Forgetting the Medical Practice of Good Faith

Nossoh Diarra, Jacob Clarke, Georgia VanDerwater, Rachel Dems, Philip Cai, Dineen Vogler

The story of Fortune’s Bones, written by Marilyn Nelson, begins with a man named Fortune,who was enslaved by an orthopedic surgeon known as Dr. Preserver Porter. Upon Fortune’s death, his skeleton was used for anatomical study by Dr. Porter and subsequent generations. The disturbing examination of his body is believed to contribute to the progression of medical science. Not only was Fortune taken advantage of, his wife (Dinah) was forced to clean the room where Fortune’s skeleton hung. Fortune’s skeleton was eventually donated to a museum by a descendant of Porter. Both Fortune’s real name and story were lost as the name “Larry” had been engraved on Fortune’s skull. Giving Fortune an imaginary name because it made it easier to accept the magnitude of suffering that he went through. Nelson also mentions that Fortune was an image of herself, enabling her to connect and empathize with the pain that Fortune had to endure. 

The practice of studying medicine has historically sought to minimize, and sometimes even justify the consequent harm brought to individuals who were promised protection. Medical professionals reimagine themselves and their subjects as small contributors to an inevitable and beneficent system (medicine and science as a whole), to ease the conflict of bringing harm to a patient. To complete this reimagining, professionals often forfeit their own agency, as well as that of the patient, to a more abstract demand for knowledge. Though the identity of the medical professional is maintained, the identity of the patient is often obscured, or destroyed to make this reimagining easier. In context, this means that while professionals will be happy to take credit for medical discoveries, the individuals who sacrificed their autonomy in a very visceral way will be carelessly or intentionally forgotten for sake of ease.

Dr. Porter did not see Fortune’s body as the end of a human life; he saw it as an opportunity. When Fortune died, Dr. Porter dissected him. He took Fortune’s body, which he had forced to endure strenuous labor and continued struggle, and he cut it open because he wanted to. Nelson writes from Dr. Porter’s point of view in Fortune’s Bones, as he describes the act of cutting Fortune open, saying his body “falls open like a bridal gossamer” (19). This intimate metaphor is extended, as Dr. Porter begins to dissect Fortune’s body, saying “I enter Fortune, and he enters me” (22). This image connotes an air of equality, mutuality and consent. However, in reality, Dr. Porter was using Fortune’s body as a prop, slicing him into pieces, ripping his organs out of his body, leaving his bones to hang in the room Fortune’s own wife cleans. So why would Nelson’s Dr. Porter use language that implies he and Fortune were equals in this endeavor? He does so for the same reason he constantly repeats the phrase “and I am humbled by my ignorance, humbled by my ignorance” (22): to convince himself that he is not solely responsible for his brutal actions against Fortune’s body in death. If Dr. Porter can convince himself Fortune’s dead body is a willing participant in his studies, if he can convince himself that he is too ignorant to see the cruelty in what he is doing, if he can convince himself that he is merely acting in the good name of science, then he does not need to accept the gravity of what he is doing. He goes so far as to imagine Fortune as the agent of the dissection, not himself, stating “Here with begins my dissection of the former body of my former slave, which served him who served me throughout his life, and now serves the advance of science” (17).

The idea of autonomy can also be applied to science. Choosing whether or not to accept their own autonomy has been a common theme in our readings about medical professionals. Doctors willingly take credit for their contributions to the growth of the medical field but deny any responsibility for inflicting harm on black people at their expense. Among Medical Apartheid and Fortune’s Bones, both medical Dr. Sims and Dr. Porter strived for success in their work without realizing the reality and ethicality of their work on black people. Known as the “father of modern gynecology”, Dr. James Marion Sims conducted several horrific experiments and procedures on a group of enslaved women. Doctors had to hold back these women while Dr. Sims made incisions, without providing anesthesia to numb the pain. 

The story of Joice Heth is also another example of the pain inflicted on a Black person at the hands of a powerful white man. P.T. Barnum, a famous American circus holder, had bought the possession of an enslaved woman named Joice Heth. After her death in 1836, Barnum ordered a public dissection to be performed to determine the cause of death and sold tickets for the public to view. Shockingly, 500 spectators showed up to this gruesome event as a form of entertainment and ensured that Barnum’s fame would rise (86-94). At the expense of Heth, P.T. Barnum used her to benefit himself and dehumanized her as an easier way to justify his cruel intentions. He made excuses to himself and to Heth that this torture would be worth it because Heth herself would become rich and famous. Unsurprisingly, Barnum was the one who reaped the befits of his own cruelty, and Heth died penniless and stripped of her dignity and autonomy. Similar to Joice Heth, Fortune was also dehumanized as it was easier to refer to him as “Larry.” By naming him with a generic name, it removes any personal or emotional connection to the body and almost takes away from the consequences of the procedures implemented by Dr. Porter. Both examples show that it was easier for the white person to take advantage of the enslaved Black person through their delusional imaginations to justify their horrible actions.

In their stories, Nelson and Morrison both discuss the scientifics about eugenics to showcase how doctors can manipulate their patients for their own benefits. Specifically, in the novel, “Fortune’s The Manumission Requiem Bones”, Nelson explains how Fortune’s body is used as a tool. Dr. Porter, a renowned surgeon, undergoes several procedures where he experiments on Fortune’s body for any scientific evidence about his life. However, diving deeper into this scene, we are able to see that no matter how much examination is done, it is Fortune’s voice and spirit that can not be owned. In this particular scene, Nelson writes, “I am not my body, I am not my bones” (27). Here, we clearly see that Fortune’s is stating that he is not his body. The use of this repetition is important as it highlights Fortune’s identity. Although Fortune’s body is physically there, he is mentally gone. Who is his and who people will remember him by will be forgotten. 

Similarly, in her novel, “Home” author Toni Morrison discusses another doctor named Dr. Beauregard, who performed sexual experiments on Cece’s body and left her traumatized. We see how disturbing one’s physical body can affect them. Connecting this back to the thesis, individuals who sacrifice their bodies for surgeons are capable of being hurt near the end because they end up losing the most important thing to them, their identity.

Understanding just how medical professionals relinquish their autonomy to the pursuit of knowledge as an act of imagination in order to justify cruelty, we can begin to question the larger and urgent implications to essential concepts like autonomy, care, and accountability.

One of the more disturbing components of this analytical framework is its wide applicability; the fallacy that imagines inflicting harm as justified if in service of larger systems isn’t by any means exclusive. While our analysis focuses on the justification of harm in medical contexts, you can trace this narrative through a plethora of situations where those in power imagine they have no choice but to seriously hurt someone for the sake of furthering some abstract and beneficent pursuit or institution. In doing so, those of authority can justify any violence to themselves as well as the public. Medical professionals such as J. Marion Sims, who built his medical understanding of gynecology from inhumane experimentation on women that he enslaved, are largely afforded praise, attention, and reward while victims of medical brutalization sacrifice their bodies, and in many cases the simple dignity of their name. This rationale for cruelty does not only discredit individual accountability, it also degrades public faith in these beneficent systems.

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