VIEW FROM THE STUDENTS’ DORTOIR AT LA MATERNITé.
COURTESY DANIEL CLARKE
After lunch there followed another lecture, slightly more soporific after the wine, and then the hour for receiving visitors in the students’ parlor. Surrounded as she was by unseasoned girls with more enthusiasm than intellect—“we have every variety of temper,” she wrote, “like dry & wet gunpowder”—Elizabeth thirsted for a draught of Blackwellian conversation. Anna visited occasionally but was easily deterred by bad weather or another magnetic séance. More often Elizabeth skipped the closely supervised visiting hour in favor of a self-prescribed course of hydropathy: she took a bath, though there was no more privacy to be had there than anywhere else. Six tubs stood side by side in a double row, presided over by a wrinkled old woman who scolded the bathers in an impenetrable patois. Elizabeth created her own solitude by closing her eyes, submerging her ears, and imagining herself “deliciously reposing on the heaving waters of some soft summer lake.”
With each passing day, Elizabeth’s level of active experience rose vertiginously—and in the absence of English-speakers with whom to discuss her new knowledge, she poured the details of her daily life into letters home. “I have been handling leeches for the first time,” she wrote, “disgusting little things.” France was a leader in the farming of medicinal leeches, which were particularly useful for bloodletting in inaccessible areas, like the vagina, where a lancet might do unnecessary harm. A leech could be introduced via a speculum and withdrawn when it had its fill of blood by pulling on a thread passed through its tail.*
Elizabeth’s diligence left little room for the luxury of friendship, but one of the senior midwives, Clarisse Mallet, “a very intelligent ladylike young woman,” took every opportunity to draw Elizabeth out of her reserve. “She cannot bear to see me alone,” Elizabeth wrote. “It seems to the French a sign of deplorable melancholy.” For once, Elizabeth found nothing to disparage, and began to take pleasure in her colleague’s company. She appreciated Mademoiselle Mallet’s observations on the wards and her cheerful tolerance of her own stilted French, though she did wish her new friend would stop touching her: “I have to welcome with a good grace, the pinches, shakes, & similar tokens of French affection.” Intellectual communion was always more comfortable than an actual caress. Friendship was awkward, and writing about it was worse. “Shall I describe to you a little private dinner, given me by Mlle. Mallet?” she wrote to Henry. “I think it will suffice to say that it was very peculiar & very merry.”
There was one other individual whose company Elizabeth enjoyed. This was Claude Philibert Hippolyte Blot, an attending physician a year younger than herself, slender and sleepy-eyed, with an elegant aquiline profile. She had the opportunity to sit by him every Tuesday while he supervised smallpox vaccinations—one of the few truly beneficial public health advances of the early nineteenth century—pressing his scalpel to each infant’s arm. Elizabeth’s awareness of Blot was mutual; when she ventured to ask him a question, she noticed, “he colours, or passes his hand through his hair and looks intently at the baby, in a very un-Frenchmanlike manner.” Within a month of her arrival, Blot was sharing medical journals and pointing out unusual cases in the infirmary. Combining ambition with a lively wit, he earned from Elizabeth what was currently her highest compliment: “His sentiments seem to be good, but his character is certainly not French.” After another month, he surprised her with a bashful request: would she help him with his English? “I think he must have been meditating this request for some time; it had hardly the air of spontaneous thought,” she wrote in her journal. “I like him. I hope we may come a little more closely together.”
HIPPOLYTE BLOT.
COURTESY SCHLESINGER LIBRARY, RADCLIFFE INSTITUTE, HARVARD UNIVERSITY
These sympathetic colleagues aside, it was still a strain to spend every waking and sleeping hour among girls whom Elizabeth found at best picturesque and at worst simpleminded. As long as the élèves paid her the respect she felt was warranted, all was well, “and it sounded not a little droll to hear the scientific terms flowing so glibly from their laughing lips, which were busily employed in talking nonsense” whenever they were off duty. “Everything delights them,” she wrote. “They are perfect children in their full, unthinking enjoyment of the present.” In sunnier moods, Elizabeth endeared herself by phrenologizing them, or sharing a few English words with a giggling group.
It was just like her teaching days, only this time she had no authority over the students, and no room of her own. After a long day of strenuous medical effort—often preceded by a sleepless night on duty—their high spirits could drive her to distraction. Games of tag and wild dance parties broke out after the lamps were extinguished. Worst of all was something called “promenading the bedsteads.” The heavy iron bed frames stood on casters, and the floor of polished tile was smooth enough that a gentle push turned each bed into a vehicle. A shove at the end of a row had a domino effect, and a bed launched down the center aisle with enough force could sail the length of the dormitory. Until the élèves ran out of energy and collapsed onto their pillows, sleep was impossible. But so was sustained irritation—not even dour Elizabeth could remain angry at these cheerful creatures for long, especially when, upon waking, “they begged me to excuse them because they were so young!”
