The things we take for granted

Prefer a female doctor? Thank the Blackwell Sisters

At some point in early 2020, I had a conversation with my youngest kid, a girl, then fourteen or fifteen. It was going to be the first US election I was eligible to vote in, having filled out the papers to apply for citizenship on January 20, 2017 (if you know, you know). And so I was telling her I was excited to vote, and she was looking at me in that what’s she blathering on about now way teens can have, which inspired me into a conversation/rant about the 19th Amendment and how a whole host of things she (understandably) was growing up taking for granted were actually hard won by pioneering women who refused to take no for an answer.

Meet the Blackwell Sisters.

Elizabeth and Emily Blackwell

Elizabeth, the elder sister born in 1821, was the first female Doctor of Medicine in America. Emily followed in her footsteps and also became an MD and together they pioneered medical care by women for women, as well as top-notch training for women doctors. Their story, wonderfully covered in The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women - and Women to Medicine by Janice P. Nimura, is one of ambition, intelligence, and, frankly, dogged determination.

As a student of sis-story, I was hooked from the get-go by this paragraph about Elizabeth in the prologue:

Medicine had not been the obvious choice for a young woman who equated illness with weakness, cared little for anyone beyond the circle of her eight siblings, and preferred the life of the mind to the functions of the body - which she found, quite frankly, disgusting. But God had chosen her, she believed, to pursue this arduous path, and she had chosen Emily, her most capable sister, five years younger, to follow her.

Oh, lucky, lucky Emily! Thankfully Emily did have the brains for the task her sister selected, and an aptitude for surgery, because it’s very clear in Nimura’s narrative, that Elizabeth was at the helm of this sisterly relationship, and it wasn’t all plain sailing. Take this example. When Emily moved to New York to be with Elizabeth, they shared a one room apartment with Emily sleeping on the sofa and Elizabeth on a bed in a six foot dressing room, and we read:

After years of wishing for each other’s companionship, Emily and Elizabeth suddenly had more of it than either of them preferred.

In 1857, the sisters opened the New York Infirmary for Indigent Women and Children, with the assistance of Maria Zakrzewska (an interesting character in her own right). It was Elizabeth’s name at the top of the billing, but in a letter to her older sister, Emily suggested being her more famous sister’s ‘noble helper’, was wearing thin:

“I have had our names put as a firm in the Directory this year,” Emily announced: where the previous city directory had listed “Blackwell Elizabeth, physician” just above “Blackwell Emily, physician,” the new edition had “Blackwell Elizabeth & Emily, physicians” - a small thing, perhaps, but not to Emily.

In her telling of the Blackwells’ story, Nimura is pretty clear that by the time Elizabeth re-emigrated to Britain in 1869 (both sisters were born in Bristol but moved to the States as children), Emily, now running their new Women’s Medical College, was ready to let her go.

Emily was ready to lead, and Elizabeth was ready to leave. They could see the point ahead where their paths diverged, and both looked forward to it with some relief.

It’s a position that’s easily understood. These were two fiercely intelligent women, both dedicated to changing the world for women, but with different strengths and weaknesses, ideas and goals.

As I learned when researching and writing about Nellie Bly, being a pioneering woman is not easy. Elizabeth’s admission to Geneva College to study medicine in 1847, didn’t bring about instant change. In some ways, her success made Emily’s path only harder as

Medical mandarins, appalled - and threatened - by Elizabeth’s progress on both sides of the Atlantic, resolved ever more strongly to exclude women from established medical schools.

And while programs of study for women to become doctors did open up in the latter half of the nineteenth century, these were separate programs, distinct from the men’s colleges the sisters had attended, and that hadn’t been their goal. It wasn’t until 1893, that John Hopkins University opened a medical school that accepted both male and female applicants, with Cornell doing the same five years later.

Elizabeth had A REALLY HARD TIME getting into medical college and then training afterwards. Her toils include LOSING AN EYE in 1849 after delivering a baby in La Maternité’s Infirmary in Paris. The infant was suffering from a form of conjunctivitis contracted because its mother had gonorrhea. Her high ambitions meant she never married, swallowed repeated rejections, and was excluded from male-dominated circles where her intelligence should have given her access by right. Extraordinary actions require extraordinary characters, and so perhaps it’s not surprising to learn that her older sister Marian had this to say about her ground-breaking sister:

Elizabeth is a peculiar person. She does not please everyone.

She did though, on the whole, please her sisters. There were five of them, none of whom ever married, and there’s a case to be made that the unsung heroines of the Blackwells’ effect on the medical world are the lesser known sisters, Anna, Marian and Ellen. Anna, a writer, spent much of her life in Europe, seeing herself far more as English than American. Marian’s life was devoted to others - their mother, and then both her illustrious sisters benefited from her care of their households, while they got on with the heady task of changing the world. Ellen had artistic ambitions, but in the end became Emily’s housekeeper, looking after her own and Emily’s adopted daughters, Neenie and Nannie. Elizabeth lived with another adoptee, Kitty, not so much a daughter as a help-mate… well, as Marian said, Elizabeth did not please everyone. But whatever their differences, the Blackwells stuck together:

Eventually Anna and Marian would join Elizabeth in Hastings, in a double house with two entrances that allowed both proximity and distance. The Blackwells, to the end, loved and annoyed each other in equal measure.

The story of the Blackwell sisters is one worth knowing. They were in the same world as other important women like Lucy Stone, married to their brother Henry, and many sisters that I’ll be talking about in the future, like the Bleechers, the Nightingales (yes, Florence had a sister worth knowing about), the Garretts (Elizabeth Garrett Anderson and her sister Millicent). They might not have been friendly or open enough to find much sisterhood with other pioneering women of their age, but they had each other.

Together, they made a difference.