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

by Marie E. Zakrzewska

CHAPTER XXXIII

Dr. Zakrzewska and the other pioneer medical women find a new foe in an increasing number of medical women who are poorly educated and otherwise unfitted—She addresses the New England Women’s Club on the “Medical Education of Women”—Unsuccessful attempt to persuade the New York medical colleges for men to accept scholarships for properly prepared women—Opening of the Woman’s Medical College of the New York Infirmary—Further movement to open for women one of the great medical colleges for men—Dr. Zakrzewska’s comment on this proposition, with special reference to Harvard—The New England Hospital Medical Society—Action taken by Harvard University in 1879 on the question of admitting women students of medicine. (1865-1880.)

The pioneer medical women (Drs. Elizabeth Blackwell, Marie E. Zakrzewska, Emily Blackwell, and Ann Preston) to whose successful struggles are due, for the first time in the history of the world, the real opening of the profession of medicine to women equally with men, had no sooner begun to take breath after their first stupendous battle, than they found themselves confronted with a new foe.

This foe was within the ranks of their own sex, and its development threatened an undermining campaign which seemed almost more disheartening than the militant one from which they had just emerged. This new foe was the increasing number of women doctors, poorly educated and otherwise unfitted, who began to appear all over the country.

Because the evil was so insidious and was cloaked by the necessity and the desire for competent medical women which had been demonstrated and aroused throughout the country, it was most difficult to meet.

The Philadelphia women met it by striving even harder to bring up the standard of the Woman’s Medical College and to expand the field of the Woman’s Hospital.

The more eastern women, meaning those of New York and Boston at the New York Infirmary and the New England Hospital, met it by trying to establish a standard and by trying to educate both the profession and the laity to accept nothing lower than such a standard.

To these women, the simplest as well as the wisest procedure seemed to be an attempt to persuade some of the best of the already existing medical colleges to accept a number of properly prepared women students.

To this end, it was proposed to inform the community at large of the situation (the subject being really as vital to the laity as to the profession, since doctors can practice only through patients), and to collect a large sum of money which might serve to endow a number of scholarships for women in some of the leading medical colleges of the country.

As early as 1865, a fund of fifty thousand dollars had been collected for this purpose, but all the colleges refused to accept women as students, even under such auspices. As the situation was particularly pressing in New York, the Drs. Blackwell were then so urged to take the next best step (the best having proved to be beyond their power) that they consented to add a college to their Hospital. And thus, in 1868, was opened the Woman’s Medical College of the New York Infirmary.

This college set a standard which was never surpassed by any of the colleges for men. But one small college insisting on a high standard could not compete numerically with rivals offering apparently equally desirable advantages and with standards easier of attainment. So the campaign continued!

In 1877, Dr. Zakrzewska being invited to address a body of leading nonmedical women (the New England Women’s Club), brought this problem to them for conference. She said in part:

At first the study of medicine appealed only to earnest women who felt a decided calling in that direction and who really thought to benefit their sex by acquiring information which would serve others through their advice. Very few, if any, of these first women combined with this idea that of vindicating their rights as Women.

It was no easy matter at that time to become a doctor of medicine. The great obstacle, want of schools, sifted out the weaker elements; and those who succeeded in obtaining teachers and in being admitted into the colleges then open to women were, as you will conceive, possessed of unusual perseverance and firmness of purpose.

But soon there appeared among the candidates for medical honors another purpose, the desire to gain these honors through simple study during a prescribed course without any laborious work.

The first suggestion of this came through some men physicians who, becoming alarmed at the movement and perhaps conscious of their own mediocrity, felt instinctively that there was danger of their being overshadowed by women, who are by nature sympathetic and more caretaking in sickness.

These raised the cry of “competition.” Many women believed the cry was caused by alarm at a real danger, that of the women making money of which the men desired to retain a monopoly, and they imagined that a new field especially adapted to their sex was opened—one in which, with a short course of technical study, they could more easily and rapidly than in other vocations open to them acquire a name and abundant means of support, if not a fortune.

The laity then awoke to this movement, and that portion of them whose head and heart were interested in the “rights” of women began to establish schools and colleges for the purpose of educating women physicians. And in a short time such institutions sprang up in several cities.

