THE DOCTORS
BLACKWELL
HOW TWO PIONEERING SISTERS
BROUGHT MEDICINE TO WOMEN—
AND WOMEN TO MEDICINE
JANICE P. NIMURA
W.W. NORTON & COMPANY
Independent Publishers Since 1923
FOR CLARE AND DAVID,
SCIENTISTS AND FEMINISTS
CONTENTS
PROLOGUE
CHAPTER 1: BRISTOL—NEW YORK—CINCINNATI
CHAPTER 2: BETWEENITY
CHAPTER 3: ADMISSION
CHAPTER 4: BLOCKLEY ALMSHOUSE
CHAPTER 5: DIPLOMA
CHAPTER 6: PARIS
CHAPTER 7: SETBACK
CHAPTER 8: LONDON
CHAPTER 9: PRACTICE
CHAPTER 10: ADMISSION, AGAIN
CHAPTER 11: EDINBURGH
CHAPTER 12: NEW FACES
CHAPTER 13: INFIRMARY
CHAPTER 14: RECOGNITION
CHAPTER 15: WAR
CHAPTER 16: COLLEGE
CHAPTER 17: DIVERGENCE
CODA
Acknowledgments
Notes
Bibliography
Index
THE DOCTORS
BLACKWELL
PROLOGUE
On May 14, 2018, a cheerful crowd of activist New Yorkers blocked the sidewalk at the corner of Bleecker and Crosby streets. Before them stood an elderly and unremarkable building: four stories topped by a pair of attic dormers, battered brick facade obscured by a fire escape, pre-hipster neighborhood bar on the ground floor. After a parade of speakers, all but one of them women, the Greenwich Village Society for Historic Preservation unveiled a commemorative plaque, the newest stop on its Civil Rights and Social Justice Map. “In this building,” it read, “the first female doctor in America, Elizabeth Blackwell, established the first hospital for, staffed, and run by women.”
Applause erupted, VIPs grinned, cameras clicked. There was a triumphant sense of reclaiming a hero; of restoring a story of female agency; of lifting, for just a moment, the grim political mood. Someone was selling eye-popping T-shirts, black and hot pink on white: ELIZABETH BLACKWELL: OG MD. The celebrants dispersed into the balmy evening, imagining the first female doctor: saintly and sepia-toned, bending solicitously over her grateful patients; or maybe a fiercer version, Original Gangster of medical women, crusading feminist. Both images were satisfying. Neither was accurate.
On May 12, 1857, in a room overlooking that same corner of Bleecker and Crosby, Dr. Elizabeth Blackwell—petite, unsmiling, soberly dressed—moved into the light slanting through tall sash windows to address a small audience of ladies and a sprinkling of gentlemen. Two rows of iron bedsteads filled the space, made up with mismatched but carefully smoothed white linens. The assembled guests had settled themselves with a waggish chuckle or two about the impropriety of mixed company gathering in a room that was, strictly speaking, a ladies’ bedchamber. It would never be so pristine again, but for now, stethoscopes and scalpels, opium and mercury, blood and piss and all the unmentionable mess of illness and childbirth and surgery and death were nowhere to be seen.
Elizabeth cleared her throat to be heard over the hoofbeats and clatter of busy Broadway, a short block away, and read with stiff gravity from the document she held: “This institution, which is publicly opened today, is a hospital and dispensary for poor women and children.”
Its unprecedented purpose, she read on, was threefold: to allow women to consult doctors of their own sex, free of charge; to provide the growing number of female medical students with the practical experience denied them by established hospitals; and to train nurses. Her tone was level and businesslike, betraying no sense that for most of New York’s burghers—not to mention their wives—the idea of a woman doctor was outrageous. She did not mention the loneliness, drudgery, and pain she had transcended to become the first woman in America to receive a medical degree, in 1849. Nor did she acknowledge the taller, equally grave woman by her side, who shared her direct gaze and determined jawline: her sister Emily, who had struggled just as mightily to earn her own degree in 1854, and without whom this moment might not have arrived.
