The Doctors Blackwell

by The Doctors Blackwell (retail) (epub)

  If certain women were too enthusiastic, even the most open-minded men continued to feel a deep discomfort with a woman who attached M.D. to her name. As long as Elizabeth could practice alone, all was well—until she needed a second opinion. The first time she called in a male colleague for a consultation, unintentional comedy ensued. An elderly woman presented with severe pneumonia, and Elizabeth asked an old acquaintance—a kindly physician who had once treated her father—to confirm her diagnosis.

  After his examination, he paced up and down nervously. “A most extraordinary case!” he exclaimed. “Such a one never happened to me before; I really do not know what to do!”

  Elizabeth was baffled. Had she mistaken the symptoms of pneumonia? But the good doctor’s agitation had nothing to do with the patient. He simply could not imagine a professional consultation with a female physician; the cognitive dissonance was too great. Elizabeth diplomatically suggested that perhaps he could think of it as a “friendly talk” rather than a clinical discussion. That did the trick: useful advice was conveyed, and the patient swiftly recovered.

  Sharing Elizabeth’s home in New York and watching her progress, observant Marian became a conduit between Elizabeth’s daily experience and Emily’s anticipation. “I think I will send you a few lines, & give you my advice about matters & things,” Marian wrote to Emily in Cincinnati, “which of course, you after the manner of all our family, will take if it suits you & reject if it don’t.” Though Marian applauded her sisters’ vocation wholeheartedly and even sometimes envied it, she believed a medical degree was useless. Elizabeth’s diploma had done little to impress her colleagues and meant even less to her patients. “I am quite convinced that the position a woman will occupy as Dr will be according to her real merit, and the personal influence that she succeeds in exerting on others—not on a mere diploma,” Marian wrote. “It is not so much study as practical experience and tact.”

  Legitimacy, Marian argued, was a matter of demonstrated skill, not credentials. If she were Emily, she would forget medical school, work with Elizabeth in New York for a while, and then go to Paris and enter La Maternité. “That experience has been of more real value to our sister than anything else,” Marian insisted. “I can see that she takes hold of obstetric cases with perfect ease & self-confidence—secure of her own knowledge, & prepared for any emergency. . . . It is general knowledge of sickness that I think she lacks.” Despite Elizabeth’s leanings toward cold water and good hygiene, Marian thought she still put far too much store in “those old hateful mineral drugs” and trusted her professors and her textbooks more than her own common sense. Emily should learn from Elizabeth’s example. “You are less conservative in your nature than E—& have seen more of heresies,” Marian told Emily, perhaps alluding to the time Emily had spent with Anna’s Brook Farm friends. “You must be eclectic—reformatory—universal—and I firmly believe you will do just as well.” As for Elizabeth, Marian thought she would find her place “less as Dr than as teacher & professor & stimulator to others,” proving, at this early stage, uncannily prescient. “I must say,” Marian confided, swearing Emily to secrecy, “if I were taken sick . . . I would doctor myself & not call upon her for aid.”

  Though she appreciated Marian’s candor, Emily had toiled too long to abandon her pursuit of a diploma—she wasn’t going to fall short of the bar Elizabeth had set. And as spring advanced, there were hopeful signs that this goal might be attainable. Dr. Mussey, who had greeted Emily’s original appeal with grudging caution, had since paid a visit to Elizabeth in New York and delighted her by mentioning “his clear perception,” Elizabeth reported, “that [Emily] ought to be a doctor.” Upon his return to Cincinnati, Mussey informed Emily that he thought her chances either at Dartmouth or at Chicago’s Rush Medical College were promising. That was enough to make up her mind; waiting had become intolerable. She began to pack, planning to visit Elizabeth in New York before continuing on to New Hampshire, where Dartmouth College’s fifty-year-old medical school attracted her more strongly than Rush, founded less than a decade earlier. The Dartmouth term would begin in early August. “I have marked out my course,” she recorded in her journal.

  “So Milly is actually setting out on her special life journey!” Elizabeth wrote to Sam upon receiving the news. “She must obtain admission somewhere, for the world wants her & must necessarily receive her.”

