A Woman's Quest: The life of Marie E. Zakrzewska, M.D.

by Marie E. Zakrzewska

CHAPTER XXIII

Details of the College building—Dr. Zakrzewska meets many men and women leaders in advanced thought in Boston—Differences between Boston and New York with regard to the question of “woman’s sphere”—History of the New England Female Medical College—She finds the educational standards of the College low, and she meets opposition in her attempts to elevate them—She establishes the hospital (Clinical Department) along lines similar to those she had developed in the New York Infirmary—Several leading men in the profession acknowledge her qualifications but refuse to act as consultants for the hospital, or to countenance the College—Letters from Dr. John Ware—Hardships of the Out-Practice. (Thirty years of age: 1859-1860.)

The New England Female Medical College had its home in Springfield Street, in the building erected for the Boston Lying-In Hospital and later occupied by the Home for Aged Men. Here the lectures were held, the officers had their rooms and the directors, their meetings; and yet, not half of the building was occupied. So I had there my office and bedroom, furnished by the lady managers of the college.

I assigned the basement rooms to the dispensary, while the rest of the lower rooms served for domestic purposes inclusive of servants’ rooms. The middle story was taken for the indoor clinical department, or hospital; while the upper floor, or attic, was arranged for students’ chambers, and for these we received rent and pay for board from those actively serving in the hospital department.

This whole affair, however, had to be organized and superintended, and as I felt unequal to added medical responsibilities I devoted myself during the whole summer (1859) to arranging this department and getting it in working order, taking every now and then a whole week’s vacation at the seashore or in the country.

New friends in the form of a board of lady managers were added to the college because increased funds were needed to carry on the new department, the most noted name on this board being that of Harriet Beecher Stowe. And the ladies and gentlemen who favored my plans when I came, three years earlier, pleading for the New York Infirmary, now bravely advanced and provided the means for this new enterprise.

Through all of my former acquaintances I at once found warm friends and protectors here in our beloved city of Boston. I may mention the names of Theodore Parker, Wendell Phillips, William Lloyd Garrison, Samuel E. Sewall, F. W. G. May, Francis Jackson, Rev. William E. Channing, Dr. W. F. Channing, Dr. Samuel Cabot, Dr. E. H. Clark, Mrs. Sarah S. Russell, Miss Abby G. May, Miss Lucy Goddard, Rev. and Mrs. James F. Clarke, Mr. and Mrs. Bond, Miss Mary J. Parkman, Mrs. R. G. Shaw, Mrs. Ednah D. Cheney, Mrs. F. Fenno Tudor, Miss Susan Carey—and there were a host of others, both men and women.

I wish I could mention all of the noble minds, pioneers of a new era in the broadening of thought. No specialism was represented, except perhaps that of Abolitionism and the Advancement of Women. Free scope of the intellect was admitted, and every one who promoted culture of mind and body was welcomed. Scores of able women sought instruction, demanding to know what was objectionable in woman’s aspirations.

These and other activities were evidences of the smoldering volcano which burst forth into active conflagration in the outbreak of the Civil War, in 1861, and which gave birth to a new type of Woman—as Minerva was said to have issued forth from the head of Zeus fully armed with weapons of force and intellect.

The names of Lucy Goddard, Abby May, Ednah D. Cheney, Sarah Shaw Russell and Anna Lowell should be engraved on plates of gold for remembrance by those who will come after, for they took a stand which made history in life, and especially in the life of women.

For, let it be understood, the impression of the great liberality of Boston society, which I had cherished and fostered as a belief, was not as well-founded as I thought, and upon closer acquaintance I was soon convinced that here also it required a great deal of courage to advocate a new era in woman’s sphere.

Although I found much less tendency to ridicule, to treat with contempt, or to prophesy failure than we had met in New York, yet the fear of losing social caste was strong here also. Declarations that the study of medicine would unsex girls or break down health and beauty prevailed throughout the community, and newspaper remarks were discouraging rather than otherwise.

In short, I had to go over the same ground as in New York, explaining the possibility of a woman physician’s being able to do precisely the same work as the average man physician. The only difference I found in the two cities was that in spite of doubt and prejudice against woman “leaving her sphere,” as it was called, intelligent men and women in Boston were ready to listen to and to discuss all possible chances.

The fact that this small medical college for women had now lived for nearly ten years induced the liberal-minded to go a step farther and to begin to employ women, especially in midwifery cases.

One of the graduates of this school was still practicing in Boston as midwife on July 1, 1889, she having by that time attended five thousand confinement cases. Although she was never sought by the well-paying portion of the Boston community, she held a very reputable position among her patients and among such of the profession as had business relations with her. Her name, Mrs. Hassenfuss, has been mentioned to me quite often by the best of men physicians. Therefore, honor to whom it belongs. This good, sensible woman, the mother of eleven children, has done her share in overcoming prejudice against women physicians.

