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Elizabeth Blackwell became America’s, and the world’s, first female M.D.

Dr. Elizabeth Blackwell
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The third of nine children born to Samuel Blackwell and Hannah Lane, Elizabeth Blackwell was born on February 3, 1821 in her family’s home on Dickson Street in Bristol, Gloucestershire, England. In residence with the Blackwells were four maiden aunts. The family later moved to the house at 1 Wilson Street, close to Portland Square in Bristol.

Elizabeth’s childhood memories on Wilson Street were happy ones. Samuel was a loving father who was a positive influence on his children. Somewhat liberal in his way of thinking with respect to child rearing, social ideologies and religion; rather than spanking his children due to bad behavior, he recorded their transgressions in a black book. After a number of offences were recorded, the wayward youngster stood the chance of finding him/herself relegated to the attic while the family sat down to dinner.

Though he may have appeared to some to be relatively lax in the manner of discipline, Samuel was far from relaxed when it came to the subject of his children’s education. A Congregationalist, Samuel exerted a very strong influence over both the religious, as well as the practical education his children received. He believed each child was to be given unlimited opportunity to develop his/her God-given gifts and talents. He hired both private tutors and a governess to supplement their intellectual development.

As business at his refinery increased, Samuel moved his family in 1828 to a home nearby. By 1830, however, riots began to break out in Bristol and Samuel felt it would be safer to move his family to America. Elizabeth was 11 years old when the family sailed on the Cosmo in August 1832 for New York City. Once they were settled in, Samuel set up the Congress Sugar Refinery.

When Samuel Blackwell joined Samuel Hanson Cox’s congregation, he quickly became an active participant in a number of reform circles. Noted abolitionists Theodore Weld and William Lloyd Garrison were regular visitors to the Blackwell home. Blackwell’s reform activities, along with the children’s exposure to these various leaders, led to them adopting their father’s liberal views; so much so they later gave up sugar in protest of the slave trade. The exposure Elizabeth received during these years led to her yeaning for more economic and intellectual independence.

Samuel’s sugar refinery was destroyed by fire in 1836. He did rebuild, but within a year, the business began to suffer financial problems. Scaling back at home, the family dismissed their servants and moved to Cincinnati, Ohio in 1838. The move was due to Samuel’s desire to cultivate sugar beets rather than refine the cane grown elsewhere which required slave labor. His efforts, however, came to naught. Samuel died on August 7, 1838, three weeks after the move, a result of biliary fever. He left behind a widow and nine children sitting on a mountain of debt.

Following Samuel’s death, financial need drove three of the sisters – Anna, Elizabeth and Marian – to start a school. Christened the Cincinnati English and French Academy for Young Ladies, it was a boarding school which provided instruction in most, if not all subjects, in exchange for tuition, along with room and board. Though not overly innovative in the instruction methods utilized, it did provide a necessary source of income for the Blackwell sisters.

Likely due to Anna’s influence, Elizabeth later converted to Episcopalianism in December of 1838 when she became an active member of St. Paul’s Church. She would not remain there for long, however, due to William Henry Channing’s arrival in Cincinnati in 1839. A charismatic Unitarian minister, Channing introduced Blackwell to transcendentalism. This did not bode well for the sisters, as a backlash in Cincinnati’s conservative community erupted and most of the students enrolled in the sisters’ boarding school withdrew. To recoup from the loss, the sisters became private tutors.

The arrival of Channing served to spur Blackwell’s interest regarding education and its reform. Working on her own intellectual self-improvement, Elizabeth began to attend a number of lectures, wrote short stories and studied art. She also explored religious services in a variety of denominations; Quaker, Millerite and Jewish among them. During the 1840s, she began to voice her thoughts with respect to women’s rights in the comments she made through letters and diary entries. She also participated in the Harrison political campaign of 1840.

With the help of sister Anna, Elizabeth obtained a teaching job in Henderson, Kentucky, earning an annual income of $400. The children she taught excited her; however, the schoolhouse and its accommodations were severely lacking. This, however, did not disturb her to the degree her first personal encounter with slavery did. Coming to the conclusion the town of Henderson was absurd and inhabited by citizens who bordered on petty and simple, Elizabeth returned to Cincinnati six months later, determined to find a more emotionally stimulating manner in which to live out her life.

In 1895, then Dr. Blackwell published a book which she titled, Pioneer Work in Opening the Medical Profession to Women. In the book, Elizabeth stated she was at first repelled by the idea of studying medicine. She hated everything connected with the body, and could not bear the sight of a medical book. “My favorite studies were history and metaphysics, and the very thought of dwelling on the physical structure of the body and its various ailments filled me with disgust.” She had considered becoming a teacher instead, but then made her way through medical school after a dying friend told her the suffering she had endured (thought to possibly be due to uterine cancer) might have been much less had she been cared for by a woman physician.

