origins of gynecology

Urogynecologist Briana Walton and Literary Historian Gabrielle Foreman join Actor and Scholar Naomi Lorrain to discuss the historical & scientific context of BEHIND THE SHEET

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On March 2, following the 2:00 pm matinee performance of Behind the Sheet, the powerful new drama by Charly Evon Simpson, everyone is encouraged to stay for our fifth talkback about the historical and scientific context of the play, as well as the many issues it addresses. On the panel this week, we have Dr. Briana Walton, director of Female Pelvic Medicine and Reconstructive Surgery at the AAMC Women’s Center for Pelvic Health, and literary historian Gabrielle Foreman, the Ned B. Allen Professor of English and Professor of History and Black American Studies at the University of Delaware, for a conversation moderated by research scholar and Behind the Sheet actor, Naomi Lorrain.

Behind the Sheet confronts the history of a great medical breakthrough by telling the forgotten story of a community of enslaved black women who involuntarily enabled the discovery. In 1840s Alabama, Philomena assists a doctor—her owner—as he performs experimental surgeries on her fellow slave women, trying to find a treatment for the painful post-childbirth complications known as fistulas. Reframing the origin story of modern gynecology, the play dramatizes how these women supported each other, and questions who, and what, history remembers.

The World Premiere of Behind the Sheet is this year’s mainstage production of the EST/Sloan Project, EST's partnership with the Alfred P. Sloan Foundation to develop new plays "exploring the worlds of science and technology," an initiative now in its twentieth year.

About the Panelists

Dr. Briana Walton

Dr. Briana Walton

Dr. Briana Walton has served as the Director of Female Pelvic Medicine and Reconstructive Surgery at Anne Arundel Medical Center (AAMC) since its inception in 2008. She is recognized as an expert in robotic/minimally invasive surgery and treatment of fibroids, urinary incontinence, and pelvic organ prolapse. In the field of robotics, she has personally performed 500 plus pelvic reconstructive surgeries while developing programmatic growth around quality, cost containment, and safety. Before starting the Women’s Center for Pelvic Health at Anne Arundel Medical Center, Dr. Walton was the Director of Benign Gynecology at Washington Hospital Center. She has also served as adjunct assistant professor of Obstetrics and Gynecology at Uniformed Services University of the Health Sciences and an assistant professor of Obstetrics and Gynecology and Urology at Georgetown University School of Medicine. Internationally, she uses her clinical skills and strengths in the treatment of health care disparities. She has worked in Ghana, Niger and most recently Rwanda where the program focuses on obstetrical fistula repairs, but the group has developed other clinical programs to treat the victims of trauma and genocide. She has served as board member and team leader for the International Organization for Women and Development.

Gabrielle Foreman

Gabrielle Foreman

P. Gabrielle Foreman is a teacher and scholar of African American studies and nineteenth-century literary history who has published extensively on issues of racial reform and slavery with a focus on the past’s continuing hold on the world we inhabit today. In her current manuscript The Art of DisMemory: Historicizing Slavery in Poetry, Performance and Material Culture, she traces the story of an enslaved Connecticut man named Fortune who was dissected and skeletonized by his enslaver, Dr. Preserved Porter. As the state abolished slavery, the Porter family turned their chattel property into intellectual property, passing down Fortune’s bones through generations of family doctors before donating his bones to a regional museum where he was the most popular exhibit until the 1970s. Our generation knows his story because the museum commissioned poet Marilyn Nelson to write about him. She and Ysaye Barnwell also created a manumission requiem with Nelson’s poetry serving as lyrics. Gabrielle teaches at the University of Delaware where she is the Ned B. Allen Professor of English and Professor of History and Africana Studies. She is also the founding director of the Colored Conventions Project, which brings decades of nineteenth-century Black activism to digital life.

Naomi Lorrain (Photo: Stan Demidoff).

Naomi Lorrain (Photo: Stan Demidoff).