After years of struggle and gradual improvement, the Philadelphia medical school for women (Woman’s Medical College of Pennsylvania) has acquired deserved value when judged by the standard of men’s schools.

And the Drs. Blackwell were later compelled to open a medical school in connection with the Infirmary (Woman’s Medical College of the New York Infirmary), in order to stem the flood of inferior physicians which was pouring forth, especially in New York, from schools which were far below mediocrity.

Thus to-day, of all the institutions open to women for medical study, only these two and the University of Michigan even try to reach the standard of medical education necessary to compare favorably with that of the men.

I say, try to reach that standard. By this, I do not wish to imply that the teachers and professors in these schools are always less capable than those in the male schools. No, the fault is in the students themselves, and so it will be for some time to come. Here, allow me to state why this is so and has been so for many years.

As I have said before, in the beginning of this movement women who persisted in the study needed uncommon perseverance and firmness of purpose. For the acquisition of these qualities, a certain amount of educational training and concentration of thought and will were requisite.

At present, such uncommon perseverance and determination are not so indispensable. It is now very easy to become a physician. If the higher and better medical schools will not admit women, the lower and the less strict are willing to do so. Socially, the woman doctor is respected and in some circles even lionized and ranked far above the teacher; therefore, two great obstacles are removed.

All that a young woman needs is the permission of her parents and the means of support while studying. Both of these are now more easily attained, since her social position is likely to improve rather than to decline as it formerly did.

Also, the number of schools and colleges has increased and they require a certain number of students in order to exist. Hence arises a rivalry among these institutions, and instead of elevating their standard to make good women physicians some lower it in order to fill their classes.

The effect of this sort of education is that the country is rapidly being swarmed with women physicians of very doubtful ability as regards either preparatory or medical education.

At the same time, the need for well-educated women physicians becomes the more pressing, as is manifested by the ready employment they all find, though there is no chance for discrimination between the real and the sham article denoted by the sign “Doctor.”

Hence, in many places the movement is beginning to be again viewed with distrust by communities which have again and again been disappointed when hoping to find scientific education and practical talent among the women practitioners who were offering their services to the public.

In a word, the so hopefully sown good seeds are in danger of being suffocated by the still more thickly sown weeds.

It is against this danger that I feel I must warn you. And I wish to call upon every educated woman within my reach to aid in destroying this evil.

Every individual can assist in this great reform; first, by trying to get clear ideas on the subject in order to discriminate and to judge; and then, to assist in every possible way those who are striving to elevate the educational and moral standards in medicine.

Some highly educated physicians have said to me, “We see no reason why a woman should not study medicine. If she can become wiser and her practice better, then we must have her, for our aim is the better; if she cannot do this or cannot even do as well as men, she will work her own destruction in her endeavors.”

Women should be willing to accept this or any other just test, but in order that the experiment shall be a fair one, they must have preparation and education and subsequent opportunity, equal to those given to the men.

The continued refusal of the larger medical colleges to admit women, under endowed scholarships or in any other way, led to the development of a more ambitious plan, this being the idea of purchasing direct partnership rights for women in one of these colleges.

But this required the raising of a much larger amount of money. In this direction there was made in 1880, a tentative proposition which involved the formation of a central organization with State branches, for the purpose of collecting such large fund and then arranging for its wise use.

The statement was made:

All sectional jealousy must be laid aside. Neither Boston, nor New York, nor Philadelphia must insist upon being the seat of the medical school. If Harvard would accept our conditions, it might possibly present certain guaranties which would give it a first claim in spite of the greater clinical advantages of the larger cities. But the College of Physicians and Surgeons in New York, and the University of Pennsylvania and the Jefferson Medical College in Philadelphia, must also be considered.

In making the large united effort which seems desirable in order to take an advance step in the education of American medical women, we must secure that great impersonal enthusiasm for a cause which shall be far above purely sectional pride.

When this proposition was submitted to Dr. Zakrzewska for consideration, she replied as follows:

In order to answer your letter of July 27 carefully, I must dictate it because an affliction of my eyes prevents me from writing myself. My health is pretty good, and the very best of oculists declare my eyes to be good, still the least use of them for reading or writing gives me so much pain that it prevents sleep and unfits me for thinking business.

