The Fevers of Reason

by Gerald Weissmann

  She also saw some of the same mock science that had flourished in France: mesmerism, homeopathy, and hydropathy, which she called the three heresies to distinguish them from the old system. But, after looking into the heresies a little more closely, she felt as dissatisfied with them as with what she had been taught: “We hear of such wonderful cures constantly being wrought by this and the other thing, that we forget on how small a number the novelty has been exercised, and the failures are never mentioned; but on the same principle, I am convinced that if the old system were the heresy, and the heresy the established custom, we should hear the same wonders related of the drugs.” There is more than an echo here of Holmes’s “If all the Materia Medica as now used, could be sunk to the bottom,—it would be the better for mankind and all the worse for the fishes.” Sound advice in the days before penicillin.

  Her mentor gave her some advice, which elicited a passionate response:

  Mr. Paget who is very cordial, tells me that I shall have to encounter much more prejudice from ladies than from gentlemen in my course. I am prepared for this. Prejudice is more violent the blinder it is, and I think Englishwomen seem wonderfully shut up in their habitual views. But a work of the ages cannot be hindered by individual feeling. A hundred years hence women will not be what they are now.

  Blackwell’s experiences in Paris and London made her eager to start out on her own in America. She wrote of her plans to her sister Emily in November 1850 (Emily had decided to follow in her sister’s footsteps and was being privately tutored by Dr. John Davis, an anatomy demonstrator in Cincinnati):

  Here I have been following now with earnest attention, for a few weeks, the practice of a very large London hospital, and I find that the majority of patients do get well; so I have come to this conclusion—that I must begin with a practice which is an old established custom, which has really more expressed science than any other system (the three heresies) but nevertheless, as it dissatisfies me heartily, I shall commence as soon as possible building a hospital in which I can experiment; and the very instant I feel sure of any improvement I shall adopt it in my practice, in spite of a whole legion of opponents. . . . I advise you E. to familiarize yourself with the healthy sound of the chest. I wish I could lend you my little black stethoscope that I brought from the Maternité.

  When Elizabeth returned to New York she was too poor to realize the dream of building an experimental hospital. “If I were rich,” she had told her sister, “I would not begin private practice, but would only experiment. As however I am poor, I have no choice.” Choice absent, she went about doing God’s work on earth. She set up a general practice and spent cold winters and steaming summers trudging the pavements with her black bag. Work on, Elizabeth! Proudly sporting the stethoscope she had brought from the Maternité, she attended to mainly poor, mainly female, chiefly immigrant patients. Her early years as this nation’s first woman doctor of medicine were not encouraging. She confessed her deep unhappiness: “I had no medical companionship, the profession stood aloof, and society was distrustful of the innovation. Insolent letters occasionally came by post, and my pecuniary position was a source of constant anxiety.” It was impossible to rent an office, the term “female physician” having been preempted by ill-trained abortionists, and she went into debt by buying a house on East Fifteenth Street. She worked in the attic and the basement, renting out the remainder of the house. Her isolation prompted her to adopt a 7-year-old orphan, Katharine Barry, and this young child became a lifetime companion, friend, and housekeeper.

  Slowly, Elizabeth Blackwell began to attract support from the New York Quaker community, and in 1854 she opened on the Lower East Side a one-room dispensary in which she treated more than two hundred women in the first year. Its first annual report, written to rouse further support, spelled out its aims:

  The design of this institution is to give to poor women the opportunity of consulting physicians of their own sex. The existing charities of our city regard the employment of women as physicians as an experiment, the success of which has not been sufficiently proved to admit of cordial co-operation. It was therefore necessary to provide for a separate institution which should furnish to poor women the medical aid which they could not obtain elsewhere.

