by Judy Alter
“I think I know what you’re saying,” I said, pausing in my work to look at him, “and I’ll try to see Sara gets what she needs.” But inwardly I thought grimly that Sara was going to have to take more responsibility because I was going to have less time.
I finally did hire a housekeeper, at the direction of Dr. Dinsmore. Her name was Kate, and she was probably only a year or two older than me. Like me, she came from a poor family, only there were five other children in her home. She allowed as how she’d rather live in, and only visit home occasionally, so we agreed on that. But Kate was all business. She swept with a vengeance, cooked a fair meal—Lord knows, better than I did—and seldom played with Sara. Poor Sara. Maybe she, of everyone, got the worst of my decision to go to medical school.
Dr. Dinsmore was pleased with his duties at the college of medicine. He was to lecture in general medicine, which meant a chance for him to explore and develop his theories about medicines and health and the human body. He found some opposition to his ideas at the school, where traditional doctors, who had been teaching not much longer than he since the school was only three or four years old, objected to his stinginess with medicines. They tended to operate on the theory that if a little was good, a lot was better, and they would dose patients heavily with cathartics, diuretics or emetics, all strong potions for the human body.
Dr. Dinsmore would talk to me about it in the evenings, when I generally found time for my reading. Sometimes he raised his voice in anger.
“If God had meant the human body to become a receptacle for laudanum, he wouldn’t have made that drug less harmful and dangerous! Don’t they understand when they lessen someone’s pain a little, they’re causing more grief by starting an addiction?”
Once or twice, he casually tossed medical books in my direction, and I was thrilled but baffled. Gray’s Anatomy had fascinating drawings of the human body, and I studied them carefully, but a text on obstetrics was beyond me and awfully intimidating.
One night he talked to me about the attitudes he thought I might face at the medical school. “They’ve not had a woman before. You’ll be the first, and they’re not likely to be pleased.”
“Will they accept me?” I looked up from my book to see that he was standing staring at me in what I had come to think of as his lecturing pose.
“Oh, I think so, with my standing for you. But they won’t be happy about it. Some people don’t think women should be doctors.”
“Why not?”
“Well, they think it’s unseemly. You should be more modest than to pry around people’s anatomy, especially that of men.”
“There’s a reverse to that,” I insisted. “Women should be glad to have a woman who’s done that. I mean, they should prefer a woman doctor.”
“Some might. But some will think every bit as badly of you as men do. And some men may refuse to let you care for them.”
“I’ll handle that when it happens,” I said with a bravado I didn’t really feel. “When should I apply?”
“Pretty soon, I suspect. The new term begins in about three weeks. Remember, Mattie, I’ll help you any way I can, but you’re pretty much going to have to fight your own battles . . . and they may indeed be battles . . . with faculty and students. Back east, you know, quite a few women are going into medicine, and they’ve even opened special women’s medical schools. But this is Nebraska, a different world.”
“I’ve survived prejudice before,” I said stubbornly, thinking of the way everyone in Princeton gossiped about Mama and whispered and pointed at me when I went to the store. Maybe I had learned from those awful days.
I went to the medical school the next day to present myself and apply for admission. And I went with knee-shaking, heart-pounding terror, the kind that made me think even as I mounted the stairs that I’d have to turn and run. If Dr. Dinsmore hadn’t been there, no telling what I’d have done.
The Omaha Medical College was housed in a dark, two-story frame building with a steep row of steps up the front to the door, a sign that said “Free Dispensary” and absolutely not a bush or blade of grass on the barren earth that surrounded the building. Dr. Dinsmore explained that the free dispensary was a way of providing patients to give students more practical experience, something missing from many medical schools.
He gave me a tour of the school from classroom and dispensary offices to the anatomy lab, where I remember avoiding a sheet-covered mound on a table, and then took me to the office to apply for admission.
It was nothing like today, with complicated requirements and the likelihood of being turned down. They pretty much accepted almost anyone who could write his name, and I was well qualified. But I was a woman.
“We haven’t had a woman here before,” the dean said. He was a dignified-looking man, tall with a white goatee and shining bald head. He wore the traditional white coat and sat behind an impressive big desk while he studied a letter from my schoolteacher in Princeton testifying to my ability to learn.
“What have you read?”
I was sure my voice would squeak and quake, but I managed to sound calm enough as I started to reel off the list of books I’d read, from Emerson and Thoreau to the European classics. He interrupted me abruptly.
“No, no. What have you read in medicine?”
Feeling foolish, I replied, “Gray’s Anatomy and some texts in general medicine. I’ve helped Dr. Dinsmore some, and I’ve talked with him a great deal about his ideas on medicine.”
“Yes. Well, you’ll have to realize his ideas don’t necessarily speak for the school.”
“They’re sound ideas,” I protested, beginning to be fed up with his air of superiority.
“No doubt, no doubt. Well, do you think you can stand to be the only woman in a class of eighteen young men?”
