In Dr. Pope’s paper, 138 women reported on their income, and out of them only eleven had then practiced over two years and failed to become self-supporting. Another item of interest is, that 32 per cent. of these women report that they have one or more persons partially or wholly dependent on them.[[142]]
So great are the imperfections, even to-day, of the medical art, so numerous all the difficulties of applying even all existing resources, so inevitable are the illusions in regard to the real cause of either success or failure, that it is the most difficult thing in the world to estimate the intrinsic ability of a physician, even by his success in practice. A large practice certainly always testifies to some kind of ability; but this is not always strictly medical. The essential test is that of accuracy in diagnosis, and this test cannot, by means of any public documents accessible, be applied. Its successful application can only be inferred by the gradual development of confidence in women, both among the more intelligent and critical of the laity, and among the more unbiassed of the professional observers, who, in consultations, have had ample opportunity to scrutinize diagnoses.[[143]] For a dozen years it has become customary in America for the most distinguished members of the profession, even in large cities, to send patients to women physicians, in any case where the circumstances of the illness lead the patient to prefer a woman.[[144]] The same is done when, from personal acquaintance, or on account of public reputation, the patient has confidence in some special woman physician, and desires her counsel therefore, for other reasons than those of delicacy.
The women physicians of America share, while rather intensifying, the main characteristics of their medical countrymen. They have, as a rule, little erudition; but they have great capacity for bringing to bear all available and useful knowledge upon practical issues. They certainly do not read enough; and there is, therefore, a noticeable thinness in their discussions of medical topics when they meet in isolated council. But they have a resolute helpfulness in dealing with the individual cases entrusted to their care, and a passionate loyalty to those who have put their trust in them. They are possessed of abundant motive power for concrete intellectual action, though they might lack this power, if the work depended exclusively on abstract intellectual interest. And, after all, it is this habit of mind which most distinctively marks the modern practicing physician, and without it the advances in medical science would be of little profit to the sick; indeed, would often not be made. And, what is often overlooked, it is precisely these mental habits here described which have been usually considered as particularly characteristic of women. Thus the introduction of women into medicine demands no modification of the typical conception traditionally held of women, but only an enlargement of the applications which may be made of this characteristic type.[[145]]
In nothing are popular views about women more at variance with fact than in regard to their capacity for operative surgery. The popular conception of surgery is itself entirely false, being inherited from a by-gone period, when hospital operations were conducted in the wards, filled with shuddering patients awaiting their own fate; amid clouds of steam from burning irons, torrents of blood, and the groans and shrieks of the victim.[[146]] But to-day, with anæsthetics, hæmostatics, and antiseptics, the surgeon may operate as calmly as on an insensible wax figure; and, moreover, with a reasonably correct technique, be assured of success in a vast majority of cases whose result was formerly, even under the best skill, always doubtful. The very greatness of the achievements of surgical genius have lessened the amount of ability requisite to perform many surgical operations; and especially have the modern conditions of operating removed the perturbating influences which female nerves might be supposed unable to resist. Moreover, the technique has become so precise that it can be taught; and women, even when defective in power of original thought, are extremely susceptible of being trained by exact drill. On this very account the model of a practical medical school should be that of a military academy, where every operation, mental or manual, that the graduate is subsequently expected to perform, will be rehearsed before graduation.
Now the remarkable thing about women surgeons is, not that they have learned how to operate when they have been taught, but that, with very insufficient teaching for the most part, they have contrived to learn so much, and to operate so successfully. Obstetrics and gynæcology have here again offered peculiar advantages, in presenting a series of cases for operation which vary from the most trifling[[147]] to the most serious capital operations in surgery. The latter have only been attempted in the last decade, and it is worth while to quote such statistics as I have been able to obtain, even though they are necessarily incomplete:
New York Infirmary: From 1875 to 1890; 535 operations (29 laparotomies); operators, chiefly Dr. Elizabeth Cushier, but in a smaller number of cases, Drs. Blackwell, Peckham, McNutt, Putnam Jacobi.
New England Hospital: From 1873 to 1890; 829 operations (48 laparotomies); operators, Drs. Dimock, Buckel, Keller, Berlin, Whitney, Smith, Crawford, Bissell, Kellogg, Angell, Pagelson.
Chicago Hospital: From 1884 to 1888; 206 gynæcological, 114 general surgery. Dr. Mary Thompson operated on all the gynæcological cases, except four; the report does not state whether she also operated on the others.
The reports of the Philadelphia Hospital do not give the total number of operations performed in it, but through the kindness of Dr. Fullerton, resident physician, I have received a report of the capital operations, nearly all abdominal:
Women’s Hospital, Philadelphia: From 1876 to 1889; 91 operations (all laparotomies, including several Cæsarean sections). Operators, chiefly Dr. Anna Broomall; for a small number of cases, Drs. Croasdale and Fullerton.[[148]]