  By 1856, the sisters were reunited. Emily had also had extensive medical training after having earned an MD degree from Western Reserve. She had walked the wards of Bellevue in New York and spent two Wanderjahre working with Sir James Young Simpson in Edinburgh, Franz von Winckel in Dresden, and William Jenner at the Children’s Hospital in London. The Blackwell pluck and persistence paid off. Elizabeth’s goal of founding an experimental hospital was achieved, but the medical experiments performed in it were in the field of women’s rights and social justice rather than physiology or therapeutics. With the help of progressive philanthropists and their good friend Horace Greeley, the Blackwells established in 1857 the New York Infirmary for Women and Children at 64 Bleecker Street. They successfully overcame every objection of the time: that female doctors would require police protection on their rounds; that only male resident physicians could control the patients; that “classes and persons” might be admitted whom “it would be an insult to treat” (i.e., beggars and prostitutes); that signatures on death certificates might be invalid (the legal rights of women in the presuffrage era were fragile); that the male trustees might be held responsible for any “accidents”; and that in any case no one would supply women with enough money to support such an unpopular effort.

  With Emily in charge of this going concern, Elizabeth traveled back to England and became the first woman to be registered as a physician in that country. She studied programs of maternal hygiene, looked over public health programs for women and children, and toyed with the notion of spending the rest of her life founding a country hospital with Florence Nightingale, to whom she had formed an intense personal attachment. The delicate overtones of her memoir anticipate lines that Katharine Lee Bates dedicated to Nightingale a generation later:

  Fragrant thy name as the City of Flowers;

  Sweet thy name as a song in the night;

  Over all wonders of womanhood towers

  Thy glory, white as the Cross is white.

  When Elizabeth returned to New York in 1860, the sisters enlarged the infirmary, added new staff, and put in place the preventive measures of the sanitarian revolution. Their most critical innovations were in community health; they were the first to send “sanitary visitors” to the poorer neighborhoods of the city; their Tenement House Service was the earliest instance of medical social service in the United States.

  The Civil War engaged the abolitionist spirit of the Blackwell family. On the day after Fort Sumter was fired on, the Blackwells helped to found the National Sanitary Aid Society; this became the nucleus of the Sanitary Commission. The Blackwells also acted as a conduit for the nursing corps which Dorothea Dix was assembling in Washington. Elizabeth wrote:

  All that could be done in the extreme urgency of the need was to sift out the most promising women from the multitudes that applied to be sent on as nurses, put them for a month for training at the great Bellevue Hospital of New York, which consented to receive relays of volunteers, provide them with a small outfit and send them on for distribution to Miss Dix.

  When the war was over and finances permitted, another dream of Elizabeth Blackwell was realized. In the course of those long nights at the Maternité she had written, “What chance have women shut out from these instructions? Work on, Elizabeth!” It was another nineteen years before women could receive such instructions in New York: in 1868 the Blackwells founded a modern medical college for women, which by 1908, when it was absorbed by the newly coeducational Cornell University Medical College, had graduated 394 women doctors. Work on, Elizabeth, indeed! The faculty included such eminent female physicians as Mary Putnam Jacobi, considered the founder of pediatrics, and Elizabeth Cushier, professor of gynecologic surgery. The laboratories for instruction in b
oth basic and applied sciences were among the most up to date in the country, and the three-year curriculum exceeded in rigor much of what passed for medical education elsewhere. Elizabeth Blackwell became the first professor of hygiene, and it was due to her efforts and those of Emily, who succeeded her, that many of the leaders of the sanitarian revolution got their start at the Women’s Medical College of the New York Infirmary for Women and Children.

  Perhaps the most remarkable aspect of the Blackwell family record is not their sanitarian or abolitionist zeal, but the large swath the family cut in feminist history. If, in the phrase of William James, the James family seemed to have “a serpent in its blood,” the Blackwells had a colt. But their sanguine temperament ran in a direction opposite to that of the saturnine Jameses. Nowadays when one speaks of “the Blackwells” one includes not only Elizabeth and Emily but also a small tribe of reformers that spanned three generations. Of the twelve children of Samuel and Hannah Lane Blackwell, three died in infancy; Anna became a newspaper correspondent for Horace Greeley; Ellen developed into an author and artist; Emily and Elizabeth were doctors; and two of the brothers, Samuel and Henry, had public careers.

