Sunday, 11 March 2018

The First Woman Doctors: Elizabeth Blackwell and her Circle

Women have always been involved in health care, as domestic healers and midwives. But in the 19th century, they began a quest to gain qualification as professional physicians and surgeons. 

The first to succeed in that aim was Elizabeth Blackwell, born in England in 1821. Her family emigrated to the United States a few years later. As a young woman, she determined to become a physician. 

Her family was supportive, but not wealthy. To earn tuition money, she taught school. That took her to the South, first to Kentucky, where she saw slavery at first hand, and became a committed abolitionist. 

In the mid-1840's, she taught in a school run by Rev. John Dickson in Asheville, North Carolina. A former physician, he approved of her medical goal and let her use his medical library. In 1846, however, the school closed down.

Blackwell moved to Charleston, South Carolina, and taught in a local boarding school. She lived in the house of Rev. Dickson's brother. Dr. Samuel H. Dickson, professor of medicine at the Medical College of South Carolina. 

With Dickson's help and encouragement, Blackwell applied to several American medical colleges. But she was rebuffed at every turn due to her gender. She persisted and in 1847, was accepted at Geneva College in Geneva, New York (now Hobart College). 

The condition of her acceptance was unusual, to say the least. All the currently enrolled male students, about 150, had to agree. They did. She received her MD in 1849. She later furthered her studies in Paris and London hospitals, particularly in obstetrics. 

Back in the US, Blackwell struggled to establish a medical practice, despite her excellent training. In the 1850's, she and her sister Emily founded the New York Infirmary for Indigent Women and Children. Emily herself was the third woman to get an MD in the US. In this endeavor they were assisted by Dr. Marie Zakrzewski, a young Polish immigrant Blackwell had mentored. (Above; Emily Blackwell, below: Marie Zakrzewski)

The Blackwell sisters also aided the Union war effort in the Civil War, helping to train nurses, though their efforts were often stymied by the male-dominated Sanitary Commission.

Blackwell returned to her native Britain several times in the late 1850's to establish an infirmary there. Although that did not succeed, she did become the first woman listed on the British General Medical Register, in 1859. She also mentored Elizabeth Garrett Anderson, the first woman to earn an MD in France, the first woman dean of a medical school, and co-founder of the first hospital staffed by women.

In 1869, after sharp disagreements with Emily, Elizabeth settled permanently in the UK. In 1874, she founded a women's medical college in London with Sophia Jex-Blake, who she had helped train. The two did not ultimately get along, clashing over goals and management.

Blackwell retired from medical practice in 1877. She subsequently devoted herself to a broad array of moral and social reform causes. These included anti-vivisection, anti-vaccination, sanitation, Christian Socialism, women's rights, sexual hygiene, and eugenics. Her stances on some of these issues were often at variance with advances in medical and scientific knowledge, and led to conflict with other early women doctors. (image: Blackwell in later years)

One of them was Mary (Putnam) Jacobi, the first American woman to earn an MD in Paris, in 1870. Jacobi rejected Blackwell's view that medicine was foremost a moral calling. Jacobi argued that its primary objective was to cure the sick and advance medical science. She also disagreed with Blackwell's contention that women should concentrate on medical specialties like obstetrics and pediatrics. In these areas, she claimed, their "female" qualities would give them an advantage over men. Jacobi argued that women should enter all fields of medicine on an equal footing with men.

Despite her disagreements with her fellow pioneering women, Blackwell's persistence and dedication was an inspiration to women aspiring to medical careers. By the late 19th century, hundreds of women had qualified to practice medicine. Thousands and then millions more would soon follow. In 1974, the US government honored Blackwell by issuing a stamp bearing her portrait.

Further Reading: Thomas Neville Bonner, To the Ends of the Earth: Women's Search for Education in Medicine (1992)

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