America’s first female doctor wasn’t all that interested in healing the sick. She was also surprisingly ambivalent about women’s rights — and about women in general.
“Women are feeble, narrow, frivolous … and undeveloped in thought and feeling,” she once wrote to a suffragist, voicing her objection to the activist’s claim that the tyranny of men was to blame for the subjugation of women. “The exclusion and constraint woman suffers, is not the result of purposed injury or premeditated insult. It has arisen naturally, without violence, simply because woman has desired nothing more.”
Elizabeth Blackwell, a British immigrant who in 1849 became the first woman to earn a medical degree in the US, is a complicated figure in feminist history. Janice Nimura’s candid account engagingly captures Elizabeth’s many contradictions, central to which was the condescension, and sometimes outright contempt, she showed her fellow women even as she sacrificed to open doors for them. In her own mind, she was the exception that proved the rule — and the hero who could elevate “the beautiful weak women” to new heights. “I see into them & feel their lovely qualities but I know they need my eye to guide them & my arm to keep them in a true position, a friendly insight to correct their faults & make them as good as beautiful,” she explained.
In “The Doctors Blackwell,” Nimura traces Elizabeth’s relentless quest to prove herself as a doctor and to correct some of the barbarities of 19th-century medicine, which tended to do more harm than good. The meticulously researched narrative — informed by newspaper reports, journal entries, and a staggering volume of letters — offers an intimate look at the close-knit, high-minded Blackwell family, including Elizabeth’s younger sister Emily, who followed in Elizabeth’s medical footsteps. The pair ultimately formed a tense partnership to found the first-ever hospital run and staffed exclusively by women. Despite the plurality of the book’s title, however, Dr. Emily Blackwell gets far less of the limelight than Elizabeth — as was the case in their real lives.
Dichotomies abound among the Blackwells, starting with Elizabeth’s father, Samuel, an antislavery activist who made his living as a sugar refiner, paradoxically profiting from a commodity steeped in slavery. Samuel Blackwell’s early death from malaria left Elizabeth, her mother, and her eight siblings penniless, forcing them to innovate to keep from starving.
Seeing her father suffer may have sparked Elizabeth’s interest in medicine. But as a rule, she had little sympathy for the sick. Just as she disdained women for what she saw as their inherent weakness, she scorned sick people for the moral weakness she believed was the root of disease. Like many doctors of her day, she believed fear predisposed people to illness. Explaining why so many Irish refugees arrived in the US infected with typhus — after spending weeks crammed together on ships crawling with lice, the actual disease vector — she hypothesized that “without employment or exercise, their minds had time to brood over the fearful scenes they had left … & the seeds of disease sown in their constitutions were thus nourished into life.”
She often conflated virtue with health — and immorality with illness. Venereal disease was, in her opinion, divine punishment for promiscuity. As a medical resident in Paris, she witnessed the ravages of syphilis and even contracted an aggressive form of conjunctivitis from the newborn child of a woman infected with gonorrhea. “I suffered according to a grand & beautiful law, that the highest must suffer for the sins of the lowest,” Elizabeth observed. “[God] fills me with a spirit of hope & confidence, that reacts continually against the disease & which will finally cure the eye.” It didn’t, of course. She lost her eye.
It’s clear that Elizabeth’s primary motive for pursuing medicine was not to heal others but to satisfy her own sense that she was among “the highest,” and therefore capable of taking on the toughest challenge she could imagine. “The idea of winning a doctor’s degree gradually assumed the aspect of a great moral struggle, and the moral fight possessed immense attraction for me,” she wrote.
But for all her egotism, Elizabeth accomplished groundbreaking feats, both in paving the way for women doctors and ushering in new standards of medicine when, as Nimura writes, the field had hardly advanced beyond the Hippocratic doctrine of the four humors. Presciently, Elizabeth saw hygiene as one of the pillars of health care and advocated for better sanitary protocols at a time when surgeons rarely washed their hands or cleaned their tools between procedures. The New York hospital she founded with her sister, which later became a women’s medical college, was immaculate and well-run; their students were held to higher standards than those at all-male medical schools. If you fell ill in Civil War-era America, you were likelier to survive at the Blackwells’ institution than almost anywhere else. You didn’t have to enjoy their company.
Likability has always been a sticking point for high-achieving women, but Elizabeth Blackwell wasted little time lamenting the fact that few people, male or female, wanted to grab a beer with her after work. Her sense of self-worth came from within — and from her family. In a letter to one of her sisters, Elizabeth expressed thanks for “the comforting word you once spoke about my music, ‘play on, people like to hear you, faults & all.’” By depicting this complicated character fully, faults and all, Nimura tells the kind of nuanced tale that people like to hear.
Jennifer Latson is the author of “The Boy Who Loved Too Much,’' a nonfiction book about a genetic disorder that makes people irrepressibly friendly and indiscriminately trusting. Follow her on Twitter @JennieLatson.
THE DOCTORS BLACKWELL: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine
By Janice P. Nimura
Norton, 336 pp., $27.95