“Yes, sir.” I really didn’t know what to expect. I’d read that Elizabeth Blackwell was greeted with spitballs and jeers when she entered school, but that had been forty years ago. Still, the students in a Nebraska school might still be every bit as crude and resentful. But I was determined to stay. If I didn’t study medicine, what would I do with my life?
When Dr. Dinsmore came home that night, he was jubilant. “Well, Mattie, you did it!” He stood in the doorway, hands in his pockets and a broad smile on his face.
“Did I?” I tried to ask casually, as though I had not been waiting all afternoon for him to come home.
“Dean Lacross said you were a most determined young lady and that the faculty would, ah, attempt to let you enter the class.”
“Attempt? What does that mean?”
“I don’t think it means much except that you can start school,” he laughed. “Don’t get so upset by one little word.”
“It has a feeling to it,” I persisted stubbornly, “a feeling like they don’t think I’ll make it or I’ll ruin the school or . . . I don’t know, something awful will happen just because they’re letting me enter medical school.”
“They probably feel that way.” He turned and left, leaving me with a strong urge to throw something at him. Instead, I wiped my hands on my apron and went after Sara, who was curled up with a reader.
“Sara Dinsmore, you get right in here and put out the plates and flatware.”
“What has happened to you, Mattie?” she asked curiously as she put the book down and unwound her skinny legs from the chair.
Three weeks later, I started medical school. At least ten times while I was dressing that first morning, I thought, “I can’t do it. I’ll just go down and tell Dr. Dinsmore that I can’t possibly do it. It’s all a mistake.” And then I’d brush my hair or buckle a shoe and think, “Nonsense. I have to do it.”
At breakfast I was calm, hiding the storm that raged inside me, but I ate little, afraid the next bite would send me running from the table to be sick.
“Ready, Mattie?” To him this was just another day, and he showed no signs of understanding my dilemma.
“Yes,” I said, picking up the
sort of notebook we had decided would be appropriate for me and gathering my handbag.
We walked in silence at first, me still afflicted with that desire to bolt and run. Home, I thought, never seemed so comfortable.
“Nervous, Mattie?”
“Of course,” I muttered.
“Good.” That was all he said until we were almost in the door of the building. But at the foot of the steps, he stopped and looked at me. “You can do it, you know. I wouldn’t have suggested, pushed or urged unless I was quite sure. You may have some unpleasant experiences, and God knows, medical school is never pleasant for anyone, but you’ll survive, and you’ll do it gracefully. If you’re going to be the only woman, do it with flair.”
With that encouragement, I began two of the hardest years of my life. Medical school is noted today for being difficult, but it was another world back in those days. It hadn’t been too many years, of course, since people simply apprenticed themselves to a physician if they wanted to become a doctor. Medical school was virtually unheard of, especially in frontier parts of the country like Nebraska had been not too many years before, and medicine wasn’t the respected profession it is today. Too many doctors were unprofessional in their conduct and unsuccessful in their treatment of patients. By the time I went to school, the profession was just beginning to see organization of its education and some enforcement of standards that were restoring the respect doctors had enjoyed since ancient times. Would I, I wondered, add to that respect or bring disgrace?
“Nonsense, Mattie Armstrong,” I scolded myself, very nearly talking aloud. “You are going to do this and do it well, because you don’t want to go back to Princeton, Missouri, and you have got to do it to make people like Mama live.” And that, sentimental as it sounds, was the thought that kept me going.
The entering students met in a lecture hall that morning, all nineteen of us seated at wooden student desks while a Dr. Henley, balding with glasses and a gray mustache and a pocket watch stretched across his thin middle, paraded back and forth, waiting to begin the class. The room was small, with fading paint and a brand-new blackboard. I remembered that the school had been established in a former boardinghouse and these were fairly new quarters for it.
I stole a look at the others in my class, all men, of course, and decided they didn’t look threatening. They were mostly young, as young or more so than I, and they looked like freshly scrubbed schoolboys. There was one a slight bit older, with a mustache and a cynical look on his face. I was later to learn that his name was David Kimberly, and he was thirty and had been an undertaker in Iowa.
There was no commotion or fuss when I entered the room, though I saw one young man poke another and point in my direction, whispering in his friend’s ear. David Kimberly nodded at me, and one or two others stared outright. Dr. Henley had been warned, it seemed, for he addressed me directly.
“Good morning, Miss Armstrong.”
I managed to return a weak “Good morning, sir.” That, of course, brought further looks from my classmates, none of whom had been addressed personally.
Finally, Dr. Henley very obviously counted our heads and announced, “I see we are all gathered, so we will begin.”
Dr. Henley was, it seemed, professor of surgery, which in those days meant any and all kinds of medicine. He was what you call a general practitioner today, and he was in effect to shepherd us through medical school, “loaning us out” to various other professors who taught anatomy and pharmacology and other scientific subjects.
“Gentlemen . . . and, uh, Miss Armstrong . . . welcome.”
I blushed and hoped I was not to be so singled out for the next two years.
“You are about to begin the most important phase of your life. Look at those around you. Some will be strong enough for this rigorous training. Others will not.”
Was it my imagination, or did everyone look at me?
