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L. Lewis Wall Interview

Wall-LewisThe J. Marion Sims Lecture is presented annually at PFD Week to continue to educate today’s gynecological surgeon about the importance of supporting and encouraging innovation within women’s health.

This year's speaker, L. Lewis Wall, MD, DPhil, granted AUGS an interview. Read his responses below and be sure to not miss his talk, Vesico-Vaginal Fistula: Historical Understanding, Medical Ethics, and Modern Sensibilities, on Friday, October 6 at 9:00 a.m.

Q: We are looking forward to hearing you speak at PFD Week. Tell me why it is important for medical professionals to discuss the research ethics of Dr. J. Marion Sims.

Dr. Wall: The work of J. Marion Sims is important for urogynecologic surgeons because he was a surgical innovator, and surgical innovation is an area which continues to confront ethical issues in modern practice--especially, for example, with respect to the widespread use of vaginal mesh in prolapse surgeries and the numerous catastrophes which has resulted from the uncontrolled experiment.

The specific issues are different in time and space, but many of the underlying problems remain. From the standpoint of historical research, much of what has been written about Sims in the last 40 years is superficial, inaccurate, distorted, and taken out of context, so from a purely intellectual point of view, it is a fascinating historical research project. Understanding the issues that Sims faced in his time and the challenges they presented, may give us the opportunity to reflect on similar issues (in a very different context) in our own time.

Q: How did you become involved in medical ethics and researching J. Marion Sims?

Dr. Wall: I have been interested in medical ethics for a long time. That interest heightened while I was on the faculty at LSU in New Orleans in the 1990s, a department that went through a major ethical scandal involving allegations of insurance fraud and unethical behavior on the part of certain faculty members. I subsequently became interested in the ethical issues surrounding surgical innovation and obtained a master's degree in bioethics from Monash University in Australia.

This all occurred around the same time that I began traveling to Africa regularly to be involved in various fistula projects. Since I have a longstanding interest in the history of medicine (my undergraduate degree is in history), I started looking into the work of J. Marion Sims, and soon encountered the current controversies about his early surgical operations, a subject with which I have been engaged for many years now.

Q. What projects are you currently working on related to improving programs and training to support women with vesicovaginal fistulas?

Dr. Wall: I am currently engaged in a number of activities related to obstetric fistula. I have just completed a book entitled Tears for My Sisters: The Tragedy of Obstetric Fistula, which will be published by the Johns Hopkins University Press in late 2017 or early 2018.

I have several fistula-related journal articles in press in collaboration with a number of co-authors. I continue to be active in the Worldwide Fistula Fund in supporting the Danja Fistula Center in Niger, which opened in 2012, as well as working with a Ugandan NGO called TERREWODE to open a new specialist fistula hospital in Soroti, northeastern Uganda, within the next three years.

I also am engaged at various levels with the International Fistula Alliance, the partnership of international trusts that supports the work of the Hamlin fistula hospitals in Ethiopia (including the urogynecology fellowship program there).