CHAPTER XXXVI
Twenty-fifth anniversary of the New England Hospital—Drs. Zakrzewska, Sewall and Morton resign as attending physicians and are appointed advisory physicians—Presentation to the Hospital of portrait of Dr. Zakrzewska painted by Miss Ellen E. Hale—Address by Dr. Zakrzewska before the Moral Education Association—Her reply to the question “Should Women Study Medicine?”—Her opinion on “What’s in a Name?” (1887-1890.)
In 1887, the Hospital celebrated its twenty-fifth anniversary, a pleasant feature of the event being the presentation to the Hospital by the graduates and internes of the portrait of Dr. Zakrzewska. This was painted by Miss Ellen E. Hale and was placed in the directors’ parlor. The occasion was also marked by the resignation of all three of the attending physicians, Drs. Zakrzewska, Sewall, and Morton. So many qualified women were becoming available for hospital service and were asking for opportunities, that these three women who had borne the burden and heat of the earlier years felt they could now stand aside and make room for their younger sisters.
Their resignations were accepted and they were immediately appointed advisory physicians, thus remaining in a position where their knowledge and skill continued to be available to the Hospital and to their successors, those immediately following them being Dr. Emma L. Call[21] and the Drs. Augusta and Emily Pope.[22]
The additional time thus available to Dr. Zakrzewska gave her greater opportunity to respond to the many demands upon her for public speaking and writing.
An address delivered before the “Moral Education Association of Massachusetts” about this date is so timely, and so pertinent to the problems which still beset us to-day, that it is here inserted:
The question is often asked me by persons not attending these meetings, What is this Moral Education Association? and What does it intend to accomplish?
When I reply, I always construct my explanation as I myself comprehend the motives of this Association and the purposes toward which we intend to work.
I am naturally an optimist. I fully believe that the world—by which I mean the human beings on this mighty planet—is constantly improving; that we, as a people of to-day, are progressing; and that we have reached a condition of physical, mental and moral improvement such as has never before been attained by the inhabitants of this globe. Yet I feel that we are far from being what we might become if each one of us would carry out fully, all the time, daily and hourly, the precepts of the Golden Rule.
In order to attain such a state of perfection, workers are constantly needed who, with deeper insight or stronger convictions or warmer hearts, shall lift the banner high over all our heads, and thus summon followers from all directions.
Now I call this Moral Education Association such a banner.
During the thirteenth century, after the knights of Middle and Western Europe returned from their crusading expeditions in the Holy Land and settled again in their homes, they formed an association, the chief object of which was to raise the “standard of honor.” A spoken word was an inviolable contract; an ignoble deed, however slight, was considered so dishonorable as to relegate the perpetrator from the order of knighthood.
To many, it may seem to have been an unmeaning pastime, this cultivation by these men of an ideal honor in themselves and in others. Yet this movement ushered in a grand era of poetry, both lyric and dramatic, of chivalry, and of learning. It formed the nucleus of right in many directions and created a new code of morals.
In this same sense, and applying it to the elevation of the honor of woman, I joined this Association because I know that it is a good field in which women can work by helping to create a code of morals befitting our enlightened age, a code which shall govern our relations to all mankind, to our children, to each other as women, and to the State.
The increase of wealth and the increase of an intelligent population producing more and more wealth—this is the bright side of our progressive age. But there is also the dark side of the picture—the increase of luxury and its twin brother, sensuality.
In nature, as a rule, it is the female who nurses the young into maturity; in this case, it is the female who must stifle these twin brothers while they are yet in their infancy, so that they may never reach their dangerous maturity.
Luxury carried beyond a reasonable degree of comfort vitiates human strength and thus enervates both body and mind; then temporary stimulation and relief are sought in the excitements of sensuality. By sensuality, I understand all indulgences which carry to excess the natural physical appetites. Man, with his greater physical force, is the aggressive element in this strife for gratification, and woman with her slighter physique, the passive.