“There will be no special favors, no leniencies granted to anyone. Each of you will be expected to perform flawlessly, for the responsibilities you are about to undertake are grave indeed. Fellow human beings will place their lives and well-being and that of their loved ones in your hands.”
Dr. Henley droned on, and I decided he was a misplaced minister as he talked about awesome responsibilities and the like. If this, I thought, was medical school, it had been vastly overrated to me. We spent the entire day listening to Dr. Henley.
I went to Dr. Dinsmore’s office when we were dismissed late that afternoon. He sat behind a rolltop desk, with books and papers cluttered on top of it and a great anatomical chart hanging on the wall. His head down in his hands, he was unaware of my coming into the small office, and I wondered if I had caught him in an unguarded moment. He had seemed, lately, to have recovered so well from the tragedies of his life and to have been so delighted with his new work. Yet I sensed a fatigue or even despair in that posture of defeat.
“Dr. Dinsmore?” I spoke softly.
He brightened immediately. “Mattie! How was the first day?”
“Fine,” I lied, preferring to save the story for home, where no one might overhear my candid opinion of Dr. Henley.
“Good, good. I was just waiting for you, so let’s get home and check on Sara.”
On the walk home, about two and a half miles, I told him in detail about Dr. Henley, laughing at some of his statements and trying to be more serious about others.
“I take it you’re amused by all this?”
Was there disapproval in his voice? “No, not amused. But I expected something different from medical school. I expected, well, maybe to be ushered to a cadaver right away or at least to memorize the bones in the body. Some awful assignment that it was impossible to complete. Instead, we got a daylong sermon.”
“But an important one. On the ethics and responsibilities of medicine.”
Chastened, I was quick to say, “Oh yes, of course. An important lecture.”
Then he laughed. “Henley’s all right. He’s a bit of a bore, but he takes all that very seriously. And it is important. You’ve worked with me, and you know about responsibility and ethics. But what about some kid just off the farm? How do you know he doesn’t take medicine as a lark, better than plowing all day? How do we know why he’s here? He’s the one who needs that daylong lecture. And you’ll get your cadaver soon enough.”
Indeed I did. Cadavers and impossible assignments and long hours of studying that left my eyes burning and my back aching. We were in school every day from eight in the morning until five at night, then we rushed home with an armload of books to sit up until nearly morning poring over the day’s work and getting ready for the next. Many nights, Dr. Dinsmore would knock at my door and stick his head in to find me asleep over my books.
“Mattie.” He’d shake me gently. “Get up and go to bed. You’ve done enough for one day.”
“Can’t. I still haven’t memorized this muscle group and its relations.”
“It will be there tomorrow.”
Sometimes I’d take his advice and crawl, bone-weary, into bed, and other times I’d defiantly sit and begin again to read the material I’d just read three times before without understanding a word of it.
I remember still one student, Pete Rendon, who became my friend, studying with me and often choosing to eat his lunch with me. We all carried sack lunches from home, for none of us could afford to eat at the boardinghouse near the school, and besides, we preferred to study while we ate. Pete was a farm boy with a high school education and, like me, a burning desire not to live as his folks did.
“What about helping other people?” I asked one day.
He stretched a bony leg down the steps on which we sat, ran his hand through his straight blond hair and thought a minute. “I’d like to be honest about that, because I’ve thought a lot about it. I guess you have to want to help people to be able to do the things medicine requires, but I’m not sure if that’s the real reason I’m here. I mean, I don’t know if it’s burning dedication
. . . or a chance to get off the farm.”
“Don’t let Dr. Dinsmore hear you,” I warned. “He thinks you’d better be dedicated or else.”
“Oh, I reckon I’m dedicated enough to satisfy him. At least, sure more than that Kimberly fellow.”
David Kimberly had rapidly become the least popular student in our class, especially with me. He ingratiated himself with teachers, tried to buddy up to students who were smarter than he was and kept asking to walk me home.
“I walk with Dr. Dinsmore,” I said frostily, because the man’s too smooth ways infuriated me. At another time, smoothness would, to my misfortune, make a big impression on me, but I wasn’t ready to meet men at that point, at least not as men.
“Ah, now, Mattie Armstrong, I know we can be friends, and you need a friend in this place.” He leered at me, or so I thought, not being sure what a leer was but having heard the word.
“I have friends, thank you.”
“We could study together, and I, ah, I could help you with your work.” He leaned close to me, ever so barely taking my elbow with his hand, grinning all the while.
“Or do you mean I could help you?” I jerked my elbow away and marched defiantly in the other direction. One would have thought, or at least I would, that such rudeness would have been enough to discourage Kimberly, but it was not. I had to contend with him during the entire two years of school, because every once in a while he’d decide to offer to help me with my studies or walk me home. I think he wanted an invitation to the house so he could get closer to Dr. Dinsmore, but he never got one.
Christmas of the first year came and went, with only two days off in recognition of the holiday. There was no time off in the summer. By the end of our first year, we were well into our studies and were given the privilege of seeing patients, with a faculty member, of course, at the free dispensary. I was, without exception, assigned to female patients.