thom, J. Marion Sims: Gynecologic Surgeon, ca. 1952, from the series Great Moments in Medicine, oil on canvas, 4 ft. 8 13/16 in. x 46 in, The collection of Michigan Medicine, University of Michigan, UMHS.30.

It is almost never mentioned that this rendering is, in fact, a painting, that it was produced around 100 years after the history it describes, and that it was commissioned by a major pharmaceutical corporation, all of which shape how and what it means.

After attending Charleston Medical College and Jefferson Medical College, Sims returned to the South to build his practice. In Mount Meigs, Alabama, he established the first women’s hospital in the United States. It was in Mount Meigs where Sims conducted the violent acts he is perhaps now most well known for, eclipsing his former heroicizing legacies: the development of the “Sims speculum,” the articulation of the “Sims position” for gynecological treatment or examination, and the epithet of “father of American gynecology” (Cooper-Owens 1, 35, 39).

At the Mount Meigs hospital, Sims performed repeated surgeries on enslaved women without the use of anesthesia. Sims’ practice both depended on and re-articulated racialized scientific practice that emphasized Black women’s purported robust fecundity and diminished ability to feel pain—ideas steeped in the racial formation projects sweeping Europe and the United States in the nineteenth century—as these same authorities grew increasingly anxious about white women’s seemingly decreasing birthrates and increasingly difficult birthing experiences (Briggs 260-2; Cooper-Owens 11). As Deirdre Cooper-Owens posits, Lucy, Betsey, and Anarcha, along with about nine other women and girls whose names are no longer known, did not only face Sims’ abuse through these surgeries. Sims also required them to perform labor under the conditions of their enslavement, labor that both supported the management of the household—caring for the Sims children, cooking, and cleaning—as well as Sims’ burgeoning medical career. For Betsey, Lucy, and Anarcha also assisted Sims during his surgeries and helped care for post-operative women as they recovered. As Cooper-Owens emphasizes: “It is no exaggeration to state that these enslaved women knew more about the repair of obstetrical fistulae than most American doctors during the mid- to late-1840s” (1-2).

Figure 2. Detail, Thom, J. Marion Sims: Gynecologic Surgeon, ca. 1952

It is ostensibly just such a scene from Sims’ Mount Meigs hospital that Thom paints for his audience. In the sizeable oil painting (spanning over 4 feet in width), the artist describes a medical encounter between Sims and Lucy. Sims stands tall in the stark black coat of the gentleman physician. His crossed arms suggest confidence and authority. In his right hand, he grasps an instrument that evokes the duck-billed speculum that continues to bear his name (figure 2).[ii] The speculum, coupled with the basin and neatly arranged surgical implements laid out on the chair in the foreground, suggest that an examination and surgery will imminently take place (figure 3). In Thom’s imagining, two medical men appear ready to assist with the surgery, while two Black women—perhaps Betsey and Anarcha—are relegated to a space beyond a large white curtain. Here, visual access to both the vulnerable body and medical knowledge are foreclosed for Black women and easily granted for the gathered white men.

Figure 3. Detail, Thom, J. Marion Sims: Gynecologic Surgeon, ca. 1952.

Thom’s figural composition visually echoes the historiographical pattern revealed and countered by Cooper-Owens, whose scholarship calls attention to the historical erasure of these women as producers of medical knowledge (6). The symbolic force of the gleaming speculum, too, underlines how power hinges on vision. This tool afforded practitioners optical access to otherwise hidden internal organs. The perspective Thom deploys, whereby the viewer seems to be looking down onto Lucy and the table, further underscores connections among visual access to patients’ bodies, medical knowing, and authority.

It is perhaps Thom’s rendering of Lucy that is most telling, and most troubling. Thom has located the height of the table such that Lucy appears to meet Sim’s gaze. While it is possible to read Lucy’s looking back as a kind of defiance, her gaze’s coupling with her kneeling posture, her arm raised to her chest, and her seemingly calm demeanor seem to suggest compliance, supplication, or even gratitude. The table communicates this, too: Lucy appears elevated—as if a sculpture on a plinth, an object to be studied. The compositional emphasis on Lucy-as-spectacle also redoubles the self-evidence of the gaze, both the medical gaze of Sims and the two male attendants, but also the viewers’: lines throughout the painting—from the floorboards that recede towards the table, to the curves of the draped curtain and the beams that join the wall to the ceiling—repeatedly guide the viewer’s gaze back to Lucy. The severe profile view through which Thom represents Lucy’s face and body draws on the history of ethnographic illustration and photography, which included a longstanding use of profile views to purportedly reveal the physiological differences among racial types. Here, the profile view underlines Sims’—and Thom’s—objectification of Lucy. Yet it also begins to betray the fiction of this imaging of Sims’ practice by calling attention to the entangled racism and exploitation that made such a scene possible.

