To work, then—though the best place for that was not London. Elizabeth might have enjoyed a warm reception among the city’s most open-minded physicians and surgeons, but they considered her an American oddity, not a medical pioneer. Her sober dignity and unique achievement made her a piquant presence at dinner or in a lecture hall, but even the most genial of her hosts would have blanched if she had asked for a place to hang her shingle.
In France, however, the February Revolution of 1848 and the birth of the Second Republic had renewed a commitment to liberté, fraternité, and above all, égalité. It was time to push onward to Paris, where the already arduous pursuit of medical training would have to be conducted in Elizabeth’s rudimentary French.
Elizabeth parted from the generous and genial Charles Plevins with heartfelt gratitude. “He must be no longer a stranger to you all,” she wrote home. “I could not thank him, words seemed too absurd.” Absurd or not, her words suggested an unprecedented depth of feeling. Plevins escorted her all the way to Dover and onto the boat that would carry her across the Channel. “He would neither let me thank him for the great pleasure his companionship had been to me,” Elizabeth wrote, “nor would he admit that he had rendered me the slightest service.”
Her letter, circulated to siblings and friends, raised eyebrows. William Elder in Philadelphia, among the staunchest of her supporters, reacted immediately. “I have not time to make any remarks upon Elizabeth’s letter,” he wrote with bemused alarm, “except to intimate my jealousy of that Mr. Charles Plevins, whom she has grown so very poetical about.” What was the man doing, escorting Elizabeth all over England? How dare he distract her from her destiny? “Women are not reliable,” Elder continued, exposing the limits of his own liberal-mindedness. “If Elizabeth bolts from the course, the starch is taken out of the enterprise and the cause will be at a discount for good.” There was no room for a romantic partner on Elizabeth’s narrow and perilous path. “Plevins!” Elder spluttered. “Why the word sounds like swearing—it’s a very bad word, we must see to it.”
He needn’t have worried. If Elizabeth’s departure caused either Charles Plevins or herself pain, it was not enough to deflect her from her course. She sailed from Dover in the rain on May 21, 1849. “I cannot give any patriotic description of the white cliffs of England,” she wrote, having had “just sufficient sensation of a queer nature to make me wish to lie down on my berth.” It was her nose rather than her eyes that told her she had arrived at Calais: “a strong smell of fish.” The downpour continued as she stumbled over the stone pier in the dark, the lighthouse above raking the night. For the first time—as gruff bewhiskered officials checked her passport, demanding “où allez-vous, Madame?”—Elizabeth felt herself truly among strangers. Sticking closely to an Englishwoman from the ferry who had warned her of the French predilection for cheating foreigners, she spent a night in Calais (“miserable little town”) followed by a day on the train, and then finally, alone, “launched boldly into the sea of Paris.”
She was not impressed. London had exceeded expectations, but Paris, which she had expected to embrace, repelled her. “I am utterly disappointed in Paris as far as I have yet seen it,” she reported, having found “small & gloomy” rooms on the narrow rue de Seine, not far from the medical institutions she intended to explore. Her rosy-cheeked landlady cheerfully volunteered to help with everything from breakfast to French pronunciation but could not dispel Elizabeth’s sense of anticlimax. Where was the sophistication, the beauty, the intellectual sparkle she had expected to find? “Paris is a place altogether overrated,” she announced after one day of residence. “The city looks as if it had suffered.” Her outlook was perhaps colored by the sudden absence of her companion. “I miss my friend Charles very much,” she wrote to Anna.
For the next few days, Elizabeth set aside medical pursuits in favor of her garrulous landlady’s company. They walked together through the neighborhoods of the Left Bank, the noble dome of the Panthéon appearing and disappearing as they turned corners. Elizabeth tried to tune her ear to Parisian chatter—“I have great trouble in expressing myself with any elegance”—and took advantage of her companion’s help in buying a decent bonnet. This proved unexpectedly challenging. “I found that my unfortunate organs were totally unable to squeeze themselves into a Parisian headdress,” Elizabeth wrote with a touch of phrenological humble-brag. In the end, she had a milliner make one in gray silk, ignoring horrified protestations that no one in Paris wore that color. She had not come for the fashion.
