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Elizabeth Blackwell had an extraordinarily perfect feminist upbringing, unusual (although by no means unique) for a nineteenth-century girl. She was born on February 3rd, 1821 in Bristol, England, third daughter in an eventual family of nine children. Her father, Samuel Blackwell, was in the sugar-refining business. He believed fiercely in equality of every sort – for the workers, for slaves and for women. His own father had been a tyrant who had treated women as serfs but Samuel had rebelled against this very early. His own wife, Hannah, was treated with respect and deference and his daughters – Anna, Marian, Elizabeth, Emily and Ellen – were given the same opportunities as their brothers – Samuel, Henry, Howard and George – to develop their individual personalities. There were also four maiden aunts who lived with the family and enjoyed Samuel Blackwell’s generous patronage and tried his patience to its full extent.
From her earliest days Elizabeth remembered being drawn with her father into agitation for the abolition of slavery and being far more interested in debating this issue than in following any of the traditional girlish pursuits. The maiden aunts disapproved of their nieces’ preoccupations with what they thought of as “unfeminine” affairs. They complained that the girls had no interest in sewing or housekeeping, and they also complained about how they were dressed in practical, unadorned clothes. (So, as a matter of fact, did the girls themselves – Anna hated “the ugly and often shabby things we were made to wear from a mistaken notion that dressing us badly would keep us free from vanity”.)5 But Samuel had his own ideas about the upbringing of his daughters and he stuck to them. As far as he was concerned, girls were as much part of the community as boys and their voices ought to be heard equally.
In 1832 the Blackwell family emigrated to America. The reasons were to do partly with anxiety over the state of the sugar business and partly with letters from a friend who had already gone to America and was urging Samuel to join him. Elizabeth, aged eleven, remembered later the excitement of the voyage over on the Cosmo but her sister. Anna remembered the horror of it “so hideous were those horrid, stinking, filthy holes . . . what a dreadful experience was our 7 weeks and four days of misery in that floating hell!”6 Once in America, the entire Blackwell family (which included not just the aunts but other assorted relatives) settled in New York City, and Samuel hired a sugar house. Elizabeth was sent to what she described afterwards as “an excellent school”. Naturally, now that they were in America, the Blackwell family interest in the abolition of slavery became even more pronounced. Their house became one of those in which escaped slaves sheltered on their way to Canada and freedom, and Samuel even wrote a book on anti-slavery rhymes which was published. Elizabeth joined the Abolitionist Vigilance Committee, the Anti-Slavery Working Society, the Ladies Anti-Slavery Society and the New York Anti-Slavery Society. The highlight of her adolescence was attending a convention with her father and staying behind to shake the great abolitionist Lloyd Garrison by the hand. She felt she was living in “exciting times” and all that dimmed the excitement, at that stage, was faint worries about her father’s prosperity. At first, Samuel seemed to be successful but then the great New York fire of 1835 destroyed his sugar house. It had been insured but the insurance company could not meet its debt and so, after he had sunk his remaining capital in a new sugar house, Samuel Blackwell was obliged to sit up every night guarding it against fire. Elizabeth sensed catastrophe, and in March 1837 she commented, “Papa condescended to inform Mamma yesterday that he had sold his . . . sugar house . . . What his plans for the future are we do not know, I suppose something about beets.”7 The house was suddenly full of masons working away but although “Papa is very busy with masons in the cellar . . . what he is doing or what his plans are for the future nous ne savons pas.”8
But they were otherwise happy, at least on the surface. It was not the present that concerned Elizabeth, aged sixteen, but the future. The future was a prospect she found rather unbearable whatever happened to her father’s business. She recorded in her diary that an uncle had offered her a hundred dollars a year to help look after his children but that she had turned him down.9 To her consternation her mother thought she ought to accept the offer, “Papa being so poor” but in spite of adoring and wanting to help her father she stoutly refused to. She loathed looking after children and resented the assumption that because she was female she must automatically like it. She also hated another common assumption – that all girls should be ladylike and behave in a docile, modest, demure fashion. She had not been brought up to it, nor had her sisters, but to her fury when men criticized her manner her sisters rebuked her. “Marianne seemed particularly displeased with me and said I behaved in the same manner to every gentleman . . . to all this I could only say that I wished they would point out the faults of which I was guilty and until then I should most certainly behave in the same manner as I considered it perfectly proper.”10 This manner was to be bold, outspoken, casual and off-hand. It meant, as Marian well knew, that Elizabeth would gain no suitors and if she had not suitors she would not marry and if she did not marry – what?