Several other ladies who had graduated from this school tried to practice in Boston although as they told me with very little financial result. They were obliged during the first years after establishing themselves to seek practical experience among the poor, either as assistant to a friendly man physician or on their own responsibility. In either case, they appeared to the people’s minds more like well-trained nurses than physicians who assume an authority which creates confidence. Their position was by no means an enviable one, and only the self-assurance produced by the American education could hold them up socially.

Here it should be said that the graduates of this school labored under disadvantages produced by obscurities in the minds of those who controlled it.

Ever since the men physicians began to organize themselves into a compact body or guild, their endeavor has been not to educate the women whom they everywhere found called to be the natural obstetricians, but to drive them entirely out of such practice and to monopolize it for themselves. This struggle continues everywhere, all over the world. And it is a struggle which will continue until both men and women are educated equally well, so that the individual patient may exercise her choice of the “trained doctor” of either sex.

A public agitation begun in Boston in the summer of 1847 culminated in 1848 in a revulsion of feeling among the laity against this attempt of the male physicians to monopolize the practice of obstetrics, and in favor of the restoration of at least a part of such practice to the hands of women. And this revolt was countenanced by a large number of the leading citizens of Boston as well as of the rest of New England.

As a result of this agitation, the Boston Female Medical School was opened on November 1, 1848, with twelve pupils. And to aid this School, the Female Medical Education Society was organized on November 23, 1848, with six members. This membership increased to a thousand or more during the following year, its larger part consisting of men of prominence in all walks of life. And in the following year, 1850, this society was incorporated “for the purpose of providing for the education of Midwives, Nurses, and Female Physicians.”

In the earliest printed report of the Boston Female Medical School (1851), most stress is laid upon the course of study for Midwives, which is as follows:

Candidates for Diplomas as Practitioners in Midwifery, must be at least twenty years of age, and must present testimonials of good moral character; they must have studied at least one year, including the Lecture terms; must have attended two full courses of Lectures, one of which must have been in this institution: and must pass a satisfactory examination before the Board of Examiners, in Anatomy and Physiology, in Obstetrics and the diseases peculiar to Women.

Nurses are referred to in the statement that:

Courses of Lectures and Instruction will be given to Nurses in reference to their important and responsible vocation of attending the sick.

And Female Physicians are considered in the paragraph:

The candidates for full Medical Diplomas must have pursued a course of Education equivalent to that required in other medical institutions; and at least two terms of their instruction must have been in this School.

While all groups are urged to seek to prepare themselves, “Persons intending to become members of the School will do well to study, in advance, some elementary work on Anatomy and Physiology—Cutter, Jarvis, etc.,” closing with the naïve statement whose wisdom cannot be gainsaid, “And any other preparatory knowledge will be useful.”

Thus we see that the Boston Female Medical School aimed as high as any of the male medical schools of the day. Really, its aim was higher, in that from the beginning it planned to have a Hospital and to make “practical” instruction in obstetrics and the diseases of women an integral part of its course. In advocating this latter procedure, it claims superiority for itself, making the statement that “the Harvard Medical School furnishes no facilities in the way of ‘practice’ in a Maternity Hospital—the most important part of an obstetric education.”

But, presumably, this school found itself practically confined to the education of midwives and nurses—groups whose qualifications were apparently not regulated by strict legal enactment. Because, in 1856, an act of legislature was passed changing the name of the Female Medical Education Society to that of the New England Female Medical College, and giving this latter body power to “appoint Professors, who shall constitute a Medical Faculty; and to confer the usual degree of Doctor of Medicine,” provision for these latter legal necessities having evidently been overlooked in the earlier incorporation of 1850.

The New England Female Medical College says nothing in its reports about midwives, but speaks only of medical students, of nurses, of female physicians, and of its purpose to have “a part of the Faculty consist of female Professors.” But it lists its medical alumnæ from 1854.

Thus becoming acquainted during the summer with the new field for my activity, I found still an added difficulty among the few women who possessed a medical diploma, namely, that not being accustomed to work with one another on a common plane, they rather feared any one whose standpoint differed from their own and who brought new views of the subject in question.

“What is, or was, sufficient for me ought to be sufficient for all who come after me,” was the common human principle on which they based their indifference towards improving or enlarging their stock of knowledge. Medicine was then taught, even in the best of colleges, not as a scientific vocation but as a practical business.

