The Doctor Wore Petticoats: Women Physicians of the Old West

by Enss, Chris

  WATCHING HER CLOSEST FAMILY MEMBERS DIE FROM TYPHOID FEVER BROUGHT NELLIE MACKNIGHT TO THE MEDICAL PROFESSION.

  Nellie was born to Olive and Smith MacKnight on December 15, 1873, in Petrolia, Pennsylvania. She was one of three children for the MacKnights. Their son and first daughter died shortly after they were born.

  Olive was very protective of her surviving child, and Smith, a land surveyor by trade, constantly showered his “only little girl” with attention. According to her autobiography, Nellie’s early years were happy ones. She was surrounded by the love and affection of her parents and numerous extended family members.

  In 1878 Smith MacKnight contracted a case of gold fever that drove him to leave his wife and child and head west. Before he left, he sent Olive and Nellie to live with his parents in New York. He promised to send for the pair once he had found gold.

  Olive was distraught over the move from their home and the prospect of being without her husband. It was a heartbreaking experience from which she never fully recovered.

  By the time Smith’s first letter from California arrived, five-year-old Nellie and her mother had settled into life on the MacKnight farm. The absence of Smith made Olive quiet, withdrawn, and despondent. Aside from the time spent with her daughter, she seemed content to be left alone. Nellie, on the other hand, was outgoing and cheerful. She was particularly close to her grandmother, whose character was much like her own. Grandmother MacKnight taught Nellie how to cook and quilt, and how to prepare homemade remedies for certain illnesses. Her grandfather and uncle taught her how to ride a horse and care for animals.

  As Olive slipped further into depression, Nellie became more attached to her grandparents. A letter from Smith, announcing that he had purchased a mine with “great potential,” momentarily lifted Olive’s spirits and gave her hope that they might be together soon. Several days later, news that Olive and Nellie would have to wait for the mine to pay off before Smith sent for them left her devastated all over again. The dispirited woman cried herself to sleep nightly.

  The stability Nellie had come to know at her grandparents’ home ended abruptly one evening in October of 1880. Her grandmother contracted typhoid fever and died after a month of suffering with the illness. Nellie watched pallbearers carry her grandmother’s wooden coffin into the cemetery. She wept bitterly, wishing there had been something she could have done to save her. The subsequent death of her favorite uncle, suffering from the same ailment, served as a catalyst for her interest in healing.

  Fearing for the physical well-being of her daughter, Olive moved Nellie to her father’s home in Madrid, Pennsylvania. Any hopes the two had that their circumstances would improve at their new location were dashed when Olive became sick and collapsed. The high temperature from typhoid fever made Olive delirious. She didn’t recognize her surroundings, her family, or her child, and she cried out constantly for her husband.

  Olive recovered after several weeks, but the fever and the sadness of being separated from Smith had taken its toll. Her dark hair had turned gray and the dark hollows under her eyes were permanent fixtures.

  Smith’s mine in Bodie, California, had still not yielded any gold and he was unable to send any money home to support his family. In order to keep herself and Nellie fed and clothed, Olive took a job at the Warner Brothers Corset Factory. Nellie attended school and excelled in all her subjects, showing an early aptitude in medicine. She pored over books on health and the human body.

  When Nellie wasn’t studying, she spent time trying to lift her mother’s melancholy spirit. Letters from Smith made Olive all the more anxious to see her husband again and even more brokenhearted about having to wait for that day to come.

  She began using laudanum, a tincture of opium used as a drug, to ease the pains she had in her hands and neck. The pains in her joints were a lingering effect of the typhoid fever. Olive developed a dependence on the drug and one night overdosed. She left behind a note for her daughter that read, “Be a brave girl. Do not cry for Mamma.” Smith was informed of his wife’s death, and although he was sad about the loss, he continued working his claim.

