Sprague lived on several more years, supported by her inheritance from Zakrzewska’s estate. Realizing that Sprague had become too feeble to care for a
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home herself, Zakrzewska had placed the Jamaica Plains property in trust for her friend’s benefit: Sprague was to have the income, whether the home be sold or rented. Zakrzewska also gave the York Harbor property as a life estate to the trustee’s wife, Mrs. Dary, ‘‘except,’’ as Sprague explained, ‘‘one room, my room which is mine for life, with its contents.’’ Mrs. Dary, Sprague explained, ‘‘knew what it meant, that the Dr. wanted her to take care of me, and she wants to do so.’’∞∑
Slowly Sprague adjusted to her loss, feeling blessed that they had had ‘‘a rare companionship.’’ What she continued to struggle with, though, especially as she grew increasingly feeble herself, was Zakrzewska’s denial of immortality. ‘‘I have found myself wondering,’’ she wrote to Severance, ‘‘how she could pass on through life, and out of it, as she did, di√ering from most of those around her, and pass out of sensible living, believing as she did to the last, that that was all. Yet she did go, and not until she was in another sphere, did she change from what you knew her.’’∞∏
Zakrzewska did pass on without ever accepting the idea of an afterlife, but her denial of immortality did not mean that she was willing to depart this earth without making sure that something more than her friends’ memories of her lived on. What she could also leave were her own words, a statement of what her life had meant to her and how she wished to be remembered. Thus, in what may be considered the ultimate assertion of one’s independence, Zakrzewska had penned her own eulogy three months before her death, with the request that it be delivered at her funeral. . . .
On 15 May 1902, three days after Zakrzewska passed away, her friends and acquaintances gathered together one last time to hear her words recited by Emma Merrill Butler, a member of the New England Hospital’s board of directors: During my whole lifetime, I have had my own way as much as any human being can have it without entirely neglecting social rules or trespassing upon the comfort of others more than is necessary for self-preservation.
And now, upon this occasion, I wish to have my own way in taking leave of those who shall come for the last time to pay such respect as custom, inclination and friendship shall prompt, asking them to accept the assurance that I am sorry to pass from them, this time never to return again.
While these words are being read to you, I shall be sleeping a peaceful, well-deserved sleep—a sleep from which I shall never arise. My body will go
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back to that earthly rest whence it came. My soul will live among you, even among those who will come after you.
I am not speaking of fame, nor do I think that my name, di≈cult though it be, will be remembered. Yet the idea for which I have worked, the seeds which I have tried to sow here and there, must live and spread and bear fruit. And after all, what matters it who prepared the way wherein we walk?
We only know that great and good men and women have always lived and worked for an idea which favored progress. And so I have honestly tried to live out my nature—not actuated by an ambition to be somebody or to be remembered especially, but because I could not help it.
The pressure which in head and heart compelled me to see and think ahead, compelled me to love to work for the benefit of womankind in general, irrespective of country or of race. By this, I do not wish to assert that I thought of all women before I thought of myself. Oh, no! It was just as much in me to provide liberally for my tastes, for my wishes, for my needs.
I had about as many egotistical wants to be supplied as has the average of womankind.
To look out for self and for those necessary to my happiness, I always considered not only a pleasure but a duty. I despised the weakness of characters who could not say ‘‘No’’ at any time, and thus gave away and sacrificed all their strength of body and mind, as well as their money, with that soft sentimentality which finds assurance in the belief that others will take care of them as they have taken care of others. . . .
And now, in closing, I wish to say farewell to all those who thought of me as a friend, to all those who were kind to me, assuring them all that the deep conviction that there can be no further life is an immense rest and peace to me. I desire no hereafter. I was born; I lived; I used my life to the best of my ability for the uplifting of my fellow creatures; and I enjoyed it daily in a thousand ways. I had many a pang, many a joy, every day of my life; and I am satisfied now to fall victim to the laws of nature, never to rise again, never to see and know again what I have seen and known in my life.
As deeply sorry as I always have been when a friend left me, just so deeply sorry shall I be to leave those whom I loved. Yet I know that I must submit to the inevitable, and submit I do—as cheerfully as a fatal illness will allow. I have already gone in spirit, and now I am going in body. All that I leave behind is my memory in the hearts of the few who always remember those whom they have loved. Farewell.∞π
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Rejecting all religious beliefs that an individual’s soul lives on after his or her body dies, Zakrzewska nevertheless wanted to make sure that her words would survive her and perhaps shape the memories her friends would take with them when they left her graveside. This was Zakrzewska’s last performance, and she used the opportunity to emphasize once again her fierce independence, her sense of duty, and her total lack of any sentimentality. As in her autobiographical sketch, which she had penned forty years earlier, Zakrzewska linked religion and sentimentality and placed them in opposition to materialism and progress.
