CHAPTER XXV
As part of her struggle to elevate the College standards, she insists the students must be trained practically as well as theoretically—Confirmation of her views by experience of Dr. J. Marion Sims—Persistence in her convictions and refusal to pass students whose work is below her standards make many enemies for her—Private practice increases—She applies for admission to the Massachusetts Medical Society—Is refused because she is a woman—Militant ostracism of women by the Philadelphia County Medical Society—Sketch of the Female Medical College of Pennsylvania—Appalled by the death rate among babies, Dr. Zakrzewska establishes a temporary asylum for infants—Continuing unable to elevate the standards of the College, she decides to resign—Her resignation is accepted, with the request that she relinquish her last year’s salary—The occurrence causes a split in the College, many of the men professors and trustees also resigning—The hospital is discontinued, and its furniture is bought by friends of Dr. Zakrzewska. (Thirty-two years of age: 1860-1862.)
If the Christmastide were prosaic, the New Year’s Day (1860) was not the less so. Business went on everywhere just the same, only that every one shouted to each other without any kind of feeling, “Happy New Year!”
As the year progressed, lectures and dispensary work, as well as the hospital department, went on; private practice increased, adding to my income, which was small. As professor, I received three hundred dollars, and as superintendent of the clinical department, an additional three hundred dollars. Each of the gentlemen professors also received three hundred dollars while the lady professor of physiology had the benefit of an endowment of that chair and received five hundred dollars. From this it must be admitted that it was not money that induced these people to work hard every day, five times weekly, to instruct the students, but a real interest in the cause of educating professional women.
Had the originator of the school (Samuel Gregory), an ambitious man, originally a missionary, been a man of higher education and broader views, the school might have been taken up by the men standing highest in the profession. The prevailing sentiment among these men seemed to be that if women wanted to become physicians, the trial should be made by giving them the same advantages as were offered to men students.
But in a monograph which had been published by this originator to promote his plans, under the title of Man-Midwifery, he not only challenged the prevailing method of practice but abused even the best of physicians by intimating the grossest indelicacy, yes, even criminality, in their relations with their patients. This was the reason why no physician in Boston would openly acknowledge me as long as I remained in connection with the New England Female Medical College.
Besides this handicap, the non-professional portion of the trustees exercised a very fatal policy in trying to increase the number of students regardless of their preparatory education, so that there existed a great contrast among the students. Some had the best of education, while others fell far below a proper standard in their preparatory studies, to say nothing of the age of some of them. Thus, we had a number of students over forty—one was fifty-six years old.
I admired the courage and persistency of these middle-aged women in studying their lessons, often mechanically without understanding their depth, yet I could not conscientiously consider them fit subjects to enter upon the practice of a profession which requires so much knowledge in various scientific directions as well as a broad education, so as to enable one to comprehend the effects of all kinds of environment upon the individual patient.
How absolutely necessary it is to cultivate in the student not only the scientist but also the philanthropist, the humanitarian, yes, even the philosopher, in order that one shall be fair and just in all situations when consulted by persons morally, mentally or physically afflicted.
I constantly taught that the treatment of patients cannot be learned from books but must be studied practically. This was a principle which only a few of the students would admit. The idea which I emphasized, that any other view of treating patients belongs in the realm of quackery, was considered by these ignorant students as an insult when I tried to explain it to them.
But it must be remembered that at this date such was the prevailing custom in even the best medical schools for, as I have already explained, students were expected to procure their practical training at the hands of their private preceptors.
That this training was liable to be a will-o’-the-wisp even with male students who had no difficulty in finding preceptors has been well shown by the personal experiences related by Dr. J. Marion Sims in his autobiography called The Story of My Life. Nowhere have I seen the consistent results of such a method of medical education as everywhere prevailed even at this time, so clearly described as in this book which was published in 1884.
Dr. Sims had a preceptor and he was graduated from the Jefferson Medical College, in Philadelphia, in March, 1835. He states that his preceptor was a very great surgeon who was often unfitted for his professional work by the habit of drinking. He also states that he was very glad when he was able to leave the office of this preceptor and attend medical lectures.
About two or three weeks after Dr. Sims opened his own office he was called to his first patient, “a baby about eighteen months old who had what we would call the summer complaint or chronic diarrhea.” He continues his story, saying, “I examined the child minutely from head to foot. I looked at its gums and, as I always carried a lancet with me and had surgical propensities, as soon as I saw some swelling of the gums I at once took out my lancet and cut the gums down to the teeth ... but when it came to making up a prescription I had no more idea what ailed the child or what to do for it than if I had never studied medicine.”
