Episode 62: The Sisters Blackwell

Elizabeth Blackwell — the first woman to earn a medical degree in the United States — and her sister Emily Blackwell are some of the most important physicians of the 19th century, firmly establishing the role of women as physicians, starting an infirmary and hospital for poor women and children, and founding a women’s medical college that was decades ahead of its time. In this episode, Dr. Nora Taranto joins me to explore the legacy of the Blackwells along with Janice Nimura, who recently published a biography of the sisters.


Please note that this transcript is generated from editorial copies of the episode and does not reflect the final audio version.


This is Adam Rodman, and you’re listening to Bedside Rounds, a monthly podcast on the weird, wonderful, and intensely human stories that have shaped modern medicine, brought to you in partnership with the American College of Physicians. The episode is called The Sisters Blackwell.


The sisters Elizabeth and Emily Blackwell are two of the most influential nineteenth century physicians in the United States, up there with William Osler. Elizabeth Blackwell, of course, was the first woman to earn an MD in the United States, and the first female physician to become registered on the General Medical Council in the United Kingdom. And since 2016, her birthday — February 3rd — has been celebrated as National Women Physicians Day in the United States. This year would have been her 200th birthday. The ACP, for example, offers the Elizabeth and Emily Blackwell Award for Outstanding Contributions to Advancing the Careers of Women in Medicine. The Hobart and William Smith Colleges, located near where Blackwell trained, have offered a Blackwell award since the 40s to distinguished women across the world; it was given posthumously to RBG this year. The Blackwell Medal is similarly giv en each year by the American Medical Women’s Association. 


Elizabeth Blackwell’s name has become synonymous with women in medicine. But just as with the Osler comparison, the hagiography around her obscures her remarkable achievements — and sometimes completely replaces the achievements of the other Dr. Blackwell, her sister Emily. So in this episode we’re going to talk about the Blackwell sisters — their upbringing, their accomplishments, and their legacy. And this story takes us from New York to Cincinnati, rural Kentucky to London and Paris, from dissections in the deadhouse of Geneva Medical School in New York, to losing an eye in a maternity hospital in Paris, to founding the New York Infirmary for Women and Children, and later the Women’s Medical College. And I’m not going to tell this story alone — I’m joined by producer Dr. Nora Taranto.


Hi Adam! So very excited to be joining you today, to talk about the fascinating Blackwell sisters through the lens of a delightful conversation with Janice Nimura, who just authored The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women–and Women to Medicine.  I tore through the book in a little over a day (between shifts in the hospital, of course), and had the pleasure of chatting with Janice about it on a chilly morning this winter.  SO many interesting themes emerged from the book. I had so many questions for Janice–about the Blackwells, about her career writing for the New York Times, Washington Post, LA Times, and Smithsonian, among others, and about her interest in medicine and the history of medicine (Medicine was the “career not taken”, she said, early on in our interview). The recipient of a Public Scholar Award from the National Endowment for the Humanities to support her work on the Blackwell sisters, Janice lends a historian’s eye, and a journalist’s enrapturing tone, to the topic. 


One of the things that stuck out to me reading the book was just how remarkable the entire Blackwell family was.


That’s right! Elizabeth and Emily grew up in a variety of spheres, and locations–each of which framed their education and worldview–and about which I didn’t actually know the details…..The story spans continents, and decades. The journey stretched from Bristol to Cincinnati, and the siblings would maintain roots in all of these places, and draw from the communities and philosophies present there…..and boy, are the stories we hear interesting, from intellectual differences with Florence Nightingale and some of the United States’ most influential suffragists, to losing an eye to gonorrhea obtained in a delivery room at La Maternite, from helping to form the US Sanitary Commission in the Civil War to months in the western reaches of Poland immersed in the benefits of hydrotherapy.  


