Significant Sisters

by Margaret Forster

  The return to America, in August 1859, was something of an anticlimax. In England, Elizabeth Blackwell felt at the centre of things, she felt permanently excited by the possibilities in front of her, but in America she was restless and impatient. This was odd because she had achieved so much there. What seemed to be the trouble was that she was no longer in harmony with Emily, Maria and their small circle whereas she felt she was with her friends in England. Towards Emily in particular she had ambivalent feelings, admiring her skill as a surgeon but quite naturally feeling envious because she had been unable to realize her own ambition. Emily, in fact, was thinking of giving up medicine which placed the future of the Infirmary in jeopardy. However much she wanted to go and settle in England, Elizabeth could not in all conscience do it. She wrote to Barbara Bodichon explaining she felt she had to stay another three years in order to see the work she had started thoroughly completed, which it would not be until a Medical School for women was established as part of the Infirmary. “The fact is,” she wrote, “that until women have a very large experience their consciousness will stand in their way and they will either be less reliable or more reliable physicians than men – for when the conscientiousness is properly supported by thorough culture and a very wide practical experience then they will become the better physicians – they will never I think stand on the same level. Now, it is our problem how to reach this higher level for let us once reach it and it will not be conquered only for ourselves.”45 The Infirmary was “indispensable” for this purpose. She explained what she meant to Barbara by describing most graphically a case that had happened the week before which normally, as still relatively inexperienced women, she and Emily would not have dealt with. “. . . We had a case of convulsions, high application of the forceps and perforation of the cranium – one of the most formidable complications of obstetric surgery. Now, in private practice, the case would have been instantly taken out of our hands but here our kind consulting surgeon stood by and I supported Emily with all my power and she had a grand experience accomplishing it all herself – and the woman is getting well.”46 Even if the patient had died Elizabeth thought one life worth the experience – “If we kill a few it does not matter,” she maintained, “the authorities receive our certificates without question . . . and then we are really not as bad in the killing line as the male hospitals.”47 But the hospital was by no means established enough and she felt she simply could not leave while that obliging male surgeon was still necessary to supervise Emily and while others were not being trained on the premises to join her. “We have resolved,” she wrote, “to make this a test winter.” If the test was passed and the 50,000 dollars raised to start a training school in the hospital then she was going to urge “Miss Garrett or some other English girl” to come over.

  By the spring of the following year, 1860, the “test winter” was safely over. A subscription list had been officially begun to endow a medical school, a house at 126 Second Avenue had been bought for use as a hospital and dispensary, and several student doctors had begun studying at the hospital as well as acting as assistants. In addition, a nurses’ training programme had been established. The outbreak of the Civil War then diverted Elizabeth’s plans. She naturally was anxious that women doctors should now show what they were made of and, of course, all her life-long sympathies were with the side of emancipation. A meeting was held at the Infirmary and Elizabeth became chairman of a Registration Committee responsible for all matters to do with training and despatching nurses to the war fronts. She was furious to discover that the United States Army was hostile to female nurses and doctors and wrote to Barbara Bodichon that “we soon found that jealousies were too intense for us to assume our true place.” Her contribution was not as great as she would have liked it to be but now, more than ever, she felt she could not abandon America, so she contented herself during the next seven years with only one quick trip to Europe. It took until 1868 before the Infirmary Medical School was opened and she felt free to leave it and to go home to England possibly for good. But she did not see her departure as in any way severing her connection with pioneer work. “I am coming,” she wrote, “with one strong purpose in my mind of assisting in the establishing or opening of a thorough medical education for women in England.”48

  Elizabeth arrived in July 1869, determined to get properly settled before sending for Kitty. Unfortunately, she found it impossible to do any settling at all without Kitty. “You can help me so much,” she wrote, “by taking charge of my things and telling me where they are; and reading and occasionally stitching for me and doing errands and keeping my rooms in first rate order and above all loving me very much.”49 Kitty arrived in August 1870 apparently flattered and not daunted by what was demanded of her. In fact, she did not like England very much. As well as trouble with her eyes (which had begun when she was ten) she had also grown increasingly deaf which prevented her making new friends with ease. She was shy and reserved by nature and used to taking a back seat so this deafness doubled her social handicap. Elizabeth did nothing to help her overcome it although she was always solicitous about Kitty’s health and did her best to improve it. But she treated Kitty as a man would his wife. Kitty’s role was to love, honour and obey without complaining – and Kitty never complained. Patiently she put up with all the moving about as Elizabeth searched for her ideal home. No sooner did she organize their household in Upper Norwood than they were back in Central London and then very soon in Swanage with trips to Europe in-between further to complicate domesticity. These trips were to benefit Elizabeth’s health which, in her forties, showed signs of cracking. She began to suffer from continuous chills and fevers and alarming attacks of colic. Kitty wrote home to an American friend that she preferred being in France or Switzerland because London had little appeal. “I can’t go to parties but that’s no great loss . . . very often Aunt Bessie is out in the evening . . . in which case I am left alone . . . the evening is soon over and I go to bed . . . As I don’t know anyone to visit in London I can’t send you an account of anything very likely.”50 Luckily, Elizabeth had decided London was not for her anyway and began househunting on the south coast. It took her a long time to find what she wanted but in 1879 she and Kitty (and Marian) became “settled” at Rock House in the old section of Hastings. This became their home for the rest of Elizabeth’s life.

