Hospital with a Heart: Women Doctors and the Paradox of Separatism at the New England Hospital, 1862-1969 9781501741791

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Hospital with a Heart

HOSPITAL i

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Virginia G.

Drachman

WITH A HEART Women

Doctors and the

Paradox of Separatism the

New England

at

Hospital

1862—1969

Cornell University Press ITHACA AND LONDON

Copyright

All rights reserved.

©

1984 by Cornell University Press

Except for brief quotations

in a review, this book,

or parts thereof, must not be reproduced in any form without

permission in writing from the publisher. For information, address Cornell University Press, 124 Roberts Place, Ithaca,

First

New

York. 14850.

published 1984 by Cornell University Press. Published in the United

Kingdom by

Cornell University Press Ltd., London.

International Standard

Book Number 0-8014-1624-8

Number 83-45930

Library of Congress Catalog Card

Printed in the United States of America

Librarians: Library of Congress cataloging information

appears on the

The paper

in this

book

is

acid- free

last

and

page

of the book.

meets the guidelines

for permanence and durability of the Committee on Production (Guidelines for

Book Longevity of

the

Council on Library Resources.

To my mother and father, Sally

Ann and

Stanley

Drachman

Digitized by the Internet Archive in

2012

http://archive.org/details/hospitalwithhearOOdrac

Contents

Preface

/ /

1.

"The Mother of Us

2.

"This All-Women's Hospital"

3.

"The

4.

"Whisperings of Discontent"

103

5.

"We Must Get Them and Keep Them'

122

6.

"The

1

5

7.

"We

i

78

Sick

21

All"

We Would

44

Heal"

7*

Institution Is at a Crisis"

Will Lose

Our

Hospital"

I

Conclusion

196

Abbreviations

203

Notes

205

Bibliography

*4*

Index

252 7

Illustrations (pp.

gi-ioi)

Dr. Marie Elizabeth Zakrzewska, founder of the

New England

Hospital, about 1870

Lucy Goddard,

first

president of the

New England

Hospital

Ednah Dow Cheney, longtime supporter and second president of the

New England

Hospital, 1884

Main building of the New England Hospital, erected

in

Roxbury,

Massachusetts, in 1872, ten years after the hospital's founding Dr. Lucy Sewell,

first

resident physician at the

New England

Hospital Dr. Susan Dimock, surgeon

program Adult's

at the

ward

and organizer of the

New England

at the

Hospital

New England

Hospital

Operating room

at the

New England

Hospital

Children's

ward

at the

New England

Hospital

Newborns

at the

Nurses

at the

New England

New England

Hospital

Hospital

nurses' training

—

Preface

Founded

in

Boston in 1862 by Dr. Marie Zakrzewska, the

gland Hospital for

Women

tant all-women's medical institutions in America. For

century,

it

provided

New

En-

and Children was one of the most impor-

women

more than

a

doctors with valuable clinical experience

and professional training and offered women patients medical care by doctors of their own sex. Born of and nourished by separatism the nineteenth-century solution to sexual discrimination tal,

by the turn of the century, confronted

its

—the

hospi-

most formidable

chal-

lenge: the opportunities of integration.

This book

tells

the story of the

women

doctors at the

Hospital during a century of separatism.

study of an all-women's hospital cal institution in

America.

and of the women doctors twined. Barred from the nineteenth-century

women

—indeed,

It

is

the

New England historical

first

of any all-women's medi-

The fates of the New England Hospital who worked there were inextricably interall-male

doctors

medical schools and hospitals,

made

through their own, all-female medical

their professional

institutions.

Built

journey

upon

the

foundation of nineteenth-century separatism, the all-women's hospitals

and medical schools provided women doctors with profesfrom men. But as the century drew to a

sional opportunities apart

1

1

Preface close, the all-male

medical institutions began to open their doors to

women. The opportunity

to work with male physicians represented major step forward for women doctors. At the same time, it threatened the survival of the all-women's medical institutions that had launched women's medical careers. The result was a paradox: whereas separatism originally laid the path to equality for women in medicine, gradually integration became a competing route to pro-

a

women

fessional equality, challenging the separatist traditions of

doctors.

The

story of the

women doctors at the New England

integration; ultimately that story reveals the for **.

Hospi-

recounts the fate of separatism in a world beginning to accept

tal

women

in

Historians have

contexts:

paradox of separatism

America.

examined the

women

history of

doctors in three

sexual discrimination, sisterhood, and professionalism.

Some

believe that nineteenth-century male physicians deliberately

tried

to

prevent

women from becoming

doctors, that only the

emergence of an organized woman's movement enabled nineteenthwomen to make inroads into the medical profession, and that the decline of the woman's movement in the twentieth century

century

women

contributed to a professional setback for crimination interpretation

is

important because

ing point for understanding the history of ica. It

uncovers the obstacles

women

and emphasizes women's unity

it

doctors.

provides the

women

doctors in

tell

dis-

start-

Amer-

doctors encountered from

in struggling for success.

discrimination perspective does not

The

men

But the

the whole story.

