Significant Sisters

by Margaret Forster

  By November Elizabeth was being given more responsibility. On November 4th she got up early, after snatching a few hours’ sleep at the end of a particularly exhausting day, and made her way along the cold corridors to the ward where she was to syringe a baby who had purulent ophthalmia. The light was poor, she was still sleepy, and as she injected warm water into the baby’s tiny eye she was aware of her own clumsiness. What she thought was some of the water she was using spurted up into her own eyes as she bent over the baby. She dashed it out and went on with the job. By the afternoon she was uneasily admitting to herself that she had a prickling sensation in her right eye. By the evening there was no pretending – both eyes were visibly swollen and closed and even before she went to be examined she had no doubt that she had contracted the dreaded disease for which she had been treating the baby. Every possible treatment was instantly resorted to. Her eyelids were cauterized, leeches applied to her temples, her eyes syringed every hour with scrupulous care. M. Blot supervised her treatment himself, sitting at her side and every two hours, with fine pincers, peeling off the false membranes constantly forming over the globe of the eye. She lay for weeks in bed with both eyes closed, in an agony of apprehension, remembering the words of Dr Webster in Geneva – “Your fingers are useless without your eyes.” After three weeks her left eye finally opened. She had a split second’s clarity and then total blackness. She was blind in one eye and her vision was impaired in the other.

  On November 26th she left La Maternité and went to convalesce in Anna’s flat. In December, to her relief, her right eye was good enough to enable her to read and write. Her brother Sam wrote in his diary back home “Poor Elizabeth writes for the first time with her one eye. The physicians have no hope of saving the vision of the other. Elizabeth hopes we all still hope. She can distinguish the flame of a lamp as through thick mist and can discern something when the hand is passed across the eye. Her sense of the greatness of the loss is unspeakable . . .”34

  The next six months were a nightmare. Pity, Elizabeth discovered, was destructive. Everyone pitied her. The cruelty of her affliction, for a brilliant young doctor who hoped to become a great surgeon, aroused an appalled pity in everyone who knew her. No one, not even the devoted M. Blot, knew what to say or how to console her. Worst of all, although she struggled against it, Elizabeth pitied herself. She did not mind the disfigurement (“I never had much beauty to boast of”35 she wrote) but she could not bear to think her future as a surgeon was over. Pathetically, she toured Europe in the first months of 1850, trying to believe against all evidence that somewhere there was someone who could restore her sight. She tried cures, she tried exercises, she tried medicines, but eventually she had to face facts. She would never, ever see with one eye (which was finally removed) and would have impaired vision with the other. The oculist Desmarres had done as much as he could but was quite adamant that even her one remaining eye could never be perfect again. She could not be a surgeon. The realization that this had to be admitted brought her as near to collapse as she was ever to be. What had all her struggles been for if she was now forced to abandon medicine? She simply could not bear it and out of her misery and rage at the gross unfairness of it came a new determination. There was more to medicine than surgery. Why should she not turn now to general doctoring?

  This is what she did. With superhuman courage she once more began seeking out people who would help her to complete a practical training as a doctor. Not only did she have her sex against her but she also had her disablement. A one-eyed woman was not exactly going to be a prime candidate for an arduous hospital training. But thanks to the endeavours of a cousin and the genuine sympathy her accident had awakened St Bartholomew’s Hospital in London agreed to let her enter as a student. In October 1850 she returned to England to become a student for the third time. She took rooms at 28 Thavies Inn and walked every day to Bart’s where she found her class of sixty “very gentlemany”. James Paget’s wife wrote of her “Well, we have our ‘Lady Doctor’ here at last and she has actually attended two of James’ lectures, taking her seat with perfect composure . . . Her manners are quiet and it is evident her motives for the pursuit of so strange a vocation are pure and good.”36 Elizabeth was not only composed but happy. To her great pleasure she had at last discovered real friends – not at Bart’s (although she was well-treated there) but among that small group of ladies who were at that time leading the embryo Woman’s Rights movement in England. Barbara Leigh-Smith and Bessie Rayner Parkes both came to make themselves known to her and she was delighted to become part of a group. In many ways, it was the niche she had been looking for all her life and she was so comfortable in it that she thought seriously of staying in England and beginning work there. Unfortunately, she had no money and thought establishing a private practice in London, where there was much more prejudice against women than in America, would be beyond her means. Back home she had the support of her family and the comfort of knowing that already other women had been enrolled in medical colleges (although not in any of the leading ones). It would be wiser to return home, establish herself, make some money and then quickly return.