The indignities of her accommodation were balanced by the undeniable value of the education she was receiving, as well as the gratifying recognition of her aptitude. Monsieur Dubois more than once lingered after a lecture to confer praise, which Elizabeth drank in like sunlight. “He wished I would stay a year and gain the gold medal,” she crowed to her journal, “[and] said I should be the best obstetrician, male or female, in America!” A year at La Maternité, he insisted, would expose her to a volume of cases equal to what most physicians saw in a lifetime.
She believed him; she was feeling more like a real doctor and less like an impostor every day. “I am actually hand in hand with nature,” Elizabeth told Marian. “I have had a dozen patients under my own care, I have aided in delivering more than a hundred—I have seen all that is remarkable in a thousand—I have bled & leeched & poulticed with my own hand, & watched disease daily.” As the three-month mark approached, Elizabeth signed on for three more—personal discomforts could not outweigh the benefits of staying. And it would be easier now that she had established a definite finish line. “As I look forward to my departure the last of December,” she reassured Marian, “I feel almost joyous.”
A buoyant optimism gilded everything Elizabeth recorded. She was granted a precious day out with Anna, and for once gave herself up to “the pleasure of looking & moving & eating & everything that was natural, & nothing that was wise.” She was proud to receive a visit from Charles Lee, the dean of faculty from Geneva College, though she was irritated that La Maternité’s regulations forbade her from showing him around.
Madame Charrier, whom Elizabeth respected as “a woman of great experience,” presented her with a lithograph of her historical namesake. The eighteenth-century Elizabeth Blackwell—a Scotswoman and no relation—was famed for her beautiful illustrations of medicinal plants, which had earned her enough to bail her doctor-husband out of a London debtors’ prison. “I imagined a whole romance out of the picture,” Elizabeth mused, “a romance of a beautiful, true spirit, struggling with a society too strong to be turned from its ancient habits of evil. But the pure spirit is not lost, it is working bravely still.” She was beginning to feel like the engineer of her own journey, gathering momentum.
* Though bloodletting has been discarded as a relic of the barbarous past, leeches are still in use. They secrete natural anticoagulants and are effective in draining congested blood from wounds to facilitate healing.
CHAPTER 7
SETBACK
On the first Sunday in November 1849, Elizabeth was working upstairs in La Maternité’s infirmary, trying to ignore what felt like “a little grain of sand, as it were, in on
e eye.” She was too busy to attend to it, and her mind shied away from its probable cause.
In the predawn dimness that morning, she had been making the rounds of the newborns. One of them was suffering from purulent ophthalmia, an aggressive form of conjunctivitis contracted when an infant passes through the birth canal of a woman infected with gonorrhea. As she washed the tiny affected eye, the contaminated liquid splashed into Elizabeth’s face. By evening her left eye was swollen, and when she woke the next morning, the lids were stuck together with gummy discharge.
Elizabeth requested leave to retreat to Anna’s new rooms on the rue de Fleurus until the eye was better, but such coddling was beyond the rights of the élèves. She then sought the opinion of Hippolyte Blot, who wasted no time confining her to a bed in the students’ infirmary. It was soon clear that both eyes were compromised. Today, though the danger of such an infection eating through the cornea is taken seriously, gonorrheal conjunctivitis is easily treated with antibiotics. In 1849 it was cause for profound concern. Though he kept his fears to himself, Blot knew that his friend was in real danger of losing her sight.
Hippolyte Blot and the faithful Clarisse Mallet made Elizabeth their highest priority, taking turns by her side for three days. It was fortunate that Elizabeth felt so warmly toward her attendants, because the treatments to which they subjected her were torture. They cauterized her eyelids. They syringed her eyes with the medicated eyewash known as collyrium; a pharmacopeia of the period mentions everything from rosewater to ammonia to sulfuric acid as possible ingredients. They applied leeches to her temples; they painted her forehead with mercury and hellebore; they administered mustard plasters, purgatives, ointments of belladonna and opium. Elizabeth lived on water and broth, her eyes enormously swollen, her sleep interrupted every two hours as Blot peeled away the opaque membrane forming over the more severely affected left cornea. It was all very far from the cold-water-and-fresh-air regimen Elizabeth preferred, which in this case was probably lucky. Had she been in any position to direct her own treatment, her future as a physician might have ended in Paris.
ANNA BLACKWELL.
COURTESY LIBRARY OF CONGRESS, MANUSCRIPT DIVISION, BLACKWELL FAMILY PAPERS
Anna received unprecedented permission to visit Elizabeth three times a day. The patient appreciated her sisterly attentions, but Anna was not a natural caregiver. “For the first few days after her illness began I wept almost the entire time,” she wrote. “The next few days I spent in something very like swearing, & up to the present time have indulged in an equal amount of both.” She informed the rest of the Blackwells, with a telling error, that Elizabeth had contracted “prurient” rather than “purulent” ophthalmia, and bemoaned “the great laws of solidarity that so sternly link us all in one, & so frequently make the noble & the good share in the penalties of the ignoble & the evil”—aggrieved that virtuous Elizabeth had been laid low by her degenerate patients.