  The day after Olive was laid to rest, ten-year-old Nellie was sent back to New York to live with her father’s brother and his wife. Nellie’s uncle was kind and agreeable, but her aunt was not. She was resentful of Nellie being in the home and treated her badly. Nellie endured her aunt’s verbal and physical abuse for two years until her mother’s sister invited Nellie to live with her at her farm 4 miles away.

  Nellie adapted nicely to the congenial atmosphere and learned a great deal from her aunt about primitive medicine. After a short time with her aunt, Nellie finally received word from her father. Smith was now living in Inyo County, California, and working as an assayer and surveyor. Nine years of searching for gold had turned up nothing. Smith decided to return to his original line of work and he wanted his daughter by his side.

  Fourteen-year-old Nellie met her father on the train in Winnemucca, Nevada. Smith agreed to meet with her there and escort her the rest of the way to his home. Although his face was covered with a beard and his eyes looked older, Nellie knew her father when she saw him. Smith, however, did not instantly recognize his child. He wept tears of joy as she approached him. “You’re so grown up!” he told her. Little time was spent before the pair took their seats to continue their journey. Father and daughter had a long way to travel before they reached Smith’s cabin in Inyo County. As the train sped along the tracks, Nellie was in awe of the purple blossoming alfalfa that grew along the route and of the grandeur of the Sierra Mountains.

  Nellie continued to be impressed with the sights and people she encountered during their two-day trip to the homestead in Bishop. Smith promised his daughter a happy life among the beauty and splendor of the California foothills. In an 1887 journal entry, Nellie recorded her thoughts about how exciting, gay, and carefree she found her new home to be:The streets of the town were like a country road, lined with tall poplars and spreading cottonwoods—quick growing trees marked boundary lines and gave shelter to man and beast. Their leaves were pieces of gold in the sunshine.

  After a brief stay at her father’s ranch, Smith enrolled Nellie at the Inyo Academy. She would be not only studying at the school but living there as well. Smith spent a great deal of time on surveying trips and wanted Nellie to be in a safe place while he was gone. The Inyo Academy was home to many young men and women whose parents were ranchers and cattlemen from all over the country. Nellie thrived at the school, and once again excelled in every subject. Upon graduation, she was valedictorian of her class.

  Smith insisted the now seventeen-year-old Nellie should go to college and continue her education. She was in favor of the idea and decided to pursue studies in literature. Smith promised to pay for her schooling only if she chose law or medicine as her point of interest. Nellie wrote:If I wished an education I must abide by his decision. My only knowledge of the law was “the quality of mercy.” My only picture of a woman doctor was that of Doctor Mary Walker, dressed in men’s clothes and endeavoring in every way to disguise the fact that she had been born a woman. That I should choose neither was unthinkable.

  As Nellie contemplated her decision, her thoughts settled on her grandmother’s struggle with typhoid fever and her mother’s fatal attempt to ease the physical pain she suffered. It didn’t take Nellie long to come to the conclusion that her “calling” was in medicine.

  Just prior to Nellie graduating from the Inyo Academy, her father remarried. Nellie’s initial reaction to her stepmother was one of indifference, but as she got to know her she had a change of heart. She was an extremely kind woman and never failed to show Nellie love and compassion. She encouraged her stepdaughter in her future endeavors and cried for days when Nellie moved to San Francisco to attend medical school.

  Smith accompanied his only child to the Bay Area and on to Toland Hall Medical College. He paid her tuition, helped her find a place to live, wished her well, and returne
d to Bishop. Their parting was difficult. Nellie was grateful for the opportunity he was giving her and vowed to be home soon with a diploma in hand. Neither fully realized how difficult it would be to fulfill that promise.

  The attitude of many of the Toland Hall professors and students toward women in medicine was vicious. Most felt a woman’s presence in the medical profession was a joke. Nellie was aware of the prevailing attitude and was determined to prove them wrong. She devoted herself to her studies, arriving at school at dawn to work in the lab. She kept late hours, poring over Gray’s Anatomy and memorizing the definitions of various medical terms.