Telling the mother to send to his office for medicine, he continues, “I hurried back to my office and took out one of my seven volumes of Eberle, which comprised my library ... and turned quickly to the subject of Cholera Infantum and read it through, over and over again.... I knew no more what to prescribe for the sick babe than if I had not read it all. But it was my only resource. I had nobody to consult but Eberle.... He had a peculiar way of filling his book with prescriptions, which was a very good thing for a young doctor.... At the beginning of his article of twenty or thirty pages there was a prescription.... So I compounded it as quickly as I knew how and had everything in readiness for the arrival of Jennie.”
Speaking of his next visit, he continues: “As the medicine had done no good, it was necessary to change it.” He once more returned to his office and “turned to Eberle again and to a new leaf. I gave the baby a prescription from the next chapter. Suffice it to say that I changed leaves and prescriptions as often as once or twice a day. The baby continued to grow weaker and weaker.” And in a short time it died, although Dr. Sims says, “I never dreamed that it could die!”
About two weeks later, he was called to his second patient, another baby which was ailing similarly to the first one. He writes, “I was nonplussed. I had no authority to consult but Eberle; so I took up Eberle again, and this time I read him backward. I thought I would reverse the treatment I had instituted with the Mayer baby. So, instead of beginning at the first of the chapter, I began at the last of the chapter, and turned backward, and turned the leaves the same way, and reversed the prescriptions. The baby got no better from the very first. And soon this baby died.”
Dr. Sims was so disheartened, he decided to leave that town, and he did so. But it is just to him to add that he further wrote, “Being obliged to continue in the profession that I had started in, I was determined to make up my deficiency by hard work; and this was not to come from reading books, but from observation and from diligent attention to the sick.”
Thus it happened at the New England Female Medical College that, feeling as strongly as I did as to the necessity for clinical training, I made but few friends among my listeners, and I felt out of place except with those few who had had superior educational training. This difference in education naturally divided the students, and the feeling of favoritism grew stronger with the majority, while my interest in this majority naturally grew weaker. The clinical department was frequented only by the few, as no rule of compulsion demanded of the students a regular attendance.
My position became tedious in its teaching duties and unendurable in its relation to the students, yet I had nothing to complain of which could be corrected without changing the whole policy of the school and eliminating the most active directors, in fact, starting a college on college foundations.
My male co-workers, men of education and experience, fully agreed with me and told me that indorsing my election, they had hoped I would prevail upon the founders to elevate the standard of the school.
I, a foreigner who, as such, was not greeted with a cordial welcome by two thirds of the directors! And the Know-Nothing spirit prevailing strongly during those years in all strata of the community!
Besides, I did not feel called upon to condemn and to reform the part of their enterprise which had been justly praised in speech and in print, and which had been sustained for years by the efforts of regular physicians in the capacity of professors and private preceptors.
So, when my first college year closed, in March, 1860, and I flatly refused to agree to the bestowal of the degree of M.D. upon several women who presented themselves, I had laid the foundation of a hatred which rendered my work extremely trying and hard, and which to a certain extent prevented the growth of our out-door dispensary practice.
However, my private practice steadily increased, and in it I had the good will, as well as the assistance when in need, of the most prominent physicians in Boston. Among these were Drs. S. Cotting, Walter Channing, H. I. Bowditch, E. H. Clark and S. Cabot.
These men advised me to attempt to gain admission into the Massachusetts Medical Society, of which they were prominent members. After preparing for the necessary examination, I presented my claim but was refused because I was a woman, their charter allowing only male candidates for the examination.
This refusal on the ground of sex decided these men not to break the rules of the Massachusetts Medical Society by consulting with me or by assisting me when advising patients to seek my attendance.
To be sure, their friendliness had not been withal an admission of the principle that women ought to be, or could be, physicians. On the contrary, I was informed in private conversation by some of these men that I was considered an “exception” to my sex; that such exceptions had existed in ancient times and were honored, and that during all the centuries such exceptions had continued to occur. Only one famous old physician, Dr. James Jackson, told me frankly and politely and in the kindest manner that it would be impossible for him to recognize as a lady any woman who was outside “her sphere.”
A similar ostracism was practiced by the Philadelphia County Medical Society against the other medical college for women, the Female Medical College of Pennsylvania, which had been opened in 1850, two years after the New England Female Medical College began under the name of the Boston Female Medical School. But the Philadelphia college had taken the precaution from the beginning to obtain the same legal authority as the male medical colleges for conferring the medical degree.
Nevertheless, it led a precarious existence and had to be closed for the session of 1861-1862, and Dr. Ann Preston feared that the institution to which she had given so much time and strength was doomed to succumb to the weight of opposition and the absolute refusal of the male physicians to meet the women physicians in consultation. However, a few of the ablest men disregarded the rules of their society and stood by the women who had just then succeeded in opening their little hospital for women and children.
