For Her Own Good: Two Centuries of the Experts Advice to Women

by Barbara Ehrenreich

  The trouble with these two classes from the point of view of the new middle class was not only that they were boorish, but that they were engaged in a war which seemed likely to destroy the entire social order. During the eighteen seventies and eighties, strikes, riots, and armed insurrections filled the newspapers and the nightmares of the middle class. Anyone could see, they argued, that there was an urgent need for scientific experts and administrators to:

  … disinterestedly and intelligently mediate between [the] contending interests. When the word “capitalist classes” and “the proletariate” [sic] can be used and understood in America, it is surely time to develop such men, with the ideal of service to the State, who may help to break the force of these collisions.4

  “Experts” could solve society’s problems because they were, as scientific men, by definition totally objective and above special interests of any kind. In the process, the problems of the new middle class itself could be solved too. Specialized “expert” occupations, accessible only after lengthy training, would provide them a secure occupational niche and a share of power far out of proportion to their numbers. Far-seeing spokesmen of their class even prophesied a future society in which—not the “half-taught plutocracy,” not the “ignorant proletariat”—but the experts themselves would rule. This, it was felt, would be the utopian summit of human civilization, since the experts would of course manage things scientifically, i.e., for the good of all.* As a leading engineer explained it, “the golden rule will be put into practice through the slide rule of the engineer.”6

  To this new middle class, science was not just a method or a discipline, but a kind of religion. Asking what “creed” best suited Americans, social commentator Thaddeus Wakeman wrote in 1890:

  The answer is, that which he knows to be true,—and that, in one word is Science. The majority of the American people are already practically secularists—people of this world.… Our people are unconsciously welcoming the incoming sway of Science and Man; and this is proved by their absence from the Churches.7

  The Moral Salvation of Medicine

  If the transformation of regular medicine into “scientific medicine” were retold as a story of religious conversion, Sinclair Lewis’s Arrowsmith would be its Pilgrim’s Progress. Lewis’s novel was based on the real-life experiences of a young medical researcher, and it captures in fiction the moral fervor of the scientific reformers as no historical study has done. At the University of Winnemac medical school, young Martin Arrowsmith encounters the extremes of scientific purity and medical commercialism, personified in his professors. There is, at one extreme, Dr. Roscoe Geake, newly resigned from the chair of otolaryngology to the vice-presidency of the New Idea Medical Instrument and Furniture Company of Jersey City, who exhorts the medical students to “put pep in their salesmanship”:

  … Have your potted palms and handsome pictures—to the practical physician they are as necessary a part of his working equipment as a sterilizer or a Baumanometer. But so far as possible have everything in sanitary-looking white—and think of the color-schemes you can evolve, or the good wife for you, if she be blessed with artistic tastes! Rich golden or red cushions, in a Morris chair enameled the purest white! A floorcovering of white enamel, with just a border of delicate roses! Recent and unspotted numbers of expensive magazines, with art covers, lying on a white table! Gentlemen, there is the idea of imaginative salesmanship which I wish to leave with you.…8

  And there is at the other extreme Dr. Max Gottlieb—“the mystery of the University” because he is a Jew, a foreigner, and a scientist obsessed by his work:

  He was unconscious of the world. He looked at Martin and through him; he moved away, muttering to himself, his shoulders stooped, his long hands clasped behind him. He was lost in the shadows, himself a shadow.

  He had worn the threadbare top-coat of a poor professor, yet Martin remembered him as wrapped in a black velvet cape with a silver star arrogant on his breast.9

  Martin and his friend Clif swear drunkenly to follow the lonely path of science:

  “… I’m jus’ sick o’ c’mmercialism an’ bunk as you are,” confides Clif.