In August, 1832, the Blackwell family left Bristol, led by parents Samual and Hannah, with eight children in tow. Protestant dissenters who were anti-slavery activists and also sugar refiners (yes, a bit of a tension), the family left England for the potentially greener pastures of America, having heard glowing reviews from family and friends alike. They first went to New York and then westward to Cincinnati, where the family ultimately settled. Filled with intellectuals, several of the elder sisters worked as teachers and remained in NY as the rest of the clan moved west.  There was Anna (first born), the hypochondriac and drama queen, then there were Marian and Elizabeth. Then there was her brother Henry, who would become a famous abolitionist and suffragist and who married Lucy Stone.  Even early in adulthood, the Blackwells were rubbing shoulders with fame as they found a group of protestant anti-slavery advocates including the likes of Henry Ward Beecher, Harriet Beecher Stowe, and others.  Both Elizabeth and Emily would work as school mistress in Henderson, Kentucky, before they each respectively embarked on their medical journeys.  And the path was not at all direct, or obvious, to Elizabeth, a creature of the mind and intellect–most drawn to philosophy and history–for whom a practical trade like medicine initially held little appeal (not even the benificence that would draw many to it). But the challenge–and the “nobility” of the quest to become a female physician–via the traditional medical education establishment was one that Elizabeth could not resist.  Emily would follow her sister some five years later into the field, though with a more pure interest in the practice of medicine, it would turn out. And we’ll leave it there, to start. 


One of the earliest revelations I had (Which actually ties into her whole narrative, I think) was realizing that Elizabeth was not determined to enter medicine from childhood, by any means. She was, primarily and principally, an intellectual at heart.  

Janice Nimura (00:13:07):

CLIP 1 Yeah. Um, yeah, I mean, Elizabeth, as a, as a young person, um, had no interest in health, in caregiving, in science, she, um, she was much more interested in history and philosophy. Um, and then she became very interested in the writings of Margaret Fuller who published this bestseller called woman in the 19th century, in which she said, um, women can be anything they want to be by, by virtue of talent and toil. And, um, you know, they can be sea captains if they want to be. Um, and, and Elizabeth really felt called by that and she wanted to be an exemplar of this idea. And then she sort of sat down and said, okay, what’s the best career path to prove this point and medicine turned out to be a very useful choice because it was a moment when, uh, in order to be a doctor increasingly the path to being a doctor was going to a medical school and getting a degree.


Janice Nimura (00:14:06):

Um, it wasn’t any more sort of apprenticing yourself to the local physician. And if there was this quantitative measure, if you could go to the lectures, take the examinations and pass them, there was nothing that anyone could say against the idea that you were just as qualified as any man. So it was really, um, a very, uh, uh, sort of, um, objective choice that this was a graphic way to prove this point. Um, the way Emily came to medicine was that Elizabeth told her to basically Elizabeth said, you know, Oh my goodness, this, this is a very lonely path. I’ve chosen this mission to be the first woman with an MD. Um, I need some company and she surveyed her four sisters and easily on Emily as the most intellectually, um, powerful of them and sort of anointed her and said, Emily, I claim you to work with me.

I found Elizabeth’s motivations to be particularly interesting. 

It raises interesting questions about career choice for passion vs for pragmatism, and decisions about career based on principle and theory versus the daily practice of the craft. Elizabeth was not drawn to medicine because of the daily patient visits. She found the nobility and morality of the profession attractive, and also realized that (in particular female) patients might benefit from having a female doctor.  But it was not the daily goings on that attracted her to the profession, or even the trade. Emily on the other hand had much more scientific, and had practical motivations. The two of them, in some ways, seem to embody the balance of medicine as a vocation and a philosophical calling, with different emphasis for each. 

