The Doctors Blackwell

by The Doctors Blackwell (retail) (epub)

  This approach was successful enough to produce a steady stream of grateful clients, but serious complications were also commonplace. When a patient died, the law placed the blame on the practitioner. Even when the procedure went smoothly, the idea of surgical abortion was unspeakable, and the power to end an unwanted pregnancy would surely encourage the weaker sex to transgress, if the shameful proof of sin could be so readily avoided. More and more states were codifying anti-abortion statutes. By 1849, Madame Restell had amassed a substantial fortune, as well as a criminal record.

  It’s difficult to say what offended New Yorkers more, Madame Restell’s métier or her money. The mainstream press delicately refrained from discussing her practice, but condemnations circulated in medical journals not subject to such restrictions; one described her as “a monster who speculates with human life with as much coolness as if she were engaged in a game of chance.” Pamphlets reporting on her trials—with their transcripts of graphic testimony—became best sellers. “Nature is appalled, that woman, the last and loveliest of her works, could so unsex herself, as to perpetrate such fiend-like enormities,” declared one prosecutor in his opening statement. A whiff of sexual license clung permanently to this woman who helped the promiscuous hide their sins. But Madame Restell’s earnings bought her skillful lawyers, and her clients included prominent names. Charges were often dropped, only to be followed by indignant editorials. “She has made enough money to drive a coach and six horses through the elastic meshes of the Law,” complained the New-York Tribune. She did, in fact, take delight in driving her open carriage up and down Broadway—a display of ostentation and confidence that seemed only to confirm her brazen wickedness. When another journal described her as “this noted ‘Doctress,’ ” it was not a compliment.

  MADAM RESTELL, AS PORTRAYED IN THE POPULAR PRESS, 1847.

  COURTESY NATIONAL POLICE GAZETTE

  Elizabeth was acutely aware of Madame Restell. The abortionist’s emergence into New York notoriety had coincided with the dawn of Elizabeth’s interest in medicine and perhaps helped to propel it—later, Elizabeth would remember her horror of abortion as formative. Restell’s second criminal trial, in the fall of 1847, gripped the public just as Elizabeth left for Geneva College. Despite all of Madame Restell’s powerful connections, she was sentenced to a year in prison. It could not have escaped Elizabeth’s sense of irony that at the moment she accepted her hard-won M.D. in 1849, the woman known as New York’s most infamous “female physician” was incarcerated at the city penitentiary—and on Blackwell’s Island, no less.*

  Where Margaret Fuller had provided Elizabeth with a positive argument for becoming a woman doctor, Madame Restell supplied the negative. And while a modern feminist might cast Madame Restell as a courageous practitioner of essential solutions for desperate women, Elizabeth—who had never faced the fear of unwanted pregnancy and never would—felt no such empathy. Even had she been tempted by Utilitarian arguments about maximizing happiness, the Hippocratic Oath she had sworn to uphold specifically prohibited abortion. “The gross perversion and destruction of motherhood by the abortionist filled me with indignation, and awakened active antagonism,” she later wrote. “That the honorable term ‘female physician’ should be exclusively applied to those women who carried on this shocking trade seemed to me a horror.”

  Loyal readers of the New-York Daily Tribune, upon seeing the announcement of Dr. Blackwell’s arrival in their city, might have remembered Greeley’s thundering condemnation of Madame Restell’s “horrible cupidity, depravity, and quackery” ten years earlier. He had always pointedly refused to run the abortionist’s lucrative advertisements. His endorsement of this new lady doctor, therefore, concluded thus: “This announcement is made without her knowledge or request, but in justice to one whose past career and eminent qualifications entitle her to public consideration and encouragement.” The item carefully omitted any use of the phrase female physician.