Once in possession of her new headgear, she was ready to resume her campaign. The consul at St. Germain invited her to Sunday dinner and took her for a stroll on the Grande Terrasse with his daughters; it seemed likely he would provide useful letters of introduction. A visit from another official bearing a form for Elizabeth to complete was a more awkward encounter: when she listed herself as étudiante, the man’s eyes widened “until the whites showed all round them.” Noticing her discomfort, he explained his own.
“Mon enfant, you must not put yourself down as student,” he instructed her. “Rentière is the word you must use!” A female student was a contradiction in terms, but a rentière was a woman of independent means—far more respectable. Elizabeth declared herself a rentière without delay. No one in Paris knew her well enough to question it. Then again, no one in Paris knew her well enough to be of much help, either.
It was discouraging. “I have nothing as yet to tell you of Paris medicine,” Elizabeth wrote to Emily, “though I have been here three weeks.” Maddeningly, medical instruction was everywhere—free lectures at the imposing École de Médecine and the Jardin des Plantes with its endless twisting beds of exotic specimens; dozens of eminent physicians offering private instruction; vast and venerable hospitals full of patients to observe—as long as you were a man. There were more students at the École de Médecine than there were in all the medical schools in America combined, yet there was no room in the Grand Amphithéatre, with its gorgeous coffered ceiling, for a woman. And for Elizabeth, concealing her sex remained out of the question. It wasn’t enough for a woman to study medicine in secret—the world needed to witness her doing it. “Well,” she sighed to Emily, “we must have patience with the age while we work hard to bring about a juster arrangement.”
The medical community of Paris reacted to her determination along a spectrum with which Elizabeth was growing familiar: “Some of them are certain that Miss Blackwell is a Socialist of the most furious class, and that her undertaking is the entering wedge to a systematic attack on Society by the fair sex,” reported the correspondent for the New York Journal of Commerce. “Others who have seen her, say that there is nothing very alarming in her manner.” It was the women who were most appalled. “Oh, it is too horrid!” one lady was quoted. “I’m sure I could never touch her hand! Only to think that those long fingers of hers had been cutting up people.” The correspondent’s favorable verdict had little to do with Elizabeth’s medical skill. “She is young, and rather good-looking; her manner indicates great energy of character; and she seems to have entered on her singular career from motives of duty.”
Welcome encouragement arrived in the form of Anna, seizing the opportunity of her sister’s residence in Paris to escape the gritty damp of Birmingham and pursue another adventure in medical tourism. This time she sought the attention of Jules Denis, Baron du Potet, an owlish and renowned mesmerist. Frustrated for the moment in her pursuit of conventional medicine, Elizabeth joined Anna at Baron du Potet’s magnetic séances, held in a darkened room “hung round with curious pictures & lined with very curious people.” The motley assemblage of “believing heretics” vied for a chance to regard themselves in du Potet’s magic mirror and whispered about the last meeting, during which a young man had actually floated up toward the ceiling!
Fully aware of the absurdity of the scene, Elizabeth refused to dismiss it completely—du Potet might claim to be able to communicate with the dead, but he had al
so successfully demonstrated his magnetic therapies at the Hôtel-Dieu, the largest hospital in Paris. “I am obliged to laugh at it,” she wrote, “& yet I have a true respect for M. Du Potet.” She might not share his faith in “antient magic,” but she honored his single-minded passion—as did many of the most prominent thinkers of the day. Who could say that magnetism wasn’t a promising addition to the pharmacopeia? Or at the very least, she recognized wisely, a comfort for her chronically unhappy sister. “He will pursue a mild soothing treatment for her,” Elizabeth reported, “& I think her residence here will be beneficial.”
Anna was not the easiest roommate—Elizabeth wished it could be Emily at her side instead—but it was good to have a sister near as she contemplated her next step. At Geneva College, she had grown accustomed to pursuing her strange quest with an audience; the anonymity of Paris had caused her momentum to waver. Having another Blackwell at hand helped dispel her self-consciousness, and her rising spirits enabled her to embrace a new plan: to surrender her freedom and enter La Maternité, France’s largest public maternity hospital, not as a qualified doctor but as a student.
Every year each territorial department in France—in 1849 there were eighty-six of them—sent two female students to La Maternité to train as midwives at government expense. It was a more progressive approach to obstetric training than anything to be found in England or America, and an unusual benefit of France’s high degree of state control in the field of education. A stay of several months would expose Elizabeth to a thousand cases—vastly more than she might see anywhere else—as well as the tutelage of Paul Antoine Dubois, a distinguished professor of obstetrics. In this one branch of medicine, there was no better practical education.