By focusing

women

doctors and

almost exclusively on the relationship between

woman's rights, it minimizes the impact of the transformation of American medicine on the lives of women doctors. Moreover, the discrimination interpretation overemphasizes the conflict between men and women and obscures the valuable support some men provided. From this point of view, the New England Hospital stands as a "feminist showplace" in a hostile world of male physicians rather than as a women's hospital that was both apart from, yet also a part of, the mainstream of American medicine. x

The second

interpretation

of the history of

focuses on the importance of female

Advocates of

lives.

this point

and ideas of women 1

2

in

women

doctors

culture in their professional

of view argue that the shared values

American

society

shaped the ways

in

which

Preface

women

doctors justified their professional careers and practiced

medicine. This perspective

is

significant because

beyond the sphere of the home

culture

how women brought

revealing

their

it

own unique

women

medicine. Yet this approach spotlights

expands female

into the medical profession,

experiences into

doctors as

women

at

the expense of their professional identities, obscuring the sim-

between

ilarities

"The

women and men

third interpretation views

fessionals.

From

this perspective,

physicians. 2

women women

doctors primarily as pro-

doctors emerge

and

first

foremost as practitioners of medicine. Instead of portraying them as

from men doctors (as the focus on female culture odds with men doctors (as the sexual discrimination

distinctly different

suggests) or at

perspective contends), supporters of this view believe that female

doctors shared essentially the same scientific and professional stan-

dards and practiced medicine

in fundamentally the same ways as male doctors. This perspective is important because it places women doctors within the mainstream of American medicine and demon-

men. But in doing so, it tips the scale in favor of these similarities and clouds the important differences that distinguished women from men doctors. 3 strates their similarities to

Individually, these interpretations present an incomplete picture

women

and professionalism were all part of the historv of women in medicine. Moreover, these interpretations lie at opposite ends of a spectrum and provide conflicting visions of women doctors. At one end the sexual discrimination and female culture viewpoints depict women doctors primarily as women; at the other end of the spectrum, the profesof

doctors. Sexual discrimination, sisterhood,

sional interpretation views

The

doctors.

women

doctors principally in their role as

women

two approaches focus on

first

almost ex-

clusively in political terms, either in their struggles against

their unity with

women. The

women

third takes

men

or

in

out of the political

arena and examines them chiefly in terms of their work. While each interpretation

new

tack:

doctors.

It

it

a significant contribution, this study takes a

synthesizes the dichotomized historiography of

portrays the

women and tion

makes

doctors,

and a medical

women

doctors

and interprets the

institution.

at

the

New England

hospital as a

women's

women as

both

institu-

1

At the heart of the historv of the

women

doctors

at

the

New

13

Preface

England Hospital

is

separatism, the foundation of women's lives in

nineteenth-century America. Beginning with the development of separate "spheres" in antebellum America,

women

spent their

lives

and mothers, while men claimed the public arena kept women in their own sphere, away own. Separatism as their from men, and it encouraged the development of a distinct female culture that tied women together in the bonds of sisterhood. Ultimately, separatism became the driving force that nineteenth-centurv women used to change their lives. Through a variety of institutions, clubs, and societies, women sought to expand the boundaries of their sphere. Although separatism dominated women's lives in the at

home

as wives

nineteenth

emerged

century,

at the

opportunities

for

end of that century, began

integration, to

which

shape women's

first

lives in

the twentieth. 5

Separatism guided the history of the women doctors at the New England from the hospital's founding in 1862 through its close a century century

later. The sexual discrimination that isolated nineteenthwomen in the home also barred women doctors from men's

-hospitals. At the

same

time, the sisterhood that nineteenth-century

women found among themselves motivated women doctors to estab"• lish their own all-women's hospitals. Indeed, the New England Hospital

was a vivid example of the growth of women's

institutions in

nineteenth-century America. But opportunities for integration in the twentieth century shook the foundations of like the

New

women's

institutions

England, challenging their separatist tradition.

At the same time, the

New England

the transformation of medicine in

Hospital must be cast within

modern America. During

quarter of the nineteenth century and the

first

the

last

quarter of the twen-

American hospitals evolved from institutions of medical charity and social control into institutions of medical science. As the modern hospital emerged, leadership shifted from lay trustees concerned with charity and social control to doctors motivated by the tieth,

demands of icies that

scientific

medicine. Doctors increasingly adopted pol-

looked inward to their professional needs and concerns

Whereas the "deservwards seeking food and

rather than outward to the needs of the sick.

ing poor" had originally filled the hospital

shelter as well as medical attention, paving patients

now went

to the

Preface hospital exclusively for medical care.

medical charity, the pitals of

its

perspective,

New England

Founded

as

an

institution of

Hospital evolved, like other hos-

From this who worked

day, into an institution of medical science. its

and

history

that of the

women

doctors

there are an integral part of the scientific, professional, and institutional transformation

of medicine in modern America. 6

*— Ultimately the history of the hospital and

its

women

doctors must

be viewed as both women's history and medical history. Separatism

and medical science formed the cornerstone of the New England, making the hospital and its women doctors unique in American history.

