This letter was signed by Drs. Zakrzewska, Emily Blackwell, Lucy E. Sewall, Helen Morton, Mary Putnam-Jacobi, Elizabeth M. Cushier, Alice Bennett, and Eliza M. Mosher—the Woman’s Medical College of Pennsylvania feeling unable to join, but writing:
... While we are in hearty sympathy with the object of your efforts, it seems impracticable at present to offer any active coöperation.
After a delay of several months, the following reply was received from Harvard University:
Treasurer’s Office, Harvard College,
No. 70 Water Street, Boston, May 2, 1882.
Dear Madam:I have the honor to enclose a copy of a vote recently passed by the President and Fellows of Harvard College, in relation to the Medical Education of Women in Harvard University.
Yours very respectfully,
E. W. Hooper, Secy.
Marie E. Zakrzewska, M.D.
(COPY)
At a meeting of the President and Fellows of Harvard College in Boston, April 24, 1882.
Upon the question of accepting the proposal contained in the communication received by this Board on September 26, 1881, from Marie E. Zakrzewska, M.D., and others, in relation to the medical education of women in Harvard University.
Voted, that while the President and Fellows of Harvard College recognize the importance of thorough medical education for women they do not find themselves able to accept the proposal contained in the communication above referred to.
A true copy of Record
Attest: E. W. Hooper, Secy.To Marie E. Zakrzewska, M.D.,
for herself and others.
Thus did Harvard lose its last opportunity to become the leader in the opening to women of the great medical schools of America, its misfortune in this respect being due to what appears to have been a certain indecisiveness.
It showed the perception and the conviction of the justice of the women’s claim as early as 1850, or even 1847 (away back when Oliver Wendell Holmes was dean of the medical school), and it seems to have had, then and afterwards (1879), the desire for performance but it appears to have failed in resolution, and so it was at the mercy of minor cross-purposes.
At any rate, the result of its vacillation was that eight years later the honor was taken by the Johns Hopkins University of Baltimore.
Meantime, Dr. Zakrzewska had in 1881 spent another vacation in Europe, and this time she particularly inquired into the progress of medical women in England. On May 28, she writes:
Dear Friends:
I shall mail this letter eventually to Mrs. Cheney, but I intend it to be of the same interest to Miss Lucy Goddard and Miss Peabody.
After a very rough passage, we arrived in London on the 17th of May at 4 A. M. My companions desired to begin sight-seeing at once and so, as is customary, we proceeded to Westminster Abbey. You all know how little appreciation I have for Fame; but whenever I go to places like this Abbey, Fame presents to me another aspect. It is entirely impersonal—names are of no consequence, but the reasons why these landmarks of civilization are placed there for the beholder are of intense interest.
You all know that every shade of greatness is here represented in the monuments to men. There are some to women also, but only because these women happened to be queens or wives of royalty, though a few have been erected to high-stationed philanthropists. In no other capacity could I discover the name of a woman.
Query: Before long, will there be erected a monument to a woman physician? We find the names of men physicians here, for no other reason than that they were eminent in their profession. Will there ever be a monument to the first woman physician because she was the leader of the movement; because she had the energy, will and talent, as well as the education, which would make her worthy of imitation; and because she is a landmark of the era marked by women’s freeing themselves from the bondage of prejudice and from the belief that they are the lower being when compared with men?
These are the speculations which follow me wherever I go and wherever I find the monumental display to and for talent. I did not find Mrs. Somerville’s name on even a tablet in the Abbey. Why is it that women do not start a movement for placing one there and in other significant places?
We need such landmarks of civilization not because those who died have lived for fame, no, but because the now-living, as well as those who will live long afterward, need encouragement for utilizing their capabilities, and monuments of this sort suggest to them the possibility of their so doing. The person who is covered by a monument is of no consequence, but the fact that a “woman” can work and make an impression upon civilization needs to be made known and to be remembered.
Apropos, the word “woman” reminds me of the custom of speaking here in London. I have not heard a single time the word “lady” used as we use it in America. The Queen is spoken of as “a good woman,” the Princess Louise as “a sickly woman,” Mrs. Somerville as “an eminent woman,” the Duchess of Blank as “a fashionable woman.” Nowhere do we hear a dressed-up cook or chambermaid mentioned in the streets as “that lady there,” but as “the woman in the velvet gown,” etc. I wish some of our prominent women in America would make a crusade against the habit of applying the word “lady” to every woman under every condition.
But now I must speak to you of what interests us most of all, namely, the work of the medical women in London. There is no doubt but that the position here of the woman physician is, professionally and legally, a far better one than with us in the United States. By the indomitable will and energy of Dr. Sophia Jex-Blake, the women who study medicine have been placed fundamentally on the same level with men. The method of study, theoretical and practical, is precisely that of the men.
And although the Royal Free Hospital has only one hundred and fifty beds for the medical school of women, while the medical school for men of St. Bartholomew’s Hospital has six hundred and that of St. Thomas’ Hospital has one thousand, five hundred, that makes no difference in the mode of study nor in the amount of knowledge which the woman student can acquire. One reason is that the number of women is only about forty while at either of the other hospitals, the number of men runs as high as seven hundred. Besides, I am told that women are more ready to gain knowledge through dispensary practice, which is entirely outside of the hospitals.
There is, however, one branch which is very much neglected, both theoretically and in clinical instruction, Dr. Charles Drysdale being my authority for the statement that this neglect is just as great in the men’s course, namely, the instruction in higher midwifery and obstetrics as taught in France and Germany. He assures me that if there are English men of eminence in this branch, they have laid the foundation by going to Germany to study. Alas, these opportunities are not open as freely to English medical women.