  The Directory of the City of New-York, for 1852–1853 lists Elizabeth for the first time on page 63: “Blackwell Elizabeth, physician.” Any pride she might have taken in that entry, however, would have been diminished by this one, in the Rs: “Restell Madam, physician.” It would take more than an endorsement from Horace Greeley to convince New York that Dr. Blackwell was something different. No one rang the bell at 44 University Place, though “insolent letters” occasionally appeared in the post. Without colleagues, without patients, and without an income, Elizabeth found herself suddenly becalmed, alone with her ideals.

  Elizabeth’s return to New York, however anticlimactic, was the catalyst Emily needed. Her sister was waiting for her. It was time to shake off her tedious teaching routine in Cincinnati and decide where and when to begin formal medical study. “I imagine you sitting in your office day by day waiting for the patients who doubtless as yet don’t come,” Emily wrote to Elizabeth. She longed to sit down with her sister and discuss a thousand things, to find out at last if this calling for which Elizabeth had claimed her was really her true path.

  Far from easing the way forward, however, Elizabeth’s achievements had arguably made Emily’s progress more difficult. Medical mandarins, appalled—and threatened—by Elizabeth’s progress on both sides of the Atlantic, resolved ever more strongly to exclude women from established medical schools. Meanwhile Boston’s New England Female Medical College and Philadelphia’s Female Medical College of Pennsylvania, opened in 1848 and 1850 respectively, provided an obvious alternative. Why should women need to study alongside men if institutions for women now existed? In addition, Eclectic medical schools, like Syracuse’s Central Medical College, had also begun to admit women; two of them, Lydia Folger Fowler and Sarah Dolley, had graduated in 1850 and 1851. The Blackwells dismissed both female and Eclectic institutions as unable to provide the level of rigor necessary to prove the legitimacy of female doctors, but the new schools made it all too easy for the gatekeepers of the medical establishment to reject applications from women. “I fear this stupid Philadelphia College may make it difficult for me to enter any college here,” Emily mused. “But what has been done may be done again.”

  In the case of the Eclectic schools, with their emphasis on empirical observation and gentler methods, there was irony in this Blackwellian attitude. Both sisters held views on hygiene and medication that were more in line with Eclectic thought. “I am convinced that a new & nobler era is dawning, for Medicine,” Elizabeth wrote, “when the low system of coarse & violent drugging shall give place to a more spiritual practice, better adapted to our delicate & wonderful living organism.” But because the primary goal, to be acknowledged as physicians by the mainstream profession, was ideological rather than therapeutic, only a diploma from a regular—and male—institution would do.

  The simplest plan, and the cheapest, would be for Emily to study at the Medical College of Ohio in Cincinnati. Though Emily craved a new identity in a different context, Elizabeth, having been a stranger and no less a target in Geneva, encouraged her to stay home. “Now though it might be very unpleasant to be gossiped about, I do not think in fact that you would be more annoyed there than elsewhere,” she assured Emily. “You go so little into society, & I having been already fully discussed, you would probably come in for a smaller share.”

  Emily had grown up following her sister’s instructions. To gauge the odds of being admitted at Cincinnati, she paid a visit to Dr. Reuben Mussey, a professor at the college who had discouraged her sister when she consulted him on the same question six years earlier. “I must tell you of my call for I think it will amuse you,” Emily wrote to Elizabeth. Assuming she was a patient, Mussey had gruffly instructed her to sit down; pen in hand, he waited resignedly for her to relate “the details of some fearful disease” so that he could write her an even more fearful prescription. Once Emily conveyed her intent, his startled response was unequivocally negative, though when he realized whose sister sat before him, and heard the details of Elizabeth’s European studies, he relente
d somewhat. “He said finally he did not think I could enter but he’d lay the matter before the faculty if I wished.” Encouraged, Emily made the rounds of as many of the professors as she could, collecting several encouraging responses. “I came home tired and hopeful,” she wrote in her journal, “full of the brightest anticipations of speedy study.”