Janice Nimura (00:15:00):

CLIP 2 And Emily surveyed her own prospects and said, all right. And, and she, Emily was, you know, I think a much more natural scientist. She was somebody who was enthralled by the natural world. For instance, she was enthralled by botany and, and, uh, you know, spent a lot of time out gathering specimens. Um, so it wasn’t a big stret  ch for her. And once she was involved, she was really drawn to the science of it. She loved surgical technique. She loved, um, learning new ways to solve medical problems in a, in a way that, that Elizabeth was never really involved with. And of course the other piece of it, um, is we don’t really know how much Elizabeth might have fallen in love with the practice of medicine, because right after she received her degree, she went to Paris to, uh, further her practical training, uh, and in, um, in a maternity ward of a public maternity hospital, which served a lot of, um, indigent women with venereal disease. She contracted Gonorrheal conjunctivitis from an infected newborn and lost one eye. This was a year after, within the year of receiving her medical degree. So, you know, it’s hard to really know what she might’ve become as a physician. If she’d had the use of both eyes, it’s kind of astonishing that she persisted and her determination to be a physician, even though she had had this, this, um, this health crisis. So soon after, um, starting out. 

Yeah, can you talk a little bit more about losing her eye?

After completing her medical training, Elizabeth traveled to Paris to continue in advanced studies in medicine. A brief aside, but I know you can give some more context to this, Adam.

Right. So Paris medicine — the Paris Clinical School — was obviously one of the most dominant centers of what we would call academic medicine in the early 19th century. Many of the ideas that are so ingrained in medicine that we don’t even think about it — like pathological anatomy, the physical exam, clinical epidemiology, efficacy determination, clinical medical education — came out of this period. And education in particular was the big draw. Paris hospitals were crowded, and education worked remarkably similarly to how we do it today — teaching attendings rounding on patients with gaggles of students in tow. By the time Blackwell went to Paris, its luster had perhaps faded a bit — the United Kingdom, and Edinburgh in particular were newly popular with American medical graduates, and it would still be a couple more decades until after the Franco-Prussion war really opened it up, but the German states were starting to develop their medical educational apparatuses. But a medical training in Paris was still de rigueur for enterprising American physicians. 

Much of Paris medicine was still closed off to women however. Blackwell was only able to find accommodation at La Maternite, which was a large women’s hospital with a training program designed for midwives from across France. She had trained for several months already in La Maternite, when the incident occured.  

While she was delivering a baby whose mother had gonorrhea, she washed the tiny newborn’s face and infected eye to clean it (this was before Germ theory, and far before the days of antibiotic eyedrops and ointment that we use today to prevent and treat the disease). Some of the fluid from the newborn’s eye wash splashed in her own face, infecting her left and then right eye too, which would soon become inflamed and pus-filled. Thus began a series of now-horrific sounding, but at that point traditional and typical, procedures and therapies to treat the gonorrheal conjunctivitis. Including collyrium (containing sulfuric acid, ammonia), forehead leech application, mercury and mustard plasters, and every other hour membrane removal from her Left Cornea–the worse infected of the two. She was bed bound in the infirmary, and her good friend Hippolyte and sister Anna tended to her. 

Janice Nimura (00:16:55):

Clip 3 Well, her sister, one of her older sisters happened to be in Paris at the same time, although I’m not sure how much, much help she was. Anna Blackwell was sort of a hypochondriac drama queen. And I think it might’ve been nice to have a sister around, but she wasn’t really that effective. Right. Um, in the course of my research, I was blessed to be able to go to Paris and wander around in the convent. That was the maternity hospital where, um, she studied where Elizabeth studied and was ill. And I, you know, my, my awe really for her determination and her interior strength was just, just skyrocketed because the idea of being in mortal pain and, and unsure whether you were going to retain your sight in the middle of a rather cold echoing stone convent, surrounded by strangers. Um, I, I, I challenge anyone to put themselves in that context and, and, and come out on, on their feet. It was hard to imagine, and it really, um, solidified my sense of Elizabeth as an indomitable spirit. She

After three weeks, her right eye began to clear, though her left never would. But it would be months before she recovered more fully, and in an attempt to regain her sight, she sought out the help of one of the alternative european schools of therapy–Hydropathy, journeying out of France for fresher mountain air and water. Ultimately, no dice, and she had her non-functional, and infected, L eye removed in the summer of 1850, and she continued on with her studies back in London. 

