May and June, 2003
by Michael Fuller
In 1845 Elizabeth Blackwell, a twenty-four-year-old schoolteacher living in Cincinnati, Ohio, decided that she wanted to become a medical doctor. At that time, no woman had ever graduated from a medical school in the United States or western Europe. Most people assumed that a respectable lady would never consider a career in medicine because all physicians faced human nudity, deadly diseases, and gruesome scenes.
Blackwell enjoyed teaching but she wrote in her diary that she felt "the want of a more engrossing pursuit." The idea of studying medicine came to her while she was visiting a friend named Mary Donaldson, who had cancer. "The delicate nature of this painful disease," Blackwell remembered, "made methods of treatment a constant suffering to her. She once said to me, 'If I could have been treated by a lady doctor, my worst sufferings would have been spared me.'"
Blackwell agreed with Donaldson that female doctors would be better able to attend to the medical needs of women. Donaldson suggested that Blackwell should become a doctor. "You are fond of study, Elizabeth," Donaldson said, "you have health, leisure, and a cultivated intelligence. Why don't you devote these qualities to the service of suffering women? Why don't you study medicine?"
"For weeks," Blackwell recalled, "I tried to put the idea suggested by my friend away, but it constantly recurred to me."
When Blackwell told some of her friends that she was thinking about applying to medical school, they scoffed at the idea and told her that she was being impractical. Her family members, who were active in the movements to abolish slavery and to win voting rights for women, approved of Blackwell's desire to study medicine, but they warned her that she might face rejection and disappointment.
Blackwell believed that men and women were entitled to equal opportunities in education. Hoping that the admissions committees at some medical schools would share her view, she decided to go ahead and apply for admission as a student. In order to save money for medical school she spend the next year teaching music. When she was not teaching, she read medical textbooks.
In the summer of 1846 Blackwell applied to several New England medical schools. She was rejected by all of them. After that, Blackwell recalled, "The idea of winning a doctor's degree gradually assumed the aspect of a great moral struggle, and the moral fight possessed an immense attraction to me." Besides studying medical texts diligently, Blackwell began to teach herself Greek. She also wrote letters to several prominent doctors, stating her goal and asking them if they could help her get into a medical school.
One of the doctors to whom Blackwell wrote was Joseph Warrington, a well-respected physician in Philadelphia, Pennsylvania. In his reply to her letter he advised her that, although he was impressed by the boldness of her aspirations, he doubted that any medical school in the United States would open its doors to a female student. He urged her to focus her talents on nursing instead. But he added that, "if the project be of divine origin and appointment, will sooner or later be accomplished."
Blackwell found Dr. Warrington's letter encouraging. He was the only doctor who had taken the time to write back to her. She decided that her chances of getting into medical school would improve if she moved to Philadelphia, where Dr. Warrington practiced, and where some of the best medical institutions and programs in the country were located.
In May of 1847 Blackwell traveled to Philadelphia and introduced herself to Dr. Warrington, who she found to be honest and good-natured. Dr. Warrington immediately liked Blackwell-he was charmed by her earnestness and determination. He offered her the use of his private medical library and invited her to attend his medical lectures. The two soon became friends, and Blackwell began to accompany the doctor on some of his house calls. Dr. Warrington also offered to write Blackwell a letter of recommendation when she was ready to apply to more medical schools.
Early that summer Blackwell submitted applications to medical schools in New York, Philadelphia, and Boston.
While waiting to hear back from the schools, Blackwell introduced herself to several other doctors working in Philadelphia. She recalled that one doctor affiliated with the University of Pennsylvania began to laugh when she told him that she wanted to study medicine. But another doctor offered to give her anatomy lessons, which she gladly accepted.
When Blackwell received only rejection letters from the schools to which she had applied, she became frustrated.
As an alternative to medical school in the United States, several physicians suggested to Blackwell that she got to France, disguise herself as a man, and attend medical lectures in Paris. A French woman had recently done that, and had passed all her courses, but had been denied a diploma after revealing that she was female.
Blackwell was not willing to disguise herself as a man. She wanted a medical school to accept her as a female student.
In August, Blackwell mailed out another round of applications to twelve lesser-known medical schools. She had little hope that she would be accepted by any of them.
One of the smaller medical schools to which Blackwell applied was Geneva College in upstate New York. When Blackwell's application and letter of recommendation from Dr. Warrington arrived at the school, it was given to the college dean, Dr. Charles Lee. It was the first time that a woman had applied to his school. Lee opposed the idea of accepting Blackwell as a student, but he know that Joseph Warrington was a well-respected physician and he did not want to displease him.
Convinced that his students would agree with him, the dean decided to place the onus for rejecting Blackwell onto them, by allowing them to vote on the matter. He interrupted a morning lecture and read to them Dr. Warrington's letter on behalf of "a lady … anxious to graduate from one of the eastern city [medical] colleges but refused admittance by all."
