Packed with photos and informative sidebars and including source notes and a bibliography, Bold Women of Medicine is an invaluable addition to any student's or aspiring doctor or nurse's bookshelf.
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The Bold Pioneers
For what is done or learned by one class of women becomes, by virtue of their common womanhood, the property of all women.
— ELIZABETH BLACKWELL
From the beginning of human civilization, women — whether trained or not — have been healers. For centuries they tended to and healed the sick in the home or the private area of life. The bold pioneers of medicine highlighted in this section began to change that. Born within a quarter century of each other, 1820 through 1846, they and other 19th-century medical women bravely left the home to practice medicine more publicly, regardless of what was said about them.
Many of these pioneering medical women did not have formal training but made the transition between private and public practice by providing nutrition and hygiene knowledge to other women and their families. In 1835 self-taught HarriotHunt tended to her seriously ill sister using medical practitioners Elizabeth and Richard Mott's system of healing with herbs, roots, and oils. When Harriot's sister recovered, they practiced medicine together, without degrees, and built up a successful business.
Twelve years later, after witnessing the first woman, Elizabeth Blackwell, graduate from medical school in the United States, Harriot Hunt applied to Harvard Medical School. She was rejected twice, though the school allowed her to purchase lecture tickets. Within a few months, however, that opportunity was also terminated, and Harvard did not allow the admission of women until 1946. The Woman's Medical College of Pennsylvania awarded an honorary degree to Harriot in 1854.
The bold pioneers all had parts to play in the American Civil War, or in Florence Nightingale's case, the Crimean War. Women were needed to nurse and comfort the many wounded soldiers. Marie Zakrzewska opened the New England Hospital for Women and Children in July 1862 with the aim of training women to be both physicians and nurses. Trained or not, women crept onto the battlefields, their presence neither approved nor desired. But they proved themselves in their ability to act swiftly and courageously. The massive amount of wounded and sick soldiers created a need that could no longer be met with men alone. Both the Crimean War in Europe and the American Civil War illuminated women's medical capabilities.
Female medical pioneers tackled tasks and jobs that men said they didn't have the brainpower or stamina to do. They studied. They observed surgeries. Sometimes they swooned at the gruesomeness of medicine, but so did the men. Even if they became queasy, wobbled, or fainted, they went back for more. They invented treatments, discovered what worked and what didn't, and set out to heal.
They fought hard, even within their own families, for acceptance. Mary Putnam Jacobi (1842–1906) was one of the pioneering women physicians when she graduated from the Woman's Medical College of Pennsylvania in 1864. Her own father wrote to her upon entrance to the school, "You know very well that I am proud of your abilities [but] ... be a lady from the dotting of your I's to the color of your ribbons — and if you must be a doctor and philosopher, be an attractive and agreeable one."
Many of these women had a natural love for science and how the body works. They endeavored to ease pain and suffering. They searched for the joy on the faces of women who were handed healthy newborns. They struggled to be part of a battle's action and help the wounded make it home to their loved ones. It was their compassion combined with know-how and a tough stomach that helped them succeed.
Several of the medical pioneers had something in common. They had parents, and especially fathers, who were forward thinking. These parents believed their daughters had as much right to education as their sons. Sometimes, though, even after the parents went to great lengths to educate them, they still believed their daughters should marry and take their place in the home. Learning might damage young women's "delicate" systems or, worse, destroy their femininity. Were they smart enough to enter the medical field? Of course they were — Elizabeth Blackwell finished first in her class — but men didn't think so.
Women such as Clara Barton and Mary Walker were severely criticized for their ambitions and competence. If a woman didn't marry or want to be married, her intentions were suspect. If she looked to the outside world for her identity, wanted higher education and a career, or worked in the company of men, her morals were questioned and her reputation suffered.
By opening these doors in the mid-1800s, Elizabeth Blackwell, Florence Nightingale, and other female medical pioneers made it possible for many women to pursue medical career paths.
Victorian Rule Breaker
I think one's feelings waste themselves in words; they ought all to be distilled into actions, and into actions which bring results.
At the time of Florence Nightingale's birth on May 12, 1820, a new class of people was emerging in Great Britain. Their ancestors had been working class, but this new group purchased larger homes, made friends with influential people, and gained status as high society accepted them. Florence's father, William Shore Nightingale, was a prosperous landowner who had inherited two estates in England. The family traveled, entertained, and did charity work. Real work was out of the question; it would lower their social standing.
The Industrial Revolution brought automated manufacturing to the big cities. Factory workers returned home to slums with impure drinking water and little food. When the poor got sick, they were carted to hospitals, most often dying there, while the rich were treated at home. Those were the rules of the era. Young Florence was outraged and was determined to change things.
Florence — named after the city Florence, Italy, in which she was born — and her older sister, Parthenope — named after Parthenopolis, a Greek settlement near Naples, Italy — were taught several languages as well as mathematics and philosophy. When Florence turned 12, her father took charge of her and her sister's educations, which was extremely rare.