This study captures their uniqueness rather than directly

comparing women and men doctors in their respective hospitals. The latter approach tends to leave out of account the practices and ideas of women that do not bear direct comparison with those of men. Instead, this expanded case study incorporates comparisons with

men when

appropriate but keeps the history of women doctors

themselves always at center stage.

one women's hospital and its doctors, I have tried to weave their story into the broader fabric of American history. Indeed, the general shift from sexual separatism to integration, the emergence of a modern medical profession, and the erosion of Victorian moralism by the rise of a science of society in America were enacted in the lives of the women doctors at the New England Hospital. These important social changes constantly presented the women doctors with new problems and chal-

Although

this

book

details the story of

lenged them to find novel solutions. As the story of the doctors at the '

struggle to

New England

become

women

Hospital so vividly shows, a woman's

a doctor was but the

first

step in her

more endur-

ing struggle to be a doctor.

Many people and writing of this book.

institutions I

am

have helped

me

throughout the

grateful to the Rockefeller Foundation,

Mary Ingraham Bunting Institute of Radcliffe College. Tufts University, and the Henry A. Murray Research Center: A Center

the

for the Study of Lives at Radcliffe College for their generous sup-

port as I researched and wrote this book. The staffs at the Sophia Smith Collection of Smith College, the Francis A. Countway Librar)

Preface

Harvard University, the Arthur and Elizabeth on the History of Women in America at Radcliffe College, and the Massachusetts Historical Society and in particular Susan Boone at Smith College and Richard Wolfe at the

of Medicine

at

Library

Schlesinger

—

—

Countway Library gave valuable assistance. I also thank Steven Fuhrman, who helped me collect data on the doctors and interns at the New England Hospital; Dianne Saran, who typed the final draft; Norma Toney, who did some last-minute typing; Carolyn Guber, who proofread the typescript; George Marcopulous, who made some last-minute corrections; and other members of the history department out

at

Tufts University

my work on

Permission

this

who helped

Women

through-

quote from various unpublished collections has

to

kindly been granted by the Francis A. cine, the

at various points

book.

Countway Library of Medi-

Arthur and Elizabeth Schlesinger Library on the History of America, the Massachusetts Historical Society, the Sophia

in

Smith Collection of Smith College, the Board of Trustees of the

New

England Hospital, the Huntington Library, Amyas Ames, and Mrs. Francis T. P. Plimpton.

Portions of

my

which originally appeared

articles,

in Journal of

American Culture, 3 (1980), 660—672, and Journal of Social History, 15 (1982), 607-619, have, with kind permission of these journals, been incorporated into Chapters

The photographs

are

3, 4,

and

6.

reproduced with the permission of the

Sophia Smith Collection of Smith College and the Board of Trustees

New England Hospital. Over the years I have benefited from the

of the

ideas

and guidance of

I owe my earliest interest in history to Eric RothHenry Graff gave generously of his wisdom and experience. My discussions with Karen Blair about nineteenth-century women have been very helpful. Michael Frisch and Jesse Lemisch encour-

many

historians.

schild.

aged

me

at

an early stage of

Many people

my

research.

offered valuable suggestions on

all

or parts of

this

Gert Brieger, Gerald Grob, James Reed, Susan Reverby, Charles Rosenberg, Sarah Stage, and Morris Vogel helped me to

book.

its

medical context. Barbara Brenzel, Mari Jo Buhle, Nancy

Ann

Lane, Regina Morantz, and Elizabeth Pleck raised impor-

deepen Cott,

tant questions

16

about the

lives

of nineteenth-century women.

Preface

I

me

am

particularly indebted to Ellen DuBois,

the importance of studying

evolution of

my work

women

who

doctors.

first

suggested to

She has followed the

for the past ten years, giving generously of her

time and her ideas. She has consistently challenged

me with

her

own

encouraged me to develop my own She understands perhaps better than anyone the long intellec-

insights, yet simultaneously ideas.

road that has led to

tual

this

book.

family has provided invaluable support. My parents encourme to pursue my interest in history and helped make possible me to do so. My daughter Abigail provided joyful interruptions

My aged for

it

and moments of sheer delight throughout the preparation of this book. My daughter Eliza, just two weeks old as I write this, inspired

me

in the final stages

Finally,

sustained

than

I

I

me

of

this

work.

husband, Douglas Jones. His belief in me has throughout my work. He has helped me in more ways

thank

my

can possibly express; but

I

know he understands. Virginia G.

