But her truly vituperative words she saved for the young women who sought
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ovariotomies in her hospital. In the letter she wrote to Blackwell in 1891, she accused these women of ‘‘indulgence in luxurious living, dislike to work and of self abnegation. . . . Yes,’’ she added, ‘‘they rather die, than bring up a family of children and work and practise self-denials.’’≥π
Zakrzewska was clearly struggling to make sense of choices she had made when she was younger, including her decision to remain childless. Although it would be a mistake to imagine her dwelling on this sense of loss, at a time in her life when she perhaps felt overwhelmed by the loss of very dear friends and unmoored by her gradual retreat from the hospital she had created and nurtured, she directed her pain and anger at women who were choosing not to bring into the world the young lives she now lamented not having had herself.
Some might be tempted to ascribe Zakrzewska’s change of view to an elusive
‘‘maternal instinct’’ that finally surfaced toward the end of her life, but I choose to see this shift as evidence of the constraints under which women lived at the time and the di≈culty of being an atheist and childless in a society that accepted neither. Disturbed by the changes taking place around her, Zakrzewska ended up embracing some of the very conventions she had once so vehemently opposed.
. . .
Zakrzewska’s ideas on gender, science, materialism, and medicine had changed considerably since her early adulthood. When she first began formulating her views in the 1850s and 1860s, she was trying to counter beliefs that women were physically and intellectually incapable of practicing medicine or that by their nature they were inclined to practice a gentler, more humane kind of medicine. She liked neither because, in her estimation, they both confined women’s sphere of influence: the former by identifying women with the private sphere of the home, denying them access to positions of power in the public arena, the latter by relegating them to what she perceived to be a subordinate place in the medical hierarchy. In challenging these beliefs, Zakrzewska redefined woman, science, and the relationship between the two. She did this by minimizing the biological di√erences between men’s and women’s bodies; by promoting and performing women’s ability to engage in rational thought; and by insisting upon an intimate connection between science and morality. Zakrzewska, who was convinced ‘‘that all [religious] belief weakens the moral sense,’’
maintained, as did other German radicals, that only the embrace of a secular and materialist world could bring about a just and humane society.≥∫ It did this, they believed, by keeping one focused on fighting the social and economic forces
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responsible for the production of human misery and by promoting science education, which they cast as the best tool for encouraging the kind of critical thinking required for a democracy to succeed. Zakrzewska, who was determined that women both participate in and benefit from this social transformation, focused her attention on dismantling any notion that women and science stood in opposition to each other.
In her promotion of science in the early decades of her career, Zakrzewska had sounded to some extent like other women physicians who had also emphasized the importance of grounding medical practice in scientific knowledge of the human body. However, where she had stood out was in the political meaning she ascribed to science as a tool of emancipation. This reflected, as I have been arguing throughout this biography, her ‘‘position’’ as a German woman with particularly strong ties to German political radicals. Thus where the vast majority of her peers had sought to bridge ‘‘sympathy and science,’’ viewing sympathy as a peculiarly feminine trait that would mitigate against the potential harshness of science, Zakrzewska had seen no reason for science to be monitored. On the contrary, she had viewed it as moral in and of itself. If anything needed monitoring, in her eyes, it was religion.
Significantly, the only other woman physician I am aware of who came close to sharing Zakrzewska’s views on science was also influenced by European radical politics. Mary Putnam Jacobi had already turned her back on her Bap-tist upbringing as a young woman, but it was her experience in Paris, which overlapped with the Paris Commune, that led her to develop an alternative moral framework grounded in Comtian positivism. Jacobi thus came to favor scientific knowledge over metaphysics, the material world over that which cannot be seen, and the cherishing of humanity over the worshiping of a divine being. Like Zakrzewska, then, Jacobi came to see science as more than a tool for acquiring knowledge about the body; it also stood for a particular view of social progress grounded in a materialist, and explicitly antireligious, worldview.≥Ω
Zakrzewska never abandoned these convictions, yet by the last decade of her life, she viewed things di√erently. Make no mistake, she remained a materialist, an atheist, and a staunch advocate of both science and women’s rights. But she now endowed matter with some sentience, she softened her diatribes against religion, and she viewed the narrow focus on the laboratory as unscientific. She also became an advocate of separate women’s institutions just at the time when women’s integration into the medical profession—as judged by their increased representation in medical schools and medical societies, their success in se-
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curing hospital internships, and their publications in elite medical journals—
seemed most secured. To be sure, Zakrzewska’s modification of her earlier emphasis on gender integration marked to a great extent her belief that women had not yet been guaranteed true equality. (She turned out, moreover, to be correct.) But her motivations were also more complex. She proved unable, for one, to view her own creation critically, but she also perceived her all-female institution as a necessary tool for guiding younger physicians to a deeper understanding of their professional responsibilities. Some of these responsibilities centered on their obligations to their patients, but Zakrzewska also focused on their obligations to other women physicians and to the ‘‘cause’’ as a whole. Thus where once she had sought to redefine ‘‘woman’’ in order to break down the doors preventing women from claiming their place in the public sphere, she now watched with concern as the kind of moral discourse she had come to take for granted vanished and the values she had fought for no longer seemed to matter to the young.