  But they were rarely in it for long. Elizabeth’s career had taken a new direction which meant she was always rushing off to committees and meetings in a wide variety of places. Although she had worked hard at it she had not quite managed to achieve that position she desired as unchallenged leader of the movement to open up the medical profession for women in England. She was looked up to, of course, and consulted and involved in most plans and projects on the subject but she did not become an absolute authority. She did not practise medicine herself and was not at the centre of the agitation. Nor, slightly to her distress, did she find she occupied the social position she had anticipated. Barbara Bodichon and her circle were still her friends but they could not automatically give her the standing she sought. But with good sense she began enlarging her interests and embarked on a social reform programme which kept her as active and lively as she had always been. The power of women to do good still obsessed her and she decided that she ought to set down all her ideas on the subject in a book. This became Counsel to Parents on the Moral Education of their Children which finally appeared in 1879. She wrote it, with some excitement at her own daring, during one of the continental tours she made for her health with Kitty. Kitty was, for once, indignant that she was not allowed to read what Auntie was writing because she was unmarried.

  In fact, Counsel to Parents, in spite of Elizabeth’s claims, was not exactly thought explosive even at the time, although she went on maintaining it was. True, several London publishers declined to print it on the grounds (according to Elizabeth) that it was too outrageous but sister Emily when she read it could not see what all the fuss had been about. Emily
thought it a bit dull and certainly tame enough to read aloud in mixed company. She commented tellingly, “It is simply a plea for purity in life in both sexes.” It was slightly more than that. According to Counsel to Parents sexual activity began at too early an age and this damaged moral development. “This life of sensation will . . . obtain a complete mastery . . . if Reason does not exist and grow into a controlling force.” So it must be curbed. But remembering her own “life of sensation” Elizabeth wrote emphatically that girls as well as boys had “a natural passion” and that there must be a single standard of sexual morality for both. She scorned the prevailing doctrine that ladies did not experience sexual sensations and stressed that mothers should develop and not try to halt the sexual instinct in their offspring. Sex, she emphasized, was noble and should be venerated, not turned away from in disgust. But in spite of striking this blow for feminism Counsel to Parents was extremely vague and unhelpful as to how mothers were meant to carry out the author’s instructions. Elizabeth seemed to imagine that she had fulfilled a promise to Lady Byron that, where sex was concerned, “mothers’ . . . attention should be firmly grasped and facts laid before them which could not be forgotten.”51 She was delighted when it was favourably reviewed and felt that her ideas would now permeate throughout society as she had always wanted them to.

  She had begun to further her aims in another way too. Realizing that unless the very grassroots of society were reached social reform through the action of mothers would never happen she had begun, in 1871, a National Health Society. This focused on her passion for hygiene and sanitary care which she wanted to spread throughout the land. A phrase was coined – “Prevention is Better than Cure” – which it was hoped would help to combat bad living-conditions in poorer homes. Always ambitious, its founder saw the society opening branches all over the country and officers of the society visiting them to lecture mothers on how to keep a clean home. Eventually, though this target was not reached, Elizabeth had the satisfaction of seeing the society inhabit headquarters in Berners Street and functioning without the need of her personal energies. These were greatly stretched in the next decade. Kitty became quite concerned at the amount of work Auntie took upon herself with such zeal. “She has been elected on the Council of the National Vigilance and also on its Parliamentary sub-committee . . . she also has the Branch of the National Vigilance here to look after. Just now the question of Poor Law Guardians is up – they want Auntie to stand . . .”52 It seemed that the single-mindedness of Elizabeth’s early days had gone – she jumped from one topic to another so that Kitty was dizzy trying to keep up. And yet, throughout all this feverish activity, there was a certain consistency of outlook. Elizabeth’s views on society hardly changed at all. She was still emphatic that a woman’s influence was pure, that her role was maternal. Over and over again, in different guises, she stressed that those qualities most natural to women were “tenderness, sympathy, guardianship.” And yet, at the same time, she rejected woman’s subservience to the male. Women were much more important than men and potentially much more powerful. It was a potential she wished them to fulfil.

  The remaining decades of Elizabeth’s long life were filled with an extraordinary mixture of causes, all taken up and applied to with tremendous enthusiasm. Christian Science, spiritualism, anti-vivisectionism, rabies treatment and psychology all at one time or another dominated her thoughts. She also took a strong interest in local Hastings politics and in co-operative farming, not to mention agriculture as a career for women. Continental travel took up a lot of her time, very pleasantly, and so did supervising Anna who continued to live outside Paris and became increasingly eccentric. Anna had become convinced she knew where the lost treasure of King James II of England was buried and was always trying to dig it up (she also thought the startled Kitty was the reincarnation of Captain Kidd). But in spite of all this hectic activity Elizabeth began at last to have intimations of mortality in her eightieth year. She found, to her annoyance, that walking to the top of the hill on which Rock House was situated exhausted her. In 1907, aged eighty-six, she had a fall which confined her to bed, and in 1910 a stroke. Kitty, aged sixty-two struggled to make her comfortable but Elizabeth was paralysed and unable to speak. On May 31st, six days after the stroke, Elizabeth Blackwell died. She was buried at Kilmun in Scotland, a place she and Kitty had visited on holiday and to which she had been greatly attracted. Kitty returned to America in 1920 and died in 1936. Very near the end Kitty quoted Tennyson’s lines –

  “O that ’twere possible

  After long grief and pain

  To find the arms of my true love

  Round me once again.”