The trustees of the newborn New York Infirmary for Indigent Women and Children, thirteen men and four women, had rejected the suggestion that one of these female physicians should tell her own story that day, fearing she might sound off-puttingly like an agitator for women’s rights. But Elizabeth was not a radical, however radical her choice to study medicine might seem. “The full thorough education of women in medicine is a new idea, and like all other truths requires time to prove its value,” she continued. “Women must show to medical men, even more than to the public, their capacity to act as physicians, their earnestness as students of medicine, before the existing institutions with their great advantages of practice and complete organization will be opened to them.” Then she ceded the floor to a man: Henry Ward Beecher, the heavy-lidded, silver-tongued, irrepressibly libidinous pastor of Brooklyn’s Plymouth Church, arguably the most famous man in New York.
“There are none less able to make provision for themselves in this world than women and children,” Beecher intoned, and then—with more brio than coherence—insisted that he believed “most thoroughly in woman’s accomplishments.” Indeed, women might well be better suited to medicine than men. “Her intuition, perception and good mother wit render her so,” he explained, surrendering to stereotype and dispensing with science altogether. “The tread of woman in the sick chamber is itself antidote.” Their expressions neutral, the Blackwell sisters applauded with the rest. Allowing this patronizing, magnetic man—whom they had known, in fact, long before his fame took hold—to proclaim that “woman was ordained to be a doctor” was the best publicity imaginable.
A dozen years earlier, at the age of twenty-four, Elizabeth Blackwell had selected medicine as a means of proving a truth she believed to be divinely sanctioned: that women could be anything they wished according to the limits of individual talent and toil, and in reaching their fullest potential would raise humanity closer to its ideal. Medicine had not been an obvious choice for a young woman who equated illness with weakness, cared little for anyone beyond the circle of her eight siblings, and preferred the life of the mind to the functions of the body—which she found, quite frankly, disgusting. But God had chosen her, she believed, to pursue this arduous path, and she had chosen Emily, her most capable sister, five years younger, to follow her.
In the decades to come, Elizabeth would make greater use of her pen than her medical instruments, her opinionated eloquence preserved in reams of her own writing, both private and published. It was plainspoken, understated Emily who quietly embraced the challenge of medicine itself, Emily who would spend her life as a practicing physician, surgeon, and instructor—though like her sister, she too fell short of empathy. “There is certainly nothing attractive in the care of miserable forlorn sick people,” she wrote to Elizabeth. “It is only as scientific illustration that I can take the least interest in them, unless it were possible to raise them, and that is a difficult matter.”
Raising the expectations and ambitions of women, from the slums of Five Points to the salons of Fifth Avenue: a difficult matter indeed. Together the Blackwell sisters managed it. Their story does not fit on a plaque.
CHAPTER 1
BRISTOL—NEW YORK— CINCINNATI
The yellowed notebook is inscribed with perfectly straight lines of Elizabeth Blackwell’s careful eleven-year-old penmanship. “There lived as my story says a Lady and Gentleman,” it begins. The Gentleman, a manufacturer like Elizabeth’s father, watches his friends emigrate from England to America,
and as he knew that
his business was a very good one and that he could bring up his children better there than in England he asked his wife what she thoght about going though she was was sorry to leave her native land, yet as she knew, that it was for her chidren’s good she consented. [sic]
They would embark in “the best vessell in the port,” in a cabin “just like a parlour,” furnished with “a carpet a sofa some chairs a piano a bookcase with several interesting books in and a number of beautiful plants on the windowseat.” Music, books, nature, and nice furniture: everything anyone could want, in a safe cozy space. It is the vision of a child trying to tame her fears.
In August 1832 the Blackwell family left their native Bristol forever. The party of fifteen—Samuel and Hannah, their eight children, a governess, two maids, and two aunts—boarded the Cosmo for seven weeks and four days of malodorous misery. Cholera—a plague that had reached England for the first time the previous year—stowed away with the steerage passengers, several of whom died en route. It was a terrifying passage from the predictable comforts of home toward an unimaginable future. Then again, home had recently become less comfortable or predictable.