The students did not know whether or not to take Dr. Lee seriously and many of them suspected that he was playing a practical joke.
Before leaving the lecture hall, Lee instructed the class members to discuss the matter among themselves and then to hold a vote.
One medical student, Stephen Smith, recalled, "For a minute or two, after the departure of the Dean, there was a pause, then the ludicrousness of the situation seemed to seize the entire class, and a perfect Babel of talk, laughter, and catcalls followed."
Smith recalled that, when the question of whether to accept Blackwell was finally put to a vote, "the whole class arose and voted 'Aye' with waving handkerchiefs, throwing up of hats, and all the manner of vocal demonstrations."
Blackwell received her letter of acceptance to Geneva College in late October 1847. She wrote in her journal that she "instantly accepted the invitation and prepared for the journey" with "an immense sigh of relief and aspiration of profound gratitude to Providence."
Blackwell left Philadelphia on November 4 and arrived in Geneva, New York, two days later.
On Blackwell's first day of school, Smith remembered, "the Dean came into the classroom, evidently in a state of unusual agitation. The class took alarm, fearing that some great calamity was about to befall the College. … He stated, with a trembling voice, that … the female student … had arrived. … With this introduction he opened the door to the reception room and a lady … entered, whom the Dean formally introduced as Miss Blackwell. She was plainly but neatly dressed in Quaker style, and carried the usual notebook of the medical student. A hush fell on the class as if each member had been stricken with paralysis. A death-like stillness prevailed during the lecture, and only the newly arrived student took notes."
A few paper darts flew her way, but Blackwell ignored them. She later wrote that she hoped her "quiet manner would soon stop any nonsense."
After being at the college for a few days, Blackwell was informed that she would not be allowed to attend classroom dissections. One of the professors though that it was inappropriate for a woman to be present when he covered the topic of reproductive systems. Blackwell protested her exclusion and was finally allowed to attend.
The male students at Geneva College grew to respect and admire Blackwell, and some of them became her good friends. But many of the townspeople, especially the women, treated her unkindly. Blackwell noticed that the women would draw their skirts aside as she passed them on her daily walks through town.
On the morning of January 29, 1849, at a ceremony at the Presbyterian church in Geneva, Blackwell graduated at the top of her class. When the president of the college, Benjamin Hale, handed Blackwell her diploma, she said to him, "Sir, by the help of the Most High, it shall be the effort of my life to shed honor on this diploma." A larger-than-usual crowd showed up for the graduation ceremony to see Blackwell become the first woman in the United States to obtain a medical degree.
The dean gave a speech congratulating Blackwell on her diploma and expressed "admiration at the heroism displayed, and sympathy for the sufferings voluntarily assumed."
In her autobiography, Blackwell noted that her graduation from medical school "produced a widespread effect in America. The public press very generally recorded the event, and expressed a favorable opinion of it."
Other women in America applied to medical schools across America, and some of them were accepted, including Elizabeth Blackwell's sister, Emily Blackwell, who was granted an M.D. degree in 1854 from Western Reserve Medical College in Cleveland, Ohio.
After graduating, Elizabeth Blackwell studied obstetrics in Paris, where she caught an eye infection from a patient and lost sight in her left eye. She then returned to the United States, where she opened a free clinic in a New York City slum. Blackwell raised money from local churches and businesses to support the free medical service. The majority of her patients were women and children.
In 1857 her sister, Dr. Emily Blackwell, joined Elizabeth Blackwell at her clinic in New York. Together they opened a charity hospital, the New York Infirmary for Indigent Women and Children. In 1868 they opened the world's first medical school for women, the Women's Medical College of the New York Infirmary.
In 1869 Blackwell left the Medical College and Infirmary under the supervision of her sister and went to England, where she organized the National Health Society and founded the London School of Medicine for Women. In 1875 Blackwell was appointed professor of gynecology a the London School of Medicine for Children. She continued to practice medicine until 1907, when she retired at the age of eighty-six. She died in Sussex, England three years later.
Abram, Ruth J., ed. "Send Us a Lady Physician": Women Doctors in America, 1835-1920. New York: W.W. Norton and Company, Inc., 1985.
Blackwell, Elizabeth. Pioneer Work in Opening the Medical Profession to Women. London and New York: Longmans, Green and Co., 1895.
Luchetti, Cathy. Medicine Women: The Story of Early-American Women Doctors. New York: Crown Publishers, 1998.
Ross, Ishbell. Child of Destiny: The Life Story of the First Woman Doctor. New York: Harper and Brothers, 1949.
Stille, Darlene R. Extraordinary Women of Medicine. New York: Grolier Publishing Co., 1997.