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In Their Footsteps: The First Women Physicians and the Pioneers Who Followed Them
Upon graduation from Geneva Medical College in 1849, Elizabeth Blackwell, M.D., became the first woman to receive a medical degree in the United States. Dr. Blackwell's admission to Geneva was the result of a joke that backfired. Certain that the all-male student body would reject her application, the faculty of Geneva placed the matter before them for a vote. The students, who assumed the request was made in jest, voted unanimously to admit her. Two weeks later, Dr. Blackwell joined their ranks. Later, she and her sister, Emily, who also trained as a physician, would found the first hospital in the world run entirely by women. "One of the greatest challenges women faced in gaining admittance to the medical establishment after Elizabeth Blackwell broke the gender barrier was persuading the public that it was not 'un-womanly' to be a physician," says Ellen More, Ph.D., professor of the history of medicine and medical humanities at the University of Texas Medical Branch at Galveston. Her most recent book, "Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995," explores how the earliest women physicians influenced the male-dominated practice of medicine and paved the way for their modern counterparts. When the first women M.D.s began practicing, most physicians were general practitioners. Before the age of specialization, Dr. More says these GPs were responsible for the entire range of medical practice, some of which - such as surgery - was perceived to be exceedingly "coarse" and outside the realm of feminine activity. "Simply to get a medical education required participating in dissection," says Dr. More. "Overcoming the general repugnance the public felt in seeing women engaged in such activities took enormous courage and persistence on the part of the first women physicians." On the other hand, Dr. More points out that medicine in the Victorian era was largely a domestic practice in which physicians entered patients' homes and familiarized themselves with patients' families. "This was perfectly congruent with women's societal roles and actually made it easier for some women to be accepted as physicians," she explains. But the growth of medical specialties and the modern hospital in the beginning of the 20th century resulted in fewer opportunities for women physicians. "Obtaining residencies in the better hospitals proved more difficult for women than men, either because they faced greater difficulty gaining admittance to highly regarded medical schools or, if they did manage to attend one, their male professors were reluctant to support their careers," Dr. More explains. Writing Medicine, Writing GenderSusan Wells, Ph.D., professor of English at Temple University and author of "Out of the Dead House: Nineteenth-Century Women Physicians and the Writing of Medicine," focuses on the contributions of early women physicians revealed through their scientific and personal writings. Some of Dr. Wells' primary sources are accounts of conversations women physicians had with their patients. She points out that in the mid-19th century, physicians, who believed the progression of illnesses were dependent on each individual's physiology, were concerned with the process of diseases on very specific bodies. "They relied heavily on patients to give them detailed information about the effects of their illnesses and about their own constitutions," explains Dr. Wells. "In the mid-1850s, when the first women physicians were entering the profession, a patient could expect doctors' visits to consist mostly of conversation and drug prescription. Very little physical examination occurred." According to Dr. Wells, women physicians were considered by patients and male physicians alike to be more adept at gaining insights into patients' illnesses by talking to them. This was especially true of female patients, who were hesitant to discuss their bodies with male physicians. More important, though, was women physicians' early recognition of the importance of patient histories in ongoing treatment. Oftentimes male physicians were not as concerned with such histories, as evidenced by their amazement at the extent of record-keeping maintained by early women practitioners such as the Blackwell sisters. Such patient records often contained more than accounts of conversations. Women physicians were also more likely to evaluate patients medically through urinalysis and temperature-taking, which, Dr. Wells reminds us, "counted as advanced medicine in 1867." Dr. Wells also recounts women physicians' contributions to scientific research, including Mary Putnam Jacobi, M.D.'s anonymous writing of "The Question of Rest for Women During Menstruation," the winner of Harvard University's 1876 Boylston Prize for Medical Writing. Dr. Jacobi, whose prize-winning article refuted women's physical frailty during menstruation, was the first physician to use survey research in a medical article. Innumerable medical scientists after her would adopt her technique of sending surveys to large numbers of people to ascertain population trends in illness and disease. Pioneers in Our MidstCarola Eisenberg, M.D., today a lecturer in the Department of Social Medicine at Harvard Medical School, has had a career of many "firsts," including being the first woman to serve as dean for student affairs at the Massachusetts Institute of Technology (MIT) in the 1970s and