  * Blackwell’s Island, now Roosevelt Island, was named for its owner, Robert Blackwell, in the late seventeenth century; there is no connection with Elizabeth and Emily’s family. It was the site of several grim municipal institutions, including a penitentiary, workhouse, and insane asylum.

  CHAPTER 10

  ADMISSION, AGAIN

  On a sweltering evening at the end of July 1852, Emily Blackwell sat down to dinner with her sister Elizabeth for the first time in three years. An uncomfortable anticipation had grown with each passing mile from Cincinnati to New York. Elizabeth had traversed Europe, transcended prejudice and pain, and won the praise of famous physicians. The sister Emily thought she knew was bold, brilliant, and capable but also uncompromising, inflexible, and exacting. Her letters made it clear that she expected no less from Emily. Would she be able to live up to Elizabeth’s formidable expectations? And even if she could, would she be able to live with her?

  The woman who answered Emily’s knock at 44 University Place had a face etched with new lines of age and illness. But Elizabeth’s missing eye was hardly noticeable—except when the glass prosthetic glinted oddly in reflected light—and her eagerness to share her medical goals with Emily was obvious. “From Wednesday noon till Monday morning we talked almost without cessation,” Emily wrote with relief. “I liked E.—she was not nearly as particular and fidgetty as I had the idea.”

  Elizabeth was equally happy with Emily. “Her visit gave me a feeling of deep joy,” she reported to Lady Byron. “She has a noble intellect, clear and strong. . . . If she can obtain the needful impulse and direction from a superior mind, I think she will make a fine scientific physician.” Whether that superior mind belonged to a medical mentor in Emily’s future, or to Elizabeth herself, was unclear. But Elizabeth’s respect for Emily was real. “I speak of her without hesitation—as a soldier of truth,” she wrote, “rather than as my sister.”

  ELIZABETH, CIRCA 1855.

  COURTESY SCHLESINGER LIBRARY, RADCLIFFE INSTITUTE, HARVARD UNIVERSITY

  Galvanized by the brief reunion, Emily boarded the airless, creaking cars again for the long ride north to Hanover, New Hampshire. Its green and white New England charm enchanted her, as did the fresh faces of its forthright residents: “The men did not wear whiskers and the women seemed more able to take care of themselves.” Blue hills, dry-stone walls, dark pine and hemlock among the spreading oaks and maples, the graceful elegance of the Dartmouth Green—it was “a different country from the west,” a lovely setting for a new life. Surely the good news of her Dartmouth admission would follow without delay.

  The professors, though courteous, remained unconvinced by this carefully dressed, well-spoken, accomplished young woman who had journeyed hundreds of solitary miles in order to make her appeal in person. She waited five days for their rejection, then packed her trunk once more. On the way south, she stopped at the Berkshire Medical Institution in Pittsfield, Massachusetts, for one more attempt. Berkshire had recently granted a medical degree to James Skivring Smith, a free Black man who went on to become the president of Liberia. But it wasn’t ready to admit a woman.

  Nine days after leaving for her glorious next chapter, Emily was back in her sister’s stifling sitting room. “Why Milly, unfortunate child, so they’ve refused you,” Elizabeth exclaimed as she walked in.

  After years of wishing for each other’s companionship, Emily and Elizabeth suddenly had more of it than either of them preferred. The dearth of patients had forced Elizabeth to a lower floor at 44 University Place, downsizing from two rooms into one. “I like the room,” Elizabeth had written sta
unchly. “It has an air of pleasant gloom about it.” Marian had gone to stay with a friend just in time for Emily’s arrival, which was fortunate. Emily slept on the sofa, while Elizabeth had her bed in the six-foot-square dressing room.

  The lack of space was an incentive for Emily to keep moving forward. Though Elizabeth was short of patients, she had made useful connections in the year since she arrived in New York, and now she got to work on her sister’s behalf. Within the week Emily met Elizabeth’s ally Horace Greeley, the newspaperman, who introduced her to the city commissioner in charge of Bellevue Hospital.

