The Doctors Blackwell

by The Doctors Blackwell (retail) (epub)

  Little Floy was barely two weeks old when one more Blackwell arrived at Fifteenth Street: Emily, home from Europe at last. After Edinburgh she had lingered for months in London, trapped by family drama: Marie’s convalescence and Kenyon’s ill health; cousin Sam’s ill-fated love for Bessie Parkes; business troubles that forced her brother Howard to seek employment in India. All these unlucky Blackwells had looked to Emily for strength—a new and not unwelcome role for the even-tempered sixth sibling. “I have experienced for the first time the strange triumphant happiness there is in standing firm in a storm supporting those who are weaker,” she wrote.

  Meanwhile she had attracted respectful recognition in London—at St. Bartholomew’s, Clement Hue had praised her “ardent love of knowledge, her indefatigable zeal in the examination of disease, her sound judgment and kind feeling”—and had finally reached Paris, where she walked in Elizabeth’s footsteps, shadowing prominent surgeons, studying at La Maternité (without mishap) and even visiting Hippolyte Blot, now a father of two. She also came in for the same kind of snark Elizabeth had earlier endured. Punch had chuckled all over again, running a caricature of “Dr. Emily” as a mannish woman in bloomers, squinting diagnostically at a lapdog clutched by a wasp-waisted young maiden. “The surname of the lady is immaterial, and, moreover, it may be hoped, will speedily be exchanged for another,” the item read, “since if to be cherished in sickness is an important object in marriage, a wife who in her own person combines the physician with the nurse must be a treasure indeed.” The joke was too stale to sting.

  Confident in her work, Emily could ignore her critics. “The European hospitals will never be closed to women again,” she told Elizabeth. “My studies here will do something to help others.” She was tempted to establish herself in Britain but understood the basic paradox: she was welcome precisely because the “old fogies” assumed that as soon as she completed her studies, she would leave.

  Emily reached New York in time for the merriest Christmas the Blackwells had enjoyed in years. The oldest and youngest siblings were absent: Anna was writing chatty dispatches for American newspapers from Paris, Howard was on his way to Bombay, artistic Ellen was now studying painting in Europe with the likes of John Ruskin and Rosa Bonheur, and George was lingering in Cincinnati. Lucy was on the road as usual. But crammed together at Fifteenth Street, the rest of the reunited and expanded clan indulged in roast beef and plum pudding. After dinner, grandmother Hannah and steadfast Marian, Elizabeth and Dr. Zak and little Kitty, Sam and Nettie and baby Florence, Emily and Henry settled snugly in the parlor, singing favorite songs and reading aloud from Robert Browning’s latest volume of poetry, Men and Women. There was a satisfying sense of return from western exile and European experiments to a base from which to launch larger plans.

  CARICATURE OF EMILY IN PUNCH, 1856.

  COURTESY NEW YORK SOCIETY LIBRARY

  Even from France, anti-American Anna could sense the consolidation. “As things have turned out, & the band being now increased by our very excellent and welcome new sisters, I can no longer even wish you all to return,” she wrote with resignation, “but earnestly hope, on the contrary, that you may now really take root.”

  * Clark studied successfully in Paris. On the voyage over, she made the acquaintance of Amos Binney, a recent widower. Within two years she married him and suspended her medical career; the couple had six children.

  CHAPTER 13

  INFIRMARY

  “I have no turn for benevolencies,” Elizabeth had written to Henry at the end of 1855. “I feel neither love nor pity for men, for individuals—they may starve, cut each other’s throats or perform any other gentle diversion suitable to the age—without any attempt to stop them on my part, for their own sakes. But I have boundless love & faith in Man, and will work for the race day and night.” Emily and Marie Zakrzewska were back in New York, each possessed of a diploma and substantial experience, and both of them were more interested in the practice of medicine than was Elizabeth herself. Let them manage the daily work of women’s health. Elizabeth would focus on the grander goal of women’s medical education, embracing the role she had always preferred: idealist.