About the Moderator

Naomi Lorrain plays Philomena in the world premiere production of Behind the Sheet by Charly Evon Simpson at the Ensemble Studio Theatre. Naomi is a New York City-based actor, playwright and scholar. She received her B.A. in the History of Science, History of Medicine and African American Studies from Yale University and her M.F.A. in Acting from NYU Tisch School of the Arts. She works part-time as a Scholars-in-Residence Research Assistant at the Schomburg Center for Research in Black Culture. Her plays include A Trojan Woman’s Tale (Villa La Pietra), The Queen of Macon County (The National Black Theatre), Shelfies (The 52nd Street Project), The Big O (Villa La Pietra), and Rigor Mortis (NYU Tisch). Recent theater credits include What to Send Up When It Goes Down (Movement Theatre Company), Stained (The Amoralist), Song for a Future Generation (Williamstown Theatre Festival), Restoration Comedy (The Flea), and Daughter of Lot (Edinburgh Fringe Festival). TV: “Orange Is the New Black” (Netflix), “Elementary” (CBS), “The Good Fight” (CBS), “Madam Secretary” (CBS). As a Scholars-in-Residence Research Assistant, she has worked on several books, including Dispossessed Lives: Enslaved Women, Violence, and the Archive by Marisa J. Fuentes. At Yale, her senior essay “Plan B: The Collision of the Birth Control Movement and the Uplift Movement Viewed Through Works of Angelina Weld Grimké” received both the Lily Rosen Prize in Women's Health for best essay that contributes to knowledge about women’s health and the William Pickens Prize for outstanding senior essay in the field of African and African American Studies.


Behind the Sheet began previews on January 9 and runs through March 10 at EST. You can purchase tickets here.

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Historian Deborah Gray White, Urogynecologist Ambereen Sleemi, Playwright Charly E. Simpson join Communications Pro Ayofemi Kirby to discuss the historical & scientific context of BEHIND THE SHEET

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On February 23, following the 2:00 pm matinee performance of BEHIND THE SHEET, the powerful new drama by Charly Evon Simpson, everyone is encouraged to stay for our fourth talkback about the historical and scientific context of the play, as well as the many issues it addresses. Joining Charly will be Deborah Gray White, Distinguished Professor of History and Women and Gender Studies at Rutgers University, and Ambereen Sleemi, Executive Director and Surgical Director of International Medical Response, for a conversation moderated by Ayofemi Kirby, who manages all communications and publicity initiatives at the Schomburg Center for Research and Black Culture.

BEHIND THE SHEET confronts the history of a great medical breakthrough by telling the forgotten story of a community of enslaved black women who involuntarily enabled the discovery. In 1840s Alabama, Philomena assists a doctor—her owner—as he performs experimental surgeries on her fellow slave women, trying to find a treatment for the painful post-childbirth complications known as fistulas. Reframing the origin story of modern gynecology, the play dramatizes how these women supported each other, and questions who, and what, history remembers.

The World Premiere of BEHIND THE SHEET is this year’s mainstage production of the EST/Sloan Project, EST's partnership with the Alfred P. Sloan Foundation to develop new plays "exploring the worlds of science and technology," an initiative now in its twentieth year.

About the Panelists

Professor Deborah Gray White

Professor Deborah Gray White

Deborah Gray White is Board of Governors Distinguished Professor of History at Rutgers University, New Brunswick, New Jersey. She is author of the seminal book Ar’n’t I A Woman? Female Slaves in the Plantation South; Too Heavy a Load: Black Women in Defense of Themselves, 1894-1994; several K-12 textbooks on United States History, and Let My People Go, African Americans 1804-1860 (1999).  In 2008, she published an edited work entitled Telling Histories: Black Women in the Ivory Tower, a collection of personal narratives written by African American women historians that chronicle the entry of black women into the historical profession and the development of the field of black women’s history. Freedom on My Mind: A History of African Americans, a co-authored college text, is now in its second edition. As a fellow at the Woodrow Wilson International Center for Scholars in Washington, D.C., and as a John Simon Guggenheim Fellow, White conducted research on her newest book, Lost in the USA: American Identity from the Promise Keepers to the Million Mom March.  She holds the Carter G. Woodson Medallion and the Frederick Douglass Medal for excellence in African American history, and was also awarded a Doctorate in Humane Letters from her undergraduate alma mater, Binghamton University. She currently heads the “Scarlet and Black Project” which investigates Native Americans and African Americans in the history of Rutgers University. With Professor Marisa Fuentes she is editor of the 2016 volume: Scarlet and Black: Slavery and Dispossession in Rutgers History.

Dr. Ambereen Sleemi

Dr. Ambereen Sleemi

Ambereen Sleemi is a female pelvic medicine reconstructive surgeon (urogynecologist) and trained obstetric fistula surgeon. She is Co-founder, Executive Director and Surgical Director of International Medical Response and leads a medical relief project in Puerto Rico, and fistula training programs in Malawi, Liberia and Haiti. Dr. Sleemi has served as an obstetric fistula surgeon for the Eritrean Women’s Project in Mendefera, Eritrea since 2007, and as a surgical team co-leader for Medicine in Action’s spring trip to Kingston, Jamaica as well as on the medical board. She spent six years on the executive committee of the International Society for Obstetric Fistula Surgeons (ISOFS) and is still an active member. In January, 2013, she developed the Haitian Women’s Heath Collaborative in partnership with the Department of Ob/Gyn at the National Hospital in Port-au-Prince, Haiti.