  But when the faculty came to a vote, the answer was no. And so began a pattern of anticipation and rejection that would repeat for nearly a year: at one college after another—Cincinnati, Columbus, Buffalo—the passive support of many melted away before the active disapproval of a few. Even Geneva, which had granted Elizabeth her diploma, and Castleton, in Vermont, which had invited Elizabeth to enroll after she was already at Geneva, now turned their backs. At Cleveland Medical College, part of Western Reserve, Emily was told, “though the large majority of the profs and students wish to admit me, the minority were so decided in opposing that I am refused.” And while the other rejections were dismaying, this one was particularly galling—because Cleveland Medical College currently had a woman enrolled among its medical students.

  Her name was Nancy Talbot Clark. Having lost her husband and daughter to disease within three years of her wedding, she had turned to medicine and won the support of John Delamater, dean of the Cleveland college. She was now in the middle of her second term. She would receive her diploma two months later, in early 1852—the second woman, after Elizabeth, ever to do so—and listen to a commencement speech that praised her achievement even while announcing that “the Faculty deems it inexpedient, hereafter, to receive ladies as Medical Students.” On the one hand, it was encouraging that another woman had managed to duplicate Elizabeth’s feat—as Emily herself had said, what had been done before might be done again. But reaction against Clark’s achievement at Cleveland had closed the door on Emily once more. It was hard to take the long view in the wake of such disappointment.

  Even Emily’s closest ally didn’t always provide the encouragement she sorely needed. “I ask myself often if I do not expect too much sympathy and companionship from Elizabeth,” Emily wrote. “Life sometimes appears cold and lonely in the future.” Like Elizabeth, she had decided that practicing medicine was a way to inspire women “with higher objects—loftier aspirations—to teach them that there is a strength of woman as well as of man.” But unlike Elizabeth, she wondered if it was presumptuous for one who knew herself to be full of flaws to aspire to such heights. “I think often my intense desire for greatness of nature and life is but a refined selfishness,” she wrote in confusion. Her solace, as always, was the outdoors:

  It gives a wonderful zest to wood rambles when every new plant is a small scientific problem, every tree or herb the expounder of the laws of the universe; when the banks and hollows are one extended college where Nature’s every friendly voice pronounces the richest, most varied and suggestive instruction, of which I have now a series of concentrated notes in a bowl in my room awaiting further consideration.

  Nature was the one school that would always admit her without question.

  In New York, Elizabeth made the best use of her underemployed days. If no one yet trusted her with a stethoscope, she would use her pen instead. Drawing upon everything she had observed in her peripatetic training, she wrote a series of essays to be delivered as lectures on the subject of raising healthy children, girls in particular.

  The lectures laid out Elizabeth’s conviction that hygiene and exercise, rather than pharmacology, were the true guardians of good health and the pathways to a shining future. These ideas were not particularly novel or controversial—the eldest of the Beecher siblings, Catharine, had published similar thoughts in her best-selling Treatise on Domestic Economy a decade earlier—but Elizabeth’s M.D. gave her opinions the imprimatur of science. Provide a child with warmth and cleanliness, simple food and fresh air, and the freedom to be active and useful, she instructed, and nature would restore the degraded human race to the glory of Adam and Eve, created in God’s image. Deprived, in her current isolation and straitened finances, of access to a medical library, she deputized Emily as her research assistant and fired off requests for information to Cincinnati. “Send me a scrap from some old Chronicle about the beef & ale consumed by good Queen Bess,” she wrote. “I speak in my introductory of the astonishing feats performed physically by oldentime women.” She denounced a system of education that required children to sit confined indoors during their growing years, and extolled the ancient Greeks, who prized physical training for both sexes.

  Girls should wait until twenty-five to choose a husband, Elizabeth insisted, by which age they would be better prepared both physically and emotionally for the challenges of marriage and motherhood. Despite her experience at La Maternité, she continued to romanticize childbirth:

  The mother, forgetful of weariness and suffering, lifts her pale face from the pillow, and listens with her whole soul. The physician, profoundly penetrated with the mystery of birth, bends in suspense over the little being hovering on the threshold of a new existence; for one moment they await the issue—life or death! But the feeble cry is the token of victory; 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.