Though she was grateful for the special care her sister was receiving, Anna flew straight to Baron du Potet for advice and was soon adding her own treatments to the regimen, giving the “magnetic influence” as much credit for Elizabeth’s progress as the devoted efforts of the hospital staff. “I have frequently found her in such excruciating pain that speech was impossible, & a paroxysm of nervous distress & pent-up feelings forcing her from her fortitude & making her weep bitterly,” Anna wrote. “In five minutes, setting my whole soul into the effort, I have had her sleeping quietly, unconscious of pain.” Whether animal magnetism was imaginary or not, the comforting presence of an older sister, her soothing touch, and the cutlets and fruit pies that Anna brought to supplement the hospital fare were powerful positive forces—both for Elizabeth’s health and for Anna’s own sense of purpose, much as she might bemoan her own martyrdom. “I have, indeed, lost again almost all the flesh I had gained of late, in consequence of this outlay of vitality,” Anna wrote. Thank goodness for du Potet, she insisted, “without whose constant aid I could not have borne a tithe of all this fatigue & anxiety, & the exhaustion which follows my constant action upon poor E’s eye.”
What she lacked in unflappability, Anna made up in journalistic gusto. Elizabeth’s left eye looked nightmarish, and Anna did not spare the home folks. Much depended on the integrity of the cornea, for, Anna explained, “if the portion mortified should suddenly detach itself, the probability is that the eye would at once empty itself through the hole.” She seemed at least as fascinated by Elizabeth’s condition as she was horrified: “The pupil presents, just now, the appearance of one of those little misshapen blackberries of three granulations, & half-dried-up, that one sees so often on some scrubby little bush; if you can fancy such a one in dull-looking lead, you have just the appearance of this poor eye.” Scar tissue on the surface of the cornea had to be cauterized repeatedly so as not to abrade the underside of the eyelid.
Throughout the ordeal Elizabeth maintained a superhuman degree of stoicism. For a woman who hid her own ailments, the situation was a particularly exquisite misery: not only was she in unimaginable pain, but her curtained sickbed stood in the middle of her own workplace, with her colleagues witness to every aspect of her helpless plight. Their tearful concern was not always easy to bear. “She is even sometimes almost tormented by the great number of little kindly-meant visits,” Anna wrote of the midwives’ attentions. “Great is the regret expressed on all sides that she should have missed such a ‘jolie opération’; such a ‘cas interessant.’ ” The enforced idleness was maddening, and beneath it lay the terrible fear that she would never be able to see an interesting case again.
Between agonizing treatments, Elizabeth remained relentlessly optimistic. “There never surely was a case of this disease round which such perfectly admirable conditions could have been united,” she declared, grateful for Monsieur Blot’s tireless attention and Mademoiselle Mallet’s deft fingers. She insisted that she could feel her eye “working & pumping & setting things to rights.” This confidence, however, was based at least partly on ignorance. “We do our utmost,” Anna reported, “to keep her from suspecting the alarms & anxieties which any little change of symptoms creates.”
After three weeks of darkness and pain, Elizabeth’s less affected right eye began to clear, and her confinement to ease. One of her first acts was a gift for the tireless Blot, who would soon leave La Maternité to open his own practice. With Anna’s help, she purchased a pair of lamps for his new consulting rooms, which sent Blot into an ecstasy of gratitude he could express only obliquely, as the institution frowned on personal interactions between an attending physician and a student, even when the student had a medical degree herself. “I do admire his delicate conscientiousness!” Elizabeth exclaimed. His solicitousness was a powerful medicine for Elizabeth’s self-regard, if not her actual vision. “He admired my braid of long hair,” she wrote, “[and] wondered how fingers without eyes could arrange anything so beautifully regular.”
At the end of December, Elizabeth dressed for the first time since the injury, and with her eye bandaged and her head swathed in a veil, she slipped from the door of La Maternité into a waiting carriage. The hospital register records her departure en congé illimité: on unlimited leave, a designation that would keep her record free from the stain of failure, even as it closed this particular door firmly behind her. (In her memoir, Elizabeth made it seem as if she were ill in the hospital for only a few weeks when in fact it was closer to two months. She always hated to admit physical weakness.)
It was only a few minutes to Anna’s rooms on the rue de Fleurus, opposite the western gate of the Jardin du Luxembourg, but even that was exhausting. Anna led Elizabeth upstairs, where she could no longer make out the details of the ceiling ornaments and the tasteful wallpaper, nor admire the view. “I felt very weak, and laughed hysterically the whole evening,” Elizabeth confided to her journal, writing mostly by feel. She could discern the light of a lamp “as through thick mist,” and tell when a hand was passed in front of her
face but not much more—and that was with her good eye.
It would be the middle of January before she was able to venture outside on Anna’s arm, heavily veiled in black lace and stepping carefully over a crust of frozen snow through the gates of the park. “I felt as if I could defy the cold of Siberia & rejoiced in every breath of the fresh sweet air,” she exulted, her writing larger and looser than before. “I never smelt a summer nosegay of more soul rejoicing odour.” Inactivity was taking a toll on her health. “I never was very fat you know, but now I am ridiculously thin,” she wrote. “The anatomy of my neck is very unpleasantly displayed.”
The Doctors Blackwell Page 12