It was not until 1867 that the Philadelphia College could be considered as on a firm basis, but within ten years from that time it produced the first woman ovariotomist in America, Dr. Emeline H. Cleveland, who was resident physician of the Woman’s Hospital after her return from study in Europe, principally in the Maternité in Paris.
Thus for me the year of 1860 ended. The college course which began in October had not varied in kind from that of the previous year, though I could note increased personal success in practice as well as in social connections.
The year of 1861 began for me in no way differently from the first in Boston. The dispensary practice increased in numbers of patients and also in greater variety and interest.
There was an especially large increase in the practice among children and infants, which gave me an insight into the neglect which the latter had to endure when boarded out among ignorant, and often indifferent, families, where the small sum received for the maintenance of these little unfortunate beings was of more consequence than their health and existence.
The frequency with which we were required to sign death certificates of infants whom we had seen but a day or two before, and who were then in an almost dying condition, was out of all relation with the number who applied in the early stages of what was then called “cholera infantum.”
This led me to inquire how far the law protected such little beings, and how far institutions gave relief either to poor mothers by boarding their offspring, or to foundlings. This brought me in contact with one of the greatest philanthropists to these little creatures, namely, Miss Matilda Goddard, who had at that time provided good homes for about eight hundred infants, keeping a record as well as an oversight of them all. No public provision existed save a few places in connection with a Roman Catholic institution.
I therefore proposed to a few friends of mine the establishment of a temporary asylum for infants, and an apartment for this purpose was secured at the corner of Washington and Oak streets. Small as was this beginning, we having about eight babies, it drew the attention of a large number of philanthropists to the need of looking after these poor beings. And then the Massachusetts Infant Asylum, as well as other provisions for these dependents upon the Commonwealth, were called into existence. The result was the saving of many a valuable life and the directing of the attention of the benevolent to the absolute need of watchfulness over those helpless beings who are at the mercy of strangers during the first days or years of their lives.
The work at the college continued to be unsatisfactory to me, and the year 1862, which was to become of such great importance to womankind in general and to me in special, opened in the usual prosaic custom then prevailing, namely, with every day filled with routine work.
However, I felt very excited, as well as very uncertain how to shape my plans and prospects, for I had decided to leave the college and its little hospital at the close of the term in March. I had communicated my intention to the directors of the college at the close of the year of my engagement, in June, 1861.
One of the most interested of the directors was Mr. Samuel E. Sewall. He asked me what my reasons were for giving up the position, and I replied in a letter to him of which I here make a copy:
About two years have passed since I became connected with the New England Female Medical College. Twice I have signed the diplomas of the graduating class, both times with reluctance and under protest.
My work as teacher in the college and as physician in the medical department has not been performed with that ease which is the result of a mutual understanding of all engaged in the same purpose, nor has it given me satisfaction.
Not one of my expectations for a thorough medical education for women has been realized; indeed, I could not even do what has been in my power heretofore, namely, discountenance as physicians those women who do not deserve that name. On the contrary, I am obliged by the resolve of the majority to put my name to diplomas which justify the holders in presenting themselves to the community as fitted to practice.
If it were the intention of the trustees to supply the country with underbred, ill-educated women under the name of physicians in order to force the regular schools of medicine to open their doors for the few fitted to study, so as to bring an end to an institution from which are poured forth indiscriminately “Doctors of Medicine,” I think the New England Female Medical College is on the right track.
Allow me to say a few words about the school in justification of this. To a critical observer, it will soon become apparent that the majority of the class of students could be made to be only good nurses; whilst some might become respectable midwives; and a very few, physicians. Yet we have to give the diploma of “Doctor of Medicine” to all, after they have passed the legal time in study.
After the first year of my work here had expired, I hoped to effect a change by remonstrating in the faculty meeting against the admission of all sorts of women, old and young, with and without common sense, and the distribution of diplomas to them all.
But I found very little support, and I was told that it would be hard to disappoint some women who had perseveringly labored for a diploma. According to my ideas, which agree, I know, with the ideas of the profession generally, perseverance alone does not entitle persons to receive a diploma. Even should a disappointment prove to be a deathblow to the student, it is better that one should die rather than receive permission to kill many.
It will be perceived by you that these circumstances are not such as to make success possible, and consequently they cannot make me contented in my position. I therefore ask you to accept my resignation as soon as the time expires for which I agreed to remain.
Knowing well how difficult it is to find a suitable professor for a college for women, I thought it well to inform you of my intention a full year in advance. Yet should you find a desirable person to fill my place before that time, I wish you to remember that I shall be thankful to be released from duties which are burdensome and unsatisfactory in result.
