CHAPTER XXI
Social success—Growth of private practice—Professional recognition—Consulting staff of leading medical men for Infirmary—Occasional opening of some dispensary clinics to women students who there introduce a needed reform—Incident of Dr. J. Marion Sims, and why a woman was not appointed assistant surgeon in the New York Woman’s Hospital of which he was chief—Second mobbing of the Infirmary following death of a patient—Definite beginning of training of nurses—Trying experience of two fires in neighborhood—Dr. Zakrzewska’s health begins to show effects of overstrain—Inquiring visitors from all parts of the United States and even from England. (Twenty-nine years of age: 1857-1859.)
During the winter of 1857-1858, our entrance into the social circles already mentioned was an immense help to the spreading of the idea of women physicians through our meeting what was then called the “higher kind of Bohemians,” among whom were preëminently women artists, aspiring journalists and dramatic students. Although we medical women were not cordially accepted, as only a few of them dared to make our acquaintance, our repeated weekly appearances (as one or more of us made it a point to attend these receptions, no matter how tired we were) familiarized these small publics with the thought that women doctors are as good as anybody.
The fashion then was to attend these “socials” regularly; and social they became. They were not stiff and meaningless as is the present fashion, where one goes once or twice during the whole season, shakes hands with the hosts, says some nothings, meets friends and foes and says more nothings, shakes many hands without knowing why, and takes some refreshment in thimble cups, which is no refreshment so scanty is it in quantity and so poor in quality, mere elegant nothings only pretty to look upon. No; in those years, receptions meant intellectual recognition, social grace, conversation, and enjoyment in whatever suited the different tastes, whether a song, or some music, or a quiet game of whist in a retired corner; and no “refreshment” to make a show of pretense, but simply plenty of good ice water.
Among these good people, of whom many have since become of eminence in literature and in art, we gradually developed professionally a small clientele who, if not paying in lucre, paid with grateful remembrance in speaking of us, spreading the idea of us and occasionally writing little articles concerning the New York Infirmary for the leading papers and journals.
I much regret not to be in possession of any of these writings for, as I remember them now, they seem to me so juvenile, so absolutely simple in their tenor, that it might appeal to our sense of humor to read them in the present altered position of women physicians.
For instance, the public was assured that none of us wore short hair like men, but dressed gracefully within the fashion; that we appeared neat in costume, nothing extraordinary indicating our calling, etc., etc. The only disagreeable thing which they found in us was that we objected to being called “Doctress,” but insisted upon the neutral appellation of “Doctor of Medicine.” This led even to lengthy discussions as to “whether the English language would conform to such a title for a woman.”
However, this publicity helped “the Cause” and, strange to say, men were the first who took to the innovation of employing a woman physician by advising their daughters and wives to avail themselves of our services.
Thus, at the end of the year 1857, I had quite a comfortable private practice established. And I took great pains to assure those to whose families I ministered that, year by year, an increase of better women doctors would be the consequence of widening their practical experience and giving them equality of opportunity with the men physicians.
Here my notes read very sanguine, as some of the men highest in professional standing were exceedingly friendly, both professionally and privately; and it is with deep gratitude that I mention the names of Drs. Kissam, Willard Parker, McCready, Aigner and Buck, who gave us their most cordial assistance.
Dr. Kissam, a prominent obstetrician, was on our consulting staff and he became quite friendly to our students, though still believing that Dr. Blackwell and I were exceptions to all womankind. Dr. McCready, attending physician at Bellevue Hospital, was another one who had put aside prejudice. The influence of these men procured for our students attendance at some of the larger dispensaries. In one, the Eastern Dispensary, Dr. Aigner, one of the Austrian exiles and a man of high education, took a sincere interest in the whole movement.
When our students expressed their surprise that no books of patients were kept in these large and rich institutions, no records of cases or prescriptions retained, in fact, that no methodical system was followed, these men inquired into our doings and came and looked through our system, by means of which every patient could be traced—the name, residence, diagnosis, treatment and subsequent course. This was a revelation to them; as it was further when I told them that I never allowed in out-door practice any student to give a prescription without signing her name to it. Thus, in case of any question being raised as to mistake in the prescription or mistake by the druggist (who was by no means in those years always a professional person in that line, but often a mere business man who opened an apothecary store), this signature would always tell where to place the responsibility for the writing of the prescription.