The proposed crusade against the mediocre medical colleges has been recognized as necessary, not only by myself but by all the physicians connected with the New England Hospital. Perhaps the fact that we are working independently of all colleges has given us a more impartial opinion in regard to these schools. We have, I think, the best chance to judge of the results which these schools produce because we receive the young graduates for the practical training.

Perhaps you will remember that I wrote you four or five years ago how discouraged I felt about the manner in which the different female medical colleges educated and inspired their students and how derogatory the result was to the whole movement.

... The proposition to raise one hundred thousand dollars for the purpose of securing admission into a male college could be carried out quite easily, comparatively speaking. In Massachusetts alone, it could be done if Harvard would consent to add a small class of women to its medical department. The fact is that when a few years ago the New England Female Medical College here in Boston was broken up, there came unofficially from some one in authority in Harvard the proposition to take it, provided the public would endow it with one hundred thousand dollars.

In such case, the female students would be educated in their own building which was two miles from the building for men. However, the examinations of the women students for entrance into the college were to be the same as those for the men, and the instruction was to be given by the same professors—in fact, Harvard Medical College repeated for the benefit of women alone.

I did not favor such an arrangement but actually discouraged it, because it seemed to me disastrous to the whole spirit of woman’s work in the profession.

I feared that after trial professors of acknowledged rank might declare that teaching six or twelve women was not satisfactory, although it might recompense them financially, and that therefore they would either give it up entirely or leave the instruction to the younger teachers.

I could not advocate a school exposed to such a risk because if the instructors of Harvard Medical College should become more prominent in the woman’s branch while the professors took the lead in the men’s branch, it would give both the students and the public the impression that the women were of secondary importance.

Another attempt to open Harvard to women has been made within a year or two by a lady who proposed to give ten thousand dollars towards a fund which would pay for a class of women in the medical department.

Many discussions concerning this proposition came up in the different meetings which were held in consequence of this offer. The result was always the same, namely, divided opinions—entirely against the admission of women at all; against their admission with men; and against the formation of a small class of women alone.

The only encouraging part of the discussion was that those who were entirely opposed to women’s studying were a very small minority, while those against coeducation were less firm in their opposition. Besides, I am perfectly sure that if the younger men who now hold positions as instructors at the College could cast their votes and could influence the Directors’ decisions, there would be more chance for the admission of women.

The New England Female Medical College was absorbed into the Boston University Medical Department, an inferior school and a homeopathic one, which has no other merit than that it admits men and women on equal terms to all its advantages; therefore, it does not injure the movement for women any more than it does the profession at large.

Our Hospital does as good a work as any hospital carried on by medical men. We have now two good women surgeons, and all kinds of operations are performed as a matter of course, without being considered extraordinary occurrences, as was formerly the case.

I can safely say that the Hospital work, which we enlarge as fast as our means will permit, has become a power throughout the country, and the Hospital in all its appointments is more or less acknowledged as the most complete of any under the control of women physicians.

This is as good a picture of the situation here in Boston as I am able to give you. If we had gained admission into the Massachusetts Medical Society, we would stand on equal footing with the best part of the profession.

In some of the smaller towns of Massachusetts, young women physicians have been admitted into the county societies, and these being a part of the Massachusetts Medical Society have thus opened a discussion which will eventually lead to the admission of women into the parent society, which is another step towards getting admission into Harvard Medical Department.

On October 1, Dr. Smith who was graduated in Zurich will take the position of resident physician with us, and we shall try to persuade other educated women to study in Zurich so that we can fill this post with such graduates and thus overcome little by little the opposition to coeducation.

Can you not see from these statements that the raising of money alone will not suffice to bring about the equally good education of women and men? To be sure, if I had a sum large enough to endow a medical college, I could bring about coeducation and thorough scientific study by getting men of the best talent from both Europe and America, but one hundred thousand dollars would be only a drop in the bucket towards such an enterprise.