It was the common dilemma of the age and Elizabeth was not oblivious to it. Another day of taking her uncle’s children out moved her to write in her diary “I wish I could devise some good way of maintaining myself but the restrictions which confine my dear sex render all aspirations useless.”11 Her father’s business declined and the one servant the family had was dismissed. The girls agreed to take turns, week about, doing her work. “This is my day for seeing to the meals . . .” wrote Elizabeth on June 7th, 1837. “I really do hate the employment and look with real dread to my week for work . . .”12 What she dreaded even more was that kind of existence going on forever with no prospect of change. When her father announced they were all moving to Ohio, where he thought he had a good business opening, she at first welcomed the news as being at least some kind of activity to break up the “dearth of incident”. The move to Cincinnati, down the Ohio river, was made in May 1838. The family, with two of the four aunts, travelled in a canal boat which Elizabeth described as “stuffed full of Irish women with whole trains of squalling dirty children.”13 Once in Cincinnati, the excitement she had felt rapidly evaporated. Nothing, after all, had changed. The daily régime was still the same, except she now gave music lessons, and her father was still worried. He was also ill. At the beginning of August he had an attack of fever which with alarming speed developed into real delirium. “We all stood round his bed that night,” wrote Elizabeth on August 6th, “with the most intense anxiety . . . he was seized with a fit of excessive restlessness . . . Oh twas distressing to behold.”14 On the 7th, he died.
Elizabeth was stunned. She wrote in her diary “never till my dying day shall I forget the dreadful feeling . . . what a feeling of hopeless despondency came over me . . . I felt as if all hope and joy had gone and nought was left but to die also . . .”15 But as well as the agony of real grief there was horror at how the family would be able to live. On the 10th, after the funeral, Elizabeth wrote that they had twenty dollars left. The only thing to do was open a school, which they did on the 27th, at nine o’clock in the morning. They also had “a grand shift round” of bedrooms to make way for boarders. The little school was quite successful but Elizabeth was glad to get thirty dollars from an old-clothes man she had asked to call. She could hardly bear the thought of the family income being dependent forever on running a school and was always on the lookout for other ways of earning money. But none appeared. By October, after a bare six weeks of teaching, she was writing, “Oh for a lodge in some vast wilderness far away from children.”16 She found the girls she taught sullen and impertinent and ungrateful. In December “we had the girls down to dance thinking it would please them but they came down in the most sulky temper and Anna had to force them to stand up. Oh, the delights of a boarding school.”17
The next few years were bitter ones. Elizabeth missed her father dreadfully and, although she and Anna and Maria
n took pride in supporting the family, she hated teaching, confessing she thought herself “rather a deficient teacher”. In 1839 she was eighteen and even more restless than she had been in New York. To her annoyance, her mother “seriously advised” her to “set my wig at Mr S.G.” She and Anna had “a talk on matrimony. She fully intends courting somebody if a better does not turn up. I really could not help crying upstairs when I thought of my situation. I know it is very wrong to be so ungrateful and I try very hard to be thankful but when I think of the long, dreary years ahead I cannot always help it.”18 The thought of marriage was obnoxious but again and again she and Anna discussed it because “we are so sick of schoolkeeping.” In March she wrote she was “sick and impatient of my scholastic duties” and by the time school was over each day she was “almost distracted”. Surely anything was better, even if that anything was marriage. But when she took a drive with a Mr Smith, whom she seems to have liked, she got “some insight into his character. He has evidently always associated with low people . . . so many little instances betray his commonness of mind which convince me he would not suit me.”19 The disappointment contributed to “a terrible fit of crying in church”. In desperation, Elizabeth tried to develop new interests. She began to learn how to make wax flowers but although she managed a rose she never progressed to a carnation. Anna, meanwhile, had had a brilliant idea: why should not one of them go to England as governess with some friends they knew who were about to set sail? The thought of England made Elizabeth’s heart beat faster – “I could fancy myself already on the ocean with the foam and the blue waves dashing around us.”20 But she did not go. Instead, she turned to religion, joining the Episcopal church (the Blackwells had always belonged to a Congregationalist sect rather like the Quakers). For a while, her sense of frustrated ambition seemed to wane a little. If she was not content she was at least not so ragingly discontented.