Charly Evon Simpson

Charly Evon Simpson

Charly Evon Simpson is the author of BEHIND THE SHEET, this year’s EST/Sloan mainstage production. Her other plays include Jump, Scratching the Surface, form of a girl unknown, it’s not a trip it’s a journey, Stained, Hottentotted, Trick of the Light, While We Wait, who we let in, or what she will, and more. Her work has been seen and/or developed with Ensemble Studio Theatre, Ars Nova, Chautauqua Theater Company, Salt Lake Acting Company, The Flea, P73’s Summer Residency, National New Play Network through its NNPN/Kennedy Center MFA Playwrights Workshop and National Showcase of New Plays, and others. Jump will receive an NNPN Rolling World Premiere, with productions at Playmaker’s Rep (Chapel Hill, NC), Actor’s Express (Atlanta, GA), Milagro Theatre (Portland, OR), and Shrewd Productions (Austin, TX) in 2019-20.  She’s currently a member of WP Theater’s 2018-2020 Lab, The New Georges Jam, The Amoralists 18/19 ‘Wright Club and she’s The Pack’s current playwright-in-residence. Charly is a former member of SPACE on Ryder Farm’s The Working Farm, Clubbed Thumb’s 17/18 Early Career Writers’ Group, Ensemble Studio Theatre's Youngblood, and Pipeline Theatre Company’s PlayLab. She is currently an adjunct lecturer at SUNY Purchase and an engager at The Engaging Educator. 

About the Moderator

Ayofemi Kirby

Ayofemi Kirby

Ayofemi Kirby is a communications and public engagement professional who builds mission-driven brands, engaged audiences and active communities, on and offline. She is passionate about helping individuals, multicultural communities and organizations across sectors tell powerful stories, start provocative conversations and build the relationships necessary to achieve meaningful results and measurable impact.

With more than 10 years of experience at the intersection of communications, civic engagement and culture, Ayofemi has managed online and corporate communications in the financial sector, developed award-winning programs that empowered Snake People across the country to be leaders in their communities and more active in our democracy, and led communications for the Congressional Black Caucus on Capitol Hill. She has also shaped and shifted community and media conversations about political, civic engagement, entertainment and cultural initiatives as an independent consultant.

Ayofemi currently manages all communications and publicity initiatives at the Schomburg Center for Research and Black Culture and continues to runs her own consultancy, CODE PR GLOBAL where she has worked with SONY Pictures, the Will and Jada Smith Family Foundation, the NYC Office of the Mayor, A+E Networks and others. Her work has shaped media coverage in and secured partnerships with the New York Times, USA Today, ARTNews, Teen Vogue, CBS News, Essence, Ebony, OkayAfrica, The Huffington Post, NBC, among many others.


BEHIND THE SHEET began previews on January 9 and runs through March 10 at EST. You can purchase tickets here.

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Historian Marisa Fuentes, Urogynecologist Ambereen Sleemi, Public Health Specialist Erin Anastasi & Playwright Charly E. Simpson join Actor Naomi Lorrain to discuss the context of BEHIND THE SHEET

From left: Marisa Fuentes, Ambereen Sleemi, Erin Anastasi, Charly Evon Simpson, Naomi Lorrain

From left: Marisa Fuentes, Ambereen Sleemi, Erin Anastasi, Charly Evon Simpson, Naomi Lorrain

On February 2, following the 2:00 pm matinee performance of BEHIND THE SHEET, the powerful new drama by Charly Evon Simpson, everyone is encouraged to stay for the third and final talkback about the historical and scientific context of the play, as well as the many issues it addresses, especially the history of gynecological surgical techniques, the rights of enslaved women to be used for experiments, what urgent gynecological concerns exist today in the developing world, and much more. Joining Charly will be Marisa J. Fuentes, Associate Professor of Women’s and Gender Studies and History at Rutgers University, Ambereen Sleemi, Executive Director and Surgical Director of International Medical Response, and Erin Anastasi, Coordinator of the Campaign to End Fistula at the United Nations Population Fund, for a conversation moderated by actor and research scholar Naomi Lorrain (Philomena in the play).

BEHIND THE SHEET confronts the history of a great medical breakthrough by telling the forgotten story of a community of enslaved black women who involuntarily enabled the discovery. In 1840s Alabama, Philomena assists a doctor—her owner—as he performs experimental surgeries on her fellow slave women, trying to find a treatment for the painful post-childbirth complications known as fistulas. Reframing the origin story of modern gynecology, the play dramatizes how these women supported each other, and questions who, and what, history remembers.