Meanwhile, we have another bright prospect in the admission of women to the University of Michigan, at Ann Arbor. Although the medical students are not in the same classrooms, yet the lectures and the opportunities for women are precisely the same as those for men.

The lectures are given in separate lecture rooms, except in chemistry. The students of both sexes work together in the laboratory and are present at most of the clinics. The work in the dissecting-rooms is quite separate, and occasionally the women are not present at some special operations.

The movement for educating women as physicians has become so widespread that I think it impossible to work for the elevation of the standard of their medical education in any other way than by having the leading women of each state keep in view as their final aim the opening on the basis of coeducation of the best medical colleges.

The number of persons now interested in the whole movement is so great and the labor to raise money to maintain the institutions, even such as they are, has required so much nerve and strength that even to hint at their abolition or their absorption in male colleges might have a detrimental effect in dispiriting the public who, taken as a whole, are not yet settled on the question of coeducation.

The American people, both men and women, have to work out the different problems of advancing their interests without having them favored or opposed by a fixed social class whose prerogative it is to exercise a controlling influence on any standard set up.

The medical education of women must now take its chance for growth like all the other questions of woman’s rights, yes, even of men’s rights, politically speaking. We are, with all the rest, passing through the phase of crystallization, and only the merit or the capacity of the individual can act to bring about a good and lasting effect.

We must grow at present by every one of us doing her utmost best from day to day; and if the principle is a correct one that it is within women to exercise their faculties according to their inclinations the same as men do, it cannot be overthrown. I do not want to give you the impression that I wish to be pessimistically indolent; on the contrary, I want you to understand that I include in that “utmost best” criticism as well as denunciation of the imperfect or mediocre and readiness for any crusade for the better, for the higher, and for the perfect ideal.

The physicians connected with our Hospital have formed a Society,[20] and have framed a constitution which admits to membership both men and women. So far we have only women members, and there are only a very few in the society who are not connected with the Hospital, because we mean to be as careful and as stringent as possible.

I wish I could visit you this winter and talk all these matters over, as I really need a rest of a year, not because I am sick but because I feel that I may be, as the strain upon my nerve power has been so intense for thirty years that relaxation is needed if I want to end my life in usefulness.

For the present, I cannot do anything more than to plan for such a recreation, but when the moment comes to carry out this plan, I shall write to you in order to make arrangements for us to meet in a way which will give us time and comfort.

The ten thousand dollars referred to in the above letter was offered in 1878 by Miss Marian Hovey toward the new building which Harvard was about to erect, she making the condition that women should be admitted as students.

According to Dr. Chadwick, the Corporation referred the communication to the Board of Overseers who in turn referred it to a committee consisting of President Eliot, Alexander Agassiz, Dr. Morrill Wyman, J. Elliot Cabot and Dr. LeBaron Russell. In 1879, majority and minority reports were presented, the latter by Dr. Russell alone.

The majority report recommended acceptance of the trust offered by Miss Hovey, and presented an outline of conditions which were thought to be desirable to govern the admission of women students.

It further stated that of twenty-one members of the Medical Faculty who expressed their views in writing, six were in favor, with restrictions; three were in favor of making the experiment but had strong doubts of its expediency or success; five were opposed, but were willing to try the experiment under certain conditions; seven were strongly opposed. Thus, fourteen were at least willing to try the experiment conditionally, while seven were unconditionally opposed.

The minority report opposed acceptance of the trust and advised that the medical women should establish their own school, modeling it upon the Harvard school.

A vote of the Board of Overseers was immediately taken upon the adoption of the majority report, the vote standing seven to nine. It was then voted to reconsider the motion two weeks later.

Meantime, a meeting of the Medical Faculty was held and the admission of women was negatived in two resolutions, one by a vote of thirteen to five and one of fourteen to four.

Following this action of the Medical Faculty, the Board of Overseers at their next meeting voted (17 to 7):

That the Board of Overseers find themselves unable to advise the President and Fellows to accept the generous proposal of Miss Hovey.

It then voted (16 to 10) for the following motion which was proposed by the President:

That in the opinion of the Board of Overseers it is expedient that, under suitable restrictions, women be instructed by Harvard University in its Medical School.