  The oldest and largest public hospital in New York, staffed by the city’s best-qualified and most public-spirited doctors, Bellevue served as pest house, lunatic asylum, and “warehouse for the destitute.” Emily paid calls on its leading physicians, and by the first of September, the decision was unanimous: she would be allowed to attend lectures. This was unprecedented—though Elizabeth had gained access to St. Bartholomew’s in London, no American hospital had yet welcomed a female student. John Wakefield Francis, consulting physician at Bellevue and co-founder of the New York Academy of Medicine, shook Emily’s hand as he delivered the good news. “Now my dear,” he instructed her, “if you have any difficulty up there come to me and I’ll settle it for you.” She was no closer to a diploma, but at least she would not be wasting her time. “Yesterday I had the satisfaction of taking out the first hospital ticket that has ever been taken by a woman in America,” she wrote to her youngest brother George. It was good to have her own “first” at last.

  The next day she was in the operating theater. A surgeon “in a long apron something like a butcher’s,” stiff with dried blood, explained to a ring of twenty students how to drain fluid from the chest as his shirtless patient, “with a rather frightened look,” shifted from foot to foot. Once the man was stretched on the narrow table, the surgeon selected an instrument and paused to invite Emily to move over where she would have a better view. “There was a great tumbling about directly, as if a cannon was about to go off there,” Emily wrote wryly. “A small vacancy was left with students filed down each side, into which I stepped.”

  She watched as the scalpel opened an incision between the patient’s ribs, and she did not look away until the wound was bandaged, “the students alternately watching the operation, & me.” Emily ignored them. After so many years of gleaning on the edges of her chosen field, here she was right in the middle of it. “I shall certainly find the study of medicine interesting, however the practice may be,” she wrote to her youngest brother. “Rather different kind of study than our botanical rambles, isn’t it George?”

  Emily soon became a familiar sight at Bellevue, walking the wards, attending postmortems in the dead house, and helping prepare prescriptions in the apothecary’s shop. “The young Drs are used to my appearance and no longer stare at me nor laugh when I feel a pulse,” she wrote at the end of her second week. She tried not to dwell on the moment when she had looked up at the blackboard to find a crude sketch of a woman wearing a Bloomer costume, the short skirt over loose pantaloons that had recently become a scandalizing symbol of women’s rights. Above it, someone had chalked “Strongminded Woman.”

  Emily’s intelligence and talent impressed her Bellevue instructors, and when she informed them that she would be leaving for Chicago to attempt enrollment at Rush Medical College, they were quick to offer letters of introduction as well as assurances that she would be welcome back at Bellevue between terms. Their gestures were genuine, but they were also likely relieved to see her go.

  On October 29, 1852, almost exactly five years after Elizabeth arrived at Geneva in the rain, Emily reached Chicago under equally stormy skies. Within twenty-four hours she introduced herself to the president of Rush Medical College, Daniel Brainard, as well as his colleagues Nathan S. Davis and John Evans. The endorsement of the Bellevue brahmins made all the difference: it was easier for Rush’s leaders to act boldly on Emily’s behalf when they could point to men of large reputation who had already done so.

  “They are all willing,” Emily scribbled to Elizabeth that evening in incredulous haste. Brainard, Emily reported, was “a very reserved grave man—he says he neither favours nor disproves of women studying—they may do as they please.” As far as the faculty was concerned, Brainard informed her, she was welcome. He cautioned her, however, that the decision to grant her a degree rested with the trustees, and he could not guarantee it.

  At the end of her first lecture, Dr. Davis—voted favorite teacher by his students the previous year—motioned for silence. “I have introduced into the Lecture Room, with the cheerful consent of all the Faculty, a lady who proposes to spend the winter with us,” he announced. Murmuring arose on all sides as he raised his voice. “To save all inquiry I will inform you that it is Miss Blackwell, sister of Miss Elizabeth Blackwell, who studied some years ago at Geneva and subsequently in Europe.” Every face in the room was now turned toward Emily. “The Americans have the reputation of being a very gallant nation,” Davis continued, his eyes sweeping the tiers of seats. “I need not tell you, you will be expected by your conduct this winter to maintain the national character.” The students burst into gallant applause.