If we first make these points clear to ourselves, it will be easy to make them clear to others and to show to every woman the necessity of being on the defensive against these twin brothers, Luxury and Sensuality. All history teaches us that they have been the destroyers of nations in ancient times. Let us not deem that we are proof against their omnipotence. The defensive weapon can be none other than a code of morals as high and as idealistic as our present state of education and development will produce.
Further, this code ought to be in accordance with the political form of life in our country. We cannot afford to imitate any other people, any other nation. The women of this continent, and especially of the United States, enjoy a place in social life such as no women of any nation ever held before, or hold now. They can have all the power they want if they will simply take it, and if they will make themselves equal to all the responsibilities such a power involves.
Especially do I wish to speak of a danger to be avoided. We need to create and to foster among women a realizing sense that we are all alike and that the worst women belong to us as much as do the best. We cannot feel proud of the virtues and talents of one woman without feeling an equal degree of shame at the vices and the degradation of another.
There is no third sex; and we must see to it that this feeling—I cannot call it an opinion—that there exists a class of animal women, shall never take root in this country. In order to effect this, we must create a code of morals in accordance with our free institutions. Never should we look across the ocean for a guiding rod. Nowhere has woman been so poetized and so idealized, nowhere have music and the plastic arts so celebrated her as on the continent of Europe—yet everywhere there woman can be bought! She is legalized merchandise, and is inspected as such for the purpose of purchase, which is prostitution.
Among the nobility and the aristocracy the men hold it below their dignity and honor to be traders or even merchants because they consider that all commercial enterprise tends to make men mercenary, so lowering their character. Yet these same men do not hesitate to purchase women; while the aristocratic and noble lady thinks it right and just that there should be a special class of women for this purpose.
This is no exaggerated statement; it is a fact that women of education and of high standing speak of a certain class of women as if there were a third sex—a creature resembling woman in all outward appearance but sterile in propagation, sterile in morals, and sterile in intellectual capacity, a slave to men, and a creature of contempt in the eyes of women.
The word by which these women are designated when spoken of is “creature.” In Europe, in common conversation and in everyday literature, this word “creature” has become a legitimatized designation for prostitutes. It is therefore deplorable to hear women in their superior position as employers speak thoughtlessly of honest, virtuous women—their nurses, seamstresses, servants and the like—as “these creatures.”
I say, therefore, that one of the laws of our moral code should be, “Respect the woman in every woman.”
This respect for all womankind leads us to consider next the moral relations to children. The highest ideal code cannot be too high here, and example should take precedence of teaching.
I would advise a whole code, explanatory of modesty, purity, chastity, truthfulness, obedience, self-denial, and self-control, clearly to be comprehended and strictly to be practiced by every woman—married and unmarried, mothers and grandmothers—so that example shall teach the virtues to the boy as well as to the girl.
Moral precepts and admonitions, repeated daily in words are listened to with indifference; but from a living example are drawn good draughts of healthful moral strength. For instance, speak before a boy, no matter how small (in fact, the smaller the more dangerous), with contempt of a woman, and you may be sure the seed of contempt toward all womanhood is sown and will grow and mature and bear fruit for another generation. The same is true if, in the hearing of girls, contempt for men is expressed; yet here the effect is less bad for, as I said before, the girl is the passive, not the aggressive, element in nature.
Next, we need a moral code in relation to men. Here, the first principle should be, what is wrong in woman is wrong in man. There is no special right for the man. Although we cannot demonstrate an absolute Right, yet the Golden Rule will always serve as a test where there is doubt. Men are born as pure and innocent and good as women. We develop qualities in them from a false conception of the aggressive impulses inherent in the masculine constitution. This is the point which we must bear in mind—man is not willfully nor intentionally vicious; but we allow him to practice a pernicious code of morals from early childhood, when we begin to say, “Oh, a boy will be a boy.”
Of course, we want a man to be a man, but we also want a woman to be a woman. And we cannot make any advance toward the standard of a true man and a true woman if we give one set of morals to the man and another to the woman. Our constitution should be alike for both sexes, although from natural causes some of the by-laws must differ. This is the only way by which we can establish such relations of men to women and of women to men as shall be honorable to both and elevating to mankind in general.