  Samuel Blackwell married Antoinette Louisa Brown, who in 1853 was ordained as the first woman minister of a recognized denomination in the United States (Congregational). One of the few pulpits that offered her a guest appearance was that of the Universalist congregation in Worcester, Massachusetts, led by Thomas Wentworth Higginson—the Higginson who nurtured Emily Dickinson’s verse and who became colonel of a black regiment of freed slaves in South Carolina. As Louisa Brown, the future Blackwell had worked in New York’s prisons and hospitals and written accounts of their need for institutional reform that were published in Greeley’s Tribune and later collected as Shadows of Our Social System (1856). Samuel Blackwell had sought her out at her upstate church precisely because of her writings. An abolitionist to the core, she became after the Civil War an ardent supporter of the suffrage movement, and both Blackwells were active in Julia Ward Howe’s Association for the Advancement of Women.

  Henry Browne Blackwell, himself an ardent abolitionist and Free-Soiler, married Lucy Stone, an Oberlin classmate of Louisa Brown Blackwell. A pioneer feminist, she insisted on keeping her own last name after marriage; women who adhered to this custom were for a while called “Lucy Stoners.” At their wedding ceremony, on May 1, 1855, the Blackwells agreed on having read publicly a protest against the marriage laws then on the books. The protest was given wide circulation in an account by the minister who presided at the wedding: Thomas Wentworth Higginson. Henry, seven years her junior, had courted Lucy for two stormy years before finally winning her by saving a fugitive black woman from her owners. After the Civil War, Lucy Stone, Henry Blackwell, and their daughter Alice edited the influential feminist periodical the Women’s Journal. The Journal became the official voice of the American Woman Suffrage Association, which Lucy Stone and Julia Ward Howe formed in 1869. The final public speech that Lucy Stone delivered was at the Columbian Exposition in 1893, naturally enough at the Woman’s Building so beloved by Katharine Lee Bates. It was Stone’s last chance at alabaster; she dodged the tomb and continued the Blackwell record of firsts by becoming the first person to be cremated in New England.

  The personal affairs of Elizabeth and Emily Blackwell remained as monogamous as those of their brothers. Aside from her early involvement with Florence Nightingale, Elizabeth spent all of her life—the last thirty years in seaside retirement—with her adopted daughter and friend, Kitty Barry. Emily and her lifelong companion, Dr. Elizabeth Cushier, spent twenty-eight happy years together in a Gramercy Park brownstone in New York and on the coast of Maine.

  It is difficult to find a group of men and women more enmeshed than the Blackwells in the great movements of the nineteenth century, to find a family more involved with intellectual conquest and social good. But many would argue that the Holmes family made as great a contribution to reform as the Blackwells. The two Oliver Wendell Holmeses, the Autocrat of the Breakfast-Table and his son, an Associate Justice of the Supreme Court, took the Brahmin road in support of many of the Blackwell causes, and the written record they left behind is more glittering by far than that of the Blackwells. Holmes Jr. thrice shed blood for the Union, and the doctor caused many to shed tears for the cause. In one of his “Medical Essays” of 1864 the elder Holmes sums up the political philosophy that he and the Blackwells espoused, and which his son was to make part of the common law:

  This Republic is the chosen home of minorities, of the less power in the presence of the greater. It is a common error to speak of our distinction as consisting in the rule of the majority. Majorities, the greater material powers, have always ruled before. The history of most countries has been that of majorities,—mounted majorities, clad in iron, armed with death, treading down the tenfold more numerous minorities. In the old civilizations they root themselves like oaks in the soil; men must live in their shadow or cut them down. With us the majority is only the flower of the passing noon, and the minority is the bud which may open in the next morning’s sun. We must be tolerant, for the thought which stammers on a single tongue to-day may organize itself in the growing consciousness of time, and come back to us like the voice of the multitudinous waves of the ocean on the morrow.