  Surely she had never witnessed a delivery so sweetly pure. But her writing was consistent with the emerging “cult of domesticity” celebrating women’s roles as mothers, teachers, and moral exemplars. Older and wiser marriage choices made by robust and healthy individuals, she explained, would provide the “physical conditions most favorable to the production of a strong and beautiful race.” As the middle-class trend toward smaller families continued, it was becoming important to get it right with fewer children. The best mother, increasingly, was not the one with the largest family but the one who invested the most time and effort in her children’s excellence.

  The woman who had fought for the right to study the human body alongside men was using her hard-won credential to help women within the home, rather than exhorting them to follow her out of it. Elizabeth continued to reject the overtures of the women’s rights movement, declining an invitation to take the stage at the third national convention in Syracuse, even though she applauded its focus on women’s education. The convention’s organizers might have breathed a private sigh of relief, given the opinions expressed in Elizabeth’s response to their invitation. “I believe that the chief source of the false position of women is, the inefficiency of women themselves—the deplorable fact that they are so often careless mothers, weak wives, poor housekeepers, ignorant nurses, and frivolous human beings,” she wrote. “In order to develop such women, our method of educating girls, which is an injurious waste of time, must be entirely remodeled, and I shall look forward with great interest to any plan of action that may be suggested by your Convention.”

  Meanwhile, given the intimate nature of women’s health issues and the necessity of winning influential individuals to her cause—not to mention her own discomfort with public speaking—Elizabeth preferred to educate a small number of women at a time, in a private setting. During the spring of 1852, she delivered her lectures to groups of like-minded ladies in a Sunday-school basement and began to build a small following among these freethinkers. Eliza Bellows, a woman of delicate health, took a particularly strong fancy to Dr. Elizabeth. Her grateful husband, the prominent Unitarian minister Henry Whitney Bellows, was happy to show the lectures to his friend George Palmer Putnam, a publisher whose list of authors included Washington Irving, James Fenimore Cooper, and Edgar Allan Poe. That June, Putnam printed them under the title The Laws of Life, with Special Reference to the Physical Education of Girls. The slim volume, bound in dark green leather, was satisfying proof of Elizabeth’s progress as a public figure. “These lectures . . . are the first fruits of my medical studies,” she announced in her introduction. “I would offer them as an earnest of future work.”

  Elizabeth’s initiative impres
sed her reserved sister. “She certainly has some of the qualities of a really great woman,” Emily wrote. “She has the power of making things succeed.” Her eagerness to join Elizabeth in New York grew. “I want to see her to judge how far I can work with her and whether we can be really friends.” For her part, Elizabeth was grateful for Emily’s contribution to her writing and bemoaned the inefficiency of the distance between them. “Oh dear if my provoking fortune would only come to the amount of paying my way, how quickly I should say come on, Dr Emily this is the place for you!”

  Though her practice still did not cover expenses, Elizabeth was beginning to see a trickle of private patients. It was clear to these women what Elizabeth had to offer: an authoritative intelligence; a good understanding of basic medicine; and best of all, the opportunity to confide the unspeakable details of gynecological trouble to a woman professionally qualified to help them. Their appreciation of her was evident and, for Elizabeth, sometimes embarrassing. “By the bye,” she warned Emily, “one great annoyance in my practice that I really don’t know how to meet—some of my patients will fall in love with me, do what I will—they absolutely haunt me—make the most enamored eyes, & three of them in unguarded moments, kissed me!” Even when she overcharged the demonstrative ones, they came back for more. These satisfied patients surely meant to convey nothing more than ardent gratitude, but Elizabeth had never liked to be touched and preferred to think of herself as above mawkish entanglements. Or perhaps it was a case of doth-protest-too-much. “I can assure you it’s no small cross,” she wrote. “I’ve no objection to kissing a healthy handsome man occasionally, but love passages with women are diabolical!”