  Emily’s formal medical education was under way. “I have today completed one month’s attendance at College,” Emily wrote to George, “and therefore feel pretty sure that no interruption will now arise to drive me out—indeed I wouldn’t go.” As elsewhere, students paid their tuition by purchasing lecture tickets, which included a line for the student’s name with a preprinted “Mr.” In her writing case Emily now carried a stack of tickets: “all testifying, with a variety of flourishes, that Mr. Emily Blackwell is entitled to attend the session of 1852–53,” she noted with amusement. Though she found “dirty little Chicago” not much to her taste, her professors pleased her enormously. James Van Zandt Blaney illustrated his chemistry lectures with elegant experiments that Emily wished her brother George could see. Joseph Warren Freer guided her dissections and deplored the dull state of her scalpels; he had turned to medicine after the death of his wife, which perhaps explained his unusual receptivity to the idea of a female doctor. John Evans, professor of obstetrics, insisted that Emily attend all his lectures on the “external generative organs,” even though, unlike Elizabeth, she offered to sit them out. “I was glad to find my self-command sufficient to prevent even my colour from changing,” she wrote afterward.

  Like Elizabeth, Emily looked for allies at the top of the hierarchy. “I like Dr Brainard best,” she wrote of the man who had founded Rush Medical College ten years earlier, “he is a man of decided talent and strong fearless character.” The professor of surgery invited her to take a seat in the front row and asked her to tea with his wife. Encouraged, a few weeks into the term she followed him out of the lecture hall to ask a question as he was preparing to return to his office practice. Finding him receptive, she took a deep breath.

  “Doctor, you don’t want a student in your office, do you?” She could hardly believe she had dared to ask.

  “I don’t know but I should like a good one,” he replied after a moment, hiding the quirk of a smile under his luxuriant mustache.

  Emily met his gaze, outwardly calm but triumphant within. They talked for an hour about everything from surgery to her sister and walked together to his office, where he showed her around. “I went home how happy,” she rejoiced in her journal. “I wrote to E., but could not sleep.” Before dawn she was back at Brainard’s office, organizing his library.

  For the next fortnight, Emily spent all her free time at Brainard’s office: reveling in his books, listening to his patients, meeting his colleagues, observing surgeries, and asking questions. Not only was the doctor willing to teach her, but his professional views were appealingly progressive: He criticized the overuse of mercury-based calomel and condemned the proliferation of patent medicines and the scoundrels who profited from them. Most important, he seemed to place mo
re value on Emily’s abilities than on her gender. “The Dr has no other students, he will not take them,” she reported proudly. “I regard this as almost as great an achievement as getting into college.”

  It didn’t last. “And so two weeks have seen my office career commenced and finished,” Emily wrote with a sigh. Although Brainard’s patients were perfectly cordial, a handful of Chicago’s more influential citizens apparently complained of her presence in his office, and he bowed to the pressure.

  At the college, however, Brainard continued to be an attentive mentor. “I went yesterday with him to see him cut off a portion of a diseased eye,” Emily recorded. “I held the patient, a young woman, who scratched away vigorously, though under the influence of ether—she said however she felt no pain, only alarm.” Brainard called on Emily to assist him—in front of the class—during an operation to correct an infant’s clubfoot, and praised her when it was over. She was pleased to discover that the actual experience of surgery—in 1852 still a dangerous, gruesome, messy endeavor, even with the introduction of anesthetics—was no more disturbing to her than it had been in the pages of her textbooks. While watching Brainard demonstrate amputation on a dog, she was happy to tell Elizabeth, “the blood affected me no more than so much warm water.” But she did feel sorry for the poor creature later, when it came wagging up to her on three legs. Vivisection, a word coined by its opponents, was the dissection of living animals for experimental purposes—a practice endorsed by many physicians who believed either that animals felt no pain, or that their suffering was outweighed by the benefit to surgical knowledge.

  In his lectures on syphilis, it was Brainard’s custom to hand out graphic pictures of the ravages of the disease. With Emily present, he made a point of passing some to her first. “I examined them carefully with great composure, & then handed them on,” she wrote. “It was nothing to me, & I don’t think the class cared.” The students respected their professor and president even if they didn’t endorse Emily’s presence. Their hesitation, Emily realized, was a matter of collective ego more than individual chauvinism. “The reason many of the students dislike the idea of opening the college to women is that they have the idea that no other regular college would do it, but that the irregular colleges will,” she wrote. “They think it would be rather derogatory to the honour of the institution in the opinion of the other colleges.” They had little against Emily personally, but they shied from the risk that their own credentials might be devalued.