The first woman to receive a medical degree in the United States died today in 1910. Now WE know em

elizabeth-blackwell

Elizabeth Blackwell was born February 3, 1821 in a house on Dickson Street in Bristol, England.

In 1828, the Blackwell family moved to Nelson Street, next to her fathers refinery.

However, in 1830, Bristol became unstable and as riots began to break out, her father decided to move his family to America.

Elizabeth Blackwell was only eleven years old when the Blackwell family sailed for New York aboard the Cosmo in August of 1832.

Her father opened up the Congress Sugar Refinery in New York City after they settled in.

In 1836, the family refinery burned down in a fire. Despite being rebuilt, her father’s refinery ran into business problems only a year later.

The family economized, dismissed their servants, and moved to Cincinnati, Ohio in 1838 in an attempt to re-establish the business.

Part of the reason for the move to Cincinnati was her father’s interest in cultivating sugar beets, an alternative to the slave-labor intensive sugar cane being produced elsewhere.

Three weeks after their move to Cincinnati, however, on August 7, 1838, Elizabeth Blackwell’s father died unexpectedly from biliary fever. He left behind a widow, nine children, and a great deal of debt.

Early adulthood

The Blackwell family’s financial situation was unfortunate. Pressed by financial need, the sisters Anna, Marian and Elizabeth started a school, The Cincinnati English and French Academy for Young Ladies, which provided instruction in most if not all subjects, and charged for tuition, room, and board. The school was not terribly innovative in its education methods – it was merely a source of income for the Blackwell sisters. Only to be abandoned in 1842.

Elizabeth then began teaching private pupils.

Then in 1844, with the help of her sister Anna, Elizabeth Blackwell procured a teaching job that paid $400 per year in Henderson, Kentucky.

Although she was pleased with her pupils, she found the accommodations and schoolhouse lacking. What disturbed her most was that this was her first real encounter with the realities of slavery. She ultimately found Henderson to be absurd and boring, the people to be simple and petty, and the whole situation, all in all intolerable.

She returned to Cincinnati only half a year later, resolved to find a more stimulating means of spending her life.

Decision to enter medicine

The idea to pursue medicine was first planted in Blackwell’s head by a friend in Cincinnati who was dying of a painful disease (possibly uterine cancer). This friend expressed the opinion that a female physician would have made her treatment much more comfortable. Elizabeth also felt that women would be better doctors because of their motherly instincts.

At first however, Elizabeth Blackwell was repulsed by the idea of a medical career.

At the time, she “hated everything connected with the body, and could not bear the sight of a medical book”.

Another influence on her decision to pursue medicine was the connotation of “female physician” at the time. Abortionists were known as “female physicians”, a name Elizabeth found degrading to what a female physician could potentially achieve.

Last but not least, part of Elizabeth’s decision to become a doctor was due to the fact that she yearned to live an unattached life, independent of a man and the chains of matrimony.

Thus Elizabeth Blackwell’s decision to study medicine was a rather arbitrary one. It was made before she realized just how difficult it would be to overcome the patriarchal barriers to her goal.

However, the difficulty only cemented her resolve.

In 1845, Elizabeth Blackwell knew that she would one day obtain a medical degree, but she did not yet know where it would be, or how she would get the money to pay for it.

Pursuit of medical education

Once again, through her sister Anna, Elizabeth procured a job, this time teaching music at an academy in Asheville, North Carolina, with the goal of saving up the $3000 necessary for her medical school expenses.

In Asheville, Elizabeth lodged with a Reverend John Dickson, who happened to have been a physician before he became a clergyman. Dickson approved of Blackwell’s career aspirations, and allowed her to use the medical books in his library to study. During this time, Blackwell soothed her own doubts about her choice and her loneliness with deep religious contemplation.

Dickson’s school closed down soon after, and Elizabeth moved this time to the residence of Reverend Dickson’s brother, Samuel Henry Dickson, a prominent Charleston physician.

Elizabeth started teaching in 1846 at a boarding school in Charleston run by a Mrs. Du Pré. With the help of Reverend Dickson’s brother, Elizabeth inquired into the possibility of medical study via letters, with no favorable responses.