  But there was no prospect of a speedy return. Elizabeth arrived in New York in August 1851 to discover she was not even allowed to put a plate up outside her door in spite of being so indisputably a hospital- as well as a college-trained doctor. Not only was the profession determined to keep her out but society itself seemed equally determined to join it. In her first year she had hardly any patients and her sister Emily wrote “her pecuniary poverty and dearth of patients weighed very heavily with her.” Nobody trusted her, least of all the very sex she had trained to help. It was reported to her that ladies said to each other “Oh! It is too horrid! I’m sure I never could touch her hand! Only to think that those long fingers of hers had been cutting up dead people!”37 Every day, as she went about the little business she had, she had to suffer this kind of ridiculous hostility. She was harassed in the streets if she went out on a case at night and had to put up with open jeering. She never thought of pretending not to care because she did care. “I am a woman as well as a physician,”38 she wrote, and as a woman she was shocked and distressed by the slights and insults heaped upon her. “Poor E.” wrote Emily, “I cannot bear to think of her lonely poverty stricken winter.” But then, in the spring of 1852, Elizabeth’s luck slowly began to turn thanks to her own efforts. She gave a series of lectures on what she called the Laws of Life, with Special Reference to the Physical Education of Girls. These were attended by some Quaker families who were so impressed by the good sense contained in them that they began to come to Elizabeth as patients. The lectures were in fact such a success that they were then collected and published and became Elizabeth’s first major work available to the general public.

  From a feminist point of view the Laws of Life was a curious publication. As far as Elizabeth was concerned the whole development of the female child was towards one goal: motherhood. Her message was that the reason why girls must take care of their bodies was to make them perfect vessels for motherhood. They must not treat them “Like the poor over-driven hacks in our omnibuses.” In particular, girls must look after themselves at the onset of puberty, even delaying it if they could. She explained (erroneously) that “the physical education of the body, its perfectly healthy development, delays the period of puberty.” Once puberty arrived and a girl became a woman and a potential mother there were four laws she ought to follow: she should exercise regularly, live in an orderly fashion, try to blend “the life of the soul and the body”, and always put her body to proper use. “By the age of 16 or 17, under proper training, she will have acquired a strong, graceful and perfectly obedient body.” The “proper use” of her body was now child-bearing. During pregnancy she should follow a régime of “regular habits, early hours, periodic exercise, cold bathing, plain wholesome food and loose comfortable clothing.” Then followed a description of childbirth so romantic that it would call into serio
us doubt Elizabeth Blackwell’s actual experience if this were not so well authenticated. “The mother,” she wrote, “forgetful of weariness and suffering lifts her pale face from the pillow and listens with her whole soul . . . the mother’s face lights up with ineffable joy as she sinks back exhausted and the sentiment of sympathy, of reverence, thrills through the physician’s heart.” This idea of the holiness of motherhood was expanded into something even more far-fetched in a letter she wrote at the time to Lady Noël Byron. “Women have hitherto been the mothers of men,” she wrote, “but Woman must become the Mother of Man . . . collective womanhood must be acknowledged in every sphere of life.”39 It was almost as though, because she had deviated from the norm, Elizabeth Blackwell was determined to discourage others from doing so – as though she was afraid the norm was threatened and she herself was part of the threat therefore she must try to balance the harm she had done by idolizing this view of a woman’s role.