Let us now consider the last but not the least point in our code of morals, that which concerns our relation to the State. This is, of course, the broadest and the most comprehensive theme with which moral education has to deal. Here again we shall see that we have our own code to make. For by “State” we mean in this country a different thing from that which Europe so designates. We do not mean a government given to a people by an aristocracy established centuries ago. We must learn to understand that when we speak of “the State,” we mean the voluntary association of a free people which governs itself through and by the individual exercise of both intellectual and physical powers. Hence, there arises at once the need of a full comprehension of our duties as members of such a State.
These duties are of two kinds—the duty of the normally endowed members (those having moderate or superior physical and mental qualities) toward each other; and, secondly, the duty of this fortunate class toward the less favored—the weak, the feeble in mind or in body and the crippled—those born or later afflicted with less capacity to take up the struggle for existence. We have all seen how the man born rich may become poor; and on the other hand, how the child born a pauper may yet lift himself to the position of the millionaire or to the highest office.
Here, then, lies our duty. Especially must we women educate ourselves and the young in regard to our relations to all humanity—particularly to the suffering, to the frail, and to the poor near our own doors. We have to create a code of morals strong enough to be just toward all the unfortunate—men, women and children; yet it must be free from that sentimentalism which cannot discriminate between an honest poor person and a criminal. On this point, endless illustrations could be given to show our lack of moral education. How difficult it is to preserve the righteous balance without being harsh to the criminal, the drunkard and the female vagrant! We have this great lesson to learn—that the poorest, the lowest, even the most degraded, when honestly striving to keep out of the almshouse or the prison, stands far higher in the scale of humanity than the reformed or the reforming prisoner; and that justice ought first to be done toward these poor degraded ones before sentimental charity is bestowed upon the criminal.
For here comes another part of this code as regards the State. What is charity? What is benevolence? What is the best way for their application? What is justice?
I would advise that all the members of this Moral Education Association, and nonmembers too, form classes where these subjects may be discussed, not simply where morality is preached to the moral, but where we enlighten ourselves by an interchange of opinion and by faithful investigation of moral questions. We need to know what is the real moral requirement in our peculiar state of American society.
We are a State which has not been produced by propagation of one and the same race, so we have thus formed a nation with its own peculiar characteristics. We are an aggregate in a free country of many races and of many nations, a country where it is possible for the slave to step at once into self-sovereignty, or for the pauper from any foreign race to rise in a few years to the position of a well-to-do trader or merchant or artist, according to the intellectual capacity which he possesses. On the other hand, even with us these people may go down and form the center of a proletarianism unless they are prevented by education both of the intellect and of the morals.
A similar opportuneness characterizes her answer to the question which continues to be asked to-day as it has been asked down the ages:
Should Women Study Medicine?
So many women, both young and of mature age, appeal to me for information concerning the profession of medicine that I have thought it desirable to express my opinion thus publicly. The principal points inquired about are How to study medicine? and What are the prospects in practice?
There are so many medical schools now open to women, both in the East and in the West, that the selection of one for the purpose of study need depend only upon individual convenience and the pecuniary resources of the student. A student needs to have means for her support during three full years of college life and, if possible, for an additional year’s residence in some hospital before entering upon practice.
Next comes the question, What can she expect in practice? Many young women enter the profession because it seems to them a lucrative business. Yet for a young person to choose this path in life because she thinks it leads invariably to success—by which she means a plentiful purse—is a mistake.
Success in the practice of medicine may coexist with small pecuniary gains; the money gain should be incidental, not primary, in the thought of the physician. A well-educated physician, who has passed through the regular course of study and who conscientiously works within the legitimate sphere of her knowledge, must allow about ten years of indefatigable labor before her practice brings a competency worthy the name of independence, by which I mean a comfortable living free from the anxieties of petty economies and allowing occasional relaxations from duty. Many a young woman has gone out of my office excited and indignant because I have expressed doubt that the medical profession would be the best career for her to choose, and her final exclamation as she left me is very significant, “You have been successful; why should not I be so?”
