Say Anarcha: A Young Woman, a Devious Surgeon, and the Harrowing Birth of Modern Women's Health
J.C. Hallman was my second follower on Twitter. (The first was my sister.) I had joined in summer 2022, scandalously late, and was eager to find out whether Twitter would help promote my new biography of the abolitionist Lydia Maria Child or ruin my life instead. My new follower intrigued me, as did the follow-up email I received shortly thereafter. He too, Hallman reported, was an admirer of Child’s. In the midst of his own research on another topic, he had unearthed a new fact about her life. Did I want to know about it? Indeed I did.
In his next email, Hallman proceeded to offer evidence correcting a mistake that had been perpetuated by Child scholars for decades and that I had repeated in my book. He laid it out in generous and meticulous detail that both turned my stomach (my book had gone to press; changes were now impossible) and made it clear that I was in the virtual presence of a formidable scholar.
So it was no surprise that, when I read Hallman’s Say Anarcha: A Young Woman, a Devious Surgeon, and the Harrowing Birth of Modern Women's Health, I encountered a truly astonishing feat of scholarship. Anarcha was the enslaved woman on whom J. Marion Sims—long touted as the “father of gynecology” for inventing a “cure” for obstetric fistula—had experimented, exploiting her extreme vulnerability for his professional glory. Hallman had done what no scholar had previously succeeded in doing, namely unearthing information about Anarcha independent of Sims’s tendentious accounts of her life. (In achieving this, Hallman’s work recalls Jean Fagan Yellin’s research proving that Harriet Jacobs, author of Incidents in the Life of a Slave Girl, was a real woman, not a fictional character.)
Hallman has also embedded Anarcha’s story in gloriously rich detail from the nineteenth century, ranging from comet showers to train derailments to international espionage in the court of Louis Napoleon. That panorama alone makes the book a riveting read. But despite the scope and the glitter, Hallman never allows us to lose sight of Anarcha: her exploitation, her humanity, the embodied Black womanhood that left her so exposed to others’ whims and schemes. Hallman’s novelistic writing and brisk pacing had me eagerly turning pages, alternately aghast at and elevated by this story of human depravity, ambition, resilience, and vulnerability. It is surely one of the most important books of the year, and certainly among the most compelling.
Our exchange about Say Anarcha took place by email.
Lydia Moland (Rail): You write in the introduction of a moment when years of searching for Anarcha in archives, libraries, and probate offices seemed to be leading nowhere. Suddenly a ten-minute encounter with an elderly woman changed everything. Can you tell that story?
J.C Hallman: For some time, I remained stuck in Anarcha’s history in late 1864. I had a letter that revealed she had been hired out a year or two before, describing her condition, but I didn’t know where it came from. After some digging in local probate offices, I figured out that the letter had come from King George, Virginia—and I was told that the local history expert was a woman named Elizabeth Lee. Lee was quite old, and didn’t answer my emails and phone messages—I had to show up at her house to get her help. At long last, we sat down and I told her the whole story: the medical experiments in Alabama, the diabolical doctor J. Marion Sims, and the young woman at the center of the birth story of modern women’s health, Anarcha. As soon as I said that name, Lee perked up in her chair. She had devoted her life to recording primary sources—and the name rang a bell for her. There was an entry in a cemetery book for a single grave in a remote forest in King George, on land that had once belonged to the man who signed the letter that described Anarcha’s condition. It was a magical moment—a moment of history clicking into place, of a blurry image spine-tinglingly coming into focus. The end of Anarcha’s story was finally clear.
Rail: Here’s an obvious and charged question. Your book hinges on Anarcha’s intensely embodied experience as an enslaved Black woman. Specifically, it hinges on the searing vulnerability of being owned by sexual predators and on a form of suffering acutely specific to female anatomy. You are a white man. What would you say to critics who worry this is not your story to tell?
Hallman: I would say don’t throw out the message because you don’t like the messenger! There are lots of ways to respond to this question. One is a little defensive: no one should have to explain why they want to be on the right side of history. Another is more thoughtful: all writers of good conscience resonate to stories that help history bend toward justice. The most concise, probably, comes from one of the book’s blurbers, Linda Villarosa, who said that systemic racism is an American problem that requires an American solution. A broad chorus of historians, scholars, artists, poets, playwrights, and journalists have contributed to the effort to remember Anarcha, and it has been my hope, through extensive research and hard work, to earn a place among that chorus of voices. I hope that readers focus on the message of the book—the reality of Anarcha’s life—rather than its messenger. Centering Anarcha’s story is the whole point.
Rail: Your book begins with two epigraphs: one of George Orwell confessing that “in the whole of history,” he can only think of the names of two enslaved people; the other of protestors on Fifth Avenue in 2016 commanding that we say Anarcha's name. You follow this by listing literally hundreds of enslaved people’s names. What's in a name?