The World Premiere of BEHIND THE SHEET is this year’s mainstage production of the EST/Sloan Project, EST's partnership with the Alfred P. Sloan Foundation to develop new plays "exploring the worlds of science and technology," an initiative now in its twentieth year.

About the Panelists

Professor Marisa J. Fuentes

Professor Marisa J. Fuentes

Marisa J. Fuentes is the Presidential Term Chair in African American History and Associate Professor of Women’s and Gender Studies and History at Rutgers University—New Brunswick. Her scholarship brings together cultural studies, critical historiography, and black feminist theory to examine gender, sexuality, and slavery in the early modern Atlantic World. Professor Fuentes is the author of Dispossessed Lives: Enslaved Women, Violence, and the Archive (University of Pennsylvania Press, 2016) which won the Barbara T. Christian Best Humanities Book Prize, the Berkshires Conference of Women’s Historians First Book Prize, and the Letitia Woods Brown Memorial Book Prize from the Association of Black Women Historians. She is also the co-editor of Scarlet and Black: Slavery and Dispossession in Rutgers History, Volume I (Rutgers University Press, 2016), and the “Slavery and the Archive” special issue in History of the Present (November 2016).  

Dr. Ambereen Sleemi

Dr. Ambereen Sleemi

Ambereen Sleemi is a female pelvic medicine reconstructive surgeon (urogynecologist) and trained obstetric fistula surgeon. She is Co-founder, Executive Director and Surgical Director of International Medical Response and leads a medical relief project in Puerto Rico, and fistula training programs in Malawi, Liberia and Haiti. Dr. Sleemi serves as an obstetric fistula surgeon for the Eritrean Women’s Project in Mendefera, Eritrea since 2007, and as a surgical team co-leader for Medicine in Action’s spring trip to Kingston, Jamaica as well as on the medical board. She spent six years on the executive committee of the International Society for Obstetric Fistula Surgeons (ISOFS) and is still an active member. In January, 2013, she developed the Haitian Women’s Heath Collaborative in partnership with the Department of Ob/Gyn at the National Hospital in Port-au-Prince, Haiti.

Erin Anastasi with children in northern Uganda (Gulu district) where she worked on a project with MSF/Doctors Without Borders.

Erin Anastasi with children in northern Uganda (Gulu district) where she worked on a project with MSF/Doctors Without Borders.

Erin Anastasi is Coordinator of the Campaign to End Fistula and Technical Specialist for Sexual & Reproductive Health (SRH)/Obstetric Fistula in the Technical Division at the United Nations Population Fund. In 2017, the United Nations Federal Credit Union Foundation awarded Erin its Women’s Empowerment Award for her leadership of the Campaign.  She received her doctorate in Public Health from the London School of Hygiene and Tropical Medicine at the University of London and her Master of Health Sciences from the Johns Hopkins Bloomberg School of Public Health. Launched in 2003, the Campaign to End Fistula now consists of over 100 global partners working in more than 55 countries across Africa, Asia and the Arab region. In each country it focuses on prevention by increasing access to quality maternal health care services; treatment, from training doctors in fistula surgery to equipping and upgrading fistula centers; and rehabilitation/reintegration, including emotional, economic, and social support.   

Charly Evon Simpson

Charly Evon Simpson

Charly Evon Simpson is the author of BEHIND THE SHEET, this year’s EST/Sloan mainstage production. Her other plays include Jump, Scratching the Surface, form of a girl unknown, it’s not a trip it’s a journey, Stained, Hottentotted, Trick of the Light, While We Wait, who we let in, or what she will, and more. Her work has been seen and/or developed with Ensemble Studio Theatre, Ars Nova, Chautauqua Theater Company, Salt Lake Acting Company, The Flea, P73’s Summer Residency, National New Play Network through its NNPN/Kennedy Center MFA Playwrights Workshop and National Showcase of New Plays, and others. Jump will receive an NNPN Rolling World Premiere, with productions at Playmaker’s Rep (Chapel Hill, NC), Actor’s Express (Atlanta, GA), Milagro Theatre (Portland, OR), and Shrewd Productions (Austin, TX) in 2019-20.  She’s currently a member of WP Theater’s 2018-2020 Lab, The New Georges Jam, The Amoralists 18/19 ‘Wright Club and she’s The Pack’s current playwright-in-residence. Charly is a former member of SPACE on Ryder Farm’s The Working Farm, Clubbed Thumb’s 17/18 Early Career Writers’ Group, Ensemble Studio Theatre's Youngblood, and Pipeline Theatre Company’s PlayLab. She is currently an adjunct lecturer at SUNY Purchase and an engager at The Engaging Educator. 

About the Moderator

Naomi Lorrain (Photo: Stan Demidoff).

Naomi Lorrain (Photo: Stan Demidoff).