This “why not” is just the hard point to explain. On April 5, 1888, it was just thirty-six years since I began to seek practice. Young (twenty-two and one-half years old), full of enthusiasm and self-reliance, willing to work, ready for self-abnegation in every direction, I felt sure that I should succeed in life, but this success never presented itself before my mind in the shape of a plentiful purse.
Besides the moral qualities I have mentioned, I started with another great advantage, namely, a good physical constitution. In no profession is sound steady health so requisite as in the medical, for the practitioner must be ready night and day, and at the beck and call of patients—whether paying or charity. Thus this profession demands a body free from annoyances of all kinds and a clear, sound head, to enable one to be decisive in judgment, firm in advice, and kind in sympathy.
Another step in the ladder of success is a good business training from early youth. By this I mean correctness in listening to every word spoken, accuracy of observation, and logical deduction. Every faculty must be, as it were, on the alert and yet kept under the control of judgment.
Yet there may be sound health, good education, and carefully trained faculties, and still a something lacking for success in life as physician. I call it a power of adaptation to the various temperaments and conditions of humanity; a moral courage; an ability to step forward and seek opportunities for practice; a kind of self-confidence and fearlessness in entering every class of life.
Thus equipped, and backed by friends or pecuniary means to sustain the respectability of the beginner during the first few years of her attempts to seek practice, a young woman has still to overcome prejudices and obstacles which are not easily described, for they are of an intangible nature, relating sometimes to personal appearance and oftener to that indefinable quality—tact.
Yet notwithstanding all these difficulties, it is far easier to-day for a woman to establish herself as physician than it was thirty years ago. The annoyance and tribulations which we pioneers had to endure were far greater than the natural ones which have always to be overcome. For women physicians were then looked upon not only as intruders upon the field hitherto occupied by men alone, but also as disreputable persons and they were constantly confounded with the women who, prefixing “Dr.” to their names, carried on a foul and illegal practice.
So great was the prejudice against the first women physicians that friends and acquaintances hesitated to invite them into their social circles. Yet in spite of this hostility, I was inclined to encourage other women to study medicine; for, inexperienced like all young people and more enthusiastic than most, I imagined that every one who expressed a desire for some active work was as willing and as well prepared to undergo hardships and privations as I myself was. Years have made me wiser and, consequently, more cautious in advising these young seekers.
Every physician, man or woman, who has acquired prominence through ability, finds himself or herself placed in the position of adviser to youth. No one claims infallibility in judgment; great talent is not always recognizable to the wisest counselor; but the duty is the same for all—a conscientious statement of what the medical profession demands. Its difficulties and the various obstacles should be stated clearly to the young man or woman who is so often dazzled by the brilliant success of the few, forgetting the many who are plodding along in economical, modest paths or have retired entirely, and who are therefore unknown.
Yet while I have thus shown the darker side, I can see that the study of medicine is full of opportunities for women, and that there are so many ways of becoming useful, if not as practitioners then as teachers and resident physicians in female schools and colleges, that no truly talented woman need fear want of success in some branch of the profession.—The Woman’s Journal, June 23, 1888.
Less weighty but not less serious, and again as though a response to another question which is agitating us to-day, is the following article reprinted from The Woman’s Journal of April 5, 1890:
What’s in a Name?
It may be true that “a rose by any other name would smell as sweet.” But even Shakespeare does not convince us that a Montague would not still be a Montague though called by another name. No, the name becomes a part of the individuality. A name has two distinct qualities—the lighter, social and emotional; and the graver, legal and representative. Pet names denote affection and are usually applied to infants as expressive of their helplessness or diminutiveness in contrast to our superiority to their small persons. The continued use of these pet names when their bearers fill active and responsible positions in life, indicates thoughtlessness if not real inferiority of intellect.