A decade earlier Samuel Blackwell, son of a Bristol cabinetmaker, had claimed his place in the industrial middle class and established his family in a terraced house at the corner of Wilson Street and Lemon Lane. An ambitious young sugar refiner, he dressed in ministerial black with a snowy white cravat, though his wife Hannah was known to indulge her frivolous side—she loved dancing and cherished her china tea service. The family was growing rapidly: first Anna and Marian, and then Elizabeth, her birth in 1821 bracketed by the deaths of two infant brothers, both named Samuel. After this came a third, healthy Samuel, followed quickly by Henry. Soon there would be Emily and Ellen, then Howard and George. The nine Blackwell children thought of themselves in alternating pairs of girls and boys, with Elizabeth the odd one out. Her nickname was “Little Shy.”
Hannah Lane Blackwell found her calling in motherhood. Her own childhood was not a time she liked to dwell upon. “I was fitted with a dress of black in expectation of my father being hanged,” she remembered. She was a little girl when her father was arrested—along with a female accomplice not his wife—for forgery, his clock-making business apparently not as profitable as he desired. His protestations of innocence during his trial were undermined by the fact that he had tried to eat his counterfeit banknotes when challenged. Escaping execution, he was transported to Australia, and Hannah never saw her father again. She found a husband whose probity—if perhaps not his business acumen—would never be called into question, and devoted herself to managing a stable and upright household.
Samuel and Hannah were idealists as well as capitalists: protestant Dissenters from the established Church of England; advocates of education, temperance, hard work, and self-improvement; staunch Whig reformers and early antislavery activists. Wait: a sugar refiner opposed to slavery? British trade in humans might have ceased in 1807, but on the sugar plantations of the Caribbean, the English still depended on enslaved labor. Samuel dealt in a commodity tied to an institution he abhorred, and he dreamed of finding a way to produce sugar without cruelty. Congregationalists in an Anglican society, antislavery activists in the sugar trade: the Blackwells held deeply moral, defiantly unorthodox opinions. In this generation—and more so in the next—they practiced an ideological contrarianism, striving toward a moral high ground that the placid mainstream ignored, dismissed, or failed to imagine. From those isolated and inhospitable heights, they aspired to shine as beacons, guiding the unenlightened toward a truer future.
HANNAH BLACKWELL AS A YOUNG WOMAN IN BRISTOL.
COURTESY SCHLESINGER LIBRARY, RADCLIFFE INSTITUTE, HARVARD UNIVERSITY.
Firstborn Anna, dictatorial and dramatic, persuaded her mother to let her sleep in the garret and invested her pocket money in a spyglass. When she felt generous, she invited Marian and Elizabeth—Emily was too little—to climb out her dormer window onto the leads of the roof. Snug in their “sky parlour,” the three girls majestically surveyed the hills and fields beyond the eastern edge of the city—until someone caught them at it. Unabashed, these daughters of progressive reformers did what they had seen the grown-ups do: they wrote a petition—“promising to sit perfectly still & not lean over the parapet”—and delivered it to their father. Samuel, in turn, responded with another Blackwell pastime: he wrote a poem, which began,
Anna, Bessy, & Polly*!
Your request is mere folly.
The leads are too high
For those who can’t fly!
After that, the girls had to content themselves with the wooden rocking horse in the back parlor—Anna in the saddle, Marian perched on the rockers behind, and Elizabeth in front.
All but the youngest of the Blackwells were born in Bristol and grew strong on a diet of nature, literature, and political consciousness. Favorite excursions included the double springs of Mother Pugsley’s Well at Kingsdown, or the craggy grandeur of St. Vincent’s Rocks, tumbling down to the river Avon, the cliff ledges home to plants found nowhere else: whitebeam, speedwell, rock-cress. Samuel and Hannah granted their daughters the same access to knowledge as their sons. Their books were mostly of the pious and improving sort—Mrs. Sherwood’s Stories Explanatory of the Church Catechism was a perennial—until Anna and Marian, with the help of a nursemaid, got hold of a few volumes of Sir Walter Scott. “There was a dreadful scene, & our beloved novels were seized & carried off to Papa, & we expected some dreadful punishment,” Anna remembered. But Samuel, curious to see what had captivated his daughters, sat down to read Scott and was captivated in turn.