  “Sure. You bet,” Martin agreed with alcoholic fondness. “You’re jus’ like me.… Ideal of research! Never bein’ content with what seems true! Alone, not carin’ a damn, square-toed as a captain on the bridge, working all night, getting to the bottom of things!”10

  But the path is more arduous than the young men can see. Distractions beckon from all sides—quick money, worldly power, venal women, even the quagmire of sentimental humanitarianism. Arrowsmith is only human, he falls again and again. But each time he realizes he has lost his soul (his work) and picks himself up once again to pursue the austere ideal of science. In the end he must set aside all worldly things—wealth, position, a rich and gorgeous wife—and retire to a laboratory built in the remote wilderness.

  Biological science had not always had the mystic and holy power with which it pulled at Martin Arrowsmith. In the eighteen seventies and eighties, when the ideas of the new biology began to circulate in the American middle class, they were greeted with a suspicion which often bordered on moral revulsion. Darwin’s theory of evolution—the most brilliant synthetic breakthrough of nineteenth- and perhaps twentieth-century biological science—“shattered the Christian cosmos.” It was not only that the theory violated the letter of the Old Testament; Darwinism went further and asserted that the world of living creatures could have gotten the way it is without the intervention of God, in fact, without conscious effort on anybody’s part. What was left, in the view of leading American Christians, was a godless universe, a moral desert—

  Life without meaning; death without meaning; the universe without meaning. A race tortured to no purpose, and with no hope but annihilation. The dead only blessed; the living standing like beasts at bay, and shrieking half in defiance and half in fright.11

  The spiritual implications of the new biological truth were, as one minister put it, “brutalizing.”

  In a lesser way, biology’s second great contribution to popular culture—the Germ Theory of Disease—further undercut the religious foundations of morality. Traditional religion saw individual disease as the price of moral failings, epidemics as acts of a vengeful God. In the mid-nineteenth century, Albert Barnes, a leading Presbyterian minister, declared cholera to be a punishment for the “vanities of natural science,” especially Darwinism. But, through the lenses of the new high power microscopes available in the mid-eighteen hundreds, disease began to look like a natural event that depended less on God than on the growth rates of what appeared to be fairly amoral species of microbes. If diseases were dispensed in some sort of microbial lottery, rather than by moral plan, then indeed this was a “race tortured to no purpose.”

  In order to become a moral force in society, biological science had had to undergo a kind of moral transformation itself. For example, Darwin’s popularizers managed to identify “evolution” with “progress,” as if natural history were a long uphill moral pilgrimage. This stratagem excused some of the more savage aspects of natural selection and—even more important—it left room for a divine Plan. The laws which science was uncovering would turn out to be the expression of the will of God—revelations of the divine Plan. Thus science could provide moral guidelines for living: for example, that one had an “evolutionary duty” to “advance the race” through proper selection of a mate, good health habits, etc. By the eighteen eighties it is difficult to find a popular tract or article on any subject—education, suffrage, immigration, foreign relations—which is not embellished with Darwinian metaphors. Charlotte Perkins Gilman’s classic Women and Economics, the theoretical breakthrough for a whole generation of feminists, appealed not to right or morality but to evolutionary theory. Women’s confinement to domestic activities had made them more “primitive” and undeveloped than men. If women were not emancipated, the whole race would be dragged down, she argued (with the naïve racism
which was typical of her time):

  In keeping her on this primitive basis of economic life, we have kept half humanity tied to the starting-post, while the other half ran. We have trained and bred one kind of qualities into one-half the species, and another kind into the other half. And then we wonder at the contradictions of human nature!… We have bred a race of psychic hybrids, and the moral qualities of hybrids are well known.12

  Germ Theory went through a similar moral transformation. If it was germs and not sin that were the immediate cause of disease, then sin could be still retained as an ultimate cause. Germ Theory was transformed into a doctrine of individual guilt not at all out of tune with old-fashioned Protestantism. Anyone who transgressed “the laws of hygiene” deserved to get sick, and anyone who got sick had probably broken those laws. The English physician Elizabeth Chesser, in her book Perfect Health for Women and Children, warned that “the time has nearly arrived when we shall not be permitted to be unhealthy.”13