But neither would there be any allowance for Elizabeth’s accomplishments or her maturity. She would enter as an élève like any other, subject to the same constraints: sleeping in a dormitory when she wasn’t on call through the night, eating in a refectory, working long hours at menial tasks, and forbidden to leave. The other students were country girls, “ignorant and degraded” in Elizabeth’s estimation. The patients, like the ones she had known at Blockley Almshouse in Philadelphia, were society’s outcasts. After all her insistence on studying medicine on the same terms as men, she now seemed to have no choice but to study obstetrics and gynecology among women. Then again, this particular opportunity would not have been available had she been male. La Maternité was housed in the old walled convent of Port-Royal, and the setting hadn’t changed much. “I shall take the veil on the first of July,” Elizabeth wrote sardonically, “& be seen no more in the world.”
She devoted the rest of June to enjoyment of the freedom she was about to surrender. Paris was not as overrated as she had first thought. She visited Notre Dame, imagining the “fearful descent” of Victor Hugo’s hunchback, and spent two hours completing one circuit of the main gallery at the Louvre—“you stand at one end, and the other is lost in the distance.” Versailles seemed to her a “living church,” wherein all French citizens could refresh themselves at the altar of history, art, music, and nature. And no one touched any of the treasures, she marveled, or even picked a flower in the gardens! Surely this was a manifestation of a better society. Indeed, Elizabeth told her cousin Kenyon, “there is a constant effervescence of life in this great city,” although she found Parisians at once “the most brilliant and the most conceited people in the world.”
The early summer of 1849 was a tense moment to be a tourist in Paris. With the unseasonable heat—thirty-two degrees, though the centigrade measurement meant nothing to Elizabeth—came cholera, the “summer complaint,” killing thousands. (Five years later the English physician John Snow would at last connect the disease to contaminated drinking water.) The political temperature was rising as well, as the city’s workers began to agitate against a government that had failed to deliver on its revolutionary promises. The Louvre and the Tuileries were full of soldiers, with more lining the streets, bayonets fixed. Agitators shouted on street corners. “We passed through hurrying crowds full of excitement,” Elizabeth wrote, “hearing fearful reports of what had happened and what was to come.” It was not a bad moment to retreat behind the walls of La Maternité.
Elizabeth could remove herself from society with the satisfaction of knowing that her reputation continued to grow. In response to her arrival in Europe, Punch, the London satirical paper, published a seven-stanza mock-epic poem of praise under the title “An M.D. in a Gown.” “Not always is the warrior male,” it began, and though it hewed to the ponderous witticism that a medically trained woman saved her husband the expense of calling the doctor, it nevertheless concluded on a note that must have appealed to Elizabeth, despite its tortured rhymes.
Young ladies all, of every clime,
Especially of Britain
Who wholly occupy your time
In novels or in knitting,
Whose highest skill is but to play,
Sing, dance, or French to clack well,
Reflect on the example, pray,
Of excellent MISS BLACKWELL!
Confident that the English-speaking world, at least, would not forget her, she prepared to enter La Maternité, determined to see it not as a prison but as an opportunity.
On July 1, 1849, Elizabeth presented herself at a low door in a high wall and left Paris behind. Port-Royal Abbey, home of La Maternité for the last half century, consisted of a quadrangle of two-hundred-year-old buildings around a courtyard of flowerbeds and gravel paths, with a garden and a small wood adjacent. Those gazing up and out over its tiled roofs could glimpse only the highest domes of the city as proof that the wider world was still there: the Panthéon to the northeast, the Observatory directly south.
A colonnaded cloister surrounded the courtyard, but instead of the deliberate tread of contemplative nuns, the walkways now echoed with the hurried steps and birdlike chatter of dozens of young women swathed in aprons of coarse white toweling: the élèves, or midwives-in-training, among whom Elizabeth would live and study. Elizabeth followed an old woman up stairways and along corridors, all bare stone and plain wood, to the “funniest little cabinet of curiosities” as ornate as the rest of the building was austere: a small chamber overstuffed with chintz sofas and china figurines, embroidery and mosaic-topped tables. This was the parlor of Madame Madeleine-Edmée Clémentine Charrier, La Maternité’s chief midwife, who had the curved spine of a crone and the twinkling blue eyes of a fairy godmother. Madame Charrier in turn conducted the new arrival to Madame Blockel, supervisor of the dormitories and the dining hall: red of face and squint of eye, with “tremendous projecting teeth” as well as “a tremendous vocal organ,” which she put to constant use keeping the lively élèves in line.