Drachman

Newton Massach usetts ,

17

Hospital with a Heart

"The Mother of Us All"

.Backward, turn backward, O Time in thy flight, Back to the dreams, grown reality bright, Dear early days, ere our work we began; Days when we wait, while thought ripens to plan; Days of our hopes, and our doubts, and our care; Days of depression, but never despair. Poor was the cradle, where our bantling was laid, Round it we watched, and we sighed, and we prayed.

—Julia Sprague, for

An

Women

"The New England Hospital and Children," 1896

impressive group assembled in Boston's Chickering Hall on Oc-

They had come

tober 29, 1902. respects to the

women

in

woman who had

to say

goodbye

dedicated her

—

to

life to

pay their

last

the "cause of

medicine," Dr. Marie Zakrzewska (pronounced Zak-shef-

ska). Dr. Zak, as

New

she was popularly known, had founded the

England Hospital for

Women

and Children

in

Boston

in 1862.'

For

the next forty years, until her death in 1902, she had devoted her life to

tice

the hospital, providing

and female

women doctors with

patients with medical care

training

and prac-

from physicians of

their

own sex. The hospital had grown and thrived under her leadership. From its tenuous beginnings with just a handful of beds, Zakrzewska had turned the New England Hospital into one of the most important women's medical institutions in the nineteenth century. Now she was dead. The size of the crowd in the chapel indicated there were main who would miss her. All the physicians from the hospital were present, among them Drs. Emma Call, Elizabeth Keller, and Emily and

Hospital with a Heart

Augusta Pope. They had come to the New England in its early years the all-male hospitals were closed to women, and they had

when

t

dedicated their professional

lives to

among the mourners including Ednah Dow Cheney, it.

Also

were several of the original directors, who had worked with Dr. Zakrzewska since the hospital's inception. Other women in the crowd, while not so closely linked to the hospital, had been among Zakrzewska's longtime friends. Among them were two prominent leaders of the woman's movement, Mary Livermore and Julia Ward Howe. They and other feminists, including Sarah and Angelina Grimke and Lucy Stone, had been loyal friends of Zakrzewska and advocates of the New England Hospital. Their support of her efforts for women doctors and Zakrzewska's participation in such feminist causes as the New England Woman's Club and suffrage linked Zakrzewska and her all-women's hospital to the woman's movement of the nineteenth century.

Men also mourned Dr. Zakrzewska's death: Henry F. Blackwell; young William Lloyd Garrison, the son of the famous abolitionist; Frederick May; and the Reverend Charles G. Ames. All these men believed in the cause of women in medicine and gave their support to Dr. Zakrzewska and her hospital. Scattered among the women at the memorial, they lent distinction to the group just as their association with the New England Hospital helped enhance its public recognition and acceptance. Other prominent male reformers, such as Theodore Parker, Wendell Phillips, and William Lloyd Garrison, would have been there as well had their deaths not preceded Zakrzewska's own. 2

"^

Zakrzewska's friends were a notable group, and she measured up

of them. Her life was one of impressive achievement. She was an accomplished midwife, a pioneer woman doctor, and the founder of a women's hospital. She was also one of the earliest to the best

members of the New England Woman's Club, a suffrage supporter, and an ardent abolitionist. In an age when few women ventured beyond their homes, Zakrzewska forged a unique path. From her earliest years, her experiences seemed to prepare her for a life of significant public

accomplishment.

Marie Elizabeth Zakrzewska was born tober 6, 1829.

22

Her

father,

an officer

in Berlin,

Germany, on Oc-

in the Prussian

army, was a

"The Mother of Us All"

descendant of the aristocratic Zakrzevvski family.

One

powerful

in

"republican

Zakrzevvski family lost

Poland

in

families its

which they lived

tury. Zakrzewska's

of

agitators"

wealth and position fell to

when

of the most Poland,

the

the parts of

Russia in the late eighteenth cen-

grandfather fled to escape the Russian czar,

re-

jected the Catholic church, and

became a Protestant and a liberal thinker. Marie's father, Martin Ludwig Zakrzevvski, followed his own father's example and became a freethinker. 3 ** Zakrzewska derived her political views from her father's side of the family; her mother's side provided the medical focus. Her grandmother was a veterinary surgeon, and her mother, Frederika C. W. Urban, was a midwife. Marie Zakrzewska was the eldest of five sisters and one brother. In her earliest years she amused herself in typical childlike ways, telling stories to her sister Minna, one year younger than herself, and plaving with dolls. As Zakrzewska fondly recalled, her dolls frequentlv "needed to be nursed and doctored," and she, as the young phvsician, cared for each one until it died. Thus, her fantasv plav with her dolls revealed not only

her vivid childhood imagination, but her

early awareness of disease

and death,

as well as

her identification

with the role of the doctor. 4

From her

Zakrzewska displayed the independence and willfulness that enabled her to make her childhood fantasy

come

earliest girlhood,

true

and

to

become one of

the pioneer

America. Already by the age of five when she

first

women

doctors in

started school, she

had adopted her parents' advice to "do right and fear nobody." The teachers "disliked me," Zakrzewska recalled, "because I would not and obey arbitrary demands without being given some reason because I insisted on following my own will when I knew I was right." Throughout her girlhood, Zakrzewska never felt truly com.

