Art of Medicine
Jan 2023

A Clinical Encounter in Historical Context

Julia O’Brien
AMA J Ethics. 2023;25(1):E79-81. doi: 10.1001/amajethics.2023.79.


This drawing considers the importance of understanding history’s role in contextualizing many patients’ present-day health care experiences.

Figure. Bandage and Bondage




Perhaps the patient in this drawing recognizes her own place in a historical narrative. A well-intentioned nurse might have no idea about how constriction for blood pressure measurement could trigger transgenerational fear in an African American patient whose pulse beats in her arm like a drum, taking her back 200 years when Africans in bondage were medically abused.

James Marion Sims (1813-1833) is credited with being the “Father of American Gynecology,”1 although his victims—Anarcha, Betsey, Lucy, and more—have been largely unacknowledged.2 At right, this drawing echoes J. Marion Sims: Gynecologic Surgeon, a 1952 painting by Robert Thom,3 reminding viewers about forgotten “Mothers of Gynecology.”4 Sims is also credited with inventing the modern-day speculum,1 which has not been significantly improved since the 1840s,5 as many women today can attest. Although racially diversifying practitioners won’t solve structural inequity alone,6 a historically conscious clinician might empathize with patients of color.


  1. Reverby SM. Memory and medicine: a historian’s perspective on commemorating J. Marion Sims. Perspectives on History. September 17, 2017. Accessed September 30, 2022.

  2. Vedantam S, Penman M, Schmidt J, Boyle T, Cohen R, Connelly C. Remembering Anarcha, Lucy, and Betsey: the mothers of modern gynecology. NPR. February 7, 2017. Accessed September 30, 2022.

  3. J. Marion Sims: Gynecologic Surgeon, from “The History of Medicine.” University of Michigan Museum of Art. Accessed October 6, 2022.

  4. Kuta S. Subjected to painful experiments and forgotten, enslaved “mothers of gynecology” are honored with new monument. Smithsonian Magazine. May 11, 2022. Accessed September 30, 2022.

  5. Eveleth R. Why no one can design a better speculum. Atlantic. November 17, 2014. Accessed October 6, 2022.

  6. Zaragovia V. Trying to avoid racist health care, Black women seek out Black Obstetricians. NPR. May 28, 2021. Accessed September 30, 2022.


AMA J Ethics. 2023;25(1):E79-81.



Conflict of Interest Disclosure

The author(s) had no conflicts of interest to disclose.

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.