  The harder she worked, the more resentful her male classmates became. They exchanged vulgar jokes with one another whenever Nellie or one of the other two women attending the school was around, in hopes of breaking their spirits. Professors were cold and distant to the women, oftentimes refusing to answer their questions.

  Doctor R. Beverly Cole, Toland Hall’s Professor of Obstetrics and Gynecology, delighted in insulting female students during his lectures. He maintained publicly that “female doctors were failures.” He told students, “It is a fact that there are six to eight ounces less brain matter in the female. Which shows how handicapped she is.”

  Nellie quietly tolerated Doctor Cole’s remarks and allowed them only to spur her on toward her goal of acquiring a degree.

  While in her third year of medical school, Nellie took an intern position at a children’s hospital. Many of the patients that allowed her to care for them were Chinese. She assisted in many minor operations and births, and she helped introduce modern medicines and cures.

  Months before Nellie was to graduate, she was granted permission to assist in a major surgery. Two physicians were required to perform an emergency mastoid operation on a deathly ill dock-worker. Nellie was one of two interns on duty and the only woman. The male intern fainted at the sight of the first incision. Nellie was a bit uneasy as well, but assured the doctor she could do the job when he ordered her at his side. She recounted the event in an 1893 journal entry:The surgeon talked as he worked. He described the blood supply, the nerve supply, the vessels that must be avoided, the paralysis that would follow if he invaded the sacred precinct of the facial nerve. Chip by chip he removed the bone cells, but the gruesome spectacle had been magically transformed into a thrilling adventure. I forgot that I had a stomach; forgot everything but the miracle that was being performed before my eyes, until the last stitches were placed, the last dressings applied.

  Nellie eagerly looked forward to graduation day. In spite of the fact that her grades were good and her talent for medicine was evident, the male faculty and students remained unimpressed with her efforts. She was confident that when she and the two other female students accepted their diploma, the men would be forced to recognize that a woman’s place in the emerging profession was a definite.

  Shortly after passing her final examination, Nellie was summoned to the dean’s office. The dean was a man who did not share Nellie’s vision of women in medicine and because of that, she feared he was going to keep her from graduating. The matter he wanted to discuss, however, was how she wanted her name to appear on her diploma. She told the dean that her christened name would be fine. The man was furious. “Nellie Mattie MacKnight?” he asked her, annoyed. “Nellie Mattie?” Nellie did not know how to respond. “How do women ever expect to get any place in medicine when they are labeled with pet names?” he added.

  The dean persuaded Nellie to select a more suitable name. She searched her mind for names from which her name might have been derived. “I had an Aunt Helen . . . and there was Helen of Troy,” she thought aloud. “You may write Helen M. MacKnight,” she said, after a moment of contemplation. The dean informed her that he would make the necessary arrangements. Before she left his office, he added, “See that it is Helen M. MacKnight on your shingle too!”

  Nellie graduated with honors from Toland Hall Medical School. Her father and stepmother were on hand to witness the momentous occasion. As her name was read and the parchment roll was placed in her hands, she thought of her mother and grandmother, and pledged to help cure the sick. Chances for women to serve the public in that capacity were limited, however. Widely circulated medical journals stating how “doubtful it was that women could accomplish any good in medicine” kept women doctors from being hired. They criticized women for wanting to “leave their position as a wife and mother,” and warned the public of the physical problems that would keep women from being professionals. An 1895 Pacific Medical Journal article surmised:Obviously there are many vocations in life which women cannot follow; more than this there are many psychological phenomena connected with ovulation, menstruation and parturition which preclude service in various directions. One of those directions is medicine.

  In San Francisco in 1893, there was only one hospital where women physicians practiced medicine. The Pacific Dispensary for Women and Children was founded by three female doctors in 1875. The facility was designed to provide internships for women graduates in medicine and training for women in nursing and similar professions. Nellie joined the Pacific Dispensary staff, adding her name to the extensive list of women doctors already working there from all over the world.

