Gynecology was built on the backs of Black women, anyway.1
patient., written by Bettina Judd, is a visceral collection of poems elucidating the history of medical experimentation on Black women that produced gynecology and its technologies. Meditating on the women rendered property through slavery, Judd sharply attends to the violence that structured their lives. patient. interrogates the legacy of J. Marion Sims, a nineteenth-century medical doctor who is widely regarded as the father of gynecology. The poems in this collection are specifically interested in surfacing the lives of three enslaved women subjected to his experiments: Betsey Harris, Anarcha Westcott, and Lucy Zimmerman.
We are an unfortunate journey a plunder …
Introduce spoon and I am sacrament2
Between 1845 and 1849, in his makeshift backyard hospital, Sims performed dozens of experimental surgeries on these women to repair vesicovaginal fistulas—a complication of childbirth resulting in a tear from the bladder to the vagina, which can cause incontinence. In the nineteenth century, fistulas were common, and because gynecology and medical interest in female anatomy did not yet exist, there were no cures. But slavery and the emergence of the new world order hinged on slave women’s reproductive capacity as means for wealth accumulation. So slave masters, concerned with the value of their property, brought their slaves experiencing fistulas to Sims for repair. Seeing an opportunity for discovery and invention, Sims operated on these women over and over again without consent, without anesthesia, and oftentimes with an audience.
Hospital curtain, showman’s speculum, surgeon’s auditorium.
There is an opening here, a thrusting, a climax, a little death.
Who will rise from that, and how?3
Years of clumsy operations and excruciating pain led to outcomes like infection, sepsis, and near-death experiences. Anarcha is estimated to have been seventeen years old when Sims started experimenting on her. He conducted thirty operations on her body before actually repairing the fistula.4 Through this horrific experimentation, Sims developed new instruments and knowledge that mark the creation of gynecology.
In these three, Sims shapes his speculum, invents his silver sutures, perfects
protocol for proper handling of the female pelvis.5
patient. lays bare that we are in the afterlife of this anti-Black and eugenicist formation of gynecology—an afterlife animated by Black women’s everyday experiences with the medical industrial complex. This is regularly reflected back to us in the litany of statistics that enumerate all the ways in which we are more likely to die. Judd, or the Researcher persona that narrates the collection, has an ordeal with medicine that unfolds both this history and the present it has made possible. Judd dislodges the linearity of time by overlapping the experiences of the Researcher, Betsey Harris, Anarcha Westcott, Lucy Zimmerman, and other Black women subjected to regimes of terror including Esmin Green, Joice Heth, Saartjie Baartman, and Henrietta Lacks—insisting that the time of violence waged on Black women’s bodies is ongoing.
The poems in patient. imagine fuller lives of women who are arrested and abstracted in captivity by the archive. Judd writes against the enclosures the archive of slavery produces, creating space for something more to exist alongside and through the terror. Care? Intimacy? Feeling? Wit? This gestures toward an interiority that confronts the reader, forcing us to think with this haunting. These poems thread a chorus of women with a self-possessing knowledge and analytic of their conditions, destabilizing the rendering of their lives as only commodity.
Becoming an un-fuckable woman, freedom
the black hole of my sex, fareto the good doctor I will be flesh
which you will think brutalbut I will be finally6
I met with Bettina to discuss patient., and to celebrate ten years since she brought these brilliant poems into the world, and all that they, and she, have taught me.
Our conversation has been edited for clarity and brevity.
Rezina Habtemariam: The narrator of patient. is the Researcher, which signals the inquiry into this specific history and the scholarship that informs the collection. What were the questions you were thinking through as you were going through the archives?
Bettina Judd: I wanted to know as much as possible about Anarcha, Betsey, and Lucy—the three women who Sims names as subjects of his experiments. (We know there were more.) I also was interested in the discourse about him, the ethical questions of the work that he did, and how folks of course resolve those ethical questions by explaining him to be “a man of his time.”
Rezina: “A man of his time.” As if abolitionists didn’t—
Bettina: Right, the idea of being “a man of your time” in the era of slavery is always ridiculous to me; because people like Nat Turner and Harriet Tubman existed. John Brown existed. Enslaved people who knew it was wrong that they were enslaved existed. And there were people who knew that slavery was wrong and still enslaved people. There were people who would understand experimenting on people without consent would be wrong. And so I was looking into the justifications for historical wrongs, which are similar to the justifications for current wrongs. How will we be regarded in a moment in which there is a genocide in Gaza? In which there is a genocide in Sudan? Will people [ignoring or supporting genocide] be described as just “a person of their time” when there is a critical mass of people who understand what is happening to be wrong? Time can’t be blamed for nonsense. These are the kinds of debates happening in some of the literature on Sims.