Naomi Lorrain plays Philomena in the world premiere production of BEHIND THE SHEET by Charly Evon Simpson at the Ensemble Studio Theatre. Naomi is a New York City-based actor, playwright and scholar. She received her B.A. in the History of Science, History of Medicine and African American Studies from Yale University and her M.F.A. in Acting from NYU Tisch School of the Arts. She works part-time as a Scholars-in-Residence Research Assistant at the Schomburg Center for Research in Black Culture. Her plays include A Trojan Woman’s Tale (Villa La Pietra), The Queen of Macon County (The National Black Theatre), Shelfies (The 52nd Street Project), The Big O (Villa La Pietra), and Rigor Mortis (NYU Tisch). Recent theater credits include What to Send Up When It Goes Down (Movement Theatre Company), Stained (The Amoralist), Song for a Future Generation (Williamstown Theatre Festival), Restoration Comedy (The Flea), and Daughter of Lot (Edinburgh Fringe Festival). TV: “Orange Is the New Black” (Netflix), “Elementary” (CBS), “The Good Fight” (CBS), “Madam Secretary” (CBS). As a Scholars-in-Residence Research Assistant, she has worked on several books, including Dispossessed Lives: Enslaved Women, Violence, and the Archive by Marisa J. Fuentes. At Yale, her senior essay “Plan B: The Collision of the Birth Control Movement and the Uplift Movement Viewed Through Works of Angelina Weld Grimké” received both the Lily Rosen Prize in Women's Health for best essay that contributes to knowledge about women’s health and the William Pickens Prize for outstanding senior essay in the field of African and African American Studies.

BEHIND THE SHEET began previews on January 9 and runs through February 10 at EST. You can purchase tickets here.

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Historian Deirdre Cooper Owens, Gynecologist Nerys Benfield and Director Colette Robert join Actor/Scholar Naomi Lorrain to discuss slavery, the birth of gynecology in America, and BEHIND THE SHEET

From left: Professor Deirdre Cooper Owens, Dr. Nerys Benfield, Colette Robert, Naomi Lorrain

From left: Professor Deirdre Cooper Owens, Dr. Nerys Benfield, Colette Robert, Naomi Lorrain

On January 26, following the 2:00 pm matinee performance of BEHIND THE SHEET, the powerful new drama by Charly Evon Simpson, everyone is encouraged to stay for what promises to be a provocative discussion of the many issues the play addresses, especially the history of gynecological surgical techniques, the rights of enslaved women to be used for experiments, race and gender relations in nineteenth-century America, and much more. Joining the play’s director Colette Robert will be Deirdre Cooper Owens, Associate Professor of History at Queens College, CUNY, and author of Medical Bondage: Race, Gender, and the Origins of American Gynecology, and Nerys Benfield, Associate Professor and the Director of Family Planning in the Department of Obstetrics and Gynecology and Women’s Health at Albert Einstein College of Medicine for a conversation moderated by actor and research scholar Naomi Lorrain (Philomena in the play).

BEHIND THE SHEET confronts the history of a great medical breakthrough by telling the forgotten story of a community of enslaved black women who involuntarily enabled the discovery. In 1840s Alabama, Philomena assists a doctor—her owner—as he performs experimental surgeries on her fellow slave women, trying to find a treatment for the painful post-childbirth complications known as fistulas. Reframing the origin story of modern gynecology, the play dramatizes how these women supported each other, and questions who, and what, history remembers.

The World Premiere of BEHIND THE SHEET is this year’s mainstage production of the EST/Sloan Project, EST's partnership with the Alfred P. Sloan Foundation to develop new plays "exploring the worlds of science and technology," an initiative now in its twentieth year.

About the Panelists

Professor Deirdre Cooper Owens

Professor Deirdre Cooper Owens

Professor Deirdre Cooper Owens is Associate Professor of History at Queens College, CUNY in Queens, New York and an Organization of American Historians’ (OAH) Distinguished Lecturer.  She has served as an American College of Obstetrics and Gynecology Fellow in Washington, D.C. and is a board member for the Berkshire Conference of Women Historians. Her first book, Medical Bondage: Race, Gender and the Origins of American Gynecology (UGA Press, 2017) won the 2018 Darlene Clark Hine Book Award from the OAH as the best book written in African American women’s and gender history. Professor Cooper Owens is also the Director of the Program in African American History at the Library Company of Philadelphia, the country’s oldest cultural institution. In the fall of 2019, she will join the University of Nebraska, Lincoln’s Department of History as the inaugural Linda & Charles Wilson Professor in the History of Medicine and the Director of the Humanities in Medicine Program. Copies of Medical Bondage will be available for saleand signing by the authorfollowing the talkback.