To explain my meaning fully, I will illustrate from my own experience both conditions—the social and the legal value of names. Quite recently I was asked whether I knew a Dr. Carrie S——, of ——town, whom the inquirer wished to consult on arriving there. Instinctively I replied that I should not care to know a “Dr. Carrie” or “Hattie” or “Maggie,” etc., and I certainly would not ask the advice of any physician who had not more sense than to advertise herself by sign or word as a diminutive person. How can a woman think deeply on any subject who has not brains enough to object to such pet names?
A short time ago, a friend who was visiting me handed me two letters to be posted. One was addressed “Mr. C. Albert ——” and the other, “Miss Nellie ——.” Glancing at the addresses, I remarked, “I thought your son’s name was Bert as I have always heard him called so, and why has your sister changed her name from Ellen?” This sister was then forty years old and had been teacher to her sister’s sons who lived in the country where there was a lack of schools suitable to prepare lads for the Latin school. Yet my friend said in reply to my remark, “No, my son’s name is Albert and we called him Bert or Bertie, but since he entered Harvard College, he has forbidden our using those names, because,” she added, “boys, you know, have more pride than girls. My sister likes to be addressed as Nellie.” Thus the teacher, twenty-two years older than her nephew, was denoted by spoken and written word “a girl” without “pride.” I wish all girls and women would comprehend this fact—that as long as they are pleased with a diminutive name, so long will they be classed in the category of diminutive human beings.
Again, consider the ludicrous side. Here enters a woman twenty years old, six feet tall, addressed as Maggie. Now, must such a woman reach a height of eighteen feet before she attains the dignity of “Margaret”—that is, the name of a full-grown woman?
I once had under my medical care a girl whose face was greatly disfigured by an eruption. She had a dark complexion and dark hair, yet her name was Lily. When a little more than fourteen years old, she came to me, her eyes sparkling with delight. “Oh,” she said, “I have found out that my real name is Lucy; I was called so for an aunt who died last week and who left me one thousand dollars in her will because I am her namesake. I cried for joy, not about the money, but because I have got rid of that horrid name of Lily.” Seeing my astonishment at her excitement, she added, “You do not know how I have suffered from my schoolmates; they nicknamed me Tiger Lily on account of my face, and now, see, Lily was only a pet name; it is not my real name!” Her mind was relieved, she was at ease and happy to assert her dignity by an appropriate name. She soon recovered from the torment of the eruption, and I have no doubt that the mental relief of having a sensible name aided in her recovery. Again, how would a woman with the dignified name of Margaret feel if she read in the newspaper the notice of her marriage with “Tommy” Smith? A certain amount of etiquette is essential in life—it gives weight and dignity to everyday occurrences, and is, as it were, an expression of a sense of social responsibilities.
The second question is the legal and representative quality. To understand the full importance of this, let us recall the fact that throughout the whole civilized globe, it is customary to give to the child the father’s name. It is not necessary to discuss here whether it would be better to change this custom and give to the child the name of both father and mother. The fact is established that the child receives a personal name prefixed to that of the family of which it is the offspring. By this latter name it becomes known, and in the course of years this name becomes a part of the individual, belongs to the character itself, and can no more be got rid of than the blood which flows in the veins and had its origin in the parents. It is a rare thing for a man to admit even the thought of changing his name; if it were Smith, he is and remains Smith, simply denoting his individuality by the prefix A, B, C, or whatever the initial may be. He cannot be addressed by any other name, and he can receipt bills and sign legal papers by no other name without being considered guilty of misrepresentation.
The importance of this individuality of name is nowhere better recognized than in Germany. A girl named at birth Anna Eleanora Miller is and remains Anna Eleanora Miller all her lifetime, no matter whether she marries once or six times in the course of her career. By no other name can she sign a deed or contract; thus only can she bear witness; and she is not summoned by the courts as witness under any other name than that of Anna Eleanora Miller.
If she has a husband, she is addressed in law by her name, Anna Eleanora (or, if she has ten given names, then by all of them) Miller, wife of Brown, or wife of Baron Ketzow, or von Alden. If she becomes a widow and marries again, she is addressed in law (of course not in social intercourse) as Anna Eleanora Miller, widow of Brown, wife of Baron von Ketzow.
