Jayant Radhakrishnan
Chicago, Illinois, United States

 

“Elihu Yale; William Cavendish, the second Duke of Devonshire; Lord James Cavendish; Mr. Tunstal; and an Enslaved Servant” Previously hung at Woodbridge Hall of Yale University. Now at the Yale center for British Art. Yale Center for British Art, Public domain, via Wikimedia Commons

The Oxford English Dictionary defines presentism as “uncritical adherence to present-day attitudes, especially the tendency to interpret past events in terms of modern values and concepts.” The term may have been used as far back as the 1870s and applies to acts, beliefs, and people that were acceptable or even lauded at the time but are now considered anathema. It is applied in a haphazard manner, whereby some are knocked down from their pedestals while others escape with their reputations intact.

Princeton University recently removed the name of Woodrow Wilson, the twenty-eighth US president, from the School of Public and International Affairs and from Wilson College, despite his many national and international achievements and his having transformed Princeton into an educational powerhouse. According to the university president, Eisgruber, “Wilson’s racism was significant and consequential even by the standards of his own time. He segregated the federal civil service after it had been racially integrated for decades, thereby taking America backward in its pursuit of justice. He not only acquiesced in but added to the persistent practice of racism in this country, a practice that continues to do harm today.”¹

The situation is different at Northwestern University, which has twice investigated the role of one of its co-founders, Dr. John Evans, in instigating the Sand Creek massacre when he was governor of the Colorado Territory. At Sand Creek, 700 soldiers of the US Cavalry murdered and mutilated approximately 150 peaceful Arapaho and Cheyenne, the overwhelming majority of whom were women, children, and the elderly. In 2014, the university concluded that Evans had no knowledge of the massacre and that he would have “opposed the attack that took place,” but they made note of his “refusal to condemn the massacre and the shameful way he minimized and justified it.” In 2017 the committee exonerated him and the chair of the committee, Landis Martin, stated that his conduct “didn’t rise to the level of taking his name off of anything. On balance, that his conduct during his life was exemplary.” When asked again earlier this year, Martin saw no reason to ask the board to reconsider its vote. Northwestern obviously disagrees with the US Government, which forced him to resign as governor of Colorado Territory in 1865, and the University of Denver, another university he founded, who held him “deeply culpable.”² He was also a founder of Mercy Hospital and taught at Rush Medical College in Chicago and he founded the Illinois State Medical Society. In addition, the towns of Evanston, in Illinois and in Wyoming, and a town named Evans and Mount Evans in Colorado are named after him.

Another famous name in education circles is that of Elihu Yale. He was born in Boston but his family left for England when he was three years old and he never returned to America. His contribution to the development of Yale University, when Cotton Mather asked for a contribution, was to send 417 books, a portrait of King George I, and nine bales of goods that the school sold for £800.³ A majority of historians agree that he traded slaves. Furthermore, he was fired by the East India Company for cheating his employers and the local people when he was the governor of Fort St. George, which later became Madras and is now Chennai. John Witt, the chairman of the committee that evaluated Yale, stated that in his actions against slaves he was “relatively unexceptional in his own time,” hence Yale University should retain its name. The university has discreetly removed a painting that hung in Woodbridge Hall that is entitled Elihu Yale; William Cavendish, the second Duke of Devonshire; Lord James Cavendish; Mr. Tunstal; and an Enslaved Servant. The enslaved servant in question, a small dark-skinned boy, is wearing a padlocked dog collar [Figures 1 & 2]. Interestingly, the same committee relegated John C. Calhoun, a former US vice president, to obscurity because he advocated for slavery as “a positive good.”^4,5 John Steele Gordon believes they decided to keep the name because they were not keen to rename the school Dummer College after the person who was most responsible for its success, Jeremiah Dummer.⁶

“Enslaved servant” wearing a padlocked dog collar. Detail of above painting. Yale Center for British Art, Public domain, via Wikimedia Commons

Recently the actions of some revered figures in medicine have also been called into question. J. Marion Sims, often referred to as “The Father of Gynecology,” had been held in great esteem for a hundred years for his numerous achievements, the most significant being the development of a technique to reliably and consistently repair vesico-vaginal fistulae occurring after difficult childbirth. Essence of the criticism is that between 1845 and 1849 he perfected his technique by operating repeatedly on slave women, who could not consent legally, in a small hospital he built in his backyard in Montgomery, Alabama. He even bought one of these women for that purpose from her owner, who did not wish her to be operated upon. There is no question that he operated numerous times on each of these women before he perfected his technique and all the operations were carried out without anesthesia.⁷

It has been argued that he was a misogynistic, cold, heartless man who used these powerless women to embellish his reputation. On the other hand, one must remember that a fistula was considered an incurable defect in those days, as many other surgeons had tried repeatedly and failed to repair them. These unfortunate women were desperate, as they had been ostracized by society because of the odor resulting from the constant leak of urine through the vesico-vaginal fistula, and flatus and feces if there was also a recto-vaginal fistula. They also suffered from severe pain in the vagina because of chronic inflammation, excoriation of the mucosa, and even calcareous deposits. His not using an anesthetic has also been criticized because ether was first used in 1842; however, since Long did not publish his results until 1848 it came into general use only in the later part of Sims’ career and he may not have known about it early on. And chloroform was first used by Simpson only in 1847. There is no evidence that he subscribed to the prevailing belief that black women had a higher tolerance for pain than white women since, as late as 1857, when he was operating on affluent white women at the Woman’s Hospital in New York, he stated that he never used anesthetic agents in fistula operations “because they are not painful enough to justify the trouble, and risk attending their administration.” This seems to be a misogynistic, rather than racist, sentiment.