Hallman: This was a way of calling Orwell out for a pretty remarkable gap in his knowledge (and one of the two people he was thinking of was probably Spartacus). I wanted to say something like, “You can’t think of two? Well, here’s five hundred.” And those five-hundred names were the names of the formerly enslaved persons whose narratives I drew on so as to give breath, atmosphere, and presence to Anarcha’s story, which otherwise would have remained an archival scaffold of data points.
Why is it important to say Anarcha, or to say the name of anyone who has been overlooked or forgotten? A name may be the final thing of a person that remains—a name on a gravestone, on a police report, in a newspaper article, or a death record. If we say their names, we make them matter—we preserve of them what can be preserved, and we keep alive the hope that their full story might one day be reconstructed.
Rail: You write at one point that “to be placed between misery and hope, between pain and promise, is to be given a choice that is so false it is indistinguishable from a command issued with the threat of a whip behind it.” What do we learn about how to parse consent and choice through Anarcha’s example?
Hallman: I hope what I’ve done is introduce another term to that list: consent, choice, and coercion. To be clear, a woman could not be physically forced to undergo a fistula surgery. Not only could such a procedure be foiled by the flexion of muscles that cannot be controlled by any binding or physical restraint, the effort could be undone at any time during a period of aftercare that can last up to two weeks. What has to have happened is a kind of coerced cooperation. That’s not consent—an enslaved person cannot provide consent, period—and as with coerced confessions in the law, this amounts to a form of psychological torture.
Rail: One of the people we both admire, the nineteenth-century abolitionist Lydia Maria Child, wrote in her introduction to Harriet Jacobs’s Incidents in the Life of a Slave Girl that white people truly wanting to fight slavery must not have ears too delicate for indelicate truths. You challenge the reader by including wrenching descriptions of sadistic tortures inflicted on enslaved people. What was it like to write those passages, and what role do you want them to play in readers’ minds?
Hallman: Even though Child plays only a small role in my book, she was an important figure for me (for reasons relating to your second question), so I was thrilled to discover your wonderful biography, Lydia Maria Child: A Radical American Life, which I’ve been recommending to anyone and everyone ever since I read it! Child is an important role model, in so many ways—and I wholeheartedly agree with her on this point. In preparation for the writing of Say Anarcha, I read all fifty-five volumes of the slave narratives produced by the Federal Writer’s Project of FDR’s Works Progress Administration. Reading them took a year; it was one of the most profound reading experiences of my life. I discovered horrors in there that were far outside the kinds of abuses I had grown accustomed to in Hollywood slave narratives. There was so much more—and it was quite painful. I felt that deeply, and tried to invest Say Anarcha with some of that feeling. I think difficult history tasks us all, as writers and readers, with approaching the truth unflinchingly. Or, perhaps, even better, flinch, consider why you are flinching, and carry on.
Rail: You've done a series of videos to accompany the book. They feature you in all kinds of places: standing alongside freeways where plantations used to be, in front of libraries, in cemeteries. Sometimes it looks like it is very hot. Why did giving readers the opportunity to see you in these places feel important?
Hallman: Haha! You’re right—it was very hot! The YouTube channel, called The Anarcha Archive, is supposed to be a kind of combination of Ken Burns-style mini-documentaries, and Carl Sagan’s old show Cosmos. I think what I was trying to do with the on-location stuff was emphasize that history is still a function of actually going to places, of visiting sites and talking to people. Right now, we have the problem of people thinking that everything can be found on Ancestry.com or FamilySearch.org. But what you realize when you actually go to places is that what’s available online is only a tiny fraction of what’s really out there, and sometimes you have to dig through horribly disorganized probate offices, or talk your way through to manuscript collections held in private hands. I loved this work because it felt like a treasure hunt, and I wanted to invest the videos with a little bit of that on-the-ground excitement.
Rail: In one of these videos, you refute the claim that Sims thought Black women were much less sensitive to pain than white women. The truth, you say, is worse. What is that truth and why do we need to hear it?
Hallman: I wouldn’t say that I refute that Sims thought it—I would say that there is no direct evidence that he said it. That might be hair-splitting, but the truth is even worse because the claims that Sims said this trace back not to him, but to his biographer, Seale Harris, who most definitely said it. The exclusive focus on Sims’s awfulness—and he was terrible in just about every way—tends to overlook the majority of the male medical establishment, which celebrated Sims with outrageous propaganda until well past the halfway point of the twentieth century. Seale Harris said that Black women had greater resistance to pain not in 1850, in Sims’s time, but in 1950—a century closer to our own time. That’s worse—the citable reality of it spreads the villainy around.
Rail: The sources for this book are outsourced, as it were—collected on an elegant website where readers can not only check each claim but see an image of the source. Why did you decide to cite your sources in that format?