After all of her extra training in Paris and London, Elizabeth found herself back in New York struggling to pay the bills before too long. She was quite surprised by this, initially. She had trained at all the fine establishments in the Western world to learn all that medicine had to offer. She had survived a horrible eye infection that she was determined would not compromise her trajectory. She was ready for New York, or so she thought. 

Janice Nimura (00:18:41): 

Clip 4 Right. I mean, she, she came back from her practical training in Paris and London decided on New York, uh, arrived at with great, like determination and confidence that she would be able to attract patients. And no one showed up, um, largely because the very phrase female physician in 1851 when she got to New York, um, most new Yorkers when they heard that phrase, what spring to mind was abortionist. Right. Um, uh, somebody who operated in the shadows in sin, um, had a criminal record, um, you know, the most famous abortionist of that moment with someone who went by the name of Madame [inaudible], uh, the notorious fifth Avenue abortionist was the episode that went with that. Um, and you know, if you look at the New York city directory for 1851, um, you see, you know, proudly Blackwell Elizabeth female physician, and then you see restal Madam female physician. Um, that is what people thought of. And so no woman who had the means to choose her medical care would choose a woman to treat her, um, the, the very few people that, that came to consult Elizabeth tended to be rather free-thinking progressive Quakers, often, um, people who were, you know, seeking alternative paths. Um, and in the end, uh, Elizabeth concluded that she really couldn’t make a living with private patients and turned toward this idea of founding charity institutions, charitable institutions, and, and, um, attracting donor money, uh, to treat indigent women and children. 

Interesting, first of all, that the very idea of female doctor brought with it this seedy underbelly–and also that alternative practitioners, not trained in the traditional sense, had already started to fill the role.  But whatever the case, Elizabeth had a lot of trouble attracting clientele, from the start. Perhaps it became clear to Elizabeth, almost immediately upon trying to hang out her shingle in NY, that despite her traditional training, she wasn’t going to be able to have the same obvious career path, or take care of the sam  e patients, as the male physicians around her. At the same time, we learn about her interest in alternative medicine–by this we mean the alternative to the traditionalist medical establishment–which may ultimately have attracted a different sphere of patients to her in the first place. But it was such a fine balance–between inclusive and innovative approaches to medical education and practice, and the respect of the establishment and patient population which was necessary to be able to practice.  

Janice Nimura (00:21:03):

Clip 5 Putting your finger on a really interesting thread, which is she needed to be mainstream enough not to alienate the establishment, but she knew she could see. So clearly that the establishment was stuck in the past. Um, you know, this was the, the, the  high watermark and the beginning of the decline of what’s known as heroic medicine, um, which, uh, usually did more harm than good. Um, the idea that you, you know, uh, if, if there was illness, what you needed to do was expel what was ever causing the illness and whether that meant bloodletting or leeches or medics or enemas, or sweating or blistering, whatever it was. Um, you know, you tried one thing after another, until the patient either gave up the ghost or recovered somehow, probably not due to anything that you were doing. Um, so this was where the establishment was. She could see that she had watched her own father die at the hands of a traditional doctor, um, could see that what was being done for him was not helping him.

Janice Nimura (00:22:07):

Um, but at the same time, she did not want to be so progressive that the establishment dismissed her as a quick, um, it’s interesting to see her. And then on top of this, you know, this is the mid 19th century. When medicine as a field is transforming itself into something that looks less like Galen and the humors, and more like what we know as medicine today, you know, be ideas of hygiene and antisepsis, and germ theory were just on the horizon. Um, so it’s really interesting to see Elizabeth, um, very open-minded really, to things that we dismiss today. Things like hydro therapy, um, mesmeric from, um, even phrenology early on, you know, the study of the bumps in the head, um, and what they say about character. She was very open-minded to all these ideas because no one had disproved them. So who knows whether they were the way forward or not?