At that time I did not realize, as I do now, that these men, like all those whose position is fully established both professionally and financially, could afford to step outside the pale of professional custom and take up what was not recognized in the strict sense of common daily life.
It is the insecure, struggling physician who is hostile to the woman innovator, actually fearing for his bread and butter much more than for any alleged inferiority of intellect or of professional skill in the woman, although these latter have always been used as the war cry against women doctors.
The Boston Medical and Surgical Journal, Feb. 16, 1853, expresses this point of view in an editorial on female physicians, apropos of Dr. Hunt’s receiving an honorary degree of M.D. from the Female Medical College of Pennsylvania. It says:
It is not a matter to be laughed down as readily as was at first anticipated. The serious inroads made by female physicians in obstetrical business, one of the essential branches of income to a majority of well-established practitioners, makes it natural enough to inquire what course it is best to pursue.
Among the young men at that time, Dr. J. Marion Sims played such a peculiar rôle and one which is so characteristic that I must relate it here. Dr. Sims had come from the South to New York in 1853, poor and unknown. He had perfected an important operation which was based on a German theory, but for which no material to practice on could be found either in Europe or America, until he was able to utilize the negro slave women. Dr. Sims quotes “the great Würtzer, of Germany”; and he told me by word of mouth that he had operated one hundred and eleven times before he had the first success. This first success followed the performance of the thirtieth operation upon one of the six or seven slave women upon whom he had unlimited freedom for experimentation.
As it happened, Dr. Sims was introduced into the same social circle in which we were acquainted, and learning from certain members that they were enthusiastically interested in women physicians, he advanced in a year’s time in such a friendly manner that he had hard work to live down his friendly advances when he later learned from his professional brethren, as well as from a wider public, that women physicians were by no means popular and could in no way forward his plans. However, he remained outwardly polite to the Drs. Blackwell and myself, inviting us to his operations in the then small beginning of the Woman’s Hospital, but excusing himself from further assistance to medical women as a hindrance to the philanthropic enterprise of enlarging the above-mentioned institution.
Dr. Sims stood on common ground with the women physicians in that he also found the medical profession unfriendly, and realized that his only hope of establishing himself was to open a hospital for himself. He says in his autobiography, which was published under the title of The Story of My Life, “I said to myself, ‘I am a lost man unless I can get somebody to create a place in which I can show the world what I am capable of doing.’ This was the inception of the idea of a woman’s hospital.... If the profession had received me kindly in New York and had acted honorably and gentlemanly and generously towards me, I would not have thought of building a woman’s hospital.... When I left Alabama for New York, I had no idea of the sort in the world. I came simply for a purpose the most unselfish in the world—that of prolonging my life.”
While no more fortunate than the women physicians in enlisting the coöperation of the medical profession, Dr. Sims had greater success with some prominent and wealthy women, who eventually established the hospital for him. The work of Dr. Blackwell and the movement in favor of women physicians had evidently made an impression upon these women also, because they adopted a by-law providing that “the assistant surgeon should be a woman”; and Dr. Blackwell and her sister, Dr. Emily, both well-qualified by their added clinical training in Europe, were the logical candidates for this position.
Dr. Sims cynically refers to this by-law as follows: “One clause of the by-laws provided that the assistant surgeon should be a woman. I appointed Mrs. Browne, a widowed sister of my friend, Henri L. Stuart, who had been so efficient in organizing the hospital. She was matron and general superintendent.”
Six months later, he told the board of lady managers that he must have an assistant. He then offered this position, successively, to two young men who had just been graduated and who declined it. His third choice was made because the man had married a young Southern friend of his youth!
Returning to the friendly physicians mentioned above, they dared to introduce our students into their dispensary clinics, and they gave clinical instruction to us at the Infirmary, thus helping on gratuitously the few women who were struggling faithfully to fit themselves for their responsible calling. It was the more estimable in these men that their audience was a small one whenever they came to our hospital during the winter evenings, the largest number never exceeding six. And they were always ready to come in consultation, even if they were requested to attend the same case repeatedly.
My heart is still full of joy when I think how kind and helpful these men were in protecting us in this way; and even, also, against brutal assault, as, for instance, in a case of appendicitis to which Dr. Kissam had been every other day in consultation and which ended in death. His advice had been the application of cold water compresses, which were in vogue at that time.
