Thursday, October 29, 2009


Roberta C.M. DeCaprio

I loved actress Jane Seymour in her portrayal of Michaela Quinn in the television series, “Doctor Quinn, Medicine Woman.” Each week she rose above new and different challenges. She boldly faced the odds of a prejudiced time, to bring medical help to a small frontier town. Thinking back on that show inspired me to do a bit of research about a real woman pioneer doctor, and my search led me to the Gale Cengage Learning site (Women’s History) where I found Elizabeth Blackwell, woman physician (1821 – 1910).

She was the first fully accredited female doctor and an ardent reformer of medical and social mores. Her sisters-in-law Lucy Stone and Antoinette Brown were pioneers in the advancement of women's rights, and her friends and associates included such 19th-century luminaries as William Lloyd Garrison, Florence Nightingale, Dante Gabriel Rossetti, Harriet Beecher Stowe, George Eliot, Dorothea Dix, religious reformer Charles Kingsley, and Julia Ward Howe, author of "The Battle Hymn of the Republic." Although considered ridiculous, even dangerous, for pursuing a medical degree in the 1840s, Elizabeth Blackwell forced open the gates of that profession. She later founded the first medical school for women, which resulted in both greater acceptances of female physicians and stricter standards for medical schools as a whole. By the time of her death in 1910, the number of female doctors in the United States had risen to over 7,000. Let me tell you more about a “real life” Dr. Quinn:

Born in Bristol, England, on February 3, 1821 Elizabeth Blackwell was the daughter of Samuel and Hannah (Lane) Blackwell. She was the third of nine surviving children in a close-knit, highly religious and moral family. Her father Samuel Blackwell was a prominent sugar refiner in the British port city of Bristol who saw to it that his five daughters received from their private tutors an education comparable to that of their brothers. This was no small achievement in a society that considered the proper education of girls to be one which left them, in the words of Noah Webster, merely "correct in their manners, respectable in their families, and agreeable in society." The highly esteemed Webster went on to note that "education is always wrong which raises a woman above the duties of her station"; Samuel Blackwell, an abolitionist and a vociferous dissenter from the Church of England, believed that the future duties of all his children included the reform of society.

As a child and an adolescent, Elizabeth Blackwell seems to have had little patience with actual sickness, once going so far as to lock herself in a closet to prevent her family from discovering that she had a fever. When a tutor used the freshly severed eye of a bull as an illustration for his physiology lesson, Elizabeth ran to the bathroom and was violently ill.