I found this aspect of Elizabeth Blackwell just fascinating. Her medical training at Geneva college was incredibly traditional, especially from a therapeutic perspective. She learned about bloodletting, calomel, purgatives, laxatives, blisters — all the traditional Western pharmacopoeia. But at the same time as she begins practicing medicine, the world starts changing rapidly. Traditional medicine is challenged by all sorts of alternative practices — homeopathy, chiropractic, and the Eclectic school especially in the United States, which I know comes up in the book a number of times. And at the same time, there’s an intellectual movement called therapeutic nihilism that’s popular in elite circles — that the body heals itself, and that traditional Western medicines actually do more harm than good. And you have people like Florence Nightingale showing that simple hygiene makes a huge difference in preventing diseases. At the same time, you have anesthesia and antisepsis slowly make their introduction, really presaging the scientific medicine of the late 19th century. And Elizabeth and Emily both have to find a way to navigate all of this.

Absolutely! She had an incredibly narrow line to walk.  And maybe because of her own family, she definitely had influences of alternative medicine…..

Janice Nimura (00:23:04):

Clip 6 She, um, she also had her sister, Anna, who I mentioned, had been with her in Paris, the hypochondriac drama queen, um, her sister, Anna was, was a real, uh, prac, uh, uh, fad follower when it came to medical trends and she was, um, not in robust health herself. So she was always trying these things. And Elizabeth was always watching, um, with, uh, sometimes with amusement, but also sometimes with an open mind, with respect for the practitioner who really believed in his usually alternative practice. So the other irony is that a lot of what the eclectics advocating things like, you know, um, less reliance on horrifying drugs, like mercury, um, more reliance on milder treatments, more reliance on hygiene, um, cold water and fresh air. U m, she could see that that was there was truth there. Um, but at the same time, she couldn’t afford to let the establishment dismiss her as an eclectic. So you, you watch both her and Emily trying to navigate this very narrow balance beam between, um, what they could see as the future of medical practice and what the establishment still persisted in, in, um, in endorsing it wasn’t

Clearly, early on in her career, and personal life–and in spite of the fact that she had trained in the traditional, Elizabeth was interested in all advances in medicine, and spiritualism. Emily, on the other hand, did not share the same focus on alternative medicine as her sister. 

Janice Nimura (00:24:41):

Clip 7 I would say less. So she wrote less about them. So it’s hard to know on any given day, um, there’s a wonderful scene early on, uh, where she, she comes in contact with a man who professes to be able to, um, read the read personality and the future from, um, from looking at handwriting. And she gives him one of her letters and one of her sister’s letters and tries to, and tries to draw conclusions from that. And it’s very interesting to, again, to watch her, her, her science mind, and her emotional mind sort of in conflict with each other kind of, um, as we all are at different times, you know, magical thinking affects all of us sometimes. Um, but mostly Emily was more interested in, in practical things. Um, when she finished her med ical degree and went for practical training in Europe, she went to Edinburgh where she apprenticed herself to James Young Simpson, who was one of the most, um, prominent physician names of the moment in the, in, in, in Britain. Um, th  e guy who had discovered the anesthetic properties of chloroform, and he was, he was a bit of a showman, but he was also an innovator. Um, and she, in her letters back to Elizabeth, um, is passionately interested in all of his techniques. The fact that he, um, gives all his patients, pelvic exams, manual, pelvic exams, this was, you know, she sort of shocked. And then she sort of, uh, admiring of his skill, um, different instruments that he was experimenting with pessaries and

Elizabeth had multiple moments of grasping for more than what traditional education could provide. But she was determined to do things by the book, to check all the boxes–but, it turns out, with a purpose. There’s a great quote from letter Elizabeth penned that seems to sum up a lot of her theory of medical education and approach: to begin with established custom and to enlighten from there, to obtain “bedside knowledge of sickness, which will enable me to commit heresy with intelligence in the future” (pp 124). I love this idea, of enabling oneself by acquiring knowledge and traditional skill, ultimately to throw over that very same tradition and make further advances–to commit heresy with intelligence. 