Figure 4. Detail, Thom, J. Marion Sims: Gynecologic Surgeon, ca. 1952.

Thom’s impetus for this work was a celebration of Sims’ career. Parke-Davis Pharmaceutical Company—often described as once among the largest pharmaceutical companies in the world—commissioned Thom to create the painting for the series “Great Moments in Medicine” between 1948 and 1952. The goal of the series was, ostensibly, to memorialize moments framed as key to the history of medicine. As the series’ name suggests, history here rhymes with progress from antiquity to the present. Per Parke-Davis pharmacist George Bender, the narrative series would help doctors, pharmacists, and the public understand “what advances in medicine, throughout the centuries, meant to the better health and welfare of our modern-day civilization” (qtd. in Metzl 1027). Indeed, Thom’s paintings circulated widely. While the original oil paintings traveled to medical conferences across North America, reproductions appeared in calendars, popular magazines, didactic brochures, and on the walls of doctors’ offices and pharmacies.  We might recognize this cross-media visual pervasiveness as a telling antecedent to the painting’s contemporary digital ubiquity. During the twentieth century, as Jonathan Metzl has revealed, Parke-Davis went so far as to send box sets directly to physicians and pharmacists that included specific instructions about how to frame and hang the prints to improve the “professional atmosphere” of their practice while, “without realizing it, viewers will be impressed with Medicine’s rich heritage of dedicated service and its continuing efforts to improve the health and well-being of mankind” (1027, 1029-30).

As Metzl argues, the profit-seeking motivations behind the Parke-Davis commission are clear. “The Great Moments,” he writes, “conveyed a sense of comfort and familiarity that allowed viewers to easily connect past with present, and medical innovation with the good name of Parke-Davis” (Metzl 1031). Thom’s painterly style—which evokes commercial illustration of the 1950s, and is often compared to that of Norman Rockwell—certainly works to certify some viewers’ perceived “comfort and familiarity,” and, for today’s viewers, a kind of sentimental nostalgia, a powerful veneer. As Metzl argues, Thom’s style, which appeared consistently across scenes from the ancient world to the mid-twentieth century, allowed “doctors, pharmacists, and hospital buyers…[to] feel reassured of the timelessness of their highly contextual values, competencies, and identities” (1031).

While Thom’s painterly nostalgia emerges clearly when contrasted with the histories recounted by Cooper-Owens or Metzl, its affective power continues to emanate when it is used to illustrate gynecology’s history. Crucially, Thom’s image glosses over Sim’s racialized and medicalized violence. The artist’s emphasis on Lucy’s compliance and Sim’s authority meshes with George Bender’s description of the painting for “Great Moments”: “Little did James Marion Sims…dream, that summer day in 1845, as he prepared to examine the slave girl, Lucy, that he was launching on an international career as a gynecologic surgeon; or that he was to raise gynecology from virtually an unknown to respected medical specialty” (qtd. in “J. Marion Sims”). Especially when untethered from the date of its production, or the circumstances of its commission, or the desires of its patron, Thom’s image condones—and even celebrates—a scene of incredible violence. More than this, as an “illustration,” J. Marion Sims: Gynecologic Surgeon gives visual form to the very model of history writing these articles’ authors ostensibly aim to write against.

Without asking how and why images like Thom’s painting mean and how they communicate differently across time, place, and platform—without interrogating why, in fact, we so desire to see Lucy under Sims’ gaze at all—we risk becoming Parke-Davis’ ideal viewers: “impressed with medicine’s rich heritage”…“without realizing it.”


[i] Often, the painting is mistitled “Illustration of Dr. J. Marion Sims with Anarcha” and mistakenly located in the collections of the Pearson Museum at the Southern Illinois University School of Medicine. The inclusion of the word “illustration,” in particular, works to naturalize Thoms’s representation as self-evident or explanatory. This painting, along with others from the larger series “Great Moments in Medicine,” has been in the collections of the University of Michigan since 2007; they are presently managed by the University of Michigan Museum of Art. It seems that these errors in title and collection stem from readers’ misunderstanding of the painting’s caption in Deborah Kuhn McGregor’s 1998 From Midwives to Medicine: The Birth of American Gynecology, where Thom’s image was reproduced on the cover and within the book manuscript. McGregor’s caption published beneath the image reads:

“J. Marion Sims with Anarcha, Betsey, and Lucy and two physician partners (illustration by Robert Thom), ‘J. Marion Sims: Gynecologic Surgeon.’ In George A. Bender with Artist Robert A. Thom, History of Medicine in Pictures (Parke Davis, 1961). (Permission for reproduction from Warner Lambert. Courtesy Southern Illinois University School of Medicine, Pearson Museum).”