The time had come, in any case, for a change. Three of the Blackwell boys were by 1842 old enough to take over from their three elder sisters as breadwinners. They went into the milling business and earned enough to support the family. The school, which had not been doing well, was closed. In 1844 Anna went off to a teaching job in New York and Elizabeth, though regretting the necessity of sticking to her last, departed for Henderson, in Kentucky, in the same capacity. She was to teach in a small girls’ district school for four hundred dollars a year. The experience was disastrous. She hated Henderson, which she wrote consisted of “three dirty old frame buildings and a steep bank covered with mud.”21 The people were dreary beyond belief and her sense of justice was continually outraged by the daily evidence of how the negroes lived and were treated. She felt she had come from civilization to a savage place. She was an object of great curiosity to the inhabitants and reported that inquisitive gapers even peered into her face and commented, “Well, I do declare she’s got a clean mouth, hasn’t she!”22 Above all else, she resented the lack of privacy – “I, who so love a hermit life for a good part of the day, find myself living in public and almost losing my identity.”23 Before she lost it entirely she gave up and went home.
Here, she again faced the problem of her own boredom. She had plenty of interesting people to talk to once more and plenty of societies to belong to but her feelings of isolation and despair were as strong as they had been in Henderson. What she wanted was some “real work”, some “hard challenge”. There was no need for her to rebel, no cause to sigh for understanding from her family. They understood, unlike so many nineteenth-century families, but what they could not do was provide an answer. What she wished to do was hidden even from herself. She was suffering, as she left adolescence behind, from that common feminist dilemma: she could see what her life was meant to be like but not what it might be like. Her one strength was that, unlike Caroline Norton and so many others, she was not duped by the promise of marriage changing her life. She viewed marriage with a cold, clear eye, managing to separate the attractions of the flesh from the reality of the marital condition. Far from not being susceptible to men she maintained she was always falling in and out of love but that she saw “What a life association might mean and I shrank from the prospect, disappointed or repelled.”24 Her “bodily urges”, about which she was remarkably frank, disturbed her. She felt they might prove “a fatal susceptibility” and tried to starve herself into losing them. It never occurred to her, of course, to go ahead and satisfy them outside marriage, nor did she reason that because she felt them she had an obligation to “nature” to see they were fulfilled. But by the time she was twenty-three, in 1845, she was feeling “the want of a more engrossing pursuit than the study of music, German and metaphysics and the ordinary interests that social life presented.”
