Bodies of Work: A Meditation on Medical Imaginaries and Enslaved Women

Abstract

The 19th-century surgical theaters in which American gynecological science was perfected were sites animated by multiple forms—and myriad conceptions—of labor. While newly professionalized white medical men celebrated the work of their own hands in speeches and in published articles, the lives and work of enslaved women in these early clinical spaces were alternately effaced and re-imagined in support of dominant narratives of medical progress. Black women’s injuries, their suffering, their instances of endurance, and, indeed, their very bodies were made to testify to the prowess of their examining physicians. The black female test subjects who comprised the first cohorts subjected to the emergent gynecological technologies of the mid-19th-century labored under the condition of enslavement. Their value in the discursive and syntagmatic spaces of the case reports written about them during the latter decades of the century was, therefore, wrought through with the political economy of chattel slavery. This essay argues that the early clinical spaces created by the American medical men heralded as the founding fathers of American gynecology—including James Marion Sims and his colleague Nathan Bozeman—mark critical locations mapping slavery’s circuits of value production. Further, it troubles prevailing historiography of slavery and medicine by considering the repetitive representations of black women’s bodies as part of the reproductive work that they were called to do.

Keywords::

• Gynecology
• labor
• representation
• slavery
• vesico-vaginal fistula

About the Author

Nicole Ivy is a Visiting Scholar in the Department of American Studies of The George Washington University. Her research interests include race and the biomedical shaping of identity; slavery; literatures of embodiment; and the development of modern medical knowledges. She earned her B.A. in English from the University of Florida and her joint Ph.D. in African American Studies and American Studies from Yale University.

Notes

“Opening Sessions of the American Society—Papers Read,” Chicago Tribune, October 1, 1884.

This fistula develops from fissures that produce abnormal passageways between organs as they heal, subsequently prohibiting bladder and/or rectal control. Today, medical researchers widely recognize compromised, extended labor, and gynecological surgical injury—including injury resulting from the use of foreceps—as the condition’s immediate causes. They also identify pregnancy at a young age and improper prenatal nutrition as significant risk factors. Present-day treatment options range from conservative methods—such as the chronic draining of the bladder with an indwelling catheter to encourage spontaneous closure in smaller fistulas—to surgery; surgical repair is prescribed for most incidences, as spontaneous closure is uncommon. For more on etiology and history of treatment strategies see: Kikelomo Bello, “Vesicovaginal Fistula (VVF): Only to a Woman Accursed,” The Female Client and the Health-Care Provider, edited by Janet Hatcher Roberts and Carol Vlassoff (Ottawa: International Research Development Center, December 1995) 19–41; Neeraj Kohli and John R. Miklos, “Managing Vesico-Vaginal Fistula,” Women’s Health and Education Center Homepage, August 13, 2006. http://www.womenshealthsection.com/content/urog/urogvvf002.php3 (accessed August 13, 2006); and Robert F. Zacharain, “A History of Obstetric Vesicovaginal Fistula,” ANZ Journal of Surgery, 70.12 (December 2000): 851.

Nathan Bozeman, The Clamp Suture and the Range of its Applicability, Considered in Relation to the Cure of the Injuries Incident to Parturition, With Statistics. 1884, emphasis mine.

I am grateful to Calvin Warren and Sarah Haley for their thinking on the inabilities of prevailing labor discourses to account for all of the uses to which black women’s bodies were put and on the flexibility of black women’s forced labor, respectively.

Elaine Scarry, The Body in Pain (New York: Oxford Paperbacks, 1987), 82–83.

Karl Marx, Capital: A Critique of Political Economy (Chicago: Charles H. Kerr and Company, 1915), 64. My citation of Marx is constrained by the limits of his treatment of chattel slavery as a proto-capitalist form. I include his description of equivalency only to describe the value of slave-as-commodity in a capitalist system.

Tiffany King, “Labor’s Aphasia: Toward Antiblackness as Constitutive to Settler Colonialism,” Decolonization: Indigeneity, Education & Society, June 10, 2014, https://decolonization.wordpress.com/2014/06/10/labors-aphasia-toward-antiblackness-as-constitutive-to-settler-colonialism/ (accessed December 15, 2015). King maintains that “Black bodies cannot effectively be incorporated into the human category of laborers.”

Semioticians have, of course, differed widely in their interpretations of the relations that signs themselves enact. An exhaustive survey of the genealogies and major debates in the sign-object relation is beyond the scope of this article. However, my reading of the work of the sign tracks back through the work of philosopher C. S. Peirce, who explicated the links between representation, signs, and truth claims. Peirce defined the sign as “something which stands to somebody for something in some respect or capacity” (CP 2.228, ca. 1897). He maintained that “a sign cannot exist as such the first time it is presented, because it must become a sign” (Hoopes, Peirce on Signs, 21). This identification of the sign’s becoming here points up the work of representation. For more on Peirce, see: James Hoopes, ed., Peirce on Signs: Writings on Semiotic by Charles Sanders Peirce (1991) and Kelly A. Parker, The Continuity of Peirce’s Thought.

Hortense Spillers, “Mama’s Baby, Papa’s Maybe: An American Grammar Book,” Diacritics, 17.2 (1987): 65.

Ibid., 67. I am indebted here to Spillers’s explication of the flesh as that “zero degree of social conceptualization that does not escape concealment under the brush of discourse, or the reflexes of iconography.” For more on Spillers’s concept of ungendered female flesh and the relation of property, see also Alexander G. Weheliye, Habeas Viscus: Racializing Assemblages, Biopolitics, and Black Feminist Theories of the Human (Durham, NC: Duke University Press, 2014).