.

.

fortable or accepted at school. Despite her obvious intelligence, even

and would have dismissed the "ugly and naughty" child when her family could no longer pay her tuition, had

the principal disliked her

it

not been for her "noble" father. 5

During these early school years, Zakrzewska began to chart a course that deviated from the traditional path of most girls her age. She described herself as industrious, punctual, and keenly perceps 3

Hospital with a Heart

tive,

yet carelessly dressed, ill-groomed,

thought of herself

and

unattractive. In fact she

as "excessively]" ugly, with

her "large nose over-

shadowing the undeveloped features" of her face. Even her peers and relatives ridiculed her. An aunt, Zakrzewska recalled, would say of unattractive people that they were "almost as ugly as Marie." Lacking the social graces of her female schoolmates, Zakrzewska was always "quiet, shy, and awkward" among them. "I never made friends with the girls, or felt like approaching them," she explained. Instead she found her playmates among her male peers. "I joined the boys in all their sports, sliding and snowballing with them in winter, and running and playing in summer. With them," she recalled, "I was merry, frank, and self-possessed." 6 Not until Zakrzewska was eleven did she share a friendship with a girl. Her friend, twelve-year-old Elizabeth, was a devout Catholic and was preparing to become a nun. In her devotion to Elizabeth, Zakrzewska aspired to become a Catholic and a nun herself. As freethinkers, her parents, who had renounced all religion, tolerated their daughter's flirtation with Catholicism. It was not long, however, before Zakrzewska adopted her parents' religious skepticism. When Elizabeth informed her that the church forbade their friendship unless she converted to Catholicism immediately, Zakrzewska gave up her friend and the Catholic church. Indeed, faced with what she saw as the "despotism of theology," Zakrzewska permanently renounced all organized religion and was from that day until her death a freethinker

like

her parents.

Left once again without any close friends, Zakrzewska remained isolated

and unhappy

until, at the

age of twelve, she formed an

attachment to one of her teachers, a

Through

this

awkwardness began

ment of her new first

man

twenty years her senior.

"most peculiar friendship," Zakrzewska's adolescent to

change. With the kindness and encourage-

"teacher-friend," Zakrzewska began to care for the

time about her appearance and her manners, striving always to

"gain his approbation" as well as that of her other teachers and her

Her new personal regimen had a positive effect on her teachwho began to favor her over the other students. Her classmates,

peers. ers,

however, resented her new, privileged position and ridiculed her and isolated her even more. Their rejection made Zakrzewska more

24

"The Mother of Us All"

dependent on her "teacher-friend," with

many of her

whom

she spent her daily

"A strong attachment grew up between us," she remembered. "He became a necessity to me and I revered him like an oracle." 7 This relationship came to an abrupt end when the teacher-friend fell ill with consumption. On the morning of his death, he sent for Zakrzewska at school. 8 By the time she received permission to leave the classroom, he was dead. "This blow fell so heavily upon me," Zakrzewska recalled, "that I wished to leave school at once," and at lunch hour, sharing

private thoughts.

the age of thirteen she quit. For Zakrzewska, school was an important training

ground

for rejecting traditions, espousing unpopular

and enduring ridicule, disapproval, and loneliness. At home, Zakrzewska chafed at her unequal treatment with her brother. Although she was a superior student, her father required her to do housework even though she wanted to read in the evenings; her brother, who disliked his studies, was compelled to do

causes, challenging femininity,

girl,

When

Marie complained, she was told that because she was a she "never could learn much." 9 But the message from home

lessons.

was not quite so

simplistic. Despite

to to

her father's insistence that

his

he nevertheless wanted her to be able "earn an independent, responsible livelihood," rather than simply marry. Zakrzewska's mother, a successful midwife, provided the

daughter learn domestic

skills,

role model. 10

An

early

childhood

experience

Zakrzewska's interest in medicine.

with

When

illness

first

aroused

she was nine, she spent a

year in an ophthalmic hospital as a companion to a blind cousin.

There she first witnessed inadequacies and injustices in hospital care and experienced the desire to "some day ... be a head nurse to prevent such wrongs." 11

The

following year, having contracted an

eye infection herself, she was placed under the care of a physician

who

influenced her profoundly. Struck by Zakrzewska's youth, en-

encouraged her to accompany him on his hospital rounds. Even though she could not see, Zakrzewska could hear his questions and directions, and she quickly became his

ergy,

and

curiosity, the physician

loyal pupil.