  And she explained that by her true love she meant Dr Elizabeth.53 Her ashes were sent to Kilmun and placed in the same grave with Elizabeth Blackwell.

  * * *

  The diaries and letters of the late eighteenth and of the nineteenth century are filled to capacity with the frustration the female sex felt at their lack of options. There seemed so little choice and what choice there was seemed so narrow. The woman who was satisfied with her lot was fortunate and exceedingly rare. Even if allowance is made for the fact that discontent finds its way quicker to the page than contentment, the evidence is still overwhelming: women felt confined and trapped by their destiny. The happy wives and mothers whose self-fulfilment lay in domesticity anyway were lucky, but even then luck was not always with them. They too experienced ennui and exhaustion faced with the unrelenting nature of their daily timetable, which is why so many of them turned to “good works” to give some other meaning to their lives. But for a great mass of women “good works” did not provide an answer. Doing good to the poor only emphasized their own uselessness. What they wanted, as Elizabeth Blackwell wanted, was “something hard”, some “hard challenge”, something structured and disciplined to which they could apply themselves. This is what entry into the professions gave them.

  The important point for feminism about this entry was how it was done. There was nothing, before Elizabeth Blackwell, to stop any woman from practising as an unqualified doctor. Harriot K. Hunt started practising medicine at the age of thirty in Boston in 1835 after trying repeatedly to get into Harvard Medical School. She studied on her own and gained some experience from accompanying friendly male doctors and then she set herself up in practice in spite of her lack of formal training. She was remarkably successful and built up a good practice of female patients and their children but the fact that, even as late as 1847, she was still re-applying to Harvard showed that she was under no illusions about her status. She was one of a few isolated examples who would always be regarded as freaks however successful they were. They were the exceptions who served simply to keep the rules rigid. The point about Elizabeth Blackwell’s career was that it proved there was no justification for regarding women doctors as freaks. Clearly, after her, it could no longer be argued that no woman could survive a medical training or pass through examinations and practical tests. The minute she had breached the wall of prejudice there were scores, literally, of others who were ready to follow her and the infuriating thing was that these others all seemed to possess Miss Blackwell’s own determination and ability. From the beginning, the women did spectacularly well and more than kept up with their male counterparts. Any girl entering on a medical career was (and still is) a choice candidate but even so the authorities were genuinely startled at the way they swept the board in examination after examination. It was this sort of outrageous success which made the male medical profession so hostile. The women dared to lack humility, that was the trouble. And this in turn presented feminism with a new problem.

  In England, the problem was particularly acute. Although Elizabeth Blackwell herself had registered with the General Council of Medical Education and Registration in 1858 no other British woman could do so because from 1860 the rules were changed: now no one without an English medical degree could register and this was impossible because the English universities still ex
cluded women from admission. Elizabeth Garrett, whom Elizabeth Blackwell had inspired, only obtained a licence to practice (in 1865) by qualifying for the diploma of the Apothecaries Society and then had to obtain her degree in Paris. The battle had to be fought and won, by Sophia Jex-Blake, all over again. It was not until 1876, after the parliamentary bill permitted universities to grant women degrees that the teaching hospitals were persuaded to accept women students. The unpleasant truth was that the male sex as a body had been proved to be unscrupulous. They did not hesitate to change their arguments as soon as they were convincingly demolished, and this became a problem for all feminists. Cunning was shown to be vital if women were to be admitted to every profession – it was simply naïve to imagine that once the male authorities saw women could follow the men successfully then they would concede they had been wrong to bar them. On the contrary, they would not admit it proved anything of the sort and instantly sought other ways to keep women out. What women learned in this first battle of the professions was that success could be fatal. It was better to proceed softly, softly, than to aim a knockout blow.

  This took some doing. Women of the calibre and with the temperament of Elizabeth Blackwell were not good at such a technique. It was humiliating. There were many women who argued that this should not have to be put up with, that men should not be allowed to humiliate them – why bother with their exams and tests and degrees, why not set up their own branches of the professions? But Elizabeth Blackwell knew this would be disastrous. Women wanted to be doctors not something different called a woman doctor. What kind of species would that be? No one would know, nor would the vast majority wish to find out. It was not just pride which made her want to follow the same medical course as men but that visionary sense with which all the early feminists were touched. She thought all the time of the future, and of this future for the whole of society. Nothing was done for herself alone, to remedy her own dissatisfaction. What she did she did because she felt there was something out of joint in society and she wished to put it right, and in particular put it right through women entering medicine.