I hope that you will not consider this an impulsive or rash step, and in order to convince you of the deliberation with which I have made this decision, and my firm determination not to alter it, I hope that you will allow me an opportunity to state to you personally, more fully, my views of the condition of the school under your patronage.
Respectfully,
Marie E. Zakrzewska
Mr. Sewall gave me this opportunity, especially because as a lawyer he wished to explain to me that this letter could not be presented to the directors and trustees of the college, as it suggested many points which would necessarily lead to legal investigations and which would involve us all in a notoriety absolutely fatal to the whole cause.
Yet I felt that no malicious intent was in me to injure the school or any one. I simply expressed my opinion and the opinion of professional men outside the college, who would not countenance the school nor assist me personally so long as my connection with it lasted.
But in consequence of Mr. Sewall’s opinion, I resigned at the end of the college term without giving any other reason than that I felt not contented in my position.
This led to many meetings of the trustees as a number of them were anxious to retain my services, especially as the hospital department depended so largely upon my superintendence. On the other hand, a number, under the leadership of the secretary, Samuel Gregory (who had already pronounced against such innovations as microscope, thermometer, test tubes, etc., as proof of incapacity to recognize the ailments of patients), tried to convince the others that “foreigners” are not fit for American institutions, as they invariably are pedants and too rude to treat the free American woman with that courtesy to which she is accustomed.
Mr. Gregory brought proof of this declaration by calling before the meetings several of the women students who were opposed to me because I had frankly told them that they might in time become good nurses.
He also tried to convince the directors, who were in great financial straits, that the school had existed for ten years without such an expensive experiment as a hospital department, and that, by my leaving, this would be discontinued as a matter of course.
Thus my resignation was finally accepted, with the request that I relinquish my last year’s salary of three hundred dollars, as the treasury was empty. I therefore became a benefactor to the college for that sum, though the treasurer did not acknowledge it in his report.
Besides this, an agreement was entered into between the college directors and my friends (who now more than ever wished to establish a hospital for women, managed by women physicians, and for the training of women as physicians and nurses) that all the furniture and fittings of the hospital department of the New England Female Medical College should become the property of these friends of mine for the sum of one hundred and fifty dollars.
[The Annual Reports of the New England Female Medical College during Dr. Zakrzewska’s connection with it, from September, 1860, to September, 1862, show total expenses for the Clinical Department of $5,362.97, and total receipts for the same department of $5,024.13, making a total deficit of $338.84. But it must be remembered that Dr. Zakrzewska’s connection with the department ended six months before the date of the last report.
Dr. Zakrzewska’s forced “donation” of her salary for her third and last year, of three hundred dollars, brought the deficit down to $38.84; and the receipt of one hundred and fifty dollars from her friends as purchase price of the furniture left a net profit in the hands of the college of $111.16.
The last Annual Report contains not only the interesting omission of acknowledgment of Dr. Zakrzewska’s donation of her three hundred dollars salary, but also the interesting acknowledgment of “donations” of one hundred dollars each from the two men professors who retired from the faculty at the same time.]
The whole occurrence brought about a split in the college and the most intelligent men, among whom was the Hon. S. E. Sewall and some of the men professors, also resigned. This was the beginning of the end of the college which, in 1874, was merged into the Boston University Medical College by an act of legislation which preserved to women as full rights as students as if they were in a college by themselves.
Thus it came about that Boston had a medical school for both sexes, though this then became a homeopathic school.
Dr. James R. Chadwick, in an article (“The Study and Practice of Medicine by Women”), in the International Review, October, 1879, states that
“in 1874, while the proposition to transfer the New England Female Medical College to Harvard University was under consideration by that corporation, the trustees suddenly merged the college in the School of Medicine of Boston University, which is under the exclusive control of homeopaths.”
And he adds the following comment:
While this act may have involved no betrayal of trust in a legal sense on the part of the trustees, it certainly was an indefensible breach of trust toward those who had contributed funds to enable women to obtain a medical education in accordance with the tenets of the regular school.
During the three years of my life in Boston, from June, 1859, to 1862, it was necessary to educate the laity to consider a woman doctor a necessity in family life; to teach it that a woman can have the endurance and fortitude of body and mind to meet the demands of the profession, night or day, winter or summer, rain or shine. Also, to get the profession accustomed to the thought that women will study and practice medicine honorably and systematically. The attainment of these ends was the real satisfaction of these first years.
Fortunately, the eyes of the laity were fully upon us and criticism was not wanting. With watchful eagerness to grasp at the least mistake or failure, this kind public kept us at the work.