  But her philosophy proved acceptable to the Quakers and the turning point was reached. Early in 1853 Elizabeth was solvent and confident enough to open a small dispensary near Tompkins Square. She also borrowed money and bought a house on East 15th Street – a very good district in New York. Partly she wanted an address befitting her status but most of all she wanted to gather as many of her family as possible under one roof with her. Gradually, over the next three years, she made welcome her sisters Ellen and Marian; her brother Henry and his new wife Lucy Stone; her brother Sam and his new wife Antoinette Brown; and Maria Zakrzewska, a German woman who qualified as a doctor in America and came as a partner, and her sister. The last to arrive were Emily Blackwell, who had been following in Elizabeth’s footsteps by gaining experience in Britain after qualifying in America, and little Kitty Barry, the orphan Elizabeth adopted in 1856.

  The adoption of Kitty, aged seven, was Elizabeth Blackwell’s indulgence to herself. She was thirty-five years old and had long ago renounced all thoughts of marriage. To this she was quite reconciled. But what she found hard to reconcile was being childless as well as husbandless. Her carnal desires, while acknowledging their existence, she could control and sublimate but her maternal ones were not so readily dealt with. She felt she must have somebody who was hers to love and be loved by. Her family were not enough. And so she began going down to Randall’s Island, where four hundred orphans were housed, and looking for a child to be hers. She finally settled on Kitty Barry, whom everyone thought plain and stupid. Kitty described years later how a “very pleasant voiced lady” with gentle hands came up to her and asked her if she would like to be her little girl and come home with her. Kitty said yes but would the lady please wait until she had finished watching the sunset. Elizabeth waited, convinced she had made an excellent choice and that this very pale-faced, black-haired child was not “stupid”. As soon as they reached East 15th Street, she told Kitty about her eye and explained about her artificial eye which she called her “toilet”. “She never said ‘Don’t speak of it’” remembered Kitty, “but I never in all my life mentioned it to anyone . . .”40

  Elizabeth’s life took on a new dimension. Although she wrote that she was intending to train Kitty up to be “a valuable domestic” there was no doubt that she very quickly realized she was going to become something much more precious. “I feel full of hope and strength for the future,” she wrote soon after the adoption. “Kitty plays beside me with her doll . . . Who will ever guess the restorative support which that poor little orphan has been to me?”41 She sent Kitty to school – what Kitty referred to as “the crack school of the day” – and carried her there herself through the snow to keep her feet dry. Out of school they went on picnics together – “Aunt Elizabeth sat somewhere on a rock and read while I experimented with paddling among the rocks”42 – and joined a gymnastic class together.

  Kitty openly adored her benefactor and felt none of the unease the rest of the Blackwell family did about their relationship. The family did not deny it was a success, but they felt Elizabeth was too possessive and was not prepared to allow Kitty to develop independently. Kitty was all too clearly meant to fulfil two functions only – to be of practical assistance (she was put very early to doing the household bills) and to be a love-object. Any real existence of her own was ruled out. Elizabeth kept her to herself and did not help her to make friends of her own age. Apart from the family, there were others who saw the adoption as a confession of failure. Women were meant to be mothers, it was a perversion of nature to deny it, and this craving for a child proved it. Elizabeth, however, dared to suggest it proved something quite different – that society was wrong to expect self-realization in one sphere to go automatically with self-denial in another. By adopting Kitty, by agreeing her maternal instincts were thwarted, she was rejecting the theory of self-abnegation. She was saying that although self-sacrifice was necessary if a woman wished to have a career there was no need for it to be total. When it came to Kitty’s turn to wish she had been a mother, Elizabeth promptly fostered a baby for her to look after. She took in an eight-month-old boy and kept him for five years because “I knew it would give you so much pleasure.”43 It was this attitude which helped to steer feminism away from the dangerous shoals of martyrdom on which, at that time, it could well have been wrecked. Never try to suppress your maternal instincts, Elizabeth Blackwell said, and provided a valuable example.