Rezina: Some of the ethical questions that people debate are also around Sims not using anesthesia, and whether or not he got consent to perform these experiments. I always find this wild—as if slavery didn’t transform Black people into property, into commodities, that literally have no ability to consent?
Bettina: There are questions about whether or not anesthesia was available. But various forms of anesthesia had been available for some time. It’s not like people were just inventing surgery and that everyone was just subject to dying of shock. There are also questions that ask if he addicted Anarcha, Betsey, and Lucy to opium to have them consent. And the answer to that [I believe] is a very likely no. If we look at his textbooks on uterine surgery, you’ll see that his preferred position—which would have been the earliest position he used on Anarcha, Betsey, and Lucy—would not allow for you to be passed out in any kind of way. You would have to be on all fours to be subjected to the work that he was doing.
So what does it mean about the violence of slavery (and coercion and “choice”) when you have to invoke that maybe they were just addicted to opium? The discourse around him completely ignored the condition of slavery in which these women were subjected to experiment and therefore ignored the way that the medical plantation was pervasive. There were people who owned slaves and played doctor; there were doctors who owned slaves. That is a part of my own family legacy. If you go to Fuquay-Varina, North Carolina, there is a highway by the name of Judd Highway, and that is named for Thomas Judd—who people in my family called Doc Judd. It is a multigenerational family of doctors. So yeah, medical experimentation on Black people in the era of slavery, on slaves who had no ability to consent, was extremely common.
Rezina: Can you talk to me about the tension of writing about women, slaves, whose lives can never actually be known?
Bettina: I’m really self-aware at this point, in writing patient, that I am a researcher doing research in an attempt to recover that which cannot be recovered, and that is their voices. As much as I can want to say that I’ve done that, I think it’s also important to admit, to attest to, and to [bear] witness to the violence of the archive of slavery, which is about erasure. There are tick marks instead of names; it’s all about the slave’s relationship to the accumulation of wealth for another. The archive doesn’t tell us the story of someone’s life.
In honoring the ways that I don’t know these women, I wanted to also take a step back and examine my role as a researcher. So there are poems that expose the researcher’s desires. I do have a desire to have a spiritual, archival, across-time-and-space relationship to them, and that’s not necessarily a given. My interest in them is only made possible through the violence that they endured. I don’t know them through any other door of their lives. I only know them through this door that is J. Marion Sims and that is its own kind of violence. So I also wanted to expose my own relationship to the profession that I was entering at the moment that I’m writing this book.
Rezina: It’s giving contradictions; it’s giving Saidiya Hartman’s critical fabulation! [Laughs] Speaking of, I’m thinking about how you write about the body experiencing fistula, and how maybe that could have translated to less sexual violence.
Bettina: Writing about the body for me, through poetry, is informed by Lucille Clifton. I was thinking about how to relate to the nasty parts of the body in ways that are gentle and honest, ways that are not interested in the sensationalism of it but interested in the thing that makes us repelled by it. J. Marion Sims wrote about how putrid Anarcha, Betsey, and Lucy’s bodies were. And because they all had fistulas, there would be smells and infection. So I was interested in how you write about leaky bodies. How do you write about the body in its realness, in its funkiness? That’s why I think, perhaps, the second poem I wrote was “You Could Smell It From the Fields.” I was thinking about how an enslaved woman’s body is so vulnerable and asking if, experiencing the fistula, would there be some protection there because they were repulsive to those who might assault them?
Rezina: You also write about Joice Heth, whose body was put on display by circus man P. T. Barnum. In your poems there is a relationship between Joice, Betsey, Anarcha, and Lucy. How did Joice Heth come into the frame for you?
Bettina: There is an article by Terri Kapsalis (she has since written a book) that talks about the relationship between P. T. Barnum and J. Marion Sims.7 There is archival evidence, specifically through their autobiographies, that describes them as friends. Sims talks about Barnum as a friend who he meets up with in New Orleans while he’s touring. In this article by Kapsalis, she writes about their relationship and gynecology as a performative practice. In reading about this relationship, one of the key things for me was that Barnum, who could arguably be the father of American popular culture—in particular, our sensationalist and outrage culture—and the father of American gynecology are homies. Both of them wanted to be the center of the circus, and both of them started their careers on the literal bodies of Black women.
