birth of gynecology

Charly Evon Simpson on medical experiments on slaves, the birth of gynecology, lost voices, and BEHIND THE SHEET

Charly Evon Simpson

Charly Evon Simpson

On Tuesday, April 3, the EST/Sloan Project, as part of the 2018 First Light Festival will present the first workshop of BEHIND THE SHEET, the powerful new play by Charly Evon Simpson about how medical experiments on plantation slaves in Alabama in the 1840s led to the birth of the science of gynecology in America. The playwright has much to tell us.

(Interview by Rich Kelley)  

How did BEHIND THE SHEET come to be? How has it changed through different drafts?

Statue of J. Marion Sims at 103rd Street and Fifth Avenue in NYC

Statue of J. Marion Sims at 103rd Street and Fifth Avenue in NYC

A few years ago, I read an article about a group of women protesting at a statue of J. Marion Sims. As someone interested in how black women’s bodies have been seen and treated throughout history, I found myself trying to learn more about Anarcha, Betsey, and Lucy (the three enslaved women we know Sims experimented on) and how slavery intersected with the rise of gynecology. When it came time to apply for an EST/Sloan commission, my brain immediately went back to this history.

The play has changed since the proposal. For example, my first proposal included a more contemporary piece—a black woman gynecologist having to reconcile this history of her field. I soon decided to just focus on the history. Characters have come and gone, scenes have been cut and added, and history has made its way in and out of the story. My first draft was very true to what we know happened. This current draft allows a little more room for my voice and imagination, while staying true to the basic facts.

As you say, the play tells a story strongly inspired by the work of J. Marion Sims, a physician often referred to as the "father of gynecology" who practiced medicine in Alabama in the 1840s. He is credited with inventing the speculum and, most notoriously, trying out new gynecological surgical procedures on slaves without using anesthesia. But you don't use his name for your main character, whom you call George, and you give the female characters names different from the ones we know from history. Why the name changes? How is the story in the play different from Sims’?

“J. Marion Sims: Gynecologic Surgeon,” painting by Robert Thom, from the Great Moments in Medicine series, shows Sims with Anarcha, as Betsey and Lucy look on.

“J. Marion Sims: Gynecologic Surgeon,” painting by Robert Thom, from the Great Moments in Medicine series, shows Sims with Anarcha, as Betsey and Lucy look on.

I’ve gone back and forth on the name changes. And, you never know, perhaps the name changes won’t exist in a future draft, but for right now, it allows me some distance from the real story. It allows me to play as a writer in a way that I wasn’t able to when I was using their real names and really focused on getting every historical detail right. With the name changes, I am acknowledging that some of this is fiction. It is historical fiction. I am very aware that we don’t know what Anarcha, Betsey, and Lucy were thinking or saying. I have J. Marion Sims’ book, for example, and what he says about them, but I don’t have their words. And I didn’t want to put words in their mouths. I want to shed light on this history and I want to give voice to the experience from the women’s perspective. For me, it is easier to explore the possibility of their perspectives without using their real names. That said, we make a point at the end of the play to bring it back to Anarcha, Betsey, Lucy, and J. Marion Sims. I don’t want to lose them or ignore them. I want the audience to know their names.

Why this play? Why now?

In December 2017, ProPublica published an article entitled “Nothing Protects Black Women from Dying in Pregnancy and Childbirth.” The article is heartbreaking and shows how much more at risk black women are when it comes to pregnancy and childbirth. Education, income…when it comes to black women successfully carrying a child to term and surviving the childbirth and weeks after, it seems nothing is protecting us. In February 2018, Serena Williams shared her own struggles and complications after giving birth. There is a long history of our physical pain being ignored. There is a long history of black women being used for medical innovation while at the same time being ignored by medicine. This history, whether we like to acknowledge it or not, has influenced our current medical systems. And it is important to know the history so that we can make strides away from it. 

Women of all races are fighting for their reproductive rights and their healthcare right now, and I think it is important to acknowledge that some women have to fight particular fights that their counterparts do not. This is one of the fights. 

Illustration of Sims repairing a vesico-vaginal fistula with silver wire sutures (1870)

Illustration of Sims repairing a vesico-vaginal fistula with silver wire sutures (1870)

BEHIND THE SHEET features five black slave women and one black slave man. How did you come to decide how many different black slave voices you wanted to dramatize? Did the number or the kind of voices change over time?

To be honest, I’m not sure. It just happened. I started with only three black women, but also wanted to somehow honor the other women Sims experimented on whose names we don’t know. So I felt free to move away from the three women and add the voices that came to me. 

