Blackwell, Elizabeth (1821–1910)

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Blackwell, Elizabeth (1821–1910)

First woman doctor of modern times, who worked to expand professional medical opportunities for women and to provide quality medical care for poor women and children. Born on February 3, 1821, in Counter-slip, England, near Bristol; died on May 31, 1910, in Hastings, England; daughter of Samuel (a sugar refiner and reform activist) and Hannah Lane Blackwell; sister of Emily Blackwell; sister-in-law of Lucy Stone (who married Henry Browne Blackwell) andAntoinette Brown Blackwell (who married Samuel Blackwell); aunt ofAlice Stone Blackwell ; tutored at home by governesses; attended Geneva College (M.D. 1849); additional medical study at La Maternité, Paris, and St. Bartholomew's Hospital, London; children: Katharine Barry (b. 1847; adopted 1854).

Emigrated from England to New York with her family (1832); moved to Cincinnati, Ohio (1838); after stints as a teacher in Ohio, Kentucky, and North Carolina, entered medical school at Geneva College in New York (1847); graduated (1849) at the top of her class, thus becoming the first woman doctor of modern times; because of prejudices against women doctors in U.S., continued her medical training in Paris and London; contracted ophthalmia, resulting in the loss of an eye; opened dispensary for poor women and children in New York City (1853); during Civil War, provided nurses for Union army; founded Women's Medical College of New York Infirmary (1868); moved to England and worked for repeal of the Contagious Diseases Acts and for dissemination of sanitary knowledge (1869).

Selected publications on medical topics:

Counsel to Parents on the Moral Education of Their Children (1880); Wrong and Right Methods of Dealing with Social Evil (1883); The Human Element in Sex (1884); (autobiography) Pioneer Work in Opening the Medical Profession to Women (1895); Essays in Medical Sociology (1899).

In 1847, when the medical faculty at Geneva College received a request for admission from a woman, they were dumbfounded. Throughout the United States, the study and practice of medicine was exclusively a male preserve. If women were involved in medicine at all, it was as midwives or as completely disreputable abortionists. Although the Geneva professors opposed the admission, they decided to circumvent the highly charged issue by consigning the admissions decision to the medical students themselves, confident that the all-male student body would never countenance a woman as a fellow student. Much to everyone's surprise, however, the medical students voted unanimously to admit the female applicant. Their decision was a joke—they never expected a woman actually to attend the school or, if she did, to complete the course of study. But for Elizabeth Blackwell, admission to Geneva College was a completely serious undertaking; it marked the initial step on her journey to becoming the first woman doctor of modern times, a renowned figure in the U.S. and Europe, and an inspiration to the many female doctors who followed in her pioneering path.

Elizabeth Blackwell was born on February 3, 1821, in the small town of Counterslip, England, just outside the bustling port city of Bristol. She was the third of nine children of Samuel Blackwell, the owner of a sugar refinery, and Hannah Lane Blackwell , a wealthy merchant's daughter. Elizabeth Blackwell's parents had met as Sunday School teachers, and the Blackwell family was firmly committed to its non-conformist Congregational faith. Samuel Blackwell was also actively involved in various reform movements of his time in England, including electoral reform, temperance, school reform and, surprisingly for someone whose business depended in large measure on the produce of plantation slave labor, abolition of slavery. He was also unusual in his commitment to providing the same education for boys and girls. Thus all the Blackwell children, including Elizabeth and her sisters, studied Latin, mathematics, metaphysics, and astronomy under the direction of a succession of tutors. The girls also pursued more traditionally feminine subjects such as French, music, painting, and embroidery.

In 1832, shortly after the Blackwell sugar refinery burned to the ground, the family decided to immigrate to the United States. Samuel

Blackwell's plan was to promote the use of beet sugar to undermine the slave-based plantation economy of cane sugar. Accompanied by three of Samuel's unmarried sisters and the children's governess, the Blackwell family settled first in New York City and then across the Hudson River in Jersey City. The Blackwells continued their involvement in reform activities. They became close friends of the radical abolitionist, William Lloyd Garrison, and even sheltered an abolitionist minister in their home after a rioting mob attacked his church. The sugar business failed to thrive in the East, however, and in 1838 Samuel Blackwell, believing that greater opportunities awaited along the expanding Western frontier, moved his family to Cincinnati.