A second reason Blackwell was drawn to medicine was the term “female physician.” At this time, “female physician” was a term which referred to an abortionist. Blackwell considered this highly degrading, due to what a true female physician had the potential to achieve.

In an effort to discover how to go about becoming a physician, Elizabeth quickly learned the road to her degree would be paved with a great many obstacles. She consulted a number of family physicians her family knew who told her that though her ambition was noble in nature, it was also impossible; both due to the cost and also the fact such an education was unavailable to women. Not to be deterred, however, Elizabeth’s mindset was such that if the idea truly was noble, a way could be found to accomplish it; thus she held fast to the challenge with the determination to see it through.

Prior to Elizabeth’s entry into medical school, sister Anna helped her to gain a job teaching music in an academy located in Asheville, North Carolina, with a goal being to set aside $3,000 for her school expenses. She acquired lodging in the home of Reverend John Dickson, who had been a practicing physician prior to becoming a clergyman. Reverend Dickson highly approved of Elizabeth’s chosen career path and offered her the use of his medical textbooks to study. He also helped her to sooth a number of personal doubts and deep set loneliness through deep religious contemplation.

From there, Elizabeth moved to the home of Samuel Henry Dickson, John’s brother and a noted Charleston physician. In 1846, Elizabeth began to teach in a boarding school run by Mrs. Du Pré. With the help of Dr. Dickson, Elizabeth sent inquiry letters regarding the possibly of entering medical school; however, the responses she received were all negative. Elizabeth later left Charleston in an effort to explore the possibility of entering medical school in either Philadelphia or New York, with the schools in Philadelphia resting at the top of her preferred list.

Boarding with Dr. William Elder in Philadelphia, she began to study anatomy under the tutorage of Dr. Jonathan M. Allen. Resuming her efforts to enter medical school, a number of the physicians she approached suggested one of two options – 1) travel to Paris and study there, or 2) disguise herself as a man if she wanted to study in the States. She was told the reason for the continual rejections she received was due to the fact she was intellectually inferior since she was a woman and if she were to prove equal to the task and a worthy opponent, they would not provide her “a stick to break their heads with.” As a last resort, Elizabeth applied to 12 “country schools”.

On a lark, Elizabeth’s application to New York’s Geneva Medical College was accepted in October 1847. Considered a near-accident, her acceptance was due in part to the fact the dean and faculty charged with the responsibility of evaluating an applicant for matriculation considered Elizabeth’s case to be of a special nature. They chose to put it to a vote with 150 male students, stipulating that if even one student object, Elizabeth’s application would be rejected. Believing the dean’s comments to be a joke, the young men voted unanimously to accept her.

A great uproar was quickly heard as Elizabeth entered class the first time. Not only did she face criticism from her fellow students, the general public expressed its opposition as well. Holding firm to her determination to overcome whatever obstacles she encountered along the way, Elizabeth eventually won the respect and admiration of many of her peers.

Not only did Elizabeth’s presence in the class room help to turn a number of boisterous young men into well-behaved gentlemen, she also had an effect on anatomy professor Dr. James Webster. When the study of reproduction came up, Dr. Webster felt Blackwell should remove herself from the class, believing the subject to be “too vulgar” for her “delicate mind”. The eloquent response she gave to Dr. Webster’s comment caused him to not only admit Elizabeth to the lecture, but also elevated the nature of the lectures from what was considered previously to be obscene.

Though Elizabeth earned the respect of her instructors and student peers, she also dealt with a great deal of isolation. Looked upon as an oddity by the residents of Geneva, Elizabeth rejected a number of suitors and friends, preferring instead to isolate herself.

During the summer between her two terms at Geneva, Elizabeth returned to Philadelphia. She lodged with Dr. Elder and applied for several medical positions in the area in an effort to obtain some clinical experience. The Guardians of the Poor who ran the Blockley Almshouse offered her the opportunity to work there, albeit with some struggle. Though she gained a level of acceptance at Blockley, a number of young resident doctors walked out on her and refused to help her with either diagnosing or treating her patients.

The graduation thesis Blackwell wrote at Geneva Medical College was on the topic of typhus. The conclusion she reached linked socio-moral stability with physical health; creating a link which would foreshadow her future reform work.

Two years later, Elizabeth likely thought “I knew I could” when she graduated first in her class on January 23, 1849 and became the first woman in the world to receive a medical degree. Her brother Henry was in attendance at the commencement ceremony. He sent this message to his family: “After a short discourse by Dr. Hale the President - the diplomas were conferred - 4 being called at a time - and ascending the steps to the platform the President addressed them in a Latin formula - taking off his hat, but remaining seated - and so handed them their diplomas, which they received with a bow and retired. Elizabeth. was left to the last and called up alone - the President taking off his hat, rose and addressing her in the same formula - substituting Domina for Domine, presented her the diploma - whereupon our Sis, who had walked up and stood before him with much dignity bowed and half turned to retire but suddenly turning back and replied, ‘Sir I thank you - by the help of the Most High, it shall be the effort of my life to shed honour upon your diploma’ - whereupon she bowed and the President bowed - the audience gave manifestations of applause - little Dr. Webster rubbed his hands - the learned curators and faculty nodded grave approbation at each other upon the platform and our Sis, descending the steps took her seat with her fellow-physicians in front ....”