And traditionalism also extended to medical education. This obviously posed a problem of sorts for women who wanted to practice medicine, since there were always questions about legitimacy of education that one could obtain.  Both Elizabeth and Emily felt strongly that women should receive the same type of medical education as men–and, ideally, from the same training institutions. Their goal at first was to infiltrate the existing, trusted, medical institutions of the day.  But almost as soon as Elizabeth earned her degree, Geneva College decided it would stop accepting women. And at the same time, women-only medical colleges started to open in the United States. The movement to provide separate medical education had begun. 

Janice Nimura (00:37:38):

Clip 8 So, okay. Let’s have women’s medical institutions. And one opened in Philadelphia and one opened in Boston, um, just after Elizabeth received her degree. And the Blackwell’s really scorned these institutions as being inferior and turning out an inferior graduate. Um, and they founded their infirmary for indigent women and children in New York in 1857, partly as a place to provide the practical training for female medical graduates that they had had to go to Europe to find. Um, and then as those female medical graduates showed up at the infirmary for training, having graduated from the women’s medical schools, the black ones were appalled at what they hadn’t learned, um, and became more and more dismissive of women’s medical schools. And although they had condemned idea of separate medical education for women, they ended up changing their minds and opening a women’s medical college of their own, because they really saw the need for a place for women to study medicine with the same degree of rigor as the men did. And so the, the medical college that they opened at the New York infirmary ended up being more rigorous than most of the male institutions that were open at the time. And certainly more rigorous than the medical educations they had themselves received. It was three years instead of two, it was, um, not to, uh, terms repeated exactly, but, but courses that built on themselves, it was practical and laboratory training, not just lectures. Um, so yeah, th th this, their attitude shifted over time because the world didn’t keep up with them. It didn’t follow their example.



Ultimately the college became a victim of its own success.

Janice Nimura (00:42:38):

Clip 9 Um, and then at, in 1899, as Johns Hopkins and Cornell began to admit women into their mainstream medical classes, Emily decided to shut down the medical college because its purpose had been served. It had tided women over to the place where the men’s medical colleges would now accept them as valid students. Um, you know, she, it was a statement that I was only here to hold the door open until the rest of the world caught up and now the doors are being opened by others, and we can stop this and allow medical education to proceed, you know, with the sexist United. Um, so yeah, I mean, I think that gesture suggests that, you know, this, this really was a step toward progress that it was it’s in the it’s, it’s part of that story.

The infirmary is still around, right?

Yes! It lives on as the New York-Presbyterian Lower Manhattan Hospital, located in Lower Manhattan. And you can visit the original site of Blackwell’s clinic and hospital in Greenwich village, not far away–there’s even a plaque to read that commemorates the site of the clinic. 

I would love to visit post-pandemic. I will of course put the link in the shownotes (https://readtheplaque.com/plaque/site-of-elizabeth-blackwell-s-infirmary-for-women-and-children)

Nora, one of the major themes of the book that came out is the question of the role of women in medicine. Can you speak a little about that?

One of the interesting tensions, in the book and in the medical world, is the role of the female medical practitioner–is it just in providing women’s health (as it traditionally was in the times of midwives)? And, by that token, was the goal to receive equivalent training to training within traditional medicine (all male, at the time), or is it to create a new way of training and ultimately practicing? Is it to incorporate the multitude of different medical theories and practice approaches floating around Europe at the time? Or was it even to practice medicine at all, or to elevate women to professionals, whatever the role? 


I think this question comes up even today, as certain medical specialties remain male-dominated, and hostile to female practitioners, and as many women gravitate to women’s health and ob-gyn. Interestingly, there has been a flip flop throughout history in the role of men and women in obstetrics. (Could do a whole separate episode on this, in fact)– and the changing (and sometimes absent) role of the physician as a provider of maternal health, at many points in history, deferring to midwives for all but surgical necessity. 