Zakrzewska was not alone among her generational peers in her distress. We have already mentioned the dismay Paris-trained physicians experienced as their professional authority, identity, and integrity were challenged by a younger generation more excited by the German laboratory sciences. There have also been several excellent studies of the struggles women in particular faced at the turn of the century as they sought to sustain their profession’s earlier interest in integrating personal, civic, and professional responsibilities in the face of a new ethos that valued allegiance to one’s profession over one’s community ties. ∂≠
Zakrzewska’s sense of loss must be recognized as part of this growing disillusionment. She may have promoted science and rational medicine louder than some, been more critical of empiricism than others, and scorned any notion that woman’s nature was more sympathetic than man’s, but she felt no less acutely the attacks being made on an older style of medical practice that had valued judgment as much as science, the doctor-patient relationship as much as laboratory and clinical techniques, and the social context of disease as much as the pathophysiology of the disease itself. For all her di√erences—and Zakrzewska’s materialism and atheism did continue to distinguish her from many of her peers—her complaints about the loss of a moral framework for guiding a physician’s actions echoed loudly the concerns of others who were troubled by the way the medical world they had known and shaped was being radically transformed.
On top of it all, Zakrzewska missed the sense of community she had nurtured
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in her hospital and the feelings she had had of being admired and respected by her students. She missed a sense of allegiance, but what she lamented most was the loss of a sense of mission. This had bound her not only to the first generations of interns, many of whom had felt part of a larger movement to challenge cultural and institutional barriers to women’s emancipation, but also to the wider community of Boston social reformers for whom the hospital had been but one part of a large program of social and political reform. The year before her retirement, Zakrzewska gave an address at the opening of the Sewall Maternity House at the New England Hospital. Her talk was filled with memories of the past: of Henry Ingersoll Bowditch’s willingness to face ‘‘social ostracism’’ by supporting the cause of women’s medical education; of the ‘‘spirit of justice’’
that led the Reverend James Freeman Clarke to support their cause; of Abby W.
May, Lucy Goddard, and other ‘‘noble women’’ without whose work and financial support the New England Hospital would never have survived.∂∞ This was the community in which Zakrzewska’s professional identity had taken form.
With most of them now deceased, she no longer felt as though the institution was her own. This made her sad, to be sure, and she worried at times that the accomplishments of her generation would not be properly memorialized, but she also realized that her time had passed. ‘‘The world changes,’’ she wrote a friend, ‘‘& with it, opinions & I am not at all desirous to have it stand still or do & go my way, others must lead & take the responsibility & I am only too glad to leave it in hands who want to have its strings.’’∂≤ Besides, she added at her retirement, ‘‘I want a few play days; and then I will go out of this life with that feeling of joy which ends a sensible existence.’’∂≥
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in Taking Leave
Following her retirement in 1893, Zakrzewska engaged in activities that had long held her interest but for which she had had too little time. High on her list were two organizations, the Roxbury Women’s Su√rage League and the New England Women’s Club.∞ In both cases, she became almost immediately involved in historical projects—researching the first women’s rights conventions for the league and the origin of women’s associations for the club—but what she enjoyed most of all were the afternoon teas, lectures, and discussion groups, when she could spend time with old friends like Julia Ward Howe, Ednah Dow Cheney, Anna H. Clarke, Lucy Goddard, and Mary Livermore. Always on the lookout for opportunities to distinguish her generation from the younger one, she insisted that the club’s get-togethers had nothing to do with the fashionable
‘‘ socials’’ of the day, ‘‘where one goes once or twice during the whole season, shakes hands with the hosts, says some nothings, meets friends and foes and says more nothings, shakes many hands without knowing why, and takes some refreshment in thimble cups.’’ In sharp contrast, she maintained, the members of the club made up ‘‘an association of friends,’’ who met regularly and spent their afternoons listening to and discussing ‘‘well expressed thoughts.’’≤ But whether their conversations were truly more meaningful or not, Zakrzewska enjoyed the opportunity to visit with old friends.
Zakrzewska’s retirement also meant that she now had more leisure time to share with her companion, Julia Sprague. By this point their family had, in Sprague’s words, become ‘‘small, only we two.’’ They had recently moved to a small house in Jamaica Plains, not far from their old Roxbury residence. (This
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Image not available
Marie Zakrzewska, ca. the turn of the century. (Courtesy Archives and Special Collections on Women in Medicine and Homeopathy,
Drexel University College of Medicine)
was, in fact, the second move in less than ten years—they had left Cedar Street and moved to Boston sometime in the mid-1880s.) As Zakrzewska explained, scaling down to a smallish residence allowed her to ‘‘use the little spare money to build me a little seashore home retreat.’’ She and Sprague had spent the summer of 1889 in York Harbor, Maine, and had found it restful for ‘‘both body
& mind.’’ Remaining class conscious to the end, Zakrzewska described how
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they had selected a spot far away from both ‘‘the fashionable’’ and ‘‘the un-fashionable plain people’’ and built a small cottage that they occupied every summer between 1 July and 15 September. As late as 1899, Sprague was still commenting upon ‘‘the perfect rest we have . . . in the beauty of land- and waterscape’’ every time they traveled to their summer abode.≥
When Zakrzewska and Sprague were not spending their afternoons at the club or vacationing in York Harbor, they were often traveling. In the winter of 1895, as a surprise present to Sprague on the occasion of her seventieth birthday, Zakrzewska announced that they would be spending the holidays in England.