She may not have mentioned science explicitly, but it was nevertheless present in her repeated references to nature. Indeed, as an indication of how Zakrzewska’s thoughts had developed since her early adulthood, her eulogy can almost be read as a manifesto for Darwinian evolution and its power to bring about social progress. Certainly influenced by Ernst Haeckel’s own reading of Darwin, Zakrzewska left her friends with an image of herself as driven by self-interest and a desire for ‘‘self-preservation’’ to ‘‘work for the benefit of womankind.’’ Progress did not require sacrifices; her work for others did not come at her own expense. The laws of nature do not work that way. No, in pursuing what was best for herself she had played her part in creating a better world for others as well.
Zakrzewska clearly wished to go out of this world taking a stand on how one could live a moral life—one committed to social progress—without necessarily embracing any religious beliefs. She knew that this was something many of her American friends, including Sprague, had di≈culty understanding, and she tried one last time to reassure them that, rather than being troubled by the absence of a deity, she derived comfort from knowing that she was a part of nature, driven by the same laws that govern the material world and that lead inevitably to social progress.
But perhaps more than anything else, Zakrzewska wished to leave her friends with a final image of herself as strong and resourceful, a type that was an alternative to the stereotypical picture of women as submissive and unable to refuse a request that they sacrifice their own needs for the good of others. She had fought for this alternative image all her adult life, promoting it in her autobiographical sketch and living it to the fullest extent possible. Sprague had once described how Zakrzewska ‘‘disliked being thought bodily weak or ailing’’; how she was ‘‘mortified by any such condition’’ and went to great pains to hide any signs of physical or mental fatigue, even during her final illness.∞∫ As Zakr-
zewska herself shared with her friend Ednah Cheney just a few years before her
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death: ‘‘I am still proud enough as a woman not to serve as an example of woman’s frailty, which will lead to a sad ending in
life.’’∞Ω
Zakrzewska’s closest friends may have seen another side of her—the woman who felt exhausted by all the responsibilities she had taken on, who felt immeasurable grief at the loss of loved ones, who regretted some decisions she had made, or who even let go of herself enough to skip around on the rocks on the beach—but it was a side of herself that she kept tightly under wraps. Even Sprague’s letters suggest that she and Zakrzewska had come to know each other more by simply going through life together rather than by discussing their feelings in any great depth.≤≠ Zakrzewska was an immensely private person, one who left no diary and relatively few letters that would allow one to learn more about her personal reflections. The letters that survived in Caroline Severance’s papers were an exception. Another cache of letters that Zakrzewska had written to Cheney might have been just as enlightening, but Sprague deemed them too revealing for public consumption.≤∞ In what she must have considered one of her last acts of love, she destroyed the letters that Zakrzewska certainly would not have wanted anyone to see.
. . .
Zakrzewska had no wish to have her personal life paraded before others; rather, she wished her name to be identified with an idea, both during her lifetime and afterward. That idea was justice, particularly in the name of women.≤≤ She had
cast her net wide, trying to work in general ‘‘for the benefit of womankind,’’ but her greatest contribution was to those women who wished to enter the medical profession. Among the first generation of women to graduate from medical school and founder of one of the first hospitals where women could receive clinical training, she had fought hard to guarantee that women would receive the best training possible. For Zakrzewska, that meant learning not only diagnostic techniques, such as microscopy and thermometry, but, more important, the use of reason, critical judgment, and rational deductions in determining the best therapeutic regimen. This approach, vague to be sure, nevertheless captures most closely what Zakrzewska meant by the term ‘‘science’’: rather than a specific method, it referred to an entire way of thinking, one that, very much in Enlightenment fashion, was expected to dispel prejudice, poverty, and disease, helping to bring about a world in which justice and humanity would reign.
That was not, however, the direction medicine followed. By the time of Zakrzewska’s death in 1902, a rather di√erent understanding of scientific medicine had taken hold. Instead of a worldview, science referred more specifically
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to the methods associated with strict scientific protocols. The results of this approach—the discovery of ever more disease-causing microbes; the production of the first vaccines and therapeutic treatments, such as diphtheria anti-toxin; and the development of new diagnostic tools, such as X-rays—hailed a new day in which specific medicines would target specific diseases, but they also functioned to further divorce disease from its social context. These developments were, moreover, accompanied by a change in the site of medical practice—more and more medicine was practiced in the hospital rather than in the home—and by changes in medical training. Higher entrance requirements, longer periods of study, more attention to the basic and clinical sciences, and, ultimately, the expectation that students would pursue postgraduate internships all marked the increased standardization of medical training and the growing prestige of a style of medical practice that circulated around the laboratory and the clinic. Indeed, just eight years after Zakrzewska’s death, Abraham Flexner published his famous muckraking report that, taking the Johns Hopkins Medical School as its ideal, cemented in place an educational model that privileged the physician-as-researcher over the physician-as-practitioner; this model led ultimately to the demise of medical schools that had as their primary goal the training of physicians who would treat the everyday health problems of their local communities.≤≥
Most of these changes were made in the name of science, but the meaning ascribed to the term only loosely overlapped with what Zakrzewska had so loudly proclaimed. When, for example, educational reformers referred to modern science as a way of developing a critical habit of mind, then it had some resemblance to Zakrzewska’s notion, although the political meaning she had ascribed to science was lost. When, however, the claim was made that scientific thinking could only, or even best, be learned in the laboratory, especially when it was linked with a style of medical practice that ignored the wider context of disease, then it had little to do with the scientific approach that Zakrzewska had promoted her entire life.