Hannah was the less flexible parent. Her faith abjured vanity—as one admired for her beauty, she struggled with it herself—and she was determined to prevent it from taking root in impressionable minds. “The pretty baby makes the ugliest person!” she insisted. Her vigilance had the contrary effect of making her children morbidly self-conscious, and their awkwardness only grew with time. “We were always so shabbily dressed that we were always painfully conscious of not looking like other people,” Anna remembered. But with so many siblings, there was never a shortage of companionship at home.
They turned toward one another and held themselves apart. Like many Dissenters—intellectually adventurous, politically engaged—Samuel and Hannah prized the moral over the material, shuddering at the lavish pageantry of the Anglican establishment even as it persisted in excluding them. (Until 1828, Dissenters were barred from public office; their sons, however brilliant, were not permitted to take degrees at Oxford or Cambridge until the 1850s.) The Blackwell children were acutely aware of the contrast between the principled austerity at home and the glittering delights of bustling Bristol.
Though Hannah’s marriage was happy, her daughters could not help noticing that the extended family was full of less contented women. Four “poor starveling aunts” lived under their brother Samuel’s roof. Mary was the favorite, a “natural lady.” Lucy—“very small, kindly, & null”—served as seamstress, though “she had not an atom of taste & knew no more of dress-making than of Greek.” Ann, in her namesake niece Anna’s unsparing estimation, was “very well-meaning, obstinate, ignorant, & ugly.” Barbara was the least popular of all, especially once installed as governess in Wilson Street: Anna called her “one of the most disagreeable, ill-tempered, strict, narrow-minded creatures alive.” Yet the girls understood that what their aunts lacked was not intelligence but opportunity. Hateful Aunt Barbara “was very clever, & education might have had its full course of usefulness in her case,” Anna mused. “But she straggled up, like the rest of her family, ignorant as a broomstick.”
Uneducated and unpartnered, the aunts had no choice but to fill whatever roles were available in their brother’s household. Marriage, however, was no guarantee of anything better. Grandmother Blackwell, tiny and gentle, lived in the shadow of her tyrannical husband, a man so unpleasant his family must occasionally have wished it were he,
and not Hannah’s father, who had been transported to Australia. Anna could not remember Grandmother Blackwell “putting forth an opinion on any subject beyond house-work & meals,” but before her death, she startled her eldest granddaughter, warning her,
how careful girls ought to be before they listened to the flatteries of a man, seeing that all that ceased when they’d got a woman to marry them, & then the poor girl found what a dreadful master marriage had given her, what a slave she was, & what a world of care & labour & worry she had got into; adding that those were wise who did not marry, & that if it were to do over again, most certainly she would not marry Grandpapa.
None of the five Blackwell girls would marry. All of them, at various times, would earn a living as teachers.
In the Blackwell household, the terms master and slave were not used lightly. In 1823 the abolitionist Thomas Clarkson stopped to speak in Bristol—a port at the center of Britain’s sugar trade—carrying with him a polished wooden chest from which he produced a display of the arts and produce of African peoples. Inspired, Samuel Blackwell joined Bristol’s Auxiliary Anti-Slavery Society and studied the tantalizing promise of sugar beets, which could be farmed in temperate climates without slave labor—an innovation in which the French had recently invested, their access to Caribbean cane sugar blocked by the embargoes of the Napoleonic wars. Samuel did not preoccupy himself with bettering the lives of plantation slaves—his focus had more to do with the moral hygiene of British sugar consumers—but his beliefs and his livelihood were still essentially opposed. His offspring took note. “We children had been so harrowed by the statements about West Indian slavery,” Anna remembered, “that we had given up taking sugar in our tea, by way of protest.” Then again, the unsweetened tea had been paid for by sugar.
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