For instance, after having been connected with the New England Female Medical College for a year, I ventured to express my surprise that no microscope was in the college, and to say that I wished for one because much that it was necessary to explain could only be done with such an instrument.

My petition for one was refused. And Mr. Sewall informed me that one of the gentlemen who was a leader in the college, after having listened to my written petition, said, “That is another one of those new-fangled European notions which she tries to introduce. It is my opinion that we need a doctor in our medical department who knows when a patient has fever, or what ails her, without a microscope. We need practical persons in our American life.” This man is long dead, yet I feel sorry that he could not have lived longer in order to see that we teach the new-fangled notion of the use of a microscope even in our public schools.

It can easily be understood that my position, both as professor of midwifery and as head of the clinical department, was not very agreeable, with such opponents among the directors of the school and having to meet the indifference of the established women doctors of Boston; and also, I am deeply sorry to say, receiving only limited support from the men physicians with whom I was associated in the college.

Although in favor of the school, the students were regarded by these physicians more in the light of trained nurses who were to become their handmaids in practice. This fact revealed itself to me when, feeling the need of consultants, I tried to reorganize the hospital staff. I found that none of the prominent Boston physicians was willing to give me his name, and the excuse was that the standard of the school was below par. On the other hand, the physicians connected with the school thought they were teaching all that a woman doctor ought to know.

Here I want to anticipate a little by telling of my first examination of students for the degree of M.D. This was to be carried on by the professors of the school, in the presence of a committee of three from the directors, but only one of the latter appeared. Several of the candidates who presented themselves for their examination were possessed of such elementary education that they had no other recommendation to the examiners than that they had attended two courses of medical lectures of twenty weeks each, and had studied with a preceptor to make up three years of reading medicine, but whom I had never seen in our clinical department.

I objected, of course, to these students as unfit for a position of the gravest responsibility. While all the rest reluctantly took my side, they added, “Nobody in Boston would employ a woman doctor in serious cases, anyhow!” However, I prevailed, and I did not have to place my name on the diploma of women who, excellent as nurses, were unfit to take the position of physicians.

By October 1, 1859, I considered myself strong enough to begin regular daily work. The housekeeping cares which I had hitherto assumed were divided with a competent woman. Financial difficulties, however, were not so easily overcome, and we had to charge a board payment of three dollars a week to such students as wished to avail themselves of residence within the building.

This arrangement added a good deal of care to me as superintendent, for, in spite of exercising the greatest impartiality between the resident students and those from outside, a feeling naturally grew up among the students that favoritism was practiced. What really happened was that, as a consequence of constant presence, the internes appeared better equipped to render assistance than the externes. A few of these latter, however, gave me credit by word and deed that, if anything, I favored the externes rather than the internes and these few became real and true friends in later years, often calling upon me or writing for advice, as well as giving me their sincere friendship.

To be appreciated as just, conscientious and unselfish has always been my ambition—other honors, or wealth, I have never sought nor received. Even at this moment, when age has come to me and health has failed, my small income from my savings gives me greater satisfaction than if I had accumulated a large competency. Though I should still like to have this latter in order that I might help many a struggling woman to whom I have to refuse aid because I am poor myself.

Among the resident students, were Lucy E. Sewall, my private pupil and devoted friend and co-worker during her life; Anita E. Tyng, a woman of talent, at present living in California; Mary H. Thompson, who became famous by establishing the Woman’s Hospital in Chicago, reëstablishing the same after it was burned during the great conflagration; Helen Morton, my associate in practice after her return from Paris in 1867, and still residing in Boston; Lucy Abbott, who became resident physician at the New York Infirmary; and others who became of more or less importance in after years.

Again our household assumed more of the condition of a family circle like that of the New York Infirmary, having a similar intimacy. This was due to the fact that, although women physicians were more tolerated in Boston society, they had not yet conquered all doubt or prejudice among the women of Boston, while the profession at large would not recognize any of them at all.

However, I made the attempt to call upon a few prominent men. For instance, I saw Dr. Henry E. Clark, who had visited the Hospital Charité in Berlin when I held the position of Accoucheuse en chef in the Maternity Department of that institution. And I had the opportunity of being very helpful to him in all he wished to gain as a young doctor seeking experience in a foreign land. He received me with kind politeness, but told me frankly that he could not sanction the study of medicine by women. He yielded so far as to pronounce me “an exception” to my sex, and he promised to assist me in private practice should I require consultation. Also, in the course of the winter, he sent me several patients, and he spoke with recommendation to those who inquired of him about me and my former position in Berlin.

Another one, Dr. John Ware, accepted me as an exceptional woman, and fatherly and kind as he was, he laughed heartily when I told him that the exceptions would multiply by the hundred.