There is also a poem from Nikky Finney’s The World Is Round called “The Greatest Show on Earth” that references Joice Heth and Anarcha of Alabama. Finney also references Saartjie Baartman. So I was introduced to Anarcha, Betsey, Lucy, and Joice Heth through poetry and this article, which is what was swirling in my head and what comes up in the moment that I’m a patient and blurt out history to the doctor.
Rezina: And this is how you arrive at the question that opens the book: Why am I patient? How were you taking up the multiple meanings of the word “patient” that frame the collection?
Bettina: I was thinking about the definitions: patient being one who is subject to medical inquiry and … care? and one who is patient, as in the state of waiting with kindness or with a quality of expectation, as in “being patient.” Also, looking at the etymology of the word “patient,” which is “one who suffers.” And that’s where the two meanings meet, at its etymology: “one who suffers.”
The title of the book uses the lowercase p. I wanted to think about the subject form of this word, which has its own hierarchies and is therefore diminutive. And then the period being the end—that to be a patient is not an ending, but what if one is perpetually patient? Whether or not that patience is about justice and rights—constantly being patient towards a better world—and maybe that could be a reference to the aspect of this book that is more about legacy than it is about trying to document a history. More about the permanence of being one who suffers.
Rezina: Yes, starting the collection by asking, “Why am I patient?” is not about finding an answer but about interrogating the structural position of being patient.
Bettina: I’m curious about “patient” as a state that one comes into and is immediately at the mercy of the “caretaker,” and the power dynamic in that relationship is such that one can be perpetually patient.
Rezina: Right, because the relation between patient and “caretaker,” if you’re a Black woman, a Black femme, is overdetermined by everything you explore in the book, a violence that is always in the room.
Bettina: Yes, the historical violence that’s there. I’m thinking about the poem “You Be Lucy, I’ll Be Betsey.” This poem is about the moment after I say to the doctor, “Do what you want. Gynecology was built on the backs of Black women, anyway”—where, for the first time, I encountered a Black woman nurse. They clearly dragged her from the other side of the hospital, like this was not her job, but history had been evoked and I was now an unruly, impatient patient. This woman comes in, and they do not know that this is still history happening. Anarcha, Betsey, and Lucy were nurses to each other during Sims’s practice. The idea that I would be pacified if I were cared for by another Black woman is overdetermined by that violence. This person, more likely, understands what care would be for me. And that’s what they were counting on.
I live in a haunted house. A house can be a dynasty, a bloodline, a body.8
ETYMOLOGY OF ANARCHA I
from the term anarchy meaning
1. absence or denial of any authority or established order.
2. absence of order see disorder.
When the tearing came there was
no baby in the canal but a new route:
fistula, with a hard f like fetal
freak, fatal, furor.
I needed the f when the break screamed
no sound from me but fire, fuchsia
Becoming an un-fuckable woman, freedom
the black hole of my sex, fare
to the good doctor I will be flesh
which you will think brutal
but I will be finally
BETSEY INVENTS THE SPECULUM
Fall 1845
Introducing the bent handle of the spoon I saw everything, as no man had ever seen before.
—from The Story of My Life by J. Marion Sims
I have bent in other ways
to open the body make space
More pliable than pewter,
my skin may be less giving
Great discoveries are made
on cushioned lessons and hard falls
Sims invents the speculum
I invent the wincing
the if you must of it
the looking away
the here of discovery
THE OPENING
Betsey leans in with sure hands
Lucy prepares for metal
slosh of seeping liquid
We are an unfortunate journey a plunder
something to be found
something not to be seen
Introduce spoon and I am sacrament
unforgivable sin and reprieve practiced
in the dark ghetto of my body
Something to master
something to enslave
Dear Lucy, dear Betsey, all of us
that we weren’t so perfectly broken,
the scent of us so eagerly hunted,
if our mouths, when opened up
could light our darkness
[1] Bettina Judd, “Initiation/Memory,” patient: poems (New York: Black Lawrence Press, 2014), 9.
[2] Bettina Judd, “The Opening,” patient: poems, 31.
[3] Judd, “Initiation/Memory.”
[4] Terri Kapsalis, “Mastering the Female Pelvis: Race and the Tools of Reproduction,” in Skin Deep, Spirit Strong: The Black Female Body in American Culture, ed. Kimberly Wallace-Sanders (Ann Arbor: University of Michigan Press, 2006), 263.
[5] Bettina Judd, “The Researcher Discovers Anarcha, Betsey, Lucy,” patient: poems, 5.
[6] Bettina Judd, “Etymology of Anarcha I,” patient: poems, 24.
[7] Kapsalis, “Mastering the Female Pelvis,” 263.
[8] Bettina Judd, “In 2006 I Had an Ordeal with Medicine,” patient: poems, 1.