The Blackwells immigrated to America in August 1832 after a series of business losses convinced Samuel Blackwell that he would be better able to support his large family in the New World. Less than enthusiastic about the move, the large family nonetheless arrived in New York City after a grueling voyage of seven and a half weeks. There they became deeply involved in the American abolitionist movement, attending meetings and, for several weeks, hiding an escaped slave in their home who was on his way to Canada. Their financial affairs grew steadily more precarious, however, and in 1837, they moved to Cincinnati where Samuel Blackwell died the following year.
In the wake of his death, the family was forced to struggle for money, taking in boarders and giving music and English lessons to local children. Although this was a time when women married fairly young and were considered fit for little else, it appears that none of the Blackwell daughters, including Elizabeth, were ever particularly interested in that institution. In 1844, Blackwell visited a family friend who was dying of cancer and who told her how much she had suffered from the humiliation of being treated by male doctors. This woman also mentioned that Blackwell, who had such a "love of study," would make an ideal doctor; it was apparently this meeting which gave her the idea of pursuing a career in medicine.
Discreet inquiries to doctor friends concerning the possibility of acquiring a medical degree were met with incredulity or disgust, but she was not deterred. The following year, Elizabeth was able to secure a post teaching in Asheville, North Carolina, where she studied medicine privately with Dr. John Dickson; the year after, she taught music in Charleston, South Carolina, while continuing her studies with Dickson's brother, Dr. Samuel Dickson. By 1847, she was ready to begin applying to the leading medical schools, and they were ready to turn her down. Sixteen schools denied her admission before liberal Geneva College (now Hobart College) in upstate New York put her application to a student vote. Probably as a joke, the students agreed to the admission of this "upstart" female.
Today's frenzied medical student, interning for days on end and mortgaging the future to pay for school bills, bears little resemblance to the medical student of Elizabeth Blackwell's day. After only three years of private (but not particularly intensive) study with a practicing physician and 32 weeks of pass/fail college study, a young man was handed a medical degree. Doctors in bloodstained coats with dirty hands operated largely without benefit of anesthesia. While Elizabeth was applying to colleges in America, the Viennese Dr. Semmelweis was becoming the first doctor to insist that his attendants wash their hands before touching open wounds. It would be almost 20 more years before chemist Louis Pasteur would suggest the existence of germs and be viciously castigated by the medical community for his gall.
In November 1847, Elizabeth arrived at Geneva College, where the wives of the faculty and the women of the town thought her "either wicked or insane," and so stayed carefully away. Passing her final examinations at the head of the class, she was granted a medical degree on January 23, 1849, an occurrence so unprecedented that the English humor weekly Punch memorialized it in a set of verses. Dr. Elizabeth Blackwell then returned to Philadelphia, where the formerly hostile hospitals now grudgingly permitted her further study. She was determined to become a surgeon.
After several months in Pennsylvania, during which time she became a naturalized citizen of the United States, Elizabeth traveled to Paris, where she hoped to study with one of the leading French surgeons. Denied access to Parisian hospitals because of her gender, she enrolled instead at La Maternite, a highly regarded midwifery school, in the summer of 1849. La Maternite's intensive course in obstetrics concerned both pre- and post-natal care, and often involved extremely ill infants. While attending to a child some four months after enrolling, Elizabeth inadvertently splashed some pus from the child's eyes into her own left eye. The child was infected with gonorrhea, and Elizabeth contracted ophthalmia neonatorum, a severe form of conjunctivitis which rendered her unable to "work or study or even read," and which later necessitated the removal of the infected eye. Although the loss of an eye made it impossible for her to become a surgeon, it did nothing to alter her intention of becoming a practicing physician--which was in no way guaranteed simply by her medical degree.
Unable to receive training, or even recognition, at Parisian hospitals, Elizabeth left France for London in October 1850. Partially through the intervention of a cousin, she was allowed to study under Sir James Paget in nearly all the wards of venerable St. Bartholomew's Hospital. While in London she became friends with the widow of Lord Byron and with Barbara Leigh Smith, who was one of the strongest proponents of the education of women in England and later the founder of England's first feminist committee. She also met Florence Nightingale shortly before that famous reformer defied convention and her family to study nursing; Elizabeth wholeheartedly agreed with Nightingale's belief that "sanitation was the supreme goal of medicine."
By mid-1851, the substantial amount of training she had received, in addition to her medical school studies, made Elizabeth more than ready for private practice. However, no male doctor would even consider the idea of a female associate, no matter how well trained. Her younger sister Emily had been struggling to become a doctor in America, and so Elizabeth returned to the United States with the intention of setting up a joint practice. The opposition Emily Blackwell encountered while trying to get a medical degree was, if anything, stronger than that which her sister had had to face. Even Geneva College refused to accept another female student, and when Emily was finally allowed to study at Rush Medical College in Chicago, that college was so strongly criticized by the state medical society that the college denied her admission for the second year of study.
Having determined to settle in New York City, Elizabeth Blackwell found it difficult to secure space for her practice; when a sympathizer finally allowed her to rent a boardinghouse room, all the other renters promptly moved out, scandalized at having to share quarters with a lady doctor. Forced to rent her own house, Elizabeth lived in the attic and used the main rooms as consulting space for the three liberal patients a week she'd managed to win over by the summer of 1852.
Less than two years later, Elizabeth opened the one-room New York Dispensary for Poor Women and Children in a slum area near present-day Tompkins Square Park on the Lower East Side of Manhattan. It was some time before necessity gave the poor women and children the courage to go to the woman doctor's clinic, but when they did, the dispensary had to move to larger quarters. In the fall of 1854, Elizabeth adopted (although never legally) a seven-year-old Irish orphan named Kitty, who gradually became one of the family and lived with her until Elizabeth died.