When

she regained her sight, the doctor presented her

with two books, one on the history of midwifery and the other on the

25

Hospital with a Heart

history of surgery. "Both

were so

read them through during the time

I

date

my

Ironically,

it

interesting," she recalled, "that

six

weeks of vacation.

.

.

.

From

I

this

study of medicine." 12

was shortly after her outspoken father

lost his

post in

army that Zakrzewska found the opportunity to explore her new medical interest. With the family on the brink of poverty, Zakrzewska's mother became a midwife. Between the ages of fourteen and eighteen, Zakrzewska eagerly accompanied her mother on her lying-in visits. By the time Zakrzewska was sixteen, she was actively assisting her mother in many of the deliveries. The experience did more than provide valuable practical experience in the art of midwifery. It exposed the young girl as well to the bitter realities of life among the poor women who made up over half her the Prussian

and meanness in palaces," she recalled, "virtue among prostitutes, and vice among socalled respectable women." 13 These visions, stamped permanently on her mind, aroused her deep sympathy for the poor whom she strove to help throughout her life. mother's practice.

Despite the

"I

human

saw nobleness

in dens,

misery she witnessed so regularly, Zakrzewska

was extremely happy during the years she worked with her mother.

was as free," she recalled, "as any German girl could be." 14 At the age of eighteen, when most girls were concerned about parties, fashion, even marriage, Zakrzewska made a decision about her career. "I

She chose to become a midwife like her mother. Her decision provoked a conflict at home. It pleased her father, who wanted his daughter to be able to support herself in adulthood. Her mother, however, who had worked out of financial necessity rather than from choice, did not approve. Despite the disagreement between her parents, Zakrzewska applied to the School for Midwives in Berlin.

Founded

in the early

nineteenth century to educate

women

as

midwives, the school was the product of more than a century of

debate in Prussia over the place of midwifery. Although

en

women had

women

in the profession of

traditionally attended other

wom-

was not until the late seventeenth century that Justine Ditrichin Siegemundin, the wife of a distinguished Prussian in childbirth,

civil

officer,

26

it

became known

as the country's first great midwife.

"The Mother of Us Air

Siegemundin decided

to study

midwifery after she was incorrectly

diagnosed as being pregnant. She quickly achieved

local fame as a and an instructor in midwifery. In 1690 she wrote a book on midwifery based on the records of her own cases. It was the first book on midwifery written by a woman in Germany, and it was widely read and influential in

practicing midwife, a consultant in difficult cases,

the profession. Despite

among many

physicians

its

success,

who

it

aroused strong controversy

believed that obstetricians, not mid-

wives, should train midwives.

The

furor over Siegemundin's book

did not impede her career, however. She held the important position of court

that post

midwife

when he

Brandenburg and retained Brandenburg into the kingdom of Prussia

to Frederick III of

raised

her death in 1705, physicians again sought to credit female midwives, and many women left the profession. in 1701. After

dis-

In 1818 a series of laws was passed to regulate the practice of

female midwives. in all cases

One

law required them to

of irregular confinements. While

an important medical check, Another law prohibited any

it

call in a

this

male physician

may have provided

clearly limited midwives'

woman

autonomy.

without formal education in

midwifery from practicing. This law led

to the

founding of the

School for Midwives in Berlin, the school to which Zakrzewska

sought entry in 1844. 15 * Acceptance was by no means automatic.

The

school accepted only

two applicants a year, and competition was keen. Many of the appliwidows of civil officers, seeking financial independence. For several years, Zakrzewska's application was

cants were the wives or

passed over in favor of these older married women.

Zakrzewska

ifyas

befriended by Dr. Joseph

fessor of midwifery in the university

Herman

Finally,

Schmidt, pro-

and the School for Midwives

and director of the Royal Hospital Charite of Berlin. Zakrzewska found that Dr. Schmidt had a deep respect for women and a strong faith in their intellect and potential. She turned to him for help as she had turned to her teacher several years before. Schmidt took a keen interest in Zakrzewska and used his influence to gain her acceptance into the school. This was no small feat. Indeed, not until Schmidt called personally on the king, who held the doctor in high esteem, did Zakrzewska finally gain admission. Once '-'T

Hospital with a Heart

enrolled, she

became Schmidt's

private pupil,

and he trained her

to

succeed him as professor in the School for Midwives and chief ac-

coucheuse

among

aroused deep resentment

in the hospital. His intentions

the male doctors in the hospital, for they strongly opposed

^^placing a

woman

in a position

of such authority. Over the course of

half a year, the controversy intensified,

and Zakrzewska ultimately woman's rights.

found herself the catalyst for a public debate over

While diplomats expressed concern about the emancipation of womSchmidt showered the government with letters attesting to women's capability to assume the responsibilities he proposed to give en,

^

Zakrzewska.