Following graduation, Dr. Blackwell chose to continue her studies in Europe and spent two years in the clinics of Paris and London where she studied midwifery at La Maternité. The “lying-in” hospital told Elizabeth her acceptance would be under the condition she was treated as a student midwife rather than a physician. Making friends with Hippolyte Blot, a young resident physician at La Maternité, Elizabeth’s medical experience was greatly boosted by his mentorship. When the year ended, Paul Dubois, considered the foremost obstetrician of his day, proclaimed Elizabeth would become the best obstetrician in the United States.

During her time here, Elizabeth contracted “purulent opthalmia” while treating a pediatric patient. Losing the sight in her left eye she went to London in 1850 while she recovered and enrolled in James Paget’s lectures at St. Bartholomew’s Hospital. Due to the blindness in her left eye, Elizabeth gave up on her dream to become a surgeon and returned to New York City in 1851.

Though now an established physician in New York City, Dr. Blackwell had few patients, in addition to little opportunity for intellectual conversations with other physicians so as to increase her medical knowledge with respect to dispensary practice. When she applied for a job as a physician in the women’s section of a large city dispensary, she was refused.

In 1853, Dr. Blackwell partnered with several friends to establish a private practice in New York City and opened a clinic in 1853 which she named the New York Dispensary for Poor Women and Children. Located near Tompkins Square, the dispensary began in a single rented room where Elizabeth cared for patients three afternoons a week.

Incorporated in 1854, the dispensary then moved into a small house on 15th Street. Taking Marie Zakrzewska, a German woman in pursuit of a medical education, under her wing, Elizabeth served as her preceptor during Marie’s pre-med studies. When Dr. Zakrzewska had completed her studies in 1857, she joined Elizabeth in expanding the original dispensary and created the New York Infirmary for Indigent Women and Children. While providing medical care to poor patients, the infirmary offered a practical solution for up-and-coming female medical students who needed a place to serve their internships due to being rejected by other facilities because they were women.

By now, Emily Blackwell had followed in her older sister’s footsteps, becoming the third US woman to graduate from medical school, and joined Elizabeth’s practice. The executive committee and board of trustees were all women, as were the attending physicians. The infirmary cared for patients who were admitted and those needing help on an outpatient basis as well, in addition to offering facilities for nurses’ training. By the second year, the infirmary’s patient load had doubled.

Elizabeth returned to Britain on several occasions to raise funds, in addition to attempting the establishment of a parallel infirmary project in England. A clause in the Medical Act of 1858 recognized doctors with foreign degrees, allowing them to practice in England. As a result, Dr. Blackwell was the first woman physician to have her name entered in the General Medical Council’s register on January 1, 1859.

Over the next fifteen years, Dr. Blackwell’s medical career remained active on both sides of the Atlantic, with a goodly level of ups and downs in both the operation of the facilities and the manner in which she felt medicine should be practiced. When she left for Britain in 1869, Dr. Blackwell’s interests were rather diversified and she split her time between authorship and social reform. In 1871 she co-founded the National Health Society. Considering herself to now be a wealthy gentlewoman who had the ability and liberty to dabble in both reform and intellectual activities due to having her American investments to support her, Dr. Blackwell enjoyed the opportunity to travel across Europe.

Elizabeth Blackwell retired from practicing medicine in the late 1870s due to failing health. She did, however, continue her campaign for reform. Between 1880-1895, Blackwell was her most active in reform movements, switching back and forth between a variety of organizations. She also discussed the idea of opening and operating a hospital with one of her closest friends, Florence Nightingale. Unfortunately, the two women later had a falling out after Nightingale returned from the Crimean War. Nightingale felt Blackwell should turn her focus towards the training of nurses rather than that of female doctors and Blackwell became highly critical of many of Nightingale’s publications.

In 1906, an elderly Elizabeth Blackwell returned to the United States where she took her first and last car ride. Her advanced age now began to severely limit her activities. The following year, she fell down a flight of stairs, leaving her on the verge of complete physical and mental disability. Dr. Elizabeth Blackwell died on May 31, 1910 in her home in Hastings, Sussex after experiencing a stroke which paralyzed half of her body. Her ashes were buried in the churchyard of St. Mumm’s Parish Church located in Kilmun, Argyllshire, Scotland.