McGregor here cites a reproduction of the image in a book meant to further publicize the “Great Moments” series and published by the series’ patron, Parke-Davis Pharmaceutical Company. McGregor offers the title given by Parke-Davis in parentheses (“J. Marion Sims: Gynecologic Surgeon”). Perhaps later authors incorrectly inferred her initial description (“J. Marion Sims with Anarcha, Betsey, and Lucy…”) to be the title, or to mean that Thom intended to picture Anarcha at the image’s center. What’s more, in the image’s caption, McGregor thanks Warner-Lambert for permission to reproduce the image. Warner-Lambert was the owner of the painting when McGregor published her book in 1998. Warner-Lambert acquired Parke-Davis—and the “Great Moments” collection with it—in 1970; Warner-Lambert subsequently owned the painting until Pfizer acquired that company in 2000. McGregor also, though, thanks the Southern Illinois University School of Medicine and the Pearson Museum. This is not because the Pearson Museum owned the original oil painting. Rather, it is likely that the library either secured a copy of Bender and Thom’s book from which McGregor reproduced the image, or they owned a reproduction of the painting that they made available to her, as we know from her acknowledgements that she worked with this library’s collections while researching From Midwives to Medicine (McGregor xii).

[ii] In scholarly works, the tool in Sims’ hand has most frequently been identified as a metroscope (Washington 1). This tool is often described as preceding the speculum, yet in its earliest iterations, it offered practitioners auditory access to the uterus, rather than the visual access to the vagina, cervix, and other internal organs afforded by the speculum (Depaul 23-4). Common models for these metroscopes, such as the model developed by Jacques-Louis Nauche and illustrated in treatises by Jean-Anne-Henri Depaul and Gustave-Joseph-Alphonse Witkowski, are cylindrical and not billed (Depaul 23; Witkowski 12). Later instruments, such as a tool developed by Récamier (which is cone shaped), are sometimes called metroscopes but are also sometimes referred to as specula; we start to see the blurring of these categories, such that a metroscope might now afford visual access (Witkowski 15; Meigs 38-41, Plate 4). With that said, it seems most likely given the painting’s mid-twentieth century commission and the visual form of the tool evoked by Thom that the artist meant to signal Sims’ own design. Furthermore, regardless of Thom’s (or Parke-Davis’) ambitions, it seems most likely given the context described in this essay that most later viewers would read the tool as a Sims speculum. What’s more, the very desire to read historical accuracy into the image—where the tool should be a metroscope—demonstrates the compelling visual realism of Thom’s painting. Parke-Davis pharmacist George Bender’s caption describing the painting (quoted in the main text) identifies the scene as a “summer day in 1845” prior to “launching” Sims’ career; Sims records in his autobiography that the idea for his speculum came in July 1845 (226-35). Yet Thom, as we will see, produced this painting over a century later for a particular patron.

Works Cited

Briggs, Laura. “The Race of Hysteria: ‘Overcivilization’ and the ‘Savage’ Woman in Late Nineteenth- Century Obstetrics and Gynecology,” American Quarterly, June 2000, 246-273.

Cooper-Owens, Deirdre. Medical Bondage: Race, Gender, and the Origins of American Gynecology. University of Georgia Press, 2017.

Depaul, Jean-Anne-Henri. Traité Théorique et Pratique d’Auscultation Obstétricale. Paris, Labé, 1847.

“J. Marion Sims: Gynecologic Suregon, From ‘The History of Medicine.’” University of Michigan Museum of Art Exchange,

McGregor, Deborah Kuhn. From Midwives to Medicine: The Birth of American Gynecology. Rutgers University Press, 1998.

Meigs, Charles. A Treatise on Acute and Chronic Diseases of the Neck of the Uterus. Philadelphia, Blanchard and Lea, 1854.

Metzl, Jonathan. “Making History: Lessons from the Great Moments Series of Pharmaceutical Advertisements.” Academic Medicine, November 2004, 1027-1032.

Sims, J. Marion. The Story of My Life. New York, Appleton and Company, 1884.

Washington, Harriet A. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. New York, Double Day, 2006.

Witkowski, Gustave-Joseph-Alphonse. Histoire des Accouchements chez tous les Peuples. Appendice: l’Arsenal Obstétrical. Paris, G. Steinheil, 1887.

Cover Image Source: Collage by Kathleen Pierce.

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