[Dr. Ware writes, under date of February 11, 1860:

My dear Madam:

I ought before now to have acknowledged your kindness in sending me a copy of your Lecture. I have read it with much satisfaction, and wish most heartily that every one of my professional brethren entertained views as just and elevated of the nature of their calling, and were as conscientious in regard to its responsibilities as you would have all be who assume them.

I take the liberty of sending in return a few publications of my own, relating in part to the same topic. You will find on the 24th page of one of the Lectures—that on “Success in the Medical Profession”—a brief expression of my opinions on the subject of Female practitioners, which, altho’ you may not agree with them, I hope you will find no reason otherwise to disapprove.

I am, with sincere respect and regards,

Yrs.
John Ware

To Marie E. Zakrzewska, M.D.

Again, referring to the earlier chapters of this autobiography, he writes, on December 13, 1860:

My dear Miss Zakrzewska:

I received yesterday a volume which I supposed, certainly I hoped, came from you. I read it at once, and with the deepest interest. I have a right, therefore, whether it came from you or not, to thank you for it. Neither can I let the opportunity escape of expressing the admiration and sympathy with which I followed you in the long struggle you endured, and which you maintained with so much of that energy, courage, perseverance and fortitude, which we are apt to call manly—as if they were our peculiar possession—and yet without any infringement of that womanly delicacy, which we certainly cannot claim.

You know perhaps my doubts about the medical education of women. It is not because I do not think well enough of women that I entertain these doubts, but rather, I suspect because I think too well of them, to be willing they should go through with a medical education, or endure a medical practice. I have put it to myself whether I could be willing that one of my daughters should go through the discipline and lead the life that I have done myself. The idea is intolerable. That you have accomplished what you have with success and honor does not satisfy my doubts—how few of either sex could do the same.

I may be mistaken, for it is very hard to be sure that we are not influenced by early impressions and the prejudices of society, and I am quite willing to find myself in the wrong, for I have the most earnest desire that every possible avenue should be opened for the admission of women, not only to places for labour, but of honor and profit. I sympathize not only with every attempt to enforce “Woman’s Right to Labour”—but to think, speak, act and enjoy.

With sincere regard, I am your friend,

John Ware

To Marie E. Zakrzewska, M.D.

Drs. Henry I. Bowditch and Samuel Cabot regretted to refuse all aid so long as I was connected with such an inferior school as they considered the New England Female Medical College to be.

Dr. Cotting, of Roxbury, was the most cordial; he expressed himself as favorable to having women physicians as auxiliaries to the professional men. He sent me more patients than any one, and they were rich as well as poor. The latter were the most desirable, as our dispensary practice was small, lacking material for the benefit of the students.

This was the great difference between New York and Boston. Within three months after opening the New York Infirmary dispensary, we were obliged to close the doors for admission after a certain hour, so full became our reception hall; while in Boston we kept open all the forenoon without getting all the patients we wanted, and we even attended to them the whole day.

This may have been due to the fact that the college and hospital were located in what was then a demi-fashionable quarter of the city, the South End, where not many poor lived; and distance was not then annihilated by street cars, of which none existed. But it was also due to a greater prosperity among the poor of Boston, this creating a prejudice against free dispensaries in general, and women physicians in special.

To all these reasons was due the very hard work which we had to do, because if a family in the distant poor quarters inclined to favor us with their patronage, we had to rejoice. And the disadvantage of such events because of walks of two or three miles in the midst of winter nights was overcome by the enthusiasm of having gained another foot-hold among the poorest of the poor. Thus we had our clientele not only, though chiefly, at the North End of the city but also in the suburbs, where not even omnibus travel was possible, there being none to South Boston, Dorchester, Roxbury, Jamaica Plain and other outlying districts.

What would life be without the enthusiasm of the young! And how much or how little would be accomplished in the evolution of reforms and progress, if the young were not ready and happy to live up to the fullest inspiration of this enthusiasm! Reasonable or unreasonable, let us not stint or discourage any enthusiastic young person in the ways and means of living up to its fullest extent! Youth will always meet with more or less success in realizing its ambition, and even if premature death should be the consequence of such efforts, it does pay to have favored and encouraged the activity of such aspirations.

The happiness which is enjoyed by enthusiastic workers is impossible to describe in words, for, though ever so little be gained from the opposition, or by perseverance, this gain gives moments of joy which cannot be outweighed by many a disappointment or by any amount of fatigue. Oh! the single hour of happiness which victory brings! Even in humble aspirations, it is worth living for. It is not the quantity of anything which satisfies a noble heart—it is the quality, and the feeling of conscious satisfaction that the best of which the person was capable has been done.