  There was still almost nowhere for a newly fledged female M.D. to acquire the practical experience that medical school did not provide. Elizabeth’s hopes in J. Marion Sims and his Woman’s Hospital had faded. “Dr. Sims has never called to see me, and is evidently striving to keep in with the conservatives,” she wrote with disappointment to Emily. Sims had succeeded in establishing his Woman’s Hospital in 1855, at Madison Avenue and Twenty-ninth Street, specializing in his signature fistula surgery; like Elizabeth, he understood that as an outsider he would be able to apply and refine his new ideas only in an institution of his own. It was now clear, however, that what Sims aimed to elevate was not the stature of women in medicine but the stature of J. Marion Sims. His Woman’s Hospital was staffed entirely by men, and though he had recruited thirty prominent women as a board of managers, Elizabeth was not fooled. “Half are doctors’ wives, the stiffest of the stiff,” she complained, “the rest the richest & best known New Yorkers, but all of the fashionable unreformatory set.” These society ladies were not going to solve the problem of practical training for female medical students. And thanks to the women’s medical schools in Philadelphia and Boston, not to mention the Eclectic schools that now admitted women—however much the Blackwells might disdain the rigor of their programs—there were a growing number of female graduates to train.

  Instead of cultivating more powerful men as trustees, Elizabeth now turned to their wives and sisters and daughters. Where Sims expected his lady managers to play a philanthropic and decoratively feminine role, Elizabeth asked her supporters to participate more actively. On Thursday evenings, they met at her house to discuss her educational mission for women and learn how best to promote it, as her disciples.

  Elizabeth crystallized her thoughts in an address, “On the Medical Education of Women,” that she published in December 1855 as a pamphlet that could serve both as a professional calling card and as a fund-raising appeal. Her thesis, elegant in its simplicity, used the obvious example of obstetrics. “Women have always presided over the birth of children,” she wrote—but in this enlightened age of forceps and chloroform, science had advanced beyond the unwritten wisdom of traditional midwifery. “The midwife must give place to the physician,” Elizabeth declared. “Woman therefore must become physician.”

  Mindful of her audience—wives and mothers, not medical students—Elizabeth framed her project in terms they could embrace. “The grandest name of woman is mother—the noblest thought of womanhood is maternity,” she assured them. However: “The woman who cares but for her own children, is a feeble caricature of womanhood, not its true representative.” To realize the fullest grandeur of motherhood, women must extend their nurturing instincts beyond the fireside. Her vision neatly included both the female medical students who chose career over marriage and the society ladies whose generosity could support their training.

  The benefits were obvious, Elizabeth explained. Medicine would be a broad new field of endeavor for unmarried ladies. As physicians, these women would in turn inspire and elevate a better class of nurses, a group Elizabeth continued to disparage: “their ignorance, faithlessness and inefficiency at present is proverbial.” Women doctors would also, of course, rescue female patients from the “unnatural and monstrous” necessity of confessing intimate symptoms to men—or worse, in the case of inpatients, serving as case studies for male medical students, a terrible exposure that led to “bitter mortification” and “a deadening of sensibility.” Even as she spoke on behalf of helpless hospital patients, however, Elizabeth seemed to fault the wealthier women who sought advice from doctor after doctor for their ailments, showing an “utter want of delicacy” in subjecting themselves to repeated examinations. And even as she feared for the “moral purity” of female patients both rich and poor, she laid no blame for this peril
at the feet of her male colleagues, who had her “utmost confidence and respect.” In aligning herself with the men, she implicated herself in their misogyny. Then again, she had never set out to like women—only to lead the way toward a world in which they were recognized.

  It was not enough for women to earn medical degrees, she continued. Just as it was impossible to become a proficient musician by listening to someone discuss music theory, it was likewise impossible to emerge from the lecture hall a competent physician. All five senses must be tuned to the observation of disease, over months of repeated experience. “A system of medical education without continual practical instruction is an absurdity, or rather an impossibility,” Elizabeth wrote. And while she had hoped her own example as a student—confirmed by Emily’s repetition of her feat—would open the doors of all hospitals to women, she was wiser now.