For Samuel Blackwell, unfortunately, Cincinnati marked the end rather than a new beginning. He died shortly after the family arrived in Ohio. His wife and children, although vaguely aware of his business difficulties, were startled to realize after Samuel's death that only $20 in assets remained to sustain the family. The two oldest sons, Samuel and Henry, quickly went out to work, while Elizabeth and her older sisters Anna and Marian , opened a boarding school for girls. As their brothers' careers prospered, the Blackwell sisters were able to close their school in 1842, apparently much to their relief. Despite her dislike for teaching, Elizabeth accepted a post at a girls' district school in Henderson, Kentucky. Surprisingly, given her family's long history of anti-slavery activism, this marked the first time Blackwell had viewed slavery firsthand. Deeply disturbed by what she saw and by her inability to change it, and feeling isolated and alone, Blackwell soon returned to Cincinnati.

A thriving intellectual life existed in Cincinnati in the 1840s, and the Blackwells were an integral part of that milieu. Although Elizabeth Blackwell had been baptized an Episcopalian in 1838, she was soon attracted to Unitarianism. Through William Ellery Channing, a Unitarian minister with connections to New England intellectual circles, Blackwell and her siblings were introduced to transcendentalism. The Blackwells also became close friends of the Beecher family, including Catharine Beecher and Harriet Beecher Stowe , the future author of the famous anti-slavery novel, Uncle Tom's Cabin. Despite such stimulating companionship, Blackwell felt that she was devoting too much time to a frivolous social life. "I must have something to engross my thoughts," she wrote, "some object in life which will fill this vacuum and prevent this sad wearing away of the heart."

A female friend dying of cancer suggested one possible avenue—Blackwell should study medicine and devote herself to serving women patients. "Had I been treated by a lady doctor," stated the friend, "my worst sufferings would have been spared me." Initially, however, Blackwell recoiled from the suggestion because she "hated everything connected with the body, and could not bear the sight of a medical book." Soon, however, she came to regard the idea of opening the medical profession to women as much more than a career; it was to be another aspect of the reforming activities so important to Blackwell and her family. She later wrote, "The idea of winning a doctor's degree gradually assumed the aspect of a great moral struggle, and the moral fight possessed an immense attraction for me." She never completely overcame her initial disinclination towards the actual practice of medicine. Throughout her long career, she was always drawn more to the social and moral ramifications of medical knowledge than to its more mundane practical applications.

Blackwell realized, however, that she would need further education in science and classical languages, as well as money to finance her medical education, in order to undertake her great crusade. In 1845, she moved to North Carolina to teach music at a school run by the Reverend John Dickson who, not coincidentally, was also a doctor. Within a year, Blackwell went to work and studied with Dickson's brother, Samuel, one of the foremost physicians in the country. Thus prepared intellectually and financially, Blackwell tried to gain admittance to a medical school. Even in Philadelphia, a Quaker city traditionally responsive to expanding women's sphere and also the center of the American medical profession, Blackwell was unceremoniously rejected. Many medical schools, engaged in fierce competition for fee-paying students, were apparently afraid that if they admitted women the men, who must necessarily form the bulk of the student body, would be scared away. Some sympathetic physicians suggested to Blackwell that her only hope lay in traveling to Paris and attending medical lectures there disguised as a man.

In October of 1847, however, Blackwell received the fateful acceptance letter from Geneva College. The students and faculty were not the only ones who viewed Blackwell's ambitions as a joke. According to Blackwell, the citizens of the small town of Geneva, New York, believed that she was either a "bad" woman or insane, and shunned her accordingly. However, her quiet demeanor and serious devotion to her studies soon won over most detractors. "The notice I attract is a matter of perfect indifference," she wrote her mother. "I sit quietly in this large assemblage of young men, and they might be women or mummies for aught I care." During the summer of 1848, Blackwell acquired some practical medical experience through her work at an almshouse in Philadelphia. Her stint in the women's syphilitic ward aroused a lifelong interest in the problems wrought by venereal disease and the white-slave trade. Blackwell's medical school thesis on typhus also grew out of her experiences in Philadelphia, where she ministered to Irish immigrants stricken with the disease.