There is an article in The Journal of Medical Ethics that states that "Although enslaved African American women certainly represented a ‘vulnerable population’ in the 19th century American South, the evidence suggests that Sims's original patients were willing participants in his
surgical attempts to cure their affliction." What do you make of this statement?

My first instinct is that, sure, if you are in pain and someone offers you a possible way out of that pain, chances are you might be willing to agree to experiments aimed at curing you. That said, “willing” is a…complicated word to use in reference to enslaved people. The power dynamic alone complicates any ideas around the word “willing”. What does willing even mean when your rights have been stripped away and your body is often being used in service of other people? When one does not own their own body, and when their worth is attached to said body, how does consent work? If any of them said “no,” how do we think their owners may have reacted? Also, if there was any notion of willingness and if it was respected at first, was there any room for that “willingness” to end? When Sims took on the financial burden of taking care of these women who were “unfit” to do much of what was expected to them, are we sure he would have been willing to stop?  Anarcha, Betsey, Lucy, and the other women—along with J. Marion Sims—didn’t know it would take numerous surgeries to find a cure for fistulas. If Anarcha wanted to stop at surgery 15, would she have been able to? What may have been done to “convince" her to keep going? 

We have a tendency to want to make our history seem way more light, bright, and friendly than it actually is. History is complicated. I’d rather we live in the complications than ignore them. 

What do you want the audience to take away from BEHIND THE SHEET?

Front page of New York Daily News on February 8, 2018 reporting on relocation of Sims statue to Green-wood Cemetery in Brooklyn.

Front page of New York Daily News on February 8, 2018 reporting on relocation of Sims statue to Green-wood Cemetery in Brooklyn.

When director Colette Robert first read the play, she said she had to put it down because it made her stomach hurt. I don’t want to cause people pain, but I do hope the audience feels the discomfort, feels the complicatedness, feels the pain that is intertwined in our history. You can be grateful there is a cure for fistulas. You can also be disappointed that it was found at the expense of black women’s bodies. Holding those two feelings inside is possible and it is messy and it is uncomfortable and I want us to do it anyway. I hope the audience walks away feeling that messiness, thinking about that discomfort, and wondering what systems we may have in place that continue this history.

What kind of research did you do to write BEHIND THE SHEET? Did you work with a consultant?

I didn’t have a consultant. I read J. Marion Sims’ book, The Story of My Life. I read numerous articles, listened to talks (like "Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology" on NPR) and parts of books like, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present by Harriet A Washington. I read Patient. by Bettina Judd which is a book of poetry intertwining her experience as a patient with the experiences of Anarcha, Betsey, and Lucy (as well as other black women who found themselves in the role of patient under racist conditions). I went to talks. Then I had to stop researching and just write the play. I wanted to respect and honor the history, but I also knew I was creating a piece of fiction and so I had to find a balance. 

How is BEHIND THE SHEET different from your other plays?

BEHIND THE SHEET is my most historical play. I have plays, like my play Hottenttotted, that has historical figures in them or attempts to discuss/shed light on an aspect of history, but this play is the most historical in that it is set in the past and tries to stay true to certain aspects of the history in a very big way.

You have been a member of EST's Youngblood program.  What impact did being a member have on your writing?

I have to say that I think the biggest impact for me was not on my writing, but on my understanding and participation in the theater community. I became a member of Youngblood only two months after moving back to NYC. While I knew a few people from college and high school doing theater in the city, being in Youngblood allowed me to meet a wide variety of actors, directors, writers, stage managers, etc. Many of my first theater opportunities came from people I met at EST. They helped me find my footing and place and continue to even after nearly two years out of the group. 

What's next for Charly Evon Simpson?


I have a few readings of new plays coming up in April and May with SPACE on Ryder Farm and Clubbed Thumb, respectively. Next January, my play Jump premieres at PlayMakers Repertory Company in North Carolina. And there are some exciting things happening in between!

The 2018 EST/Sloan First Light Festival runs from February 5 through April 6 and features readings and workshop productions of eight new plays. The climax of every EST/Sloan season is the annual Mainstage Production, which this year is the world premiere of BUMP by Chiara Atik. Directed by Claudia Weill, BUMP is a wildly entertaining exploration of the history of pregnancy and childbirth, from colonial times until now. Tickets are on sale now for performances, May 9 through June 3. The First Light Festival is made possible through the alliance between The Ensemble Studio Theatre and The Alfred P. Sloan Foundation, now in its twentieth year.