On the morning following the day on which the patient died, a number of men appeared before the Infirmary, demanding entrance and creating within ten minutes a large mob to whom they were talking loudly, declaring that this was an institution of some cranky women who killed people with cold water. I had found means for sending a messenger from the back door to Dr. Kissam, and it was through his presence that no harm was done to the institution. He addressed the mob and advised the disturbed people to have a coroner sent for to make an examination in the presence of twelve of themselves as a jury. It was a sight to behold—these poor distraught men in overalls, with dirty hands, disheveled hair and grim faces, standing by during the autopsy, and at its close, declaring their satisfaction that death had been an unavoidable consequence of the disease.
New Year’s Day, 1858, was one of the brightest and pleasantest winter days we ever enjoyed. A friend to women physicians had placed money in my hands for gifts to our faithful servants; and another friend sold to me at half price a whole piece of thibet, so that I was able to present each one of my hardworking women with a dress, as well as with some sweetmeats, all of which were duly appreciated.
Perhaps nobody, nowadays, can understand the willingness and devotion of the women who assisted me in carrying on this primitive little hospital: who were willing to work hard, in and out of hours; who fared extremely plainly and lodged almost to uncomfortableness; yet who felt that a good work was being accomplished for all womankind. And this was true of all—students, nurses and domestic help.
The eight months of experiment had stimulated us all with great hope for the future, and we now began to make more positive plans for the education and training of nurses. The first two who presented themselves for this training were superior women, one a German, the other an American, but neither was willing to give a longer time than four months, during which they received no compensation except their keeping and one weekly lesson from me on the different branches of nursing.
After these left, it was again a German woman who presented herself, and who, after four months’ training, remained as head nurse for several years. The second pupil nurse was sometimes of American, sometimes of Irish, descent and nothing remarkable.
This whole year had nothing special to note except that the press began to take a little more favorable notice of our doings and was ready to speak in favor of a Fair which again was arranged for at the end of the year; and this publicity spread the idea of women’s competency to take care of sick people.
We had constant applications from students to share in the experience of practice which we offered, and who were willing to live outside in order to attend the dispensary; while the number of patients in daily attendance at this latter increased so rapidly that we had to establish the rule of locking the door against admission after a certain hour.
Among the applicants were all sorts of extremists—such as women in very short Bloomer costume, with hair cut also very short, to whom the patients objected most strenuously; others were training as practitioners in a water-cure establishment, and wished to avail themselves of our out-door practice in order to introduce their theories and methods of healing. In fact, we were overrun with advisers and helpers whom we had to refuse. Popular prejudices could be overcome only in the most careful and conservative manner; and even our most ardent friends and supporters shared to a certain degree in the feeling of uncertainty as to the success of our experiment.
Personally, I received during this year great comfort in the acquaintances and lifelong friendships gained. And the recollection of these friends calls forth such a deep feeling of gratitude for their devotion in our work of love, and for their trust in me, and of admiration for their high purpose to serve humanity, that I consider it worth while to have lived if for no other reason than to realize through them the goodness of womankind.
So the year closed upon us as one which had brought great satisfaction in all we expected to gain, professionally and as bearers of a new idea. Youth was with us all, and our hopes of success knew no limit. We were the happiest, even if materially the poorest, of a group of women which included friends engaged in different lines of work, such as journalism, art and music. Of these, none identified herself so closely with us as Mary L. Booth, later editor of Harper’s Bazar, who spent every Sunday with us, and who often shared my room and bed when she was out at night as reporter of the New York Times too late to return to her home in Williamsburg.
Oh! happy days! Springtime of life! It was the “May” which never returns to the human being, and the beauty of which we realize only long after it has passed. Memories of these glorious days keep with us and reconcile us to the many sad, dark, anxious and trying hours through which we all have to pass in one form or another. These latter make us wiser, perhaps, but certainly not happier, even though we have struggled successfully through the years and feel that we should be contented with what we have accomplished.
Still, there was a dark side to my experience during that year. The sick headaches, to which I had been subject off and on since childhood, came upon me quite often and very unexpectedly, evidently due to the overstraining of all my forces, physical and mental, and I was quite often obliged to relinquish some very important duties.
Before leaving this year’s record, I must add a few remarks concerning our work, that is, mine and that of the ten or twelve students who had been connected with the Infirmary now for twenty months.
