Wednesday, May 25, 2011

The Human Pain of Medical Advancement

WASHINGTON -- Could this be the year of unlikely associations? In recent weeks, several intriguing pairings have arisen to capture our attention: Pixar and Disney, Shaq & Kobe, stem-cell research and the Holocaust. What's that you say? Not so fast?

Michael Steele, the earnest but bumbling Republican candidate for Senate in Maryland, likened stem-cell research to Nazi atrocities when speaking to the Baltimore Jewish Council earlier this month.
"You, of all folks, know what happens when people decide they want to experiment on human beings, when they want to take your life and use it as a tool," Steele told the group. "I know that as well in my community, out of our experience with slavery, and so I'm very cautious when people say this is the best new thing, this is going to save lives."

Amid mounting condemnation from Jewish groups and others, a chastened Steele apologized for his remarks. Later he reversed himself and said he supports stem-cell research, especially when cells can be extracted without destroying the embryo.

Lost in the hubbub was Steele's comment comparing slavery to stem-cell research. That part of his speech seems to have drawn little reaction beyond an obligatory slap from Kweisi Mfume, who happens to be one of the Democrats vying to run against Steele. But, said Mfume, "Any further comparison to equate slavery to stem-cell research is a reach that I and others who are the descendants of slaves don't understand." As a descendant of slaves who picked cotton in Mississippi and broke horses in Missouri, I can comfortably say that Mfume doesn't speak for me. I do understand.

As with many Americans, explanations of stem-cell research leave me equal parts concerned and confused. I am clear, however, that much of the controversy revolves around whether one thinks of an embryo as a person. Similarly, scientists often questioned the humanity of slaves, and some even theorized that the African captives living among them were little more than monkeys. In "The Descent of Man," for example, Charles Darwin suggested that blacks and chimpanzees were "intermediate" species between Caucasians and gorillas.

Unsurprisingly, the scientific establishment's confusion about slaves' humanity led to practices that would not be tolerated today. In "Ar'n't I A Woman," historian Deborah Gray White wrote that enslaved women "had experimental gynecological operations and cesarean sections performed on them." Like fertilized egg cells in modern laboratories, they were unable to speak for themselves.

In most instances, slaves who were subjected to medical experiments died in obscurity, their involuntary contributions to medical advancement lost to history.

Then there is the case of Anarcha, Lucy and Betsy. They were among a group of slave women in Alabama who ended up under the knife of J. Marion Sims, a founder of modern gynecology whose statue stands in New York's Central Park.

Sims' major breakthroughs included the invention of tools used in pelvic examinations and devising a way to repair vesicovaginal fistula, a dangerous condition that sometimes develops after childbirth. His pioneering techniques came at the expense of women such as Anarcha, Lucy and Betsy, each of whom he operated on several times between 1845 and 1849. Anarcha, according to Sims' own records, underwent surgery 30 times. Not once did she or any of Sims' other subjects benefit from anesthesia, despite the introduction of ether and nitrous oxide that same decade.

In a 1985 paper on Sims, former Spellman College professor Diana E. Axelsen noted that he praised his subjects' apparent willingness to endure pain. But she also points out that the women "were in no position to demand that he search for an effective anesthetic." In another relevant observation, Axelsen determined that "Sims failed utterly to recognize his patients as autonomous persons."

I wondered how Sims' experiments on slave women -- and the ethical questions surrounding them -- were addressed in contemporary medical schools. If historically black institutions are any indication, his deplorable record gets a free pass.

Carla Richardson-Lambert, an obstetrician-gynecologist in Washington, D.C., told me that Sims' experiments on slave women "were not discussed at all" when she was training at Howard University's medical school. I got the same response from Marie C. Smith, an Atlanta-based ob-gyn who attended Meharry Medical College. Both women are African-American.
What would Anarcha, Lucy and Betsy think of black women doctors? Did they even imagine such a possibility while suffering their countless unnameable agonies? What would they think of the stem-cell debate?

Perhaps I'll ponder those questions while visiting Sims' monument in New York or the one in his home state of South Carolina. And another question as well: where is the monument to Anarcha, Lucy and Betsy? (The Washington Post)


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