Dr. Nerys Benfield

Dr. Nerys Benfield

Dr. Nerys C. Benfield is an Associate Professor and the Director of Family Planning, the Fellowship in Family Planning, and the Global Women's Health Program at the Albert Einstein School of Medicine. She is a practicing obstetrician-gynecologist in Bronx, New York and is affiliated with Montefiore Medical Center. Her research interests include the integration of contraceptive counseling, access, and distribution into medical care for high-risk women both domestically and internationally, uro-genital fistula, and clinical training and health technologies in low-resource settings. Dr. Benfield has worked in eastern Democratic Republic of Congo since 2008 where she has developed an academic collaborative research and clinical training program with research interests that include the integration of contraceptive counseling, access, and distribution into medical care for high-risk women, uro-genital fistula, and methods to optimize evidence-based clinical training and the use of health technologies such as information and communication technologies (ICT) and ultrasound in low-resource settings.

Colette Robert

Colette Robert

Colette Robert is the director of the world premiere production of BEHIND THE SHEET by Charly Evon Simpson (New York Times Critic’s Pick) at the Ensemble Studio Theatre. Her recent directing credits include: Ma Rainey’s Black Bottom (NYU Grad Acting), Mary’s Wedding (Chester Theatre Company), Big Love (Sarah Lawrence College), How My Grandparents Fell in Love (EST, New York Times Critic's Pick), What Every Girl Should Know (NYU/Stella Adler Studio), Hottentotted (The Tank, Ars Nova/ANT Fest), The Mountaintop (Chester Theatre Company), Icons/Idols (The New Ohio/Ice Factory Festival), Flops, Failures, and Fiascos (The Civilians), and When Last We Flew (Diversionary Theatre and FringeNYC, GLAAD Media Award). As a playwright, her play The Harriet Holland Social Club Presents the 84th Annual Star-Burst Cotillion in the Grand Ballroom of the Renaissance Hotel has been developed with Fuller Road Artist Residency, New Georges, Mabou Mines, and The Drama League. Colette is a member of Ensemble Studio Theatre, a co-facilitator of the New Georges Jam, and an adjunct lecturer in the Humanities department at Hunter College. 

About the Moderator

Naomi Lorrain (Photo: Stan Demidoff)

Naomi Lorrain (Photo: Stan Demidoff)

Naomi Lorrain plays Philomena in the world premiere production of BEHIND THE SHEET by Charly Evon Simpson at the Ensemble Studio Theatre. Naomi is a New York City-based actor, playwright and scholar. She received her B.A. in the History of Science, History of Medicine and African American Studies from Yale University and her M.F.A. in Acting from NYU Tisch School of the Arts. She works part-time as a Scholars-in-Residence Research Assistant at the Schomburg Center for Research in Black Culture. Her plays include A Trojan Woman’s Tale (Villa La Pietra), The Queen of Macon County (The National Black Theatre), Shelfies (The 52nd Street Project), The Big O (Villa La Pietra), and Rigor Mortis (NYU Tisch). Recent theater credits include What to Send Up When It Goes Down (Movement Theatre Company), Stained (The Amoralist), Song for a Future Generation (Williamstown Theatre Festival), Restoration Comedy (The Flea), and Daughter of Lot (Edinburgh Fringe Festival). TV: “Orange Is the New Black” (Netflix), “Elementary” (CBS), “The Good Fight” (CBS), “Madam Secretary” (CBS). As a Scholars-in-Residence Research Assistant, she has worked on several books, including Dispossessed Lives: Enslaved Women, Violence, and the Archive by Marisa J. Fuentes.

BEHIND THE SHEET began previews on January 9 and runs through February 10 at EST. You can purchase tickets here.

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A Note on the Scientific & Historical Context of BEHIND THE SHEET

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In the spirit of the EST/Sloan Project’s commitment to “challenge and broaden the public’s understanding of science and technology and their impact in our lives,” we offer this essay on some of the scientific and historical background to BEHIND THE SHEET by Charly Evon Simpson, the 2019 EST/Sloan mainstage production. BEHIND THE SHEET begins previews on January 9 and runs through March 10. You can purchase tickets here.

Background essay by Rich Kelley

The first Women’s Hospital in America is thought to be the four-story, 20-bed institution that used to stand at Madison Avenue and 29th Street in New York City, founded by Dr. J. Marion Sims in 1855 where he operated on ailing white women. That claim, however, ignores the two-story, eight-bed “sick house” Sims had set up on a small slave farm in Mount Meigs, Alabama, where from 1844 through 1849 he performed surgical experiments on between 10 and 17 enslaved women, most of them suffering from what we now call obstetric fistulas. 