  It is now more than a century and a half later, and while the condition of women is not what it was then, we can see that the thoughts that stammered on the Blackwell tongue were slow in organizing themselves. It was not until 1915 that the medical school of New York University consented to give its first faculty position to a woman, Dr. S. Josephine Baker, one of this century’s pioneers of social medicine. Dr. Baker had graduated from the Women’s Medical College of the New York Infirmary for Women and Children in 1895, and after a distinguished period of practical work, she became a lecturer in child hygiene at Bellevue Hospital. In her autobiography, she wrote:

  They never allowed me to forget that I was the first woman ever to impose herself on the college. I stood down in a well with tiers of seats rising all around me, surgical-theater fashion, and the seats were filled with unruly, impatient, hardboiled young men. I opened my mouth to begin the lecture. Instantly, before a syllable could be heard, they began to clap thunderously, deafeningly, grinning and pounding their palms together. Then the only possible way of saving my face occurred to me. I threw back my head and roared with laughter, laughing at them and with them at the same time—and they stopped, as if somebody had turned a switch. I began to lecture like mad before they changed their minds, and they heard me in dead silence to the end. But the moment I stopped at the end of the hour, that horrible clapping began again. Frightened and tired as I was from talking a solid hour against a gloweringly hostile audience, I fled at top speed. Every lecture I gave at Bellevue, from 1915 through to 1930, was clapped in and clapped out that way; not the spontaneous burst of real applause that can sound so heart-warming, but instead, the flat, contemptuous whacking rhythms with which the crowd at a baseball game walk an unpopular player in from the outfield.

  We’ve come a long way since 1930, and these days the impediments to full equality in the profession are more likely to arise de facto than de jure, but the verdicts of prejudice can be as stern as those of law. The medical and social causes to which the Blackwells, the Holmeses, the Stones, and the Bakers devoted themselves have by and large prevailed: abolition of slavery achieved, the Union preserved, sanitation promoted, infections curbed, child and maternal health protected by the state, women’s rights in the profession moving slowly ahead. We are farther along than Elizabeth Blackwell hoped for on her return from London. Women are not what they were over a century ago. Yet we are still some distance from realizing her fondest hope, that of a social movement which would unite the sexes under the banner of moral reform.

  On December 1, 1850, Elizabeth Blackwell wrote that she regretted she had been unable to attend the Convention for Women’s Rights held in Worcester, Massa
chusetts, the previous October:

  But I feel a little perplexed by the main object of the Convention—Women’s Rights. The great object of education has nothing to do with woman’s rights or man’s rights, but with the development of the human soul and body. . . . My great dream is of a grand moral reform society, a wide movement of women in this matter; the remedy to be sought in every sphere of life. . . . Education to change both the male and female perverted character; industrial occupation, including formation of a priesthood of women; colonial operations, clubs, homes, social unions, a true Press; and the whole combined that it could be brought to bear on any outrage or prominent evil.

  George Eliot could have called that grand moral reform movement “meliorism”—and she did.

  17.

  Call Me Madame

  Le concret c’est de l’abstrait rendu familier par l’usage.

  [The concrete is the abstract made familiar by usage.]

  —Paul Langevin (1923)

  ON APRIL 19, 1906, THE 47-YEAR-OLD NOBEL LAUREATE, Pierre Curie, was run over by an oversize, horse-drawn wagon filled with bales of army uniforms. He was attempting to negotiate the tricky Parisian intersection where traffic from the rue Dauphine, the quai de Conti, the quai des Grand-Augustins, and the Pont Neuf have created Gallic havoc for over a century. Curie had just left a meeting of reform-minded university professors at which he had argued for legislation to improve the lot of junior faculty and to prevent laboratory accidents. He had planned to stop at his publisher’s office, but the office was shut because of a strike by equally reform-minded trade unionists. Absentminded and somewhat radium-sick, he turned away in the spring rain, and was on his way to the library of the Institut, when the six-ton wagon rumbled down the bridge from the Île de la Cité and crushed his skull.