Zakrzewska had voiced her displeasure with many of these changes before her death. She had, however, only vaguely understood the e√ect these changes would have in particular on women physicians. Even before Flexner published his report, all-female medical colleges had begun closing their doors, unable to raise the funds necessary to implement such reforms as the building and furnishing of teaching clinics and laboratories. At first some women viewed the increase in coeducational institutions as a clear sign of progress, but this opti-
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mism turned out to be short lived. Whereas women made up 5 percent of the medical student body in 1899, three years after Zakrzewska’s death they had dropped to 3.5 percent and then to an all-time low of 2.9 percent in 1910. This drop marked a decline in absolute numbers as well, from 1,063 students in 1899
to 573 eleven years later.≤∂
As historians of women and medicine have revealed, the reasons for this decline were varied and complex. Overt discrimination, such as the implementation of sex-based quotas, certainly played a role. The loss of female role models
—coeducational institutions, unlike the all-female medical schools, rarely hired female educators—also contributed to an atmosphere that could be inhospitable to women. Another factor that worked to lower the numbers of women studying medicine was the greater investment of time and money that an elite medical education now demanded. For some this meant that their families were now reluctant or unable to finance their careers; for others, the four years of study following graduation from college meant a greater commitment and sacrifice than they were willing to make. In fact, the medical profession simply lost its appeal for some. Whether this reflected the increasingly masculine image of the scientist-physician, the greater di≈culty women experienced trying to balance family and career, or the gradual severing of modern medicine from any kind of social reform agenda, the result was that in addition to the structural impediments to women’s pursuit of medicine, a growing number of women no longer seem to have been as drawn to medicine as their predecessors once were.≤∑ Zakrzewska would most assuredly have watched all this with great sadness, disturbed both by medicine’s embrace of a research ethic that often lost sight of the people it was trying to serve and by women’s gradual exclusion from the elite echelons of the profession. I am not sure, though, that she would have been totally surprised. Her skeptical attitude toward coeducational institutions in the last decade of her life had reflected her deep suspicion that the United States was not yet ready to grant women full equality with men. She was right.
. . .
In the twentieth century, as women physicians continued to struggle to achieve fair representation, Zakrzewska’s story would occasionally be told in the interest of advancing women’s medical careers. Thus in 1924, Agnes Vietor, previously an assistant surgeon at the New England Hospital, published A Woman’s Quest: The Life of Marie E. Zakrzewska, M.D. This 514-page biography, written largely from materials Zakrzewska had given to Vietor, served a particular purpose for the author. At the time, a good medical education had come to include a year’s
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internship following graduation from medical school, yet women faced a new wave of discrimination when they applied to fill these posts. Vietor thus used Zakrzewska’s biography to argue for the injustice of keeping the doors to hospital and clinical internships clo
sed to women. ‘‘[T]he battle which she [Zakrzewska] faced and fought is not ended,’’ Vietor told her readers. ‘‘It remains for all lovers of justice to sustain the impulsion which carried her on and so to continue the fight till the truth of her watchword, ‘Science has no sex,’ is acknowledged.
Then, and only then, will her life’s work be fulfilled.’’≤∏
Vietor, who fully embraced the role hospitals had come to play as ‘‘great centers of laboratory and clinical investigation and research,’’ worried little that Zakrzewska, at the end of her life, had viewed such a development critically.
What Zakrzewska symbolized to her was not a particular medical style but rather a quest to prove that women had the same ability as men to think scientifically and should, therefore, be granted opportunities ‘‘on equal terms with men.’’≤π It was Zakrzewska’s insistence that ‘‘science has no sex’’ to which she drew most attention because she continued to believe that the greatest obstacle before her remained the notion that gender di√erences existed in men’s and women’s scientific abilities. To Vietor, Zakrzewska’s life was ‘‘one more document testifying to the Humanity of Woman,’’ a humanity that was ‘‘neither male nor female; it is both.’’≤∫
When World War II broke out, Zakrzewska’s name was once again used in the service of advancing women’s cause, this time as part of a battle to give women physicians, in Dr. Emily Dunning Barringer’s words, ‘‘complete equality as to rank and professional status within the Medical Reserve Corps of the Army.’’ Barringer, president of the American Medical Women’s Association in 1942, had been spending much of her time in Washington trying to convince Congress to pass legislation that would allow women to receive these commis-sions.≤Ω Whether it was her idea to feature Zakrzewska in an installment of the Du Pont Corporation’s series ‘‘Cavalcade of America’’ is unclear, but she clearly played a role.≥≠ At the end of the broadcast, Barringer gave an impassioned speech defending women’s right ‘‘to stand shoulder to shoulder with their male colleagues.’’≥∞
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