  “There is but one way of meeting the imperative need of our women for hospital instruction,” she declared. “We must create a hospital to meet the want.” Not a dispensary—a hospital, where female students could learn without restriction. “I know the difficulty of this undertaking,” Elizabeth told the assembled ladies. It would require a huge effort of both publicity and fund-raising, guided by “sound judgment and good taste”—all of which she trusted her listeners to provide. She proposed the grand sum of ten thousand dollars and announced that the Thursday meetings would become sewing circles in preparation for a charity bazaar.

  Marie Zakrzewska attended faithfully, though with growing impatience. The canny entrepreneurial spirit that had kept her afloat upon her arrival in New York recoiled from what she saw as Elizabeth’s hopeless impracticality. “There was scarcely any life in these gatherings,” she grumbled, “and when I saw ladies come week after week to resume the knitting of a baby’s stocking (which was always laid aside again in an hour or two, without any marked progress), I began to doubt whether the sale of these articles would ever bring ten thousand cents.” On Sundays, she and Elizabeth escaped for long walks on Staten Island or the Jersey side of the Hudson, refreshing themselves with sunsets and wildflowers. Their deepening friendship allowed Zakrzewska to suggest a more sensible plan: the foundation, for now, of a more modest “nucleus hospital.”

  Fund-raising began in earnest. Emily collected contributions from friends in Europe; Zakrzewska made trips to Boston and Philadelphia, explaining the project to progressive supporters of the female medical colleges in those cities. Even among allies, the idea of a woman practicing in a hospital was a hard sell. “If you must talk on hospitals, do not mention women doctors,” one Fifth Avenue matron requested—though thanks to Florence Nightingale, it was perfectly fashionable to discuss nursing. A circular printed in June 1856 softened Elizabeth’s pitch, insisting that while the new hospital would indeed be a place for women to receive medical training, it was also “designed to meet another want, not supplied by Hospitals generally, viz: an earnest religious influence on the patients.” It would be a Christian charity above all, staffed by respectable nurses, in which “scientific instruction will always be subordinate to the welfare of the patient; each individual no matter how degraded, being regarded as a human soul as well as a body.”

  The house on Fifteenth Street filled with boxes and baskets of handiwork to sell at the bazaar. “I shall have an Art, Book, Fancy, Useful, and Refreshment table,” Elizabeth decided—but the problem, as the ladies of Elizabeth’s committee quickly discovered, was that no one would rent them a room in which to set up their tables, even if they paid in advance. At the last minute they secured a space at the Stuyvesant Institute, the very Broadway venue that had hosted J. Marion Sims’s 1855 lecture announcing his women’s hospital. This seemed auspicious—except that the ladies would not be permitted to use the lecture hall. They were welcome, however, to an attic loft three flights above, where nailheads stuck up from the floorboards and bare rafters ascended into the gloom.

  Donated rugs and drapes and borrowed chandeliers soon dressed the space, and evergreen boughs hid the raw beams. For four days in December 1856, the Ladies’ Fair charged ten cents admission for the privilege of shopping, and the New-York Tribune reported takings of more than $1,100 toward a projected $5,000, “the sum required to rent and furnish a suitable house for the accommodation and support of forty patients, with a dispensary for outside patients attached.”

  The paper also provided a satisfying clarification. “This enterprise must not be confounded with the Institution known as the Woman’s Hospital, located on Madison avenue, which is now in operation, as that is a Woman’s Hospital under the care, exclusively, of male practitioners,” noted the reporter, referring to Sims’s new establishment, “while this Institution is to be under the care and control of female physicians, with some of our eminent medical men attached as consulting advisers.”

  Sims had recently disappointed the Blackwells again. Despite Elizabeth’s dim opinion of the women on his board, and perhaps due to her inspiring example, they had included in their bylaws a clause stipulating that Sims must hire a female assistant surgeon. The obvious candidate was Emily Blackwell, who upon her return from Europe was the best qualified—in fact, the only—female surgeon in New York. Sims ignored her, flouted his own board, and appointed Thomas Addis Emmet, a well-connected young surgeon whom Sims knew socially. The Blackwells’ disillusionment with Sims was complete.

