On a cloudy afternoon on October 19, 1927, as a chilly autumn wind swept
down off the Blue Ridge Mountains, rattling the windows of the infirmary
at the Virginia Colony for Epileptics and Feeble-minded, Dr. John H.
Bell jotted a few notes about an operation he had performed earlier that
day. He was the superintendent of this sprawling institution, a campus
of regimented brick dormitories and rolling farmland set amid the bluffs
overlooking Lynchburg, and one of the country's finest. The morning's
procedure was simple, and dozens of such operations had taken place here
over the years. But for this patient he wrote with particular care,
since it was a case that might draw a bit of attention.
"Patient sterilized this morning under authority of Act of Assembly in
1926, providing for the sterilization of mental defectives, and as
ordered by the Board of Directors of this institution," he wrote. "She
went to the operating room at 9:30 and returned to her bed at 10:30,
recovered promptly from the anaesthesia with no untoward after effects
anticipated. One inch was removed from each Fallopian tube, the tubes
ligated and the ends cauterized by carbolic acid followed by alcohol,
and the edges of the broad ligaments brought together with continuous
suture. Abdominal wound was united with layer sutures and the
approximation of the closure was good."
The patient lying before him on the operating table that morning was
Carrie Buck, a plump, twenty-one-year-old woman who had been under his
care at the Colony for over three years. He knew her well. On the day
she was admitted, he had been the first to examine her, and he took
special note of her dark eyes and slight features, her low, narrow
forehead and high cheekbones. He would see her in the Colony's
cafeteria, where she was assigned to work, and his words to her were
usually cordial and kind. Yet during most of this time, Dr. Bell and
Carrie Buck had been, in name at least, legal adversaries.
So, as he finished his surgical report, he decided to add another formal
comment: "This is the first case operated on under the sterilization
law, and the case was carried through the courts of the State and the
United States Supreme Court to test the constitutionality of the
Virginia act, and an appeal before the Supreme Court for a rehearing
recently having been denied."
It was a momentous day. It had taken over three years to test and
litigate Carrie's case, but less than an hour to cut and ligate her
Fallopian tubes. But for Dr. Bell, this operation was far more than a
legal victory. As a "test case," it had been a carefully orchestrated
lawsuit meant not only to sterilize Carrie against her will, but also to
protect a bold but controversial social policy he believed would improve
the welfare of the nation. Today was the beginning. It was cold, but
outside the window, beyond the white, two-tiered veranda on the front
façade of the infirmary, Dr. Bell could look out over the Colony and
consider the long battle he and other reformers had been fighting for
Beyond the veranda, the parallel rows of austere brick dormitories made
this state-run institution look something like a military camp, its
geometric precision imposing order on a vast Virginia wilderness, even
as magnolias and elms gave the Colony the gentle, pastoral feel of a
Southern plantation, peaceful and decorous, like Jefferson's Monticello
just hours to the north. Dr. Bell, too, had devoted his life, both as a
physician and a scientist, to building a more perfect land. Sterilizing
Carrie just may have been one of the most important things he had ever
done, and as he considered her surgery he may have even dared to think,
as a colleague would later tell him, that "a hundred years from now you
will still have a place in this history of which your descendents may
well be proud."
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