The dispensary was doing well, and Elizabeth was beginning to have grander plans--not just an enlargement of her clinic, but an actual hospital where women doctors could treat poverty-stricken women and their children. She had managed to pull strings for the medical education of a German immigrant, Marie Zakrzewska, who had been chief of midwifery at the Royal Hospital in Berlin, and Dr. Zakrzewska returned to work in the dispensary after receiving her degree from Western Reserve Medical School (now Case Western Reserve) in Cleveland. In 1854, Emily Blackwell had also graduated from Western Reserve Medical School and departed for further training in Europe, where she studied under Sir James Simpson of Edinburgh, Scotland, and attempted to raise funds for her sister's dream hospital. After returning to America in 1856, Dr. Emily Blackwell joined her sister Elizabeth's clinic in New York, and on May 12, 1857, the New York Infirmary for Indigent Women and Children was opened.
Liberal and reformers' groups from as far away as France and Boston had contributed funds towards the hospital's existence. Its beds were full within a month, although the first two times a patient died the hospital had to withstand attacks by neighborhood mobs convinced "the lady doctors were killing their patients." In 1858, Elizabeth, whose hospital had also served as a training ground for newly graduated female doctors, took a year's leave of absence to further the cause of women's education in England. While in London, she lectured extensively and became the first woman to have her name entered in the British Medical Register. It was one of these lectures that convinced Elizabeth Garrett Anderson, later the pioneer of English female doctors, to take up the study of medicine. Elizabeth apparently gave serious thought to remaining in England and possibly setting up a hospital similar to her own New York Infirmary, but at the end of the year she returned to America, where the infirmary soon moved to larger quarters.
In April 1861, the newly formed Confederacy fired on Fort Sumter in South Carolina, and the Civil War began. In New York, Elizabeth and Emily Blackwell set up the Woman's Central Association of Relief to train nurses for the conflict; the army at this time had no hospital units. This association soon became the celebrated United States Sanitary Aid Commission, officially appointed by President Lincoln. Fearing that their notoriety would hinder the project, the Blackwells withdrew from the organization as it grew.
The Emancipation Proclamation was issued in September 1862, and, though it declared free only those slaves in seceded states, many working-class Northerners took it to mean that freed slaves would appropriate their jobs when they were drafted to fight. Violent riots broke out in New York City for three days in July 1863, during which time hundreds of blacks were slaughtered. Buildings, including some a mere block from the infirmary, were burned to the ground. White infirmary patients demanded that the Blackwells discharge several expectant black mothers who had escaped the South, a demand with which the doctors refused to comply.
The Women's Medical College opened in November 1868, adjacent to the New York Infirmary, with Elizabeth as professor of hygiene. It was the first school devoted entirely to the medical education of women and to upgrading that education. It later became one of the first medical schools in America to mandate four years of study. The first black woman to become a doctor, Rebecca Cole, was also one of the first graduates of the Women's Medical College.
Elizabeth returned to England in 1869, leaving the infirmary and the college in her sister's hands. Certain sources say that disputes between the sisters were the primary reason for the departure, but in her autobiography Elizabeth notes that by that period "the early pioneer work in America was ended," and in England it was not. In addition to her private practice and her efforts for women's rights, she took up the fight against venereal disease or, more specifically, the fight to repeal the Contagious Diseases Act. This act required the licensing and regular physical examination of prostitutes in an attempt to stem the spread of syphilis and other diseases. Elizabeth, who was highly moral and considered herself more a "Christian physiologist" than a doctor, saw this law as tacit permission for men to behave immorally.
Her health was gradually growing worse. In 1873, she was forced to spend time in Italy to recover strength lost in several bouts of illness. The following year, while curtailing her private practice, she was made professor of gynecology at the newly incorporated London School of Medicine for Women, which had been organized by Elizabeth Garrett Anderson and by Sophia Jex-Blake, who would later become the fifth woman to have her name entered in the British Medical Register. Elizabeth's most important work, Counsel to Parents on the Moral Education of Children, was written in 1876. A highly controversial book at the time, it openly discussed sexual matters such as masturbation (of which she strongly disapproved), and would probably strike a modern reader as ill informed and dated.
In her later years, Elizabeth was also a strong opponent of vivisection and vaccination and considered the fledgling science of bacteriology to be utter nonsense. In 1879, she moved permanently to the village of Hastings on the English Channel, where she finally gave up private practice and wrote her autobiography, published in 1895 under the title Pioneer Work in Opening the Medical Profession to Women. A final four-month trip back to the United States was made in 1906, but she was too ill to visit the New York Infirmary, which had moved to buildings on 15th Street in Manhattan.
Elizabeth Blackwell died in England on May 31, 1910, at the age of 89. Due to scarce funds and the increasing acceptance of female students at more established universities, the Medical College had closed in 1899. The hospital she founded, however, now vastly enlarged and renamed New York Infirmary-Strang Clinic, still operates on East 15th Street.
Elizabeth Blackwell, the “real life” Dr. Quinn, never deterred from her dream of working in medicine. Her determination to reach her goal, against all odds (even with the ability to use only one eye), paved the way for all women doctors. Today female physicians are accepted and respected in hospitals and communities world-wide, many specialists in their field.


Tanya Hanson said...

Roberta, this was long LOL but worth every word and minute. Dr. Quinn is one of my favorite-ever TV shows, and the themes of prejudice against her sre so realistic. Grrrr.

I had heard of Elizabeth Blackwell of course, but not of Emily's medical background. I did not realize Elizabeth had lost an eye. Amazing obstacles she overcame, huh?

I am surprised, however, that she opposed vaccinations and bacteriology.

Fascinating material here. Thanks for the great post.

Tess Thieler said...

Dr. Quinn, Medicine Woman is my all time favorite TV series! I own all the DVD's and still watch them. They are far better than the stuff on TV these days even if I've seen the whole series 5 times through now. haha. I've written some DQMW fanfiction and have been active on the forum for nearly 5 years now. I must say, the history in your post was amazing. The only real female doctor ever mentioned on the forum over the years was a Dr. Susie who practiced in Colorado back in the 1800's. Elizabeth Blackwell was indeed an amazing woman.