To make this clearer, let me illustrate still further by giving the name of a well-known lady who, after she became a widow, studied medicine and now practices dentistry in Berlin, having been dentist to all the children of the Empress Friedrich. Her diploma would be utterly valueless had it been given to her with the name of her first husband; only by her maiden name could she be authorized as a practitioner. Her sign at the door reads, “Dr. Henriette Pagelson, widow of Hirschfeld, wife of Tiburtius,” she having, after a few years of practice, contracted a marriage with Dr. Tiburtius. Thus she is, and remains, Henriette Pagelson, and by this name only is she professionally and legally responsible; this stamps her individuality, and the other names of Mrs. Hirschfeld and Mrs. Tiburtius become merely social and conventional designations.
The question of changing names will and ought to become of grave importance before the law in this country. As we now have women lawyers, it should be their special charge to bring up at once this neglected matter—the question of the legality of diplomas as regards the names thereon—before the legislatures in their respective states.
Let me suppose a case in order to show the gravity of this subject. A young woman who has studied medicine receives a diploma under the name of Anna Elizabeth Brown. In a few years she marries, removes the sign from her door and puts up a new one reading “Dr. A. E. Stone.” Soon after this she has to sign a death certificate, which she does by writing “Anna Elizabeth Stone, M.D.” Such a document has no legal truth in it. Again, suppose the relatives of a patient sue this doctor for malpractice, cannot the lawyer make a good case from the fact that her diploma certifies to the ability of “Anna E. Brown,” and that a “Dr. Stone” does not exist? Does not this create a flaw or an irregularity in the indictment executed by the complainants? Still further, the husband “Stone” dies, and in a year the widow marries McIntosh and again changes sign and signature to “Dr. A. E. McIntosh,” while no diploma, and therefore no such doctor of that name exists, but only the original “Anna Elizabeth Brown, M.D.”
What is thus true in the medical profession is true in commercial pursuits and in all professions. Annoyances also arise in social relations. A short time ago, I was asked if I knew a Dr. Alice Smith of a certain city, she having referred to me for professional recommendation. I at once declared the woman to be a fraud. A few months later, Dr. Alice Smith, having been informed of my not very complimentary appellation, sent me a letter expressive of much injured feeling. In this letter, she gave her maiden name under which she had served as interne in our New England Hospital where we had valued her as one of our best assistants.
Now, if men cannot see the importance of this demand for a settlement of the question of women’s names, I wish that our women lawyers would bring the subject before the legislatures, requesting some decision on the legal qualifications as to names for any professional or business relation of women, whether they are single, married or widowed. If the woman cannot call her name her own and will not drop the diminutive pet name, she does not deserve to be considered a full human being.
Let me be understood—I do not mean to say that in social life a woman should not accept the name of her husband. I do not desire to overturn existing customs, and I think it is far more sensible to be “Mrs. Smith” in common social life than to be “Dr. Brown,” which may be the title on the diploma, but all this could easily be left to personal decision. Princess Louise of England will not be called Marchioness of Lorne. Baroness von Essmarsch prefers to be called Frau Doctor (having married Dr. von Essmarsch), and objects to the title of Princess Mecklenberg to which she is entitled, and by which she is addressed, as aunt of the present Empress of Germany. Here love casts aside all titles; nevertheless, it is only as Princess Mecklenberg that she can legally be addressed, or legally be empowered to sell or to give away even a few feet of land. The only signature valid in law is “Princess Mecklenberg, wife of Dr. von Essmarsch.”
Throughout Europe, the women in all classes cling more closely to their family names than we do. On visiting cards, one commonly sees “Mrs. Brown, née Miller.” If one wishes to be specially respectful, one addresses in the same way, mentioning both names, the envelope which incloses even a friendly letter to a married woman. And, finally, on the gravestone placed above a deceased married woman, the maiden name is always conspicuously inscribed before the married name.