During

this

period of public debate Zakrzewska's mother and

fa-

ther switched their respective positions on their daughter's professional aspirations. Zakrzewska's mother, convinced of her

daugh-

to midwifery, became her staunch supporter. Her on the other hand, shocked by the public attention his daughter's ambitions had provoked, urged her to abandon her career and to marry. Both parents remained fixed in their new positions so that until each died, Zakrzewska's mother remained the ter's

commitment

father,

loyal advocate of

her daughter's professional aspirations, while her

father continued to resist her efforts to forge a professional Finally, all

life.

formal opposition to Zakrzewska's appointment gave

way, and at the age of twenty-two, a jubilant Zakrzewska took over the weighty duties of her mentor.

"The joy

that

I

felt,"

she recalled,

"was great beyond expression." 16 Her happiness was short-lived,

however, for Schmidt,

who had been

day she assumed her new

ill

for

responsibilities.

some

The

time, died the very

loss

was more than a

personal one for Zakrzewska, as she had always relied on Schmidt to

support and protect her from the It

hostility

of the other male doctors.

was not long before she found her enemies too formidable Despite her short tenure as

to

months later. chief accoucheuse and professor of

handle by herself, and she resigned her position

six

midwifery, the experience had a lasting effect. Zakrzewska learned

two important lessons: the value of male support and the burden of male opposition. Schmidt had been an important ally, shielding her from her adversaries and smoothing her way to the top. His death underscored her own vulnerability

28

as a

woman and prepared

her

"The Mother of Us All" for the alienation

and struggle she

later

endured

as a

woman

man's profession. This lesson ultimately became important

New England

Hospital, for Dr. Zakrzewska

made

in a

at the

a point of seeking

the advice and support of respected male physicians and philanthropists in

Schmidt

Boston. Furthermore, Zakrzewska's close relationship with

formative point in her career was influential in shap-

at the

ing her professional identity. She adopted the professional values of

her mentor, one of the most influential physicians

brought them

to

New England

Hospital.

Having

Her

left

in Berlin,

America, where she strove to maintain them

and

at the

the Charite, Zakrzewska faced an uncertain future.

special training with

Schmidt had prepared her for more than a "What was I to do?" she asked. "I was not

typical midwife's practice.

made

is commonly done. My education and demanded more than this." 17 Only months before his

to practice quietly, as

aspirations

death, Dr. Schmidt had

shown her

a report

announcing the opening

of the Female Medical College of Pennsylvania. "In America," he

had told his protegee, "women will now become physicians." Schmidt had given Zakrzewska a new goal. Whereas she had once wanted to be a midwife like her mother, with Schmidt's encouragement, her new aspiration was to become a physician like her mentor. She decided "to go to America to join in a work open to womanhood on a larger scale." 18 Her mother encouraged her, but her father again told her to get married.

When

she agreed to take her third

Anna, she won her father's reluctant acquiescence. At the age of twenty-four, Zakrzewska left her family, her homeland, and the sister,

prospect of a successful career in midwifery to seek greater medical opportunities for herself in America.

Her motives were more than purely also

wanted

to

professional, however. She

expose the despotism of her homeland and

pressive policies toward

women.

its

op-

"I came for a purpose/' she

re-

had to show to those men who had opposed me so strongly was a woman that, in this land of liberty, equality, and fraternity, I could maintain that position which they would not per-

called. "I

because mit to it

I

me

at

home." 19 Nevertheless, despite her

was an enormous personal

can assure you that

this

sacrifice for

political convictions,

her to leave Germany.

was the hardest moment

I

ever knew,

29

1

she

Hospital with a Heart

recalled of the day she left

imprinted the

street, the

home. "Upon my memory is forever window behind which my moth-

house, the

er stood waving her handkerchief." 20

Two months

Marie Zakrzewska arrived in New York ready Though her goal was ambitious, it was by no means an impossible one. Other women in America were already doctors. Some, such as Boston physician Harriot Hunt, apto forge

later,

her career as a doctor.

prenticed with a practicing doctor before establishing a practice.

Adamson Dolley, and Clemence Lozier, trained at homeopathic, eclectic, or other irregular medical schools. Although the orthodox, regular medical community shunned irregular institutions, the latter provided a popular Others, including Lydia Folger Fowler, Sarah

alternative for

were divided

and

its

many

as well

nineteenth-century doctors.

on

this issue.

Some found

institutions appealing because of their

principles, their milder therapeutics,

women

in medicine.