Then in 1847, Elizabeth left Charleston for Philadelphia and New York, with the aim of personally investigating the opportunities for medical study. Her greatest wish was to be accepted into one of the Philadelphia medical schools.

Upon reaching Philadelphia, Elizabeth boarded with Dr. William Elder, and studied anatomy privately with Dr. Jonathan M. Allen as she attempted to get her foot in the door at any medical school in Philadelphia. She was met with resistance almost everywhere. Most physicians recommended that she either go to Paris to study, or that she take up a disguise as a man to study medicine.

The main reasons offered for her rejection were that;

1) she was a woman and therefore intellectually inferior, and

2) she might actually prove equal to the task, prove to be competition, and that she could not expect them to “furnish [her] with a stick to break our heads with”.

Out of desperation, she applied to twelve “country schools”.

Medical education in the United States

In October 1847, Elizabeth Blackwell was accepted as a medical student by Geneva Medical College, now Hobart College, located in upstate New York. Her acceptance was a near-accident. The dean and faculty, usually responsible for evaluating an applicant for matriculation, were not able to make a decision due to the special nature of Elizabeth’s case. They put the issue up to vote by the 150 male students of the class with the stipulation that if one student objected, Elizabeth Blackwell would be turned away. The young men thought this request was so ludicrous that they believed it to be a joke, and responding accordingly, voted unanimously to accept her.

When Elizabeth Blackwell arrived at the college, she was rather bewildered. Nothing was familiar – the surroundings, the students, the faculty. She did not even know where to get her books and was probably too shy to ask. However, she soon found her footing.

Elizabeth had an enormous impact on the class. Her presence turned a group of boisterous young men into well-behaved gentlemen. Whereas before, there was so much confusion and chaos in the lecture hall that the lecture itself was barely audible, with Blackwell’s arrival, the male students sat quietly and listened attentively to lecture.

When Dr. James Webster, the anatomy professor, got to the reproduction section of his lectures, he asked Elizabeth to excuse herself, arguing that it would be too vulgar for her delicate mind. Elizabeth’s eloquent response not only made Webster admit her to the lecture, but also elevated the previously obscene and vulgar nature of the lectures.

Elizabeth soon received encouragement from both professors and students. However, she experienced a lot of isolation as well. She was looked upon as an oddity by the townspeople of Geneva. She also rejected suitors and friends alike, preferring to isolate herself.

In the summer between her two terms at Geneva, she returned to Philadelphia, stayed with Dr. Elder, and applied for medical positions in the area to gain clinical experience. The Guardians of the Poor, the city commission that ran Blockley Almshouse, granted her permission to work there, albeit not without some struggle.

Elizabeth slowly gained acceptance at Blockley, although some young resident physicians still would walk out and refuse to assist her in diagnosing and treating her patients. During her time there, Elizabeth gained valuable clinical experience, but was appalled by the syphilitic ward and those afflicted with typhus.

Her graduating thesis at Geneva Medical College ended up being on the topic of typhus.

The conclusion of this thesis linked physical health with socio-moral stability – a link that foreshadows her later reform work.

On January 23, 1849, Elizabeth Blackwell became the first woman to achieve a medical degree in the United States.

The local press reported her graduation favorably, and when the dean, Dr. Charles Lee, conferred her degree, he stood up and bowed to her.

Elizabeth then continued her studies in Europe, returning to the United States in 1851 to pursue her career.

Medical career in the United States

Back in New York City, Elizabeth opened up her own practice. She was faced with adversity, but did manage to get some media support from entities such as the New York Tribune. She had very few patients, a fact Elizabeth attributed to the stigma of woman doctors as abortionists.

In 1852, she began delivering lectures and published The Laws of Life with Special Reference to the Physical Education of Girls, her first work, a volume about the physical and mental development of girls.

Although Elizabeth herself pursued a career and never married or carried a child, this treatise ironically concerned itself with the preparation of young women for motherhood.