  Meanwhile, Elizabeth’s life was taking on a better (and a more feminist) shape in other ways. If she was happier in her domestic life now that she had Kitty she was also much happier professionally because she had been able to enlarge and open up her dispensary to a wider and more needy public. She moved her premises to a much poorer area, south of 14th Street along the East River, where her dispensary became the New York Dispensary for Sick Women and Children (although her home remained in East 15th Street as did her private consulting rooms). It was her intention that it should be a kind of hospital run for women by women but she was obliged for the time being to make use of the services of friendly male doctors. Her friends and family thought she was mad. They thought she ought to go on with private practice but Elizabeth scorned anything so tame. Private practice was deeply unsatisfactory and did not answer her need to retain that sense of mission with which she had begun. Every time a case became interesting in private practice she always had to end up calling in a male doctor to perform whatever complicated operation or treatment was needed and she was tired of it. Unless women ran a hospital and gained hospital experience they would always be looked on as inferior. “We must be able,” she wrote, “to command all the exceptional and difficult cases.”44

  The work was hard but at least the patients came in droves and she found herself treating those very illnesses she had wanted to reach – menstrual disorders, pregnancy complications, sexual diseases, mammary tumours and abscesses, and prolapses of the uterus. She experimented with all kinds of treatments and began to amass a useful bank of knowledge on female problems. In May 1857, after a giant fund-raising campaign, she was able to move on to the next and most significant stage of expansion: the dispensary officially became an Infirmary. At 64 Bleecker Street the New York Infirmary for Indigent Women and Children was opened. Women served on the board of trustees, women were on the executive committee and the attending three physicians were all women – Elizabeth, Emily and Maria Zakrzewska. It was a moment of great triumph, followed at once by months of gruelling work. In the first six months 866 cases were treated, 48 as in-patients. In the next six months the numbers doubled and Elizabeth had to take on five new members of staff, all girls straight out of medical college. Emily, as the surgeon among them, was the star and Elizabeth had nothing but praise for her. But as the Infirmary consolidated its success she began to feel less indispensable and to plan a trip to England to raise more funds for even greater things. Part of the truth was also that she still missed the circle of friends she had made there. She never found equivalents for Bessie Rayner Parkes, Lady Noel Byron and Barbara Leigh-Smith. Barbara
Leigh-Smith, now married to Edward Bodichon, came to see her in 1858 and together they discussed Elizabeth’s return. One justification for it appealed to Elizabeth strongly: she could rally the women of England to enter medicine like the women of America.

  On August 18th, 1858, Elizabeth once more set sail for England, accompanied this time by the excited Kitty. She was worried about taking Kitty but was even more worried that if she left her behind she might be unhappy. They had a very stormy passage and Kitty was “ignominiously seasick”; Elizabeth got her nose sunburned towards the end of the trip. At first, Kitty was no problem. She toured parts of England and Wales with Elizabeth and was thrilled by all she saw, but then Elizabeth had to go on to Paris to start trying to raise money in earnest and it was really not convenient to tag along a nine-year-old. So poor Kitty was sent to a boarding school in Surrey, vouched for by Barbara Bodichon. But even with this recommendation Elizabeth cared enough about Kitty, and was understanding enough of her position, to give her secretly three stamped addressed envelopes which, if there was anything wrong, Kitty could use to write to her. She told Kitty that if she had something confidential to say she should drop the envelopes into the village post-box, not the school’s. This was what a miserable Kitty was eventually obliged to do after suffering several punishments for nothing. Elizabeth immediately had her removed and sent on to her in Paris where she placed Kitty in “a class of young Americans . . . supposed to be a kind of kindergarten”.

  Once she had secured a definite promise of money for use in America she returned with Kitty to England. Here, she had discussions with Florence Nightingale and also had her name put on the new British Medical Register. She lectured, too, on the principles of health, disease prevention and the advantages of opening the medical profession to women. The young Elizabeth Garrett attended one lecture. Afterwards Elizabeth Blackwell wrote to her sister Emily, “I saw a young lady who is quietly forming her determination . . . to study medicine . . . she consulted about the preliminary studies and will give this year to classics and chemistry.”