  If, to the middle-class public, science was a source of moral precepts, a kind of secularized religion, then the scientist was its prophet. In him, progressive-minded Americans found a culture hero for the new century. General Francis A. Walker, the president of MIT, announced in 1893 that America’s scientists outdistanced all other occupational groups in their “sincerity, simplicity, fidelity, and generosity of character, in nobility of aims and earnestness of effort.”14

  The experimental scientist was a fitting moral paragon for the modern age. He was an intellectual of sorts; that is, he did “brain work,” but he had none of the effete otherworldliness which Americans found so distasteful in philosophy professors, poets, and other impractical types. In fact, the lab man was as ruthlessly hardheaded, materialistic, and pragmatic as any capitalist entrepreneur—“a real man.” Yet, at the same time, he was an altruist whose unselfishness reached superhuman heights: Metchnikoff drank cholera vibrios by the tumblerful to test their effects; later “microbe hunters” cheerfully exposed themselves to the carriers of yellow fever, malaria, tuberculosis.

  With his selflessness, his obsessive drive, his apparent scorn for material reward, the scientist assumed some of the qualities of the Christian Redeemer: taking on his shoulders (bent from too many hours over the microscope) the sins—and diseases—of the multitude. “Within these walls,” says the inscription on New York’s Sloan-Kettering Institute for cancer research, “a few labor unceasingly that many may live.” And it was to the altar of biological science that America’s first billionaires, Rockefeller and Carnegie, went to expiate their guilt through philanthropy—as if in the ascetic atmosphere of the biological laboratory the wages of sinful accumulation could be turned into life.

  What happened to elevate biological science and science in general from the status of a godless rebel to such a state of grace? “Good works” were part of the answer. The “miracles” of modern science outdid anything that the nineteenth-century Christian God deigned to effect. Sir William Osler pictured science pouring from a cornucopia, down onto man’s head, “blessings which cannot be enumerated.…” After the late nineteenth century, an evangelist would be as foolish to denounce science as the devil’s work as he would be to forego microphones, electric lights, and all vehicles based on the principle of internal combustion. But science did not triumph through works alone. In fact, it sometimes went the other way: the prestige of science was so great that science took credit, in the public mind, for innovations from other sources. An instrument maker, not a scientist, invented the steam engine; two bicycle mechanics designed the first airplane; a rising standard of living, not vaccines and antitoxins, eventually brought down the rate of infant mortality. So the “scientism”—science worship—of the nineteenth and twentieth centuries was not just a matter of pragmatic appreciation. Science was able to become a neo-religion because of its special qualities as an ideology. It was tough and yet transcendent—hardheaded and masculine, yet at the same time able to “soar above” commercial reality.

  No one could question the masculinity, the aggressiveness, of the new experimental biology. Earlier generations of biologists had been content to observe nature—to catalog it, describe it, label its parts. The new scientist pursued nature, trapped it in his laboratory, encircled it with experimental conditions representing different possible truths, and tightened the circle until the answers came out. Oliver Wendell Holmes, Sr., a regular doctor and early champion of scientific medicine, described his attitude toward scientific investigation in the language of undisguised sexual sadism. “I liked to follow the workings of another mind through these minute, teasing investigations,” he confided to his friend and fellow physician S. Weir Mitchell, “to see a relentless observer get hold of Nature and squeeze her until the sweat broke out all over her and Sphincters loosened.…”15

  But the aggressiveness of science—true science—is very different from the commercial aggressiveness of the Market. The only value known to the marketplace is self-interest; and if the Market encourages the qualities of rationalism and quantitative thinking, it does so only to put them at the service of profit. Science, on the other hand, is the embodiment of disinterestedness (or perhaps we could say, the disembodiment of the self-interestedness of the Market). It is rational and calculative, but only in the interests of truth. Ideally, neither whimsy nor wishful thinking nor the desire for fame can becloud the scientist’s deliberations: the judgment of the “results”—the graphs, columns of figures, comparative measurements—is final. It is this image of uncompromising disinterestedness and objectivity which gives science its great moral force in the mind of the public. Science is supposed to serve no special interests, no class or privileged group. It rises above all that is narrow, mundane, greedy, just as the “McGurk Institute” for medical research in Arrowsmith perches majestically on top of twenty-eight floors of commercial offices:

  The McGurk Institute is probably the only organization for scientific research in the world which is housed in an office building. It has the twenty-ninth and thirtieth stories of the McGurk Building, and the roof is devoted to its animal house and to tiled walks along which (above a world of stenographers and bookkeepers and earnest gentlemen who desire to sell Better-bilt Garments to the golden dons of the Argentine) saunter rapt scientists dreaming of osmosis in Spirogyra.16

  With the moral transformation of science, the laboratory took on a sacred quality. The laboratory was the temple of objectivity from which science could survey the world of man and nature—a kind of “germ-free zone” separated off from the filth, commercialism, and cheap sentiment of the world. Martin Arrowsmith’s first few moments in his new lab at the “McGurk Institute” are as refreshing to his spirit as a cathedral to a pilgrim:

  … When he had closed the door and let his spirit flow out and fill that minute apartment with his own essence, he felt secure.

  No Pickerbaugh or Rouncefield could burst in here and drag him away to be explanatory and plausible and public; he would be free to work, instead of being summoned to the package-wrapping and dictation of breezy letters which men call work.…

  Suddenly he loved humanity as he loved the decent, clean rows of test-tubes, and he prayed then the prayer of the scientist.…17

  The Laboratory Mystique

  While young Dr. Arrowsmith was struggling along on his pilgrimage in quest of scientific purity, other regular doctors—the leaders of their occupation—were beginning to appraise the laboratory as a possible solution to medicine’s troubles.

  The men who were to reform medicine, that is, transform it from regular medicine into “scientific” medicine, came from the new middle class and shared its visions and anxieties. If they were science-minded, that was not so much because they were doctors as because they were members of a class which had staked its future on science and expertism. They were not graduates of commercial medical schools; they were college-educated men who had studied medicine at Harvard, John Hopkins, or Penn and had finished off their studies with a
year or two in Berlin or Heidelberg (Germany had replaced England as the mecca for young doctors). There they had listened reverently to the great European fathers of experimental biology, drunk beer in rathskellers with the scions of European nobility, and perhaps had a chance to dabble in a laboratory. They returned to the United States, perhaps not with a thorough education in experimental science, but at least with “the idea of experiment,” as Dr. S. Weir Mitchell put it, and a passion to stamp this idea on the murky form of regular medicine.

  The scientific reform of medicine was not as easy a project as one might expect from the vantage point of the late twentieth century, with our supertechnological, instrument-dominated medicine. The average regular doctor, as opposed to the scientific elite, still had the mentality of a small-business man, worrying more about the day-to-day competition than the long-range future of the profession. He was respectful, as were most native-born middle-class Americans, toward science, though not through any firsthand acquaintance. Few practicing physicians had ever seen a microscope or used a thermometer, nor is it likely that they had much interest in such “advanced” technology. As one regular doctor remarked cynically upon the invention of the ophthalmoscope, “what the ophthalmoscope discloses are morbid conditions which are not for the most part more curable by being seen.”18

  “Heroic” bleeding and purging had subsided somewhat in the late nineteenth century, but regular therapy was still dominated by the need to produce some sort of a tangible commodity. Surgery had been added to the doctors’ repertoire, thanks to the introduction of ether and chloroform in the eighteen forties, and it was performed for all sorts of excuses on a variety of organs (see Chapter 4). In terms of drugs, opium and quinine were edging calomel out of the doctor’s little black bag by the eighteen sixties. Quinine—which is useful for controlling malaria, if prescribed properly—was handed out in erratic doses for fevers in general. With opium, however, and alcohol, the doctors had at last found something which really worked. Opium, alcohol, and cocaine did indeed “cure” pain, and the pragmatic physician used them liberally for everything from pneumonia to “nerves.”