Dr. Drysdale, as well as some of the most prominent women practitioners here, expressed the wish that Boston or some other large city in the United States which has a hospital for women would so develop this particular branch as to induce the educated medical women of England to go thither in order to perfect themselves therein. The opinion of those who express such a wish is that money would gladly be paid to its full value for such opportunity for study.
Such an opening for the English student would react very beneficially upon our American medical student, for there is no doubt but that the English medical women and students have in every respect a higher average education than we have. And the standards of education and civilization can best be raised through international intercourse.
We now have in Boston decidedly good women surgeons and the beginning of a good department in surgery. This is of momentous importance for the reason that surgical work tells best both in the profession and among the laity. We also have in Boston excellent women obstetricians who do a great deal of obstetric surgery, but who give instruction to only the few privileged students of our Hospital.
This branch could easily be enlarged and developed by our Hospital Staff if through larger means, greater opportunity for practice could be afforded them, and thus make it worth her while for the attending physician to give more thorough instruction both to our own students and to students from abroad. By saying making it worth her while, I mean allowing her compensation for time and labor.
On the whole, we must begin to think of compensating our staff of women physicians. Now that the woman physician is an accepted fact in America, it becomes our duty to compensate those who have spent time and money in study (and especially those who have gone to the continent of Europe) for the labor which they expend upon the students not able to follow such a course.
After introducing the woman into society as a physician, we must now take the next step, namely, see that those who follow are well-educated; and, therefore, we must utilize the knowledge of the former by giving her the chance to spread it among the new disciples. In other words, every physician with a good education who comes to us must be well paid, so that her time and strength will belong to our patients and to the students of the Hospital. And if other students who are not inmates of the Hospital wish to avail themselves of our instruction, they must be made to pay for it, whether this instruction be given by the resident physician or by one of the attending physicians.
This has been my view for some years, and I am now very much confirmed in it through talk with the friends of medical education here, where I see most clearly that work without money value set upon it is not expected nor is it considered to be of the first class.
The students here pay £80 for the theoretical instruction and £40 for the hospital instruction, besides paying for their board outside of school and hospital, for they do not reside in either. Our institutions in the United States would not permit such a rate, nor do I wish to suggest it, but I wish that the friends of the movement for the medical education of women would come forward, as have those here in England, and provide us with means so that we can afford to pay an ample salary to our physicians, or at least to our resident physician, and thus secure her services for some years to come for the benefit of all concerned.
The English generosity in this respect seems marvelous to me. For instance, the Royal Free Hospital would not connect the medical school for women with its work, saying that it had not room for them. The governors of the hospital were asked how much money was needed, and the enormous sum of £5,000 was set for a limited number of years, namely, five. At the expiration of this time, a similar sum, or even more, or perhaps nothing at all, might be needed. In a very short time the sum was raised, the money being used to build another wing to give room to the women for study.
Out of the funds of the school, towards which the student contributes £40 for three years’ study, a large sum is paid to the physician who gives the instruction in this hospital. The funds of the school are raised by private subscription, and the fees charged to the students, although high, do not suffice to pay for the instruction given. In so far as the fees do not suffice, the situation is similar to that in our American colleges and schools; it differs in that the instructors are fully paid for the time and knowledge given to the students. The result is a higher education in medicine and a higher grade of individual physician than in the United States.
In the two branches, surgery and the medical treatment of general diseases, the woman student has now in London ample opportunity. Plenty of material is provided, not only by the Royal Free Hospital but also by the New Hospital for Women, as well as by the dispensary attached to the latter. The latter hospital is carried on precisely as is our New England Hospital for Women and Children except that it has no maternity department. It admits patients for as little as four shillings a week but only a few are entirely free.
The attending physicians are all married women of high social position, mothers and housekeepers and quite rich. It is thought by the English women that these prominent women should work in order to live down the prejudice, which seems to be very strong, that if women study or do anything they will cease to be willing to become mothers and housekeepers. This explained why in the medical school the “Mrs.” was always introduced to me before the “Miss” was spoken of.
I think this is all I have to communicate to you about the work which lies so near to our hearts, and as my London visit closes to-morrow I think I shall have nothing more to add, but shall see what the women in Germany are doing.
But I may tell you that I attended a small, public, woman suffrage meeting held to consider Mr. Hugh Mason’s proposition in the House of Commons to give the franchise to women. The meeting was a rather select one. The audience was admitted only by cards, which, to be sure, any one could procure beforehand, but which forms more or less of a hindrance to attendance.
The speakers were all women and in favor of the measure. They were seven in number and each spoke for about ten minutes. They were fluent, eloquent, concise and modest. Their dignity was superb. There was a great deal of applause, and happiness over what had been gained was expressed in many a face. But the whole affair lacked vitality, enthusiasm, and breadth of feeling and fellowship. And, compared with even our smallest meetings, no matter whether held by women alone or by both men and women, it made me homesick for Boston—for America!
Should you see any of our Doctors (for instance, Dr. Morton), ask them whether they care to read this epistle. Perhaps Dr. Smith will decipher it and read it at one of their meetings. But let Miss G. have it first, and tell me in a few words what you think of it, and how you are doing and whether your health and that of our friends is good and strong and ready to carry our work a little farther on.
I am getting rested, and while my two companions are going sightseeing I am writing this. If you want to recommend our lodgings here, do so. They are in every respect desirable and recommendable. Be sure to give my love to all inquiring friends—Miss Farnham, Miss Cary, Mrs. Boardman, and a number of others whom I have no more paper to mention.
Faithfully yours,
M. E. Zakrzewska.
In 1880-1881, the New England Hospital took the important step of requiring all resident students to be the possessors of the degree of M.D., and of changing their status to that of internes.