the first woman full dean for student affairs at Harvard Medical School, a position she held for 12 years. A native of Argentina, Dr. Eisenberg was the daughter of progressive parents who promoted their three daughters' career interests in a time and a country where education for girls was required only until age 12. As a teenager in the 1930s, Dr. Eisenberg accompanied her father on a tour of Argentina's state psychiatric hospital. What the young girl witnessed there - 3,500 patients treated as subhuman and chained to their beds - horrified her. Determined to change what she saw, Dr. Eisenberg began working at the hospital and became a psychiatric social worker. Restless to do more for psychiatric patients, Dr. Eisenberg applied and was accepted to a medical school with an almost exclusively all-male student body. "I didn't have any role models," she recalls. "I had never even met a woman physician. The only thing I did know is that I wanted to be a psychiatrist." When in 1943 Dr. Eisenberg completed the eight years of medical school required in Argentina, she was one of a handful of women graduates. To pursue her study of child psychiatry, Dr. Eisenberg left her native country and accepted a fellowship at the Johns Hopkins University School of Medicine, where she later became an assistant professor of pediatrics and psychiatry. In 1968, Dr. Eisenberg became a staff psychiatrist at the Student Health Service of MIT. Four years later, she was tapped to become MIT's first woman dean of student affairs. Then one day in 1978, Dr. Eisenberg received a call from the president of Harvard University asking her if she would be interested in serving as the dean for student affairs at its medical school. Dr. Eisenberg knew that, as the first woman in her new position, she was under intense scrutiny. "There were many things I did not know," she admits, "and I asked for help when I needed it. I disarmed people, I think, by telling them when I didn't know something, by being honest and not pretending." Today Dr. Eisenberg continues to practice psychiatry, teach, and participate in international humanitarian efforts. She has mentored countless other women throughout her career, starting women's groups at MIT, Harvard, and the National Academy of Sciences. "There is still a machismo attitude, particularly within some fields of medicine; it's changing but changing slowly," she says. "More effort should be dedicated to opening doors for women." The Color of MedicineWomen physicians of color have had to face racial barriers as well as those imposed by gender. Dr. More recounts in her book stories of African-American women physicians showing up for their residencies only to be turned away because of the color of their skin. Marilyn Hughes Gaston, M.D., decided at age nine that she wanted to be a physician and was immediately given reasons why she could not. She was poor, she was black, and none of her teachers encouraged her interest in science. It was not until a physician at the hospital where Dr. Gaston worked after college took her aside to speak to her that she gained the confidence she needed. "He told me if I really wanted to be a physician, I would never be satisfied with the nursing duties I was then performing," she recalls. "He told me to go for it, and I did." Dr. Gaston entered the University of Pennsylvania School of Medicine in 1960. Of the six women in her class, she was the only African American. She was the fifth African American to enter the school, and the third African-American woman to do so. Upon graduation, Dr. Gaston would go on to achieve a number of "firsts" in a world in which African-American women physicians were virtually nonexistent. She completed her residency in pediatrics in her hometown of Cincinnati and went on to become an associate professor of pediatrics at the University of Cincinnati College of Medicine and direct a center aimed at eradicating sickle cell disease. She would continue her work in this area at the NIH, where changes she instigated in the management of the disease resulted in significant decreases in morbidity and mortality in young children. Following her desire to provide quality health care to the uninsured, Dr. Gaston also helped found a health center in Cincinnati in an impoverished, underserved African-American community. Dr. Gaston's stellar scientific credentials, combined with her work in disadvantaged communities, led to her appointment as the director of the Bureau of Primary Care within the Health Resources and Services Administration, a federal entity with a budget of $5 billion and a mission to increase access to quality preventive and primary health care for approximately 12 million underserved individuals. She is the first African-American woman to direct a Public Health Service bureau. Among her many accomplishments, Dr. Gaston points to a scholarship program established at the University of Cincinnati College of Medicine in her name as what she hopes will be her most enduring legacy. Each year, the university awards full, four-year medical scholarships to two disadvantaged minority students. In them, Dr. Gaston sees her own youthful determination to trump the disadvantages of poverty, racism, and sexism. "My staff tease me because I am always calling these students, like a protective mother hen," says Dr. Gaston. "But I have realized that what you learn from a mentor is at least as important as what you learn in the classroom." |
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