  In the beginning, Doctor MacKnight’s duties were to make patient rounds and keep up the medical charts by recording temperatures, pulses, and respiration. After a short time she went on to deal primarily with children suffering from tuberculosis. She also assisted in surgeries and obstetrics, and was involved in diphtheria research.

  In 1895, Nellie left the hospital and returned home to help take care of her ill stepmother. Within a month after Nellie’s arrival, her stepmother was on her way to a full recovery. Nellie decided to stay on in Bishop and set up her own practice.

  The response she received from the community and the two other male physicians in town was all too familiar to her. She persevered, however. She set up an office in the front room of her house, stocked a medicine cabinet with the necessary supplies, and proudly hung out a shingle that read HELEN M. MACKNIGHT, M.D.,

  PHYSICIAN AND SURGEON.

  Doctor MacKnight traveled by cart to the homes of the handful of patients who sought her services. She stitched up knife wounds, dressed severe burns, and helped deliver babies. As news of her healing talents spread, her clientele increased. Soon she was summoned to mining camps around the area to treat typhoid patients. Although her diploma and shingle read Helen M. MacKnight, friends and neighbors who had known her for years called her “Doctor Nellie.” It became a name the whole countryside knew and trusted.

  While tending to a patient in Silver Peak, Nevada, Nellie met a fellow doctor named Guy Doyle. The physicians conferred on a case involving a young expectant teenager. Doctor Doyle treated Doctor MacKnight with respect and kindness. Nellie was surprised by his behavior, and made note of her reaction in an 1898 journal entry:I had worked so long, fighting my way against the criticism and scorn of the other physicians of the town, that it seemed a wonderful thing to find a man who believed in me and was willing to work with me to the common end of the greatest good to the patient.

  What began as a professional relationship grew quickly into romance. The couple decided to pool their resources and go into business together. They opened an office inside a drugstore on the main street of Bishop. In June of 1898, Helen and Guy exchanged vows in a ceremony that was attended by a select few in Inyo County. According to Nellie’s account of the event:My wedding dress was a crisp, white organdy, with a ruffled, gored skirt that touched the floor all the way around. The waist had a high collar and long sleeves. The wedding bouquet was a bunch of fragrant jasmine. . . . A small group of friends came to witness the ceremony, and the gold band that plighted our troth was slipped over my finger.

  Doctor Nellie MacKnight Doyle and Doctor Guy Doyle provided the county with quality medical care for more than twenty years. The couple grew their practice and took care of generations of Bishop residen
ts. Nellie and Guy had two children—a girl and a boy. The daughter followed in her mother’s footsteps and pursued a medical degree. Upon her graduation from college, she was given a foreign fellowship in bacteriology.

  Doctor Nellie M. MacKnight spent the last thirty years of her life studying and practicing anesthesiology. She died in San Francisco in 1957 at the age of eighty-four.

  PATTY BARTLETT SESSIONS

  MORMON PHYSICIAN

  A doctor, if he had good sense would not wish to visit women in

  childbirth. And if a woman had good sense she would not wish a

  man to doctor them on such an occasion.

  —Brigham Young, December 1851

  The shrill cry of a woman in immense pain filled the otherwise quiet night sky over Utah’s Salt Lake Valley. Patty Bartlett Sessions smiled down at the expectant mother and wiped the sweat off her forehead. Barely out of her teens, the woman was in the final stages of delivery and frightened of the experience her body was going through. Her pleading eyes found compassion in the fifty-two-year-old midwife caring for her.

  Patty Bartlett Sessions had helped bring hundreds of babies into the world. The sparsely populated western frontier of the 1800s was in need of trained birth attendants who could help ensure mother and child survived the grueling process of labor and delivery. The gifted midwife calmly reassured the frantic mother-to-be with stories of the healthy infants she had laid in the arms of anxious mothers. The exhausted woman nodded and tried to smile through a contraction.