Left, First Woman’s Hospital in New York City, 1857; Right, Dr. Sims’ first women’s hospital, Montgomery, Alabama (photographed in 1895 by Edward Souchon. Courtesy of the Reynolds Historical Library at the University of Alabama at Birmingham)

Left, First Woman’s Hospital in New York City, 1857; Right, Dr. Sims’ first women’s hospital, Montgomery, Alabama (photographed in 1895 by Edward Souchon. Courtesy of the Reynolds Historical Library at the University of Alabama at Birmingham)

Dr. Sims had come to Alabama in 1840, at the age of 27, to open a new medical practice. He had closed his first practice in South Carolina after his first two patients, infants, had died, probably from cholera. Sims quickly developed a reputation as a skilled surgeon. In those days bleeding to death was a constant danger during surgery and Sims describes in his memoirs how he relied on speed in the surgical area to save his patients.

Sims’ speculum

Sims’ speculum

While widely known as the “Father of Modern Gynecology,” Dr. J. Marion Sims was quite frank in his memoirs about his initial distaste for the field: “If there was anything I hated, it was investigating the organs of the female pelvis.” Little was known of female anatomy at the time and, frustrated by what he couldn’t see in 1845 during his first case of an obstetric fistula, Sims turned a pewter spoon into a kind of duck-billed retractor. Describing the first use of the “Sims speculum,” he wrote, “I saw everything as no man had ever seen before. The fistula was as plain as the nose on a man’s face.” 

What he saw led Sims to believe he could find a way to repair a devastating condition that had plagued women for centuries. “I said at once, ‘Why cannot these things be cured?’” The case at hand involved the pregnancy of Anarcha, a seventeen-year-old slave girl who had been in labor for three days when Sims was called. He was not able to save the baby, and, days later, he observed that she had developed both kinds of obstetric fistulas: a vesico-vaginal fistula and a rectal-vaginal fistula. These can occur during long, obstructed labors when the infant’s head is too large to pass through the pelvic canal. The infant’s head traps the soft tissues of the pelvis up against the pelvic bone, cutting off the blood supply. When labor continues for several days, the tissues die. In a vesico-vaginal fistula, the wall between the bladder and the vagina breaks down and creates a hole, leading to uncontrollable urine leakage. In a rectal-vaginal fistula, the wall between the rectum and the vagina breaks, causing fecal leakage. The ensuing incontinence often produces infections, strong odors, and, over time, the painful inflammation and scarring of the inner legs. Fistula patients quite often become ostracized from family and friends, depressed recluses, unable to live in their homes.

“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.

To test his idea, Sims needed more patients with the same condition. We know from his records the names of two others, Betsey and Lucy. As Sims writes, “I made this proposition to the owners of the negroes: If you will give me Anarcha and Betsey for experiment, I agree to perform no experiment or operation on either of them to endanger their lives, and will not charge a cent for keeping them, but you must pay their taxes and clothe them.”

He kept them for five years. Each had a fistula and was experimented on several times, Anarcha perhaps as many as thirty times. When two years passed without a breakthrough, the white colleagues who had assisted Sims drifted away and he had to train his slaves to assist him in the experiments, including restraining patients during surgery, which was performed without anesthetic. Many became addicted to the opium he gave them to ease their pain.

Illustration from a contemporary medical textbook shows patient in “Sims position”

Illustration from a contemporary medical textbook shows patient in “Sims position”

By continually operating on these women, Sims perfected many of his techniques. To improve his ability to visualize the fistula, he invented the “Sims position,” when the patient lies on her left side with her left leg straight but flexing her right knee and hip, pulling the right leg up.

Sims eventually realized he needed something stronger to hold the repair. On June 21, 1849, he used fine silver wire on Anarcha for the first time. On day seven after the operation he re-examined her and found that the fistula had healed perfectly. Sims was ebullient: “I realized that in fact at last my efforts had been blessed with success and that I had made perhaps one of the most important discoveries of the age for the relief of suffering humanity.”

Sims would go on to a storied career as a surgeon in New York and Europe, but questions continue to rage about his contention that his patients consented to his experiments. Sims defenders make the case that these women had much to gain from these operations given the crippling effects of fistula and that no other treatment existed.

In Medical Bondage: Race, Gender, and the Origins of American Gynecology, historian Deirdre Cooper Owens presses the case that we understand Sims in his historical context:

“Gynecological surgeons during the early and mid-nineteenth century were neither exceptionally cruel nor sadistic physicians who enjoyed butchering black women’s bodies, as some scholars have argued. They were elite white men who lived in an era when scientific racism flourished. Ideas about black inferiority were established and widely believed, as was the underlying assumption about black people’s intelligence. Black women, particularly those who were enslaved, were a vulnerable population that doctors used because of easy accessibility to their bodies. Further, the value of black women’s reproductive labor demanded that it be “fixed” when it was seen as “broken” by those who depended on their labor.”