In 1853, Elizabeth established a small dispensary near Tompkins Square. She also took Marie Zakrzewska, a German woman pursuing a medical education, under her wing, serving as her preceptor in her pre-medical studies.

In 1857, Dr. Marie Zakrzewska, along with Elizabeth and her sister Emily, who had by then also obtained a medical degree, expanded Elizabeth Blackwell’s original dispensary into the New York Infirmary for Indigent Women and Children.

Women served on the board of trustees, on the executive committee, and as attending physicians. The institution accepted both in and outpatients, and served as a nurse’s training facility. The patient load doubled during its second year.

Civil War efforts

When the civil war broke out, the Blackwell sisters aided in nursing efforts. Elizabeth sympathized heavily with the North and even went so far as to say she would have left the country if the North had compromised on the subject of slavery.

Medical career at home and abroad

Elizabeth Blackwell made several trips back to England to raise funds and to try to establish a parallel infirmary project there. In 1858, under a clause in the Medical Act of 1858 that recognized doctors with foreign degrees practicing in Britain before 1858, she was able to become the first woman to have her name entered on the General Medical Council’s medical register (January 1, 1859).

By 1866, nearly 7,000 patients were being treated per year at the New York Infirmary, and Elizabeth was needed back in the United States. The parallel project fell through, but in 1868, a medical college for women adjunct to the infirmary was established. It incorporated Elizabeth’s innovative ideas about medical education – a four-year training period with much more extensive clinical training than previously required.

At this point, a rift occurred between Emily and Elizabeth Blackwell. They both had extremely headstrong personalities, and a power struggle over the management of the infirmary and medical college ensued.

Elizabeth, feeling slightly alienated by the United States women’s medical movement, left for England to try to establish medical education for women there. In July 1869, Elizabeth sailed for England.

In 1874, Elizabeth Blackwell established a women’s medical school in London as the London School of Medicine for Women, with the primary goal of preparing women for the licensing exam of Apothecaries Hall.

After the establishment of the school, Elizabeth Blackwell lost much of her authority, and was elected as a lecturer in midwifery.

Elizabeth resigned this position in 1877, officially retiring from her medical career.

Then Elizabeth became interested in a great number of reform movements – mainly moral reform, sexual purity, hygiene, and medical education, but also preventative medicine, sanitation, eugenics, family planning, women’s rights, associationism, Christian socialism, medical ethics, and antivivisection – none of which ever came to real fruition.

She switched back and forth between many different reform organizations, trying to maintain a position of power in each.

Elizabeth Blackwell had a lofty, elusive, and ultimately unattainable goal: evangelical moral perfection. All of her reform work was along this thread. She even contributed heavily to the founding of two utopian communities: Starnthwaite and Hadleigh in the 1880s.

She believed that the Christian morality ought to play as large a role as scientific inquiry in medicine, and that medical schools ought to instruct students in this basic truth.

Last years and death

Elizabeth Blackwell, in her later years, was still relatively active. In 1895, she published her autobiography, Pioneer Work in Opening the Medical Profession to Women. It was not very successful, selling fewer than 500 volumes. After this publication, Elizabeth slowly relinquished her public reform presence, and spent more time traveling. She visited the United States in 1906 and took her first and last automobile ride. Elizabeth Blackwell’s old age was beginning to limit her activities.

In 1907, Elizabeth fell down a flight of stairs, and was left almost completely mentally and physically disabled.

On May 31, 1910, Elizabeth Blackwell died at her home in Hastings, England after suffering a stroke that paralyzed half her body.

Her ashes were buried in the graveyard of St Munn’s Parish Church in Kilmun, Scotland, and obituaries honoring her appeared in publications such as The Lancet and The British Medical Journal.

Now WE know em

Blackwell's headstone is the tall, white cross at the bottom of the hill.

Blackwell’s headstone is the tall, white cross at the bottom of the hill.

 

 

Blackwell was commemorated on a U.S. postage stamp in 1974

Blackwell was commemorated on a U.S. postage stamp in 1974

 

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March 16 2013 – Rebecca Cole

 

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