  The Tribune was Horace Greeley’s paper, and the bias of the article was clear. The Blackwells’ project, it noted, had technically predated the founding of Sims’s hospital, which was already receiving funds from the state; surely a similar level of support for the Blackwells would shortly follow. There it was, in print: affirmation that the Blackwells’ goal was valid and should be realized, written by someone who seemed familiar with Elizabeth’s “On the Medical Education of Women.” Women, the Tribune declared, had always been healers—and now “manifested the capacity and the inclination to resume their old place in the modern profession.”

  The brick house on the corner of Bleecker and Crosby had been the home of the Roosevelt family, the branch whose most famous scion, later in the century, would be christened Franklin Delano. A remnant of privilege, it was built in the Dutch style with four chimneys and a dash of architectural elegance in its quoined corners. Its painted shutters and neatly swept stoop looked toward the fading elegance of Bond Street and the Corinthian flourishes of Colonnade Row, but the best addresses had already migrated farther north, to Washington Square and up Fifth Avenue. To the south and east, in the notorious slum of Five Points, wood-framed tenements sported broken windows like black eyes, and ramshackle stairways climbed crookedly up exterior walls from squalid cellars to airless attics, every square foot of living space claimed by too many of the city’s most recent arrivals. On a visit a decade earlier, Charles Dickens had toured it with a police escort. “Debauchery,” he wrote, “has made the very houses prematurely old.” The Blackwells’ New York Infirmary for Indigent Women and Children stood on the threshold between high and low, patron and patient.

  Having raised just enough to secure the lease—from both private donors and the New York state legislature, which had allocated the same one thousand dollars it directed to all the city’s dispensaries—the Blackwells planned to open on May 12, 1857. It was Anniversary Week, when progressive organizations like the Temperance Union and the Anti-Slavery Society held their national meetings in New York. The city would be full of sympathetic supporters.

  It was also Florence Nightingale’s thirty-seventh birthday. Though the “Lady with the Lamp” hewed firmly to nursing as the appropriate role for women in medicine, she had conferred a cautious blessing on the Blackwells’ endeavor during her correspondence with Emily. The advent of women doctors was inevitable, Nightingale agreed; it was just a matter of the right woman leading the way. “She must have both natural talent and experience and undoubted superiority in her knowledge of Medicine & Surgery,” Nightingale wrote. “She must be entirely above all flirting or
ever desiring to marry, recollecting that to her, the Apostle of the cause, her cause must be all in all.” Both Blackwells could recognize themselves in those terms, even if they disagreed in theory with Nightingale’s insistence that medical women must remain forever celibate. Whether the Blackwells were the right women Nightingale did not say, but she retained a deep respect for Elizabeth despite their divergent opinions. “Pray remember me most affectionately to your sister, whom I shall never forget,” she had closed her letter to Emily. The Blackwell sisters were abundantly aware of the usefulness of Nightingale’s fame, even if their opinions diverged. The date was not an accident.

  NEW YORK INFIRMARY BUILDING AT THE CORNER OF BLEECKER AND CROSBY STREETS .

  COURTESY NEW YORK ACADEMY OF MEDICINE

  Henry Ward Beecher, their keynote speaker, was another wise choice. Congregants and tourists flocked to his sermons at Brooklyn’s Plymouth Church, familiarly known as “Beecher’s theater”; on Sundays the Brooklyn ferries were dubbed “Beecher boats.” For his exuberant homilies—encouraging seekers to pursue the truth of their individual natures—he was paid a salary of five thousand dollars a year, his success unmatched even by his best-selling sister, Harriet Beecher Stowe. The Blackwells understood the power of Beecher’s rhetoric to propel their project. In its coverage of the infirmary’s opening, the New York Herald devoted more column inches to Beecher’s remarks than to any other aspect of the event.