Many question why Sims did not use any anesthetic in his operations on slave women but later did so in New York when his clientele were mostly white women. Some contend that Sims believed that African American women had a higher tolerance for pain. Additionally, when he began his experiments in the 1840s, Sims may not have had full knowledge of what anesthetics were available. The first public lectures about nitrous oxide and diethyl ether did not take place until 1845 in Boston and their use did not become common in surgical practice until the 1850s. But even in the 1850s, Sims remained skeptical about the use of anesthesia. In a lecture to The New York Academy of Medicine in 1857, Sims remarked that the Sims position “permits the use of anesthetics if desired, but I never resort to them in these operations, because they are not painful enough to justify the trouble. “

Owens’ book presents an even-handed account, but importantly, much of the book turns our attention and appreciation to the unheralded experiences and contributions of the women Sims and others experimented on:

“Beginning with those nearly ten black bondwomen who labored under Sims as leased chattel, patients, and nurses, they serve as the counter to Sims’s designation as ’father’. They are the rightful ‘mothers’ of this branch of medicine.  . . . Their bodies enabled the research that yielded the data for white doctors to write medical articles about gynecological illnesses, pharmacology, treatment, and cures.”

The statue

The Sims statue when it stood on Fifth Avenue outside Central Park

The Sims statue when it stood on Fifth Avenue outside Central Park

Sims was the first medical professional to have a statue in his honor in New York City in 1894. It was first in Bryant Park and then moved to Central Park where it stood outside the New York Academy of Medicine on Fifth Avenue. In response to protests about the statue during the summer of 2017, Mayor Bill de Blasio charged the Public Design Commission with determining what should be done. In its January 2018 report, the commission was quite scathing in its recommendation that the statue be moved.

“In short, especially in its current location, the Sims monument has come to represent a legacy of oppressive and abusive practice on bodies that were seen as subjugated, subordinate, and exploitable in service to his fame. To confront this legacy in accordance with the principle of Historical Understanding, the Commission feels that the City must take significant action to reframe the narrative presented in the monument.” The status has been relocated to Greenwood Cemetery, where Sims is buried, and there are plans to add in both locations a plaque adding the names of Anarcha, Lucy, and Betsey along with a description of the roles they played in Sims’s life.

The state of obstetric fistulas today

In the developed world, ready access to obstetrical care, and especially caesarean section, have virtually eliminated the problem. However, fistulas remain an urgent problem in the developing world. The World Health Organization reports that more than two million young women live with obstetric fistulas in Asia and sub-Saharan Africa and 50,000 to 100,000 new cases occur each year.  When those afflicted are able to get timely access to quality obstetrical care, 80% to 95% of them can be repaired surgically.

BEHIND THE SHEET by Charly Evon Simpson, the 2019 EST/Sloan mainstage production, begins previews on January 9 and runs through March 10. Tickets are available here.

Recommended Reading

 Books

 Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present by Harriet A. Washington (Doubleday, 2007)

 Medical Bondage: Race, Gender, and the Origins of American Gynecology by Deirdre Cooper Owens (University of Georgia Press, 2017) Note: the opening to this essay was inspired by the opening of the introduction to Medical Bondage

 The Story of My Life by J. Marion Sims (D. Appleton & Co., 1884) 

 Journal Articles

 The medical ethics of Dr J Marion Sims: A fresh look at the historical record” by Lewis Wall in Journal of Medical Ethics, June 2006.

 “J. Marion Sims, the Father of Gynecology: Hero or Villain?” by Jeffrey S. Sartin, MD in Southern Medical Journal, May 2004.

 “A History of Obstetric Vesicovaginal Fistula” by Robert F. Zacharin in Australian and New Zealand Journal of Surgery, June 2008.

 “On the Treatment of Vesico-Vaginal Fistula” by J. Marion Sims in The American Journal of Medical Sciences, 1852. Reprinted in International Urogynecology Journal, 1998.

 “The medical ethics of the ‘father of gynaecology’, Dr J Marion Sims” by Durrenda Ojanuga in Journal of Medical Ethics, March 1993.

 Radio shows/Podcasts

 “Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology” on an episode of NPR’s Hidden Brain, February 7, 2017

 “The Controversial Figure of J. Marion Sims” Episode 51 of Legends of Surgery

 Websites

 J. Marion Sims in the online Encyclopedia of Alabama

 J. Marion Sims in Wikipedia

A Dr. J. Marion Sims Dossier at the University of Illinois – poets on J. Marion Sims

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