“The Doctors Blackwell”, a book written by author Janice P. Nimura described the journey women traveled to become physicians in the 19th century. A review of the book by Donna Rifkind appeared in the January 10, 2020 Wall Street Journal. She wrote: “America in the mid 19th century was rampant with many varieties of uncontrolled disease, while the art of medicine was at best rudimentary and at worst likely to kill… City hospitals of the time had evolved from poorhouses and served as final refuges for the destitute. Often unheated and always overcrowded, they were more successful at spreading illness than curing it”.
To become a physician in America during this period required much less effort than in most European countries whose medical schools were more advanced. In 1869, the President of Harvard University issued this warning noted in the Nimura book: “The whole system of medical education in this country needs thorough reformation. The ignorance and general incompetency of the average graduate of the American medical Schools, at the time when he receives the degree which turns him loose upon the community, is something horrible to contemplate.” The medical school education was described in the book review. Admission was nearly automatic for anyone “who could scrape up the fees” and consisted of two 16-week sessions. Students could attend the lectures after purchasing tickets. The second session was identical to the first session. Between the two sessions the students searched for a physician to observe their practices in order to gain experience. There was also a major impediment- you had to be a man. “Women could be nurses, midwives or doctresses- but the notion of a licensed female was unimaginable”.
It was 1847. A twenty-six year old woman from Cincinnati, one of nine children in a British sugar refiner’s family, Elizabeth Blackwell, was determined to imagine she could become a physician. She became the first American woman to earn a medical diploma in 1849 from Geneva Medical College in Philadelphia after experiencing rejection and physical threats. She recruited her younger sister Emily who earned her MD diploma in 1854. Both sisters traveled to Europe to pursue additional training, Elizabeth to London and Emily to Paris. They set up a practice in New York City on the lower east side, then established a hospital in which newly graduated women physicians could gain experience. In 1857 the sisters established their New York Infirmary for Indigent Women. “It has been my most toilsome lesson, Emily wrote, to translate my thought into common language of life”.
Emily and Elizabeth both died in 1910, the year women doctors constituted 6% of all physicians in the country. Today more than half of all medical students in the country are women. Nimura wrote: “Their story does not fit on a plaque, but it fits as a vivid echo of our own America, suspended as we are in another feverish moment of both crisis and opportunity”.