In January 1849, Blackwell graduated from medical school at the top of her class. Her brother Henry, who attended the commencement exercises, reported that the president of the school had stated in his valedictory that "by her ladylike and dignified deportment [Blackwell] had proved that the strongest intellect and nerve, and the most untiring perseverance were compatible with the softest attributes of feminine delicacy and grace, to all which the students manifested, by decided attempts at applause, their entire concurrence." (Henry would soon marry Lucy Stone ).

Despite her academic success, Blackwell realized that she needed additional hands-on training to be able to actually practice in her chosen profession. Like most medical schools at that time, Geneva College required only that its students study under a physician prior to admission and then follow two courses of lectures of 16 weeks each for its graduates to qualify for practice. Blackwell realized that she could not acquire the necessary experience in the tightly closed medical world of the U.S. and thus resolved to complete her training in Europe.

Although fêted in London, where she was introduced to leading medical men and permitted to observe operations, Blackwell had a more difficult time being admitted to hospitals in Paris, where she hoped to follow physicians on their daily rounds. Eventually, she went to work at La Maternité, one of the largest maternity hospitals in the world and an important training center for midwives. Despite the hard work and the fact that she was treated as an aide rather than a degreed physician, Blackwell described the experience as "invaluable. It enabled me later to enter upon practice with a confidence in one important branch of medicine that no other period of study afforded." While treating an infant with ophthalmia, however, Blackwell contracted the disease herself. Though her doctors were able to prevent the complete loss of her vision, her left eye eventually had to be removed.

Despite this tremendous physical and emotional setback, Blackwell persevered in her medical training. Returning to London, she studied at St. Bartholomew's Hospital, where she was cheered by her fellow students at the first lecture she attended. She also came to know Barbara Bodichon and Bessie Rayner Parkes , proponents of expanding educational and professional opportunities for women, and Florence Nightingale , soon to become famous for her nursing work in the Crimean War. Buoyed by her professional successes in London and sustained by a burgeoning network of friends, Blackwell seriously considered remaining in England to pursue her career. She decided, however, that both the expense of opening a medical practice in Britain and the prejudices faced by a woman doctor there would be greater than in the United States. She wrote to her mother that it was in America that, "Women will first be recognized as the equal half of humanity." Blackwell accordingly returned home in the summer of 1851.

Things might be better for women on the American side of the Atlantic, but Blackwell found it difficult to carve out a niche for herself in the medical profession in New York, where she had decided to settle. She wrote to her younger sister Emily , who was also contemplating a career in medicine, "A blank wall of social and professional antagonism faces the woman physician that forms a situation of singular and painful loneliness, leaving her without support, respect or professional counsel." To raise money, Blackwell presented a series of lectures on physical education for girls. These talks brought her some patients, notably women from prominent Quaker families in the city. Blackwell, however, also wanted to help less fortunate women. Because no dispensary would accept her services, she opened her own dispensary in 1853. Its goal was to allow poor women the opportunity to consult a physician of their own sex. Blackwell also seized the opportunity to implement and disseminate among her impoverished patients information on sanitation that she had absorbed from Nightingale. Establishing herself as an accepted physician was an uphill battle, however. On a few occasions, when a sick woman died, an angry mob stormed the building, shouting that the lady doctor was murdering her patients.

The dispensary flourished nonetheless, and Blackwell was soon assisted in her practice by two other female physicians: Marie Zakrzewska , a Polish immigrant whom Blackwell had assisted in enrolling in the medical school at Western Reserve University in Cleveland and who later founded the New England Hospital for Women and Children in Boston, and Blackwell's sister Emily, another graduate of Western Reserve. On May 12, 1857, the dispensary was rechristened as the New York Infirmary for Women and Children. Over the next 90 years, it served more than one million patients.

In 1858, Blackwell returned briefly to England. She enrolled herself on the medical register there, becoming the first woman to do so. She also gave a series of lectures in London on women in the medical profession. One young woman in the audience, Elizabeth Garrett (Anderson) , was so inspired by Blackwell's speech that she resolved to pursue a career in medicine herself, and became the first female doctor in Britain.

When the Civil War broke out in the United States, Blackwell assisted the Union army in recruiting nurses. The government was initially reluctant to employ female nurses, despite the desperate need for medical personnel, because the common perception was that all nurses were drunks or prostitutes. Blackwell served as chair of the registration committee for The Women's Central Relief Association, whose chief function was to supply nurses for the army. She vetted many of the candidates herself, to ensure that they would not contribute to the already low reputation of female nurses, and also gave a series of lectures to the novice nurses.