The prejudice against women physicians was by no means confined to that stratum of society where education and wealth nurtured the young. We found it just as strong, through habit and custom, among the working people and among the very poorest of the poor. Their coming to our dispensary was not a priori appreciation of the woman physician, but was the result of faith in the extraordinary, just as now faith-curers with other claims are sought and consulted in illness.
Our work was that of real missionaries. Even among the well-to-do and intelligent, little or nothing was known of hygiene. If “a goneness in the stomach” was felt, whisky, brandy or a strong tonic was resorted to for relief. Diet, rest and the sensible use of water were never considered.
So among the poor we found everywhere bad air, filth and utter disregard of food. And sponges, as well as soap, were carried in the satchels of our young medical women along with the necessary implements of the physician. And the former were given to the patients’ friends, after showing them the use of water and soap in fever cases as well as in ordinary illness. It was an innovation in the minds of the people, the teaching that sick people must be bathed and kept clean, and that fresh air was not killing.
The good results obtained by the addition of these sanitary auxiliaries whose use was permitted only through our persuasion, created almost a superstitious faith in us and resulted in sending to us patients from a distance of ten and twelve miles from Bleecker Street. This made increased demands on our physical and nervous powers, for we made it a point not to refuse any person if it were at all possible to see her.
Thus we placed foundation stones here and there all over Manhattan Island upon which to build our superstructure of medical practice by women. In this respect, as in all solid production in nature and in civilization, a sound foundation must be created first. No reform, no culture can be successful if we limit ourselves to the higher intellects. We must under all conditions be careful not to speak over the heads of the mentally mediocre crowd.
The soil in which the seed is sown must be examined, then prepared, and then cultivated in the most prudent and careful manner—only then can we expect to have the seed take root and grow.
The gaining of confidence is not obtained by showing your own superiority; nay, it is by hiding this latter and allowing the persons whom you want to benefit to think well of themselves, yet continuing to lead them, indirectly, to the idea that there is a possibility of their bettering themselves. Only by such a proceeding is it possible to bring about confidence; then an attachment follows and, finally, a dependence upon your higher wisdom which will always end in admiration and gratitude. Whenever this is not the case, it shows failure in our having been wise, or kind, or comprehending of the situation; in short, it is the fault of the would-be benefactor.
We had two strange accidents in the neighborhood during that year. Our backyard and outbuildings faced the rear of a livery stable containing more than forty horses. This stable took fire one afternoon about five o’clock. I was just coming home, and I felt so sure of the solidity of our own buildings that I was able to control the excitement of all our inmates who, in bed and out of bed, were perfectly quiet and remained in their rooms in spite of the smoke and noise and all the confusion which a large fire causes.
A few months later at four o’clock in the morning, I was just retiring to my room after having attended a patient below when I heard the cry of “Fire!” And looking out of my window, I saw that a man had upset a fluid lamp, filling the whole room with flames, while he with his night shirt on fire was seeking to escape through the door which he could not find, thus burning to death before my eyes. It was an appalling spectacle, and before I could really comprehend the situation, firemen appeared and worked hard, for the conflagration soon included several buildings.
Again, I could control my patients and the other inmates, although our students and servants dressed hastily and were ready to obey commands in case of need. Fortunately for us, the wind blew the flames in the opposite direction from our house, and I trusted in this fact. Had I had the experience of the Chicago and Boston conflagrations, I would not have trusted to the wind nor perhaps have been able to control a family of nearly forty heads. Such is the blessing of youthful inexperience! But the strain of anxiety on these two occasions was tremendous, and I was laid up each time for a couple of days with a severe sick headache.
Visitors interested in women physicians came from all parts of the United States as well as from England, but especially from Boston. I was often at the same time amused and pained when disappointment was expressed over the smallness of our hospital, and we had to take great pains to explain our out-door department work.
From the very beginning, I had instituted record books in which the name, age, residence, occupation, diagnosis and treatment of every individual case were written—of those who were in the hospital, those who came to the dispensary clinics, and those who were attended at their homes.
These books revealed to the visitors our activity, and they were admired also by our professional brethren. No such records then existed in their dispensaries but were introduced after our example, primitive as it was in those years. However, having such records saved us a great deal of annoyance in many ways, as we offered them for inspection to all whom they concerned; and they protected us against any accusation of carelessness, ignorance or malpractice of any kind.
It was the same with the prescriptions given when the medicines were not provided by us. I insisted that every one who wrote a prescription should sign her name, if not also the name of the patient. As my name was so long, I have always signed M. E. Z.