However, in those early days when anesthetic agents were not well understood, the risk of administering ether or chloroform to a patient in the knee-chest position without intubating the airway or having control of respirations could have been prohibitive. It is also true he could not obtain legal consent from slaves; however, he discussed details of what he would be doing with the patients and it seems likely they wished to be cured.⁸ His surgical technique, particularly the use of a monofilament silver wire in an infected wound rather than a braided linen or catgut suture that would harbor organisms in its interstices, are still valid concepts. He is accused of administering large amounts of opium to his patients to make them dependent but that was part of standard postoperative care at the time.⁹ Amongst his many other contributions is a speculum that is still used, as well as use of the knee-chest (or prone jack-knife) position for vaginal examination and the lateral position with the upper hip and knee flexed at 90° for digital rectal examination. A sigmoid (S-shaped) self-retaining bladder catheter he devised has since been supplanted by better ones.

Sir William Osler, often called the “Father of Modern Medicine,” also has recently lost his favored status even at his alma mater, McGill University in Canada, where students have decided to drop Osler eponyms.¹⁰ He was known as a humanitarian, clinician, and teacher who made many major contributions. He practiced at McGill, the University of Pennsylvania, the Johns Hopkins Hospital (where he was one of the four founding professors), and then at Oxford University, with distinction. He originated the concept of bedside teaching and established a residency program when he was at Johns Hopkins. However, he also made questionable statements such as “I hate Latin Americans,” and with regard to immigrants, “the question with us is what are we to do when the yellow and brown men begin to swarm over. There is no trouble so far as China and Japan are concerned – they are foreign countries (that is not part of the British Empire). We can say we do not want their people, but the case is different with the Indians who are our fellow citizens (of the British Empire). We ought, if we could, say to them, ‘Come on in you are welcome’. But we have to safeguard our country. Therefore, we shall be bound to say ‘We are sorry, we would if we could, but you cannot come in on equal terms with Europeans’. We are bound to make our country a White man’s country.” He made two other particularly distasteful remarks. The first was “the coloured, usually both syphilitic and alcoholics were the worst risk in pulmonary disease” and the second was in a fictional manuscript about indigenous people where he stated that “every primitive tribe retains some vile animal habit not yet eliminated in the upward march of the race.”¹¹ He was also the vice president of the First International Eugenics conference.

His defenders state that he had the same beliefs as any Edwardian. According to them, what he said about Latin Americans was a joke, and the one about Indians was in reference to a particular event, the Canadian government not permitting the ship Komagata Maru to unload its passengers from Punjab, in British India, who were trying to circumvent the new Canadian immigration law.¹² Even if one believes the first two excuses, it is hard to swallow the explanation that his extremely crude statement about deaths in the “coloured ward” was an attempt to support the woman physician who was in-charge when six patients died overnight, and no one has tried to explain away his statement about indigenous people.

The chasm between those who find nothing of merit in these individuals and wish to have any mention of them deleted from our history and those that believe that anything unsavory in their careers should be whitewashed because of their substantial contributions is too great for a compromise. Regardless of which side of the great divide one lands on, there is a lot to be learned from their actions and statements.

 

References:

1. Eisgruber CL (2020): President Eisgruber’s message to community on removal of Woodrow Wilson name from public policy school and Wilson College. By the Office of Communications. June 27, 2020.
2. Ghiglione L (2020): Commentary: Northwestern’s connection to the Sand Creek massacre and a call for a national week of mourning. Chicago Tribune November 27,2020.
3. www.yale.edu/about/history.html
4. Doctor G (2017): The Indian history of the racist, slave-trading Yale university founder. Scroll.in February 15, 2017.
5. Pavilonis V (2020): “Cancel Yale”? Not likely. Yale News June 28, 2020.
6. Gordon, JS (1999): “Philanthropist”. American Heritage 50(3): 68.
7. Ojanuga D (1993): The medical ethics of the ‘father of gynaecology’, Dr. J Marion Sims. J Med Ethics 19(1):28-31.
8. Wall LL (2006): The medical ethics of Dr J Marion Sims: a fresh look at the historical record. J Med Ethics 32(6):346-350.
9. Wall LL (2007): Did J. Marion Sims deliberately addict his first fistula patients to opium? J Hist Med Allied Sci. 62(3):336-356.
10. Motion regarding the eponyms of Sir William Osler— motion relative aux éponymes de Sir William Osler (2019): MEDICAL STUDENTS’ SOCIETY of McGill University-L’ASSOCIATION des ÉTUDIANT(E)S en MÉDICINE de l’Université McGill December 2, 2019. Available: www.mcgillmed.com/wpcontent/uploads/2017/09/Motion-regarding-the-eponyms-of-Sir-William-Osler-2019
11. Persaud N, Butts H, Berger P (2020): William Osler: saint in a “White man’s domain” CMAJ November 9;192:E1414-6. doi: 10.1503/cmaj.201567
12. Bryan CS (2020): Sir William Osler, eugenics, racism, and the Komagata Maru incident, Baylor University Medical Center Proceedings, DOI:10.1080/08998280.2020.1843380

 

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JAYANT RADHAKRISHNAN, MB, BS, MS (Surg), FACS, FAAP, completed a Pediatric Urology Fellowship at the Massachusetts General Hospital, Boston, following a Surgery Residency and Fellowship in Pediatric Surgery at the Cook County Hospital. He returned to the County Hospital and worked as an attending pediatric surgeon and served as the Chief of Pediatric Urology. Later he worked at the University of Illinois, Chicago from where he retired as Professor of Surgery & Urology, and the Chief of Pediatric Surgery & Pediatric Urology. He has been an Emeritus Professor of Surgery and Urology at the University of Illinois since 2000.

 

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