Her hope was that Sprague would find that the ‘‘climate suits’’ her, as she had not been feeling well of late.∂ It also gave Zakrzewska an opportunity to visit once again with Elizabeth Blackwell. The two women had had their rocky moments from time to time, stemming most likely from the tensions that had developed while they were both still working in New York. But Zakrzewska had developed considerable admiration and a√ection for Blackwell over the years, and she looked forward to sharing memories of the beginning of the women’s medical movement and their thoughts on what the future might hold.∑ By all
accounts, the visit went well; Zakrzewska and Sprague spent almost three weeks of their three-month sojourn with Blackwell and her daughter, Kitty, attending teas, socializing with other friends, and enjoying the Christmas holiday together. It was to be their last visit. Zakrzewska never returned to Europe; nor did she expect to. Although she was not yet experiencing serious health problems, she was feeling the e√ects of age. As Sprague wrote Kitty the year after they returned, ‘‘I know her, better of course than any one else,’’ and know how much she has always hated letting anyone see her when she was unwell. Now, however,
‘‘she has had to find out that she also is mortal and must yield to mortal’s fate.’’∏
The last long excursion the two women made together was in 1901, one year before Zakrzewska’s death. This time they spent ten weeks on the West Coast, visiting Caroline Severance and other friends. Zakrzewska, whose health had deteriorated by this point, thought the trip might provide a distraction from her ills. As she described it, she had begun to have ‘‘some confusion of mind’’ years earlier, which had turned into ‘‘noises’’ in her head by December 1900.π Since
Sprague was also not well, Zakrzewska hoped the trip would restore both of them to some degree. Zakrzewska did, in fact, appear to be buoyed by this trip.
Sprague described in a letter to Severance, one day after they left their friend to head up the coast, how Zakrzewska had forgotten ‘‘while at the beach in Mon-terey, that she was not ‘sweet 16,’ climbed about on the rocks, slipped about on
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the anemones and sea-weed, etc., and went to bed last night as lame as if she were 70, and today groans with a headache, but as it is improving now, she rouses to say, ‘give her my love, and tell her I wish I had half a dozen of her oranges now.’ ’’∫
Whatever benefits Zakrzewska may have enjoyed from her trip did not last.
‘‘I had the benefit of a change,’’ she wrote Blackwell, ‘‘but no improvement in the condition of my troublesome head.’’ Most upsetting to her was that she could no longer engage in any mental activities. She found reading too di≈cult, and even when Sprague read aloud to her in order to keep her abreast of current events, she could barely remember what she had heard the following day. Distressed by her limitations, she felt as though she were ‘‘killing the time day after day until the time of everlasting rest will come.’’Ω
‘‘Everlasting rest’’ would arrive within the year. Early in 1902, Zakrzewska had a series of angina attacks that, combined with her headaches, made her life
‘‘a burden.’’∞≠ Still, she held on for several more months, much of that time in pain. Although she continued to walk to the market and ride the cable car every day with Sprague, she could no longer tolerate visits from friends and had reached a point where she needed opium at night in order to get any rest.
Unable to engage in any enjoyable activity at all, she shared with Sprague her desire that her life come to an end.∞∞ That happened on the morning of 16 May 1902, after a restless night. The physician who attended Zakrzewska in the last months of her illness listed ‘‘Arterial Schlerosis,’’ ‘‘Valvular disease of the heart,’’
and ‘‘Apoplexy’’ as the causes of death. More than likely Zakrzewska su√ered a heart attack brought on by hardening of the arteries. This may explain the noises she had been hearing for the previous few years: they may have resulted from an aneurysm caused by the arteriosclerosis. ∞≤
‘‘Your letter had a little strengthening remark in it,’’ Sprague wrote to Severance a few months after Zakrzewska passed away, ‘‘which some day will be of use to me, I hope. No, I ought to be thankful in not having to look on, and ‘see her mind farther eclipsed than it was.’ ’’∞≥ But after forty years together, Sprague was having di≈culty adjusting. They had done everything together, from building a home life to traveling, to caring for each other in times of need. ‘‘I am living a life so di√erent that I do not know myself,’’ she confided several months later to Kitty Blackwell. ‘‘But you will comprehend the di√erence in my two lives. The void is great, but I am trying to be strong, and what helps me is the knowledge that she understood her disease and wanted to die.’’∞∂
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