Florence didn't want to follow tradition by marrying and raising a family. She longed "for something worth doing instead of frittering time away on useless trifles." Her mother didn't understand her habit of daydreaming and believed there was something horribly wrong with her.
A flu epidemic hit the Nightingale household and surrounding village in January 1837, and Florence tended to the sick. Shortly after, on February 7, 1837, she claimed to have heard God calling her. She said, "God spoke to me and called me to His service." She had no idea what God had in store for her.
Florence tried to figure out how she could best help the village people. In 1845 she presented a plan to her parents. She would study nursing at the Salisbury Infirmary under the guidance of a close family friend, Dr. Richard Fowler. Her parents and extended family were horrified by her yearnings. Every time she brought up the subject to her sister or mother, they would swoon and faint, taking to their beds. How could she humiliate them like this?
In a letter to her father, Florence complained about women struggling to put their abilities to use. She said, "Why cannot a woman follow abstractions like a man? Has she less imagination, less intellect, less self-devotion, less religion than a man? I think not. ... It cuts her wings, it palsies her muscles, and shortens her breath for higher things and for a clearer, but sharper, atmosphere, in which she has no lungs to live. She has fed on sugar plums, her appetite is palled for bread."
Florence had received offers of marriage, one from her first cousin (not unusual for the time) Henry Nicholson and one from Richard Monckton Milnes, who pined after her for years. But she didn't see the point of married life when she could be useful to the sick.
To dampen Florence's nursing desires, her parents allowed her to travel. She traveled with an older couple, Charles and Selena Bracebridge, who introduced her to influential people, the most important of these being Sidney and Elizabeth Herbert. Social reform was one of the Herberts' interests, and they became fast friends with Florence.
At first Florence's travels energized her. She was allowed the freedom of exploration that she had never had before. Then the daydreams that plagued her throughout childhood returned. She was inflicted with headaches and feared she was losing her mind. She languished in her room with scarcely the energy to get out of bed.
Her worried chaperones took her to the Institute for Protestant Deaconesses at Kaiserswerth, Germany, to be examined by a doctor. A few years earlier, she had wanted to study nursing there, but her parents had forbidden the trip. Now she traveled to the institute without permission. When her mother found out, she demanded that Florence return home to help her sister, Parthe, get over her recent illness.
Once again Florence was trapped! But no one could stop her from corresponding with important people on medical and social policy. About a year later, she escorted her ill sister (no one really knew what was wrong with Parthe) back to the Kaiserswerth Institute. This time Florence was finally allowed to attend nurses' training.
Her living arrangements at Kaiserswerth were brutal — waking at 5:00 am, suffering through hours of instructions only to be rewarded with measly food of thin vegetable broth, rye tea, and black bread. Still, Florence was thrilled to assist at surgeries and ached to lead a bustling public medical facility. The head pastor complimented her to Sidney Herbert, her influential friend back in England, as the most talented nursing intern the institute had yet trained.
Florence, now nearly 35, was still seeking permission from her parents to do as she wished! But when Liz Herbert proposed Florence as the new superintendent for the Harley Street Home, a small charity hospital for poor women, Florence jumped at the chance, ignoring her mother's protests. It wasn't considered ladylike at that time to be paid by an employer, so Florence's father stepped in and offered her an allowance of £500 per year — today about $57,000 per year.
Florence worked diligently and within just a few months had transformed the hospital from an inefficient charity hospital into a place of well-being. She ordered new equipment, trained nurses, and kept a careful inventory of supplies. The hospital's efficiency had improved so much that Florence began to look for a new challenge.
Most nurses in the 1850s were uneducated. They were considered to have come from the lower class and of no higher social status than prostitutes. Their pay was next to nothing, and many drank as they worked. The profession was in dire need of an overhaul, and Florence was up to the task. But Russia's unwanted expansion plans thwarted her wish to establish a nursing school.
In March 1854, as Russia forged into Turkey seeking Constantinople's Black Sea port, England and France joined forces with Turkey, entering the Crimean War. Britain's valuable trade routes had to be protected. But the British Army's inept officers and careless and often incomplete paperwork caused chaos as thousands of unprepared men were shipped off to the Crimean Peninsula to fight.
The soldiers who weren't killed by Russian gunfire soon became ill with cholera and other diseases. The wounded and sick were piled onto overcrowded, undersupplied ships bound for an old barracks in Scutari, Turkey. Supplies had been ordered but were slow to appear.
With no food, no bedding, not even a cup for a desperately needed drink of water, the soldiers suffered. The barracks had been built over cesspools. Sewer lines were often blocked, leading to overflow throughout the hallways, which in turn contaminated most of the water supply.
When reports of the soldiers' plight reached England, Florence jumped into the fray, organizing nurses and supplies to travel to the war zone at her own expense. At the same time, Sidney Herbert, who was now secretary at war, tapped her for help. Now she had government support, and suddenly to her mother, sister, and everyone else, she was Britain's heroine!