Hallman: Say Anarcha is first and foremost a literary work—heavily researched, yes, but a history that aspires to the condition of literature. Putting the sources online was a way of emphasizing that it should be judged as a story. The YouTube series is really an extension of this “illustrated bibliography,” which is available at AnarchaArchive.com. Mechanically, there were two reasons for it. One was simply that in printed form the notes of the book would have extended to more than a thousand pages. Putting the resource online meant that I did not have to select a small portion of the sources to appear only in the printed book (even seven percent would have filled eighty-five pages). The second is that I wanted to offer something I’d never seen before: the chance for interested readers to consult the book’s sources, in real time. I didn’t want to offer only a traditional citation, written in a coded shorthand that only archivists can read. Instead, I wanted to show the materials directly, and offer the chance for the reader to scrutinize, as they read, the book’s more speculative narrative choices. I think this sort of “illustrated bibliography” is unique—but perhaps it shouldn’t be.
Rail: There are a few episodes in the book that are so bizarre as almost to defy belief. One is when Anarcha is commandeered to tend to a menagerie of animals that are being experimented on by a French surgeon in the basement of something called the Egyptian Building. What does this story tell us about what being an enslaved woman was like?
Hallman: And this is one of those speculative choices! I knew that Anarcha was being experimented on in Richmond’s Egyptian Building (which still exists). Also, I knew that the most likely place for her to be staying at the time was the building’s laboratory, as women with ongoing fistula conditions are often shunned from contact with other people. I also knew that Mauritian-French doctor Charles Édouard Brown-Séquard was performing animal experiments in the Egyptian Building during the time Anarcha was present. In having Anarcha assist in Brown-Séquard’s experiments, I was trying to represent some of the more heinous associations of chattel slavery—and offer Brown-Séquard, a vicious opponent of slavery, an opportunity to note the hypocrisy: he was criticized by his colleagues for his animal experiments, even as they experimented on Anarcha.
Rail: You accuse Sims of many things, most notably of not curing Anarcha’s obstetric fistula and then claiming that he did. What, to your mind, was his greatest sin?
Hallman: It’s arguable that Sims’s most lethal period as a doctor came well after the fistula experiments—women died during Sims’s experiments on cancer sufferers in New York City, and in his attempts at Battey’s Operation (the removal of healthy ovaries to produce premature menopause in women suffering from epilepsy, hysteria, etc.). However, Sims’s greatest sin is surely using Anarcha’s story to promote his own fame, when what the record reveals is that she was never truly cured. This false story gave Sims great power, and he abused that power: as one of his critics claimed, the mutilation and loss of life attributable to Sims and his disciples far outweighs whatever clinical gains might be attributed to him (and it turns out that these are very few, if any).
Rail: The book is a harrowing record of nineteenth-century medicine’s struggle for respectability. It will leave any reader profoundly grateful for any day that fluids enter and exit the body as they should. What are your thoughts about medical progress after writing this book?
Hallman: Sims is definitely a villain in the book, but there are many doctors in the book who were also his critics. And there are several doctors quoted in the book who called for a more humble profession, for doctors to accept that their rewards and acclaim would not be the same as those for soldiers and politicians. Today, there are many doctors working inside medical organizations to ensure that the truth of this particular history, and others like it, be fully told. The true heroes of the past are now being recognized by modern physicians who are themselves acting heroically in not turning a blind eye to difficult histories.
Rail: You end the book by telling the reader about fistula treatment centers in Ethiopia, Nigeria, and Uganda. Would Anarcha recognize herself in the women who care for each other there?
Hallman: It’s possible. The true progress that stemmed from the Alabama fistula experiments was the patient-centered model of care that was pioneered by Anarcha and the enslaved women who were experimented on alongside her. In Africa, this model of care has turned fistula sufferers into survivors, nurses, doctors, caregivers, and activists. Credit for this belongs not to Sims, but to Anarcha and the others. It’s certainly possible that Anarcha would recognize herself—and there are certainly hints that she had become aware that her story was historically significant. I leave this as an ambiguous possibility in the book, but it’s very possible that Anarcha had been able to glimpse how consequential her history was to become.
Rail: One of the most haunting phrases in a book full of haunting phrases is “fistula tourism.” What is that, and what should we learn about it?
Hallman: The story of progress in the ongoing efforts to arrest the African fistula crisis is the book’s happy ending, in a way. There is a great deal more work to be done—millions of women continue to suffer, but hundreds of thousands have been cured or have had their lives improved, and that is in no small part thanks to Anarcha and what she represents. However, there is a dark side to what’s happening in Africa and the developing world, as well. The influence of Sims has not been wholly stamped out. Doctors and medical supply companies continue to use women of African descent for surgical experience and to test medical equipment. There has been great progress in correcting the past and an improving the present, but there is much more work still to be done.