After the war, Blackwell was able to fulfill one of her long-standing ambitions—to found a medical school of the first rank for women. Although women's medical schools had been established as early as 1848 in Boston and 1850 in Philadelphia, and other medical schools had begun accepting women as well as men students, Blackwell was concerned that women studying at these institutions would receive inadequate training and thus impugn the status of all women in the medical profession. In 1868, the Women's Medical College of the New York Infirmary opened its doors. The school, which enjoyed access to clinical facilities at several major New York hospitals, boasted a rigorous curriculum with three years of required study and an emphasis on sanitation in medicine. Blackwell herself was professor of hygiene at the new school. In 1899, Cornell University absorbed the Women's Medical College into its own medical school.

Unlike Marie Zakrzewska and Emily Blackwell, Elizabeth remained unfulfilled by the practice of medicine. She wrote to Zakrzewska, "I am different from you in not being a natural doctor; so, naturally, I do not confine myself to practice. I am never without some patients, but my thought, and active interest, is chiefly given to some of those moral ends, for which I took up the study of medicine." Blackwell had long desired to settle in England to pursue these "moral ends" through broader social reform work, and, in 1869, after she had saved enough money to ensure herself an independent income, Blackwell and Kitty Barry , the girl Blackwell had adopted in 1854, departed for England. Increasing friction with Emily over the administration of the Infirmary and Medical School may also have hastened her departure.

In England, Blackwell became involved in a variety of social reform movements. Some of her activities grew out of her experiences in the United States. Beginning in 1874, Blackwell worked with Elizabeth Garrett and Sophia Jex-Blake , another woman doctor, to establish the London School of Medicine for Women, the first women's medical school in Britain. Drawing on her interest in sanitation, Blackwell was a founding member of the National Health Society. Seeking to live up to its motto that "Prevention is Better Than Cure," the organization provided instruction and resources for the improvement of public health.

For Doctrix Blackwell—that's the way To dub in rightful gender—In her profession, ever may Prosperity attend her!
—Punch Magazine

Blackwell also used her fame as the first female physician to voice her opinion on some of the more controversial social issues of the day. Backed by her experiences at the Philadelphia almshouse some 20 years earlier, she participated in the debate on sexual morality, claiming that the sexual double standard—which allowed men to engage in premarital and extramarital sex while demanding that women remain chaste before marriage—was harmful to society, leading to prostitution and venereal disease. In her book Counsel to Parents on the Moral Education of Their Children, she argued for a single sexual standard but also urged the importance of chastity for both men and women. Blackwell also opposed Britain's Contagious Diseases Acts which required registration and periodic medical examinations of prostitutes—but not their male customers—to prevent the spread of venereal disease. In 1881, she founded the Moral Reform Union to oppose the legislation and to provide information about sexual morality to the public. In the early 1880s, she also became involved with the Social Purity Alliance which condemned social vice and urged men to abandon their sinful ways. Her ideas on sexual morality led Blackwell to reject artificial birth control, fearing that it would lead to immorality and harm women's health. Instead, she argued that women should control the timing of sexual relations and that couples should exercise self-control in sexual matters.

Blackwell's evolving social philosophy led her away from mainstream developments in medicine. In the 1880s and 1890s, she became involved with various religious groups. In a speech presented to the Christo-Theosophical Society and later published as Christianity in Medicine, Blackwell argued, much like Mary Baker Eddy and the Christian Scientists, that disease originated in sin. Based on this anti-materialist view of medicine, Blackwell opposed vaccination. Her acquisition of two dogs in the late 1880s led to her involvement with the anti-vivisection movement. She came to believe that vivisection resulted in over-reliance on surgery in medicine, and she came to see operative medicine as mutilation rather than a means to cure disease.

During her first decade in England, Blackwell moved frequently and spent a good deal of time traveling on the Continent. In 1879, however, she and her adopted daughter Kitty finally settled in Hastings, a seaside resort on the southern coast of England. Eventually Blackwell's sisters Anna and Marian also moved to the town. Though Blackwell had cut back on public activities after 1895 owing to ill health, she did make one final visit to the United States in 1906—her first trip back to America since her departure in 1869. In 1907, Blackwell fell while on vacation in Scotland and suffered a head injury that permanently impaired her mental faculties. She died in Hastings on May 31, 1910, and was buried in Scotland.