A desperately seasick Florence arrived in Scutari, Turkey, on November 4, 1854. She discovered a filthy hospital, ripe with open sewers, rats, and disease. The little food that was available included stale biscuits and boiled animal carcasses with only a tiny bit of meat still attached. On top of the horrid conditions, no orders for her or her nurses had been dispatched!
Florence carried on, writing detailed notes of the diseases, wounds, and problems with contaminated water. She set up shop the best she could, some days on her feet for more than 20 hours.
"I hope in a few days we shall establish a little cleanliness," she wrote. "But we have not a basin nor a towel nor a bit of soap nor a broom — I have ordered 300 scrubbing brushes ... But one half of the Barrack is so sadly out of repair that it is impossible to use a drop of water on the stone floors, which are all laid upon rotten wood, and would give our men fever in no time ... I am getting a screen now for the Amputations, for when one poor fellow who is to be amputated tomorrow, sees his comrade today die under the knife it makes impressions — and diminishes his chances."
Rev. Sydney Osborne described Florence during her time at Barracks Hospital, remarking, "It is a face not easily forgotten, pleasing in its smile ... a quiet look of firm determination to every feature. ... I can conceive her to be a strict disciplinarian; she throws herself into a work at its head. As such she knows well how much success must depend upon literal obedience to her every order."
Florence wrote frequent letters to the British government pleading for a sanitary commission to improve the hospital's conditions. When the commission finally arrived in 1855, they flushed the sewers, improved the drinking water, and carted away garbage, including a horse carcass discovered floating in the fresh water supply.
The death rate at the Barracks Hospital was 60 percent when Florence arrived. After the sanitary commission did its work, it was reduced to less than 1 percent. She eased the chaos with strict organization and sanitation work at the hospital.
Florence traveled across the Black Sea to observe the hospitals in Crimea. There she was nicknamed the Lady with the Lamp because she walked with her lantern during late-night rounds checking on wounded and sick soldiers. She fearlessly nursed those with disease and was stricken herself on May 12, 1855. Feverish and weak, she scribbled notes on hospital reform and the bungled war. Her nurses forced her to rest, and by August she was back at work. The war ended when Russia retreated from Crimea at the hands of France, Great Britain, and Turkey in 1856.
Florence's troubles during the Crimean War motivated the rest of her life. She established nursing methods, setting the standard for many years. In her book, Notes on Nursing: What It Is, and What It Is Not, she defined what was best for the patient.
After the war Florence had one year of good health. The Crimean fever (known as brucellosis, an infection caught from drinking the unpasteurized milk of infected animals) returned, and she was effectively bedridden for the rest of her life. Modern-day antibiotics would have cured her, but they were not invented until 1928.
From her bedroom Florence calculated deaths and diseases, noting details about the illnesses, what cured them, what did not, and what could have been done differently. She invented a graphic to tell the story of the Crimean War called the Polar Area Diagram. Each month during the war, she recorded the numbers of soldiers who died from preventable causes compared with those who died from accidents and other events, all in various-colored wedges.
The blue wedges, which showed death from disease, shrunk dramatically after the 1855 sanitary commission had cleaned the sewage lines. Sanitation was the key. An obvious conclusion in our time, but in Florence's it was a relatively new thought. Using powerful graphics she made sense of the data, "to affect thro' the Eyes what we fail to convey to the public through their word-proof ears."
Excerpted from "Bold Women of Medicine"
Copyright © 2017 Susan M. Latta.
Excerpted by permission of Chicago Review Press Incorporated.
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Table of Contents
Foreword by Gina Routh, DO: Shaped by Experiences,
Introduction: "Go Tomorrow to the Hospital to See the She Doctors!",
PART I: THE BOLD PIONEERS,
Florence Nightingale: Victorian Rule Breaker,
Elizabeth Blackwell: Medical Pioneer,
Clara Barton: Bold Angel,
Marie Zakrzewska: Woman's Spirited Ally,
Rebecca Lee Crumpler and Rebecca Cole: The First African American Women Physicians,
Mary Edwards Walker: Gutsy Surgeon in Pants,
PART II: MEDICAL WOMEN MAKING HEADWAY,
Bertha Van Hoosen: Unstoppable Petticoat Surgeon,
Susan La Flesche Picotte: A Bridge Between Worlds,
Elizabeth Kenny: Dogged Nurse from the Outback,
Mary Carson Breckinridge: Mountaineer Nurse on Horseback,
Helen Taussig: From Blue to a Lovely Shade of Pink,
Virginia Apgar: The Apgar Score,
PART III: AND TODAY STILL FIGHTING,
Catherine Hamlin: The Fistula Pilgrims,
Edna Adan Ismail: The Dump That Became a Hospital,
Anne Brooks: Sister Doctor with Attitude,
Jerri Nielsen: Icy Courage,
Kathy Magliato: A Persistent Heart,
Bonnie Simpson Mason: Taking It to the Nth Dimension,
Adele Levine: A Leap of Faith,
Sherrie Ballantine-Talmadge: Back on the Field!,