Before Elizabeth had a chance to unpack, Madame Charrier was back with a crowd of students and a question: would the new arrival care to spend the night on duty in the salle d’accouchements? Someone handed over a clean apron (“with the injunction not to lose it, or I should have to pay three francs”), and Elizabeth plunged into her first shift on the labor and delivery ward.
Eight babies were born that night in a large room full of shadows, with a hearth at one end, candlelight winking off copper and tin implements, two rows of beds, and cabinets stacked with linen in the corners. In the center rose “a large wooden stand with sides, on which the little new-comers, tightly swathed and ticketed, are ranged side by side”: wrinkled red faces peeking from beneath peaked caps bearing labels with name and gender, each infant wrapped like a mummy in black serge. Elizabeth’s first letter home evokes an orderly scene of quiet competence—“very little crying” from the newborns, their student attendants “pretty and pleasant.”
She left out the screaming pain of labor, not to mention the peril of giving birth in 1849. Even wealthy women, well attended in the comfort of their own bedrooms, died in childbirth. Only the most desperate—those rejected by their families or by society—gave birth in a hospital, where eve
n if the wards were swept and scrubbed, no one washed hands, aprons, or instruments between patients. Puerperal fever was a permanent resident. So were rats. And while linens might be changed, mattresses that were repeatedly soaked in the fluids of childbirth stank, especially in July. The eight new mothers, exhausted, drenched in sweat, supine on blood-soaked sheets, appear nowhere in Elizabeth’s account. “It was really very droll,” she wrote.
Perhaps she meant to spare her family—mindful of her younger brothers—the pain and fear that preceded the tidy row of newborns. Perhaps she dismissed the new mothers—many of them beggars or prostitutes—as a category of nameless, faceless women rather than a collection of individuals. Perhaps she had already absorbed the French attitude toward patients as teaching tools. Or perhaps, after this shocking introduction, she was trying to reassure herself by projecting professional nonchalance. To her journal, she confided what was not for general consumption: watching the student midwives trying to turn a breech baby while the mother writhed and moaned in agony, “I almost fainted.”
After such a beginning, it was no challenge to sink into sleep the following night, despite the close proximity of the fifteen young women with whom Elizabeth now shared a room. Her dortoir, up a twisting stairway with a massive, rough-hewn wooden banister, was a smaller echo of the labor ward she had just left, with rows of iron bedsteads and wooden chairs under facing walls of windows, a gilded crucifix at one end, and two small pendant oil lamps that radiated barely enough light to read by—if she had time or energy left for reading. There would be no privacy for the next three months, or however long Elizabeth could bear to stay.
The days were closely scheduled. The bell perched on the ridgepole clanged at five each morning, but Elizabeth kept her head on the pillow on principle. “Of course I lie ten minutes longer pretending to sleep,” she wrote, “partly from anger at the noisy bell, partly to display to the angel, the remnant of independence that still remains to me.” She was grateful for her Protestantism, which excused her from morning and evening prayers and the daily infant baptisms in the lofty stone chapel at one corner of the quadrangle. (What had once been the nuns’ choir, separated from the rest of the chapel by an imposing iron grille, was now in constant use as a laundry.) After a quick wash and a hastily bolted bit of bread saved from the day before, Elizabeth rushed from infirmary rounds, to classes with Madame Charrier, to a lecture from the eminent Monsieur Dubois—“a little bald gray haired man, with a clear gentle voice, & very benevolent face.” These were followed by study groups outside on the grass or at the heavy trestle tables in the salle d’études, once the nuns’ chapter house. Elizabeth found these sessions far beneath her medical ability but excellent for French language practice, as each student in turn parroted the instruction of the leader. When the bell rang for the midday meal, the students repaired to the round tables of the refectory, where the plain hearty fare was always accompanied by something stronger than water. Elizabeth had left the temperance pledge far behind. “I am learning to take wine,” she wrote. “Everyone advises me to do so, and I shall soon be able to drink my bottle a day.”
The Doctors Blackwell Page 11