One day, Elizabeth went to visit a friend of hers who was ill. Visiting friends who were ill was in fact one of the main afternoon occupations of ladies of her time and she counted herself fortunate to be extremely healthy. If she even had a headache this was so surprising that it would feature in her diary and be remarked upon as extraordinary. But the majority of her contemporaries and their mothers were ill almost continually with one sort of minor ailment or another, half of them unmentionable. A huge number of these illnesses fitted into a category labelled “uterine disorders”. The most common of these disorders was “uterine catarrh” which, according to one medical expert of the time, kept a quarter of the female population in bed for half their lives. Elizabeth’s friend, whose name she did not record, had an uterine disorder of a grave nature. She was in great pain and knew she was dying. She told Elizabeth that if only she had had a woman as a doctor her sufferings might not have been so great because she might have been able to report symptoms early on that she had simply been too embarrassed to mention. “You are fond of study,” Elizabeth reports her as saying, “you have health and leisure; why not study medicine?”25 The very thought appalled Elizabeth and she said so. Then, soon after, the friend died and Elizabeth found herself haunted by the suggestion made so sadly and wistfully. Half the attraction was the sheer originality of the idea and the other half the obvious usefulness. Hadn’t she wanted “real work” and some “hard challenge”? Slowly, slowly the notion of taking up medicine grew no matter how often she reminded herself of her natural repugnance towards disease and all it entailed. Hadn’t she always hated biology, hadn’t the sight of “a bullock’s eye on its cushion of fat” disgusted her? Wasn’t she unfit to study medicine? Almost in an attempt to close the matter Elizabeth wrote off to several well-known doctors asking for their opinion of a woman trying to qualify as a doctor. Their opinion was unanimous: quite impossible but a very good idea, because there was undoubtedly a great need for women doctors.
This verdict reflected the general concern with women’s health felt at the time. Throughout America female invalidism seemed endemic. Catherine Beecher, who carried out a survey in 1835, was not unduly astonished to discover that very few women seemed to think they enjoyed good health. This was hardly surprising as so few of them led healthy lives. The middle-class woman was encouraged to think indolence desirable and the working-class woman was worked brutally hard. All of them wore clothes ruinous to activity. The average woman had a dress with fifteen to twenty pounds of material hanging from a severely constricted waist under which were the notorious whalebone corsets. It was hard to do anything but walk sedately, but then to be sedate was part of being feminine and feebleness was another. With physical activity curtailed or disapproved of and mental stimulation thought harmful the middle-class woman was often driven, through sheer boredom and inactivity, into “hysterics”, so called because this was put down to the behaviour of the uterus. A Dr Robert Barnes declared that “all nervous disorders are caused by ovario-uterine disorders”26 and he was overwhelmingly supported. The remedy was even more of that rest and quiet which had produced the condition in the first place. Either that, or surgery.
Gynaecological surgery was literally murderous. In 1835 a Dr Sims, who was a pioneer in modern
gynaecological surgery said that when he began practising “doctors were killing their patients.” The ways in which they killed them were various but one of the commonest was to follow surgery by the application internally of leeches. The doctor was instructed to count the leeches in case they crept into the uterus itself and stayed there, sucking away. One doctor remarked, “I have scarcely ever seen more acute pain than that experienced by several of my patients under such circumstances.” Then there was cauterizing the vagina with all manner of poisonous solutions and perhaps worst of all clitoridectomy, performed as a cure for masturbation. It was hardly surprising that women preferred to suffer in silence, or rely on home remedies, nor was it surprising that they came to regard the female parts of their body with fear. The tragedy was that few women knew how their own bodies functioned since they were rarely taught the true facts of menstruation and pregnancy (and these facts in any case were not then properly established). When a book entitled Female Physiology was published in 1854 as an attempt to provide a handbook for young ladies the reviewer in the British Lancet was outraged – “What? Is it to be tolerated that a medical practitioner, a man above all others who should be imbued with modesty . . . shall unblushingly give to the ladies . . . drawings of the vagina, uterus, spermatozoa, various stages of labour etc . . . I was nauseated by the task of perusing this offensive volume.” So women were kept in ignorance and learned about themselves only by experience. Modesty and delicacy kept them prisoners of this ignorance even when they had gained some experience – anything out of the ordinary, anything differing from what their experiences had taught them to expect, was worried about and whispered about with their friends but very rarely discussed with a doctor, until, as in the case of Elizabeth’s friend, the pain or the bleeding or the swelling grew too great to be hidden. And by that time it was usually impossible even to alleviate suffering, never mind preserve life.
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