The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine

It is hard to imagine the enormity of the obstacles that Elizabeth and Emily Blackwell overcame throughout their lifetimes. In the mid-nineteenth century, women were meant to follow the traditional path and stay home caring for children and family. Viewed as pitiable, undesirable, contemptible, even dangerous, women who wished to follow non-traditional paths endured skepticism and outright hostility at every turn.From an early age, Elizabeth Blackwell knew that she was different from her peers but she willed herself to be unconcerned with the opinions of others and grew to be comfortable with her status as an outsider. As she grew up, her interests focused on health issues, especially for women, and she became driven to learn everything she could about the human body and the effects of disease. She also recognized that her younger sister, Emily, had similar interests and even greater aptitude, and strongly encouraged this interest.Elizabeth began a seemingly quixotic quest for acceptance into medical school, convinced that she should become a physician. In those days, society as a whole and the medical profession in particular, found the idea of a woman physician unthinkable. However, she was undeterred in her determination, stubbornly unwilling to compromise her principles, and staunchly persuasive in her campaign to be accepted into a reputable medical school on the same level as the male students. She was able to secure admission to Geneva Medical College in western New York State, class of 1847-1848. While not entirely on terms she had requested, at least she had arrived at an institution that could grant her a medical degree and perhaps some semblance of legitimacy. Notably this did little to smooth the way for Emily to enter a top-level medical college five years later. After submitting numerous applications, she was eventually allowed to begin her medical training in 1852 at Rush Medical College in Chicago. However, the trustees bowed to public outcry and voted not to allow her to finish. After exhausting numerous other options, Emily was at last admitted to Cleveland Medical College where she was allowed to finish her medical education and won her M.D., graduating in 1854.Working together for many years and separately for many more, the sisters would spend the rest of their lives trying to raise the level of medical care available for women and those of little means. At the same time they were struggling to be accepted as trained physicians, and to elevate the standing of women in the medical profession.This book helped to understand what drove these women to defy conventional norms for women of their day. They displayed extraordinary character and unshakeable self-assurance in the face of near-universal opposition and withering condemnation.

The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine, by Janice P. Nimura, is the history of the first female physicians in the United States. Elizabeth, the determined older sister, was first. She encouraged — in some ways pressured — her younger sister Emily to follow in her footsteps. Elizabeth’s admission to Geneva Medical College actually began as a student prank. Its absurdity (no spoilers) emphasizes how outlandish the idea of a woman doctor was in 1847. To the surprise of her peers and the faculty, Elizabeth turned out to be a stellar pupil. For men entrenched in the belief that women had no place in the profession, her achievement was the exception that proved the rule. In the words of the Dean, she was that rare woman who “possessed the proper moral, physical, and intellectual qualifications to be admitted to the medical brotherhood.” Actually, that attitude was fine with Elizabeth, who also saw herself as superior. Nimura highlights the differences in personality between the sisters, the elder self-confident and judgmental, the younger self-doubting Instead compassionate. To her credit, their respective flaws are not sugar-coated. Instead Nimura shows how well they complemented each other. To echo the subtitle, Elizabeth focused on education, bringing women to medicine; Emily applied herself to practice, bringing medicine to women. My one criticism is that the book is too detailed. Nimura’s laudable desire to thoroughly document the untold lives of these remarkable women is sometimes overshadowed by forgettable lists of addresses, people, and occasions. As a writer of historical fiction (see my Amazon author page www.amazon.com/author/asewovenwords), I know the importance of being selective about how much research one shares with readers. That caveat aside, The Doctors Blackwell reminds us that advanced in women’s professional acceptance and health care owe much to the determined efforts of these two trailblazers. (Why writers read: “I find television very educating. Every time somebody turns on the set, I go into the other room and read a book.” – Groucho Marx)

Elizabeth Blackwell, the first woman to receive a regular MD degree in the English-speaking world, is a legitimate hero to women, to medicine, and perhaps anyone who has tackled societal prejudices. Nimura does a wonderful job of bringing her story, and equally importantly, her sister's story to a new generation. The Blackwell family left mountains of letters and Nimura has plumbed them for nuggets that put an accessible human feel to a brilliant, determined, and often standoffish person. As a reader, and a physician, I felt that I could probably see Blackwell or her current incarnation in people around me. Nimura has also made a nice addition to the Blackwell canon, which already has a first-rate biography (Julia Boyd's 2005 "Excelllent Doctor Blackwell") and numerous admiring retellings of her story. If I could offer a criticism, and it is not to Nimura as much as to the wave of current reviewers, Blackwell was a genuine innovator, no doubt, but she had help. Austin Flint, Stephen Smith and other New York physician leaders were appalled by their colleagues' misogyny and swam against professional currents from the Blackwells' arrival in New York until their death in 1910 - and beyond. This does not get much attention in Blackwell biographies and even less in homages to her. I don't wish to downplay the challenges women physicians faced, and to some extent still face, but change is about bringing others along. This point in our history feels like a good time to ask how to do that.

Although the book is well researched and readable, the Blackwell sisters are not personalities who earned my esteem. They broke the glass ceiling for women in medicine but the reasons for doing so were not as honorable as one would hope. I did not find them to be likable people but they were real women and the author reported the truth.

Using the Blackwells' journals, newspaper articles and other historical documents, the author tells how the sisters, each in their own way, fought the exclusively male-controlled medical system to pursue their educations and become recognized, practicing physicians. I found the ending a bit abrupt, and lacking direct links between the Blackwells' efforts and the progress of women in the medical profession.