Elizabeth and Emily have somewhat different approaches to this, and take on different roles–both as practitioners and as thought leaders. Elizabeth focuses more on the theoretical, the philosophy, the building of the infrastructure to create paths for female advancement. Meanwhile, Emily is more interested, from the beginning, in the practice of medicine, and specifically of gynecologic medicine. At the time, as now, maternal health was a challenge in and of itself, and deeply related to socio-economic status.  Elizabeth trained at La Maternite in Paris, but Emily was the one of the two more interested in the practice of treating gynecologic disease, and improving maternal health, in particular (though this was by no means the full scope of her medical practice). But early on, She chose to train with James Young Simpson, long-standing Chair in midwifery and diseases of women and children at the University of Edinburgh–and she’s thinking critically about the care being provided, because she is aware of the peril of childbirth. 


Janice Nimura (00:26:21):

Clip 10 Um, yeah, I mean, and, and she’s very focused. She’s drawing sketches of these things in the margins of her letters and, and really curious to know to what extent she can debunk some of Simpson’s conclusions about what these things do and whether they’re useful or not. Um, she’s very aware that, um, that women are imperiled by motherhood often. And is there, what can we do to make a woman’s health more secure, uh, in, in, in the current social context, you know, really interesting questions that Elizabeth’s not really asking, she’s much more about prevention and not, not, um, treating, uh, troubles so much.

In many ways, it seems, women’s health was an easier lift.

Janice Nimura (00:27:26):

Clip 11 Yeah, no, I, that’s a good question. I think it’s, it probably co mes down to access. I mean, women were expected to be involved in, in obstetrics. Um, and so they were, uh, you know, the, the practical training that they could, but they both ended up benefiting from at [inaudible] maternity hospital in Paris, um, was some of the best training they received, mostly because this was a hospital that was used to training women to be midwives. Um, that’s where they  could go. Most hospitals, weren’t interested in, um, female medical graduates wandering around learning stuff, and you didn’t learn anything practical in medical school. So you needed that practical training. So, you know, everything was sort of driving them toward expertise in women’s health, because that’s where, um, the world could sort of fathom seeing them. Um, it was funny. I, I gave a talk about the black walls at some point and, um, a man in the audience raised his hand and said, do you know when in history it became the norm for female physicians to treat men. And that’s a really good question and a really hard question to answer, um, because I mean, you could argue that, uh, you know, battlefield nurses treated men, but that was under duress. You know, at what point did, did men choose to see women? And I think that’s still a vexed question if you really, you know, fed truth serum to male patients.  


This point struck home to me, as a female physician today–the resistance to trusting female physicians, then and even now.  I’ve had friends and family growing up tell me their mothers would still prefer to see doctors–even gynecologists–who are male, because they trust them more. And I’ve personally had a number of patients in my two years of residency who either stated they would prefer male providers, and or expressed relief when I mention that there is a head doctor above me (whom they often assume will be a male). 


(That’s not even getting into intersectionality of the physician more broadly–which we haven’t yet discussed under the auspices of this Women in Medicine banner, but which is absolutely worth mentioning, and thinking about–that there are many other marginalized groups in medicine today that still face tacit or explicit questions about belonging in medicine.) 


The Blackwells, unmarried and female, met with resistance and questioning in almost every medical space they attempted to join–and whenever they asked for institutional legitimacy. Throughout the second half of the 19th century,  Elizabeth learned to operate at the edge of tradition. She also learned to pivot, as the world frequently did not bend to her ideals. She pushed forward from the individual sphere, in which she was ultimately lauded for her successes and rubbed shoulders amiably with the intellectual elite, to the world of actual medical practice, in which she found that even with a traditional medical degree, the title Doctor, and extensive training at some of the Western world’s greatest hospitals, she still bore the Scarlet W.  Emily followed, and faced many the same trials. And yet, in their decade-long careers, despite being refused entry, or acknowledgement by much of the establishment, they ultimately managed to practice medicine–to deliver medical care to patients, to establish hospitals, and–some might say most importantly, to Elizabeth–to figure out a means of training and educating female students in their own image–rigorously, upholding the top standard. 


There’s so much more to explore about their lives, and their role as female physicians and pioneers. So, I guess there has to be an episode 2.