Jennifer L. Morgan, Laboring Women: Reproduction and Gender in New World Slavery (Philadelphia, PA: University of Pennsylvania Press, 2004).

Dorothy Roberts, Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (New York: Vintage Books, 1998).

Leopoldina Fortunati, The Arcane of Reproduction: Housework, Prostitution, Labor and Capital (New York: Autonomedia, 1995). For more on her discussion of women’s labor at/as the excess of Marx’s formation of waged work see especially her fifth chapter, “In the Sphere of Circulation … ”

Steven M. Stowe, Doctoring the South: Southern Physicians and Everyday Medicine in the Mid-Nineteenth Century (Chapel Hill, NC: The University of North Carolina Press, 2004).

Harriet Washington, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (New York: Doubleday, 2006); Marie Jenkins Schwartz, Birthing a Slave: Motherhood and Medicine in the Antebellum South (Cambridge, MA: Harvard University Press, 2010).

Harriet Washington, Medical Apartheid, 2.

J. Marion Sims, Silver Sutures in Surgery: The Anniversary Discourse before the New York Academy of Medicine, Delivered in the New Building of the Historical Society on November 18, 1857 (New York: Samuel S. and William Wood, 1858), 11.

Nathan Bozeman, Urethro-Vaginal, Vesico-Vaginal, and Recto-Vaginal Fistules: General Remarks: Report of Cases Treated with the Button Suture in This Country and in London, Edinburgh, Glsgow and Parisian Hospitals (New Orleans: Printed at the Bulletin Book and Job Office, 1860), 39. Referencing the aforenamed article, Deborah Kuhn McGregor cites Bozeman’s argument that “women in bondage recovered more quickly than impoverished British victims of vesico-vaginal fistula” in Sexual Surgery and the Origins of Gynecology: J. Marion Sims, His Hospital, and His Patients (New York: Garland Publishing, 1990), 186. She reads this thinking as rooted in antebellum Southern regionalism and as example of Bozeman’s pro-slavery medical perspective.

Although Nathan Bozeman entered the professional discourse on vesico-vaginal fistula through the pained bodies of black women, it is not the case that all of J. M. Sims’s enslaved patients were sold to him along with the clinic. As noted in the previous chapter, Sims, as lessee, would not have retained legal ownership of the women and would not have been free to legally deed them to Bozeman. While Sims’s personal papers trace the sale of his personal slaves to a local broker, they do not confirm a sale to Bozeman.

Following Adriana Cavarero and Judith Butler, I choose accountability over identification here in a tacit acknowledgment of the latter’s ethical limits. Butler cites Cavarero’s assertion that an “altruistic ethics of relation … desires a you that is truly an other, in her uniqueness and distinction” without forcing the false security of an absolute presence to oneself. Thus, we might imagine, as a corrective of Bozeman’s enacted sympathy, a relational strategy of self-making that relies on the “giv[ing] of an account to someone” such that “I” am always already implicated in the other and not transparently self-evident. This notion of accountability as a basis for ethical narration, I think, cuts in another way: Bozeman’s failure to name as injurious the very clinic in which he operates effects the additional violence of sanctioning enslavement. Judith Butler, Giving an Account of Oneself (New York, Fordham University Press, 2005), 34, emphasis in the original.

Susan Sontag, Regarding the Pain of Others (New York: Picador, 2003), 102.

Nathan Bozeman, Urethro-vaginal and Vesico-vaginal Fistules: Remarks upon Their Peculiarities and Complications: Their Classification and Treatment: Modifications of the Button Suture: Report of Cases Successfully Treated (Montgomery: Barrett and Wimbish, 1857), 9.

Ibid., 45.

Ibid.

Nathan Bozeman, Remarks on Vesico-Vaginal Fistule, with an Account of a New Mode of Suture, and Seven Successful Operations (Louisville: Hull and Brother, 1856), 95.

It bears reiterating here that Sims advertised the clinic as a “Surgical Infirmary for Negroes” during his ownership of it. Although the archive is unclear about many of the specifics of Bozeman’s proprietorship of the property, it is possible that he continued to use it as an exclusively black-populated surgical space—especially given his continuance of Sims’s fistula work. Extant records neither confirm nor deny the clinic’s integration.

Bozeman, Remarks on Vesico-Vaginal Fistule, 94.

Nathan Bozeman, Transactions of the American Gynecological Society 9 (New York: D. Appleton and Co., 1885), 381.

Ibid., emphasis mine.

Bozeman, Remarks on Vesico-Vaginal Fistule, 24.

Saidiya Hartman, Scenes of Subjection: Terror, Slavery and Self-Making in Nineteenth-Century America (New York: Oxford University Press, 1997), 62, emphasis mine.

Bozeman, Urethro-vaginal, Vesico-vaginal, and Recto-vaginal Fistules, 25.

Ibid.

Bozeman, Transactions 9, 36.

Bozeman, Urethro-vaginal, Vesico-vaginal, and Recto-vaginal Fistules, 24.

Ibid.

Bozeman, Urethro-vaginal, Vesico-vaginal, and Recto-vaginal Fistules, 25.

Ibid.

For more on the romance of reunion and post-slavery nostalgia, see: David W. Blight, Race and Reunion: The Civil War in American Memory (Cambridge, MA: Belknap Press, 2002), especially the chapter, “The Lost Cause and Causes Not Lost,” 255–99.

Hartman, Scenes of Subjection, 37.

Aime Cesaire, Discourse on Colonialism, tr. Joan Pinkham, Discourse on Colonialism (New York: Monthly Review Press, 1972), 42.

Bozeman, Remarks on Vesico-Vaginal Fistule; Transactions 9.

Michel Rolph-Trouillot, Silencing the Past: Power and the Production of History (Boston: Beacon Press, 1997), 52.