On

and

the other hand,

Women

doctors

irregular medicine

unorthodox medical

their relative tolerance of

women who

identified with

the regular branch of medical practice dismissed irregular

women

doctors as inferior and claimed they threatened the efforts of

wom-

en to attain equality with regular male physicians. Zakrzewska shared this latter point of view. Having trained

Germany

at a

regular institution tied to the medical

elite,

in

she consid-

ered neither an irregular medical school nor even an apprenticeship satisfactory.

Only

a regular medical school

would do. Her goal was

not without precedent. Elizabeth Blackwell had recently graduated

—

from the Geneva Medical College in New York the first woman in America to receive a diploma from a regular medical school. Her sister Emily was at the medical school at Western Reserve College in Cleveland. Other significant signs were the recent founding of the New England Female Medical College in Boston, which gave women formal training in midwifery, and the Female Medical College of Pennsylvania in Philadelphia, which offered women regular medical training apart from men. Encouraging signs extended beyond the field of medicine. By the middle of the century, women throughout the Northeast began to expand their lives beyond the limits of their homes. They joined church organizations, moral reform societies, and temperance orga3o

"The Mother of Us All" nizations.

Many became

involved in antislavery

activity.

And

only a

hundreds of women gathered in Seneca Falls, New York, endorsed suffrage, property rights, and other reforms for women, and launched the formal beginnings of a woman's rights movement. Initially, Zakrzewska did not identify with this early feminism. Yet it was not long before her personal experience showed her that the woman's movement and the entrance of women into medicine were closely entwined. Throughout her first year in New York, Zakrzewska was far from realizing her goal of becoming a doctor. In a small apartment above a grocery, she hung out her shingle. While she waited for the pafew years before Zakrzewska's

tients

arrival,

who never came, her sister Anna took a job with a dressmaker, home only two dollars and seventy-five cents after a long

bringing

week of work. Penniless, friendless, and unable to speak English, the two young women struggled simply to survive. Finally, in desperation Zakrzewska took their last five dollars and invested all but twenty-five cents in worsted materials and an advertisement in a German paper for women who could knit. In this way she launched a business producing worsted goods in her tenement apartment. The enterprise became a financial success and pulled Zakrzewska and her sister out of their poverty. At the same time, it had important implications for Zakrzewska's future:

that she later used at the to the tragic lives

of

it

gave her business experience

New England

Hospital,

many German women who,

and

it

exposed her

unlike herself, were

when they became acquainted," she explained, "with many of those unfortunates who had been misled and ruined on their arrival by persons pretending, friendship." 21 Their ruined lives evoked in Zakrzewska a deep and lasting sympathy that she seduced, sexually exploited, and forced into prostitution arrived in America. "I

first

extended to the many immigrant women who sought care at the New England Hospital. While Zakrzewska made her small worsted business a success, a later

full

year in

New York

Gity brought only frustration regarding her

primary goal of becoming a doctor.

Armed

with letters of support

male physicians in Berlin, she tried to make contact with male physicians in America, expecting the same support from them. But they only discouraged her efforts. "Evervwhere my inqui-

from

influential

Hospital with a Heart

ries

about

women

doctors were received with a pitiful shrug of the

shoulders," she explained. "I had idealized the freedom of America

and

especially the

reform of the position of women" she com-

plained. 22

Only when Zakrzewska sought the help of women did she receive encouragement. In the spring of 1854, she visited the Home for the Friendless, hoping that the women who ran it would be able in some way to help her launch her medical career. Zakrzewska received the help she sought. Only two days after her

visit, the matron of the meet Dr. Elizabeth Blackwell. Following graduation from Geneva Medical College in 1849, Blackwell had opened a small outpatient dispensary for poor women and children on New York's Lower East Side. 23 The meeting between Zakrzewska and Blackwell was significant for both, marking the beginning of a lifelong relationship. "From this call of the 15th of May, 1854, I date my new life in America," Zakrzewska recalled. "Now," she continued, "I was Finding the welcome and the beginning of which I had dreamed, and all the many days of disappointment were instantly forgotten." 24 Dr. Blackwell too was delighted with her new acquaintance. Of this initial meeting she wrote to her sister Emily, "I have at last found a student in whom I can take a great deal of interest. There is true stuff in her, and I shall do my best to bring it out." 25 While Zakrzewska gave Blackwell invaluable aid in the infirmary, Blackwell became Zakrzewska's medical preceptor and English instructor and helped her gain acceptance as a student in the medical department of Western Reserve College. Their relationship symbolized in microcosm the isolation of women doctors in mid-nineteenth-century America and the striking need for the friendship and colleagueship a community of medical

home arranged

women

for her to

could provide. 2

*'

With Blackwell's help, Zakrzewska began her formal medical training in the

fall

of 1854. Entering medical school was a turning

marking the first formal step in attaining her goal of becoming a doctor. But it had significance that extended beyond her career plans. It changed her attitude toward the woman's rights movement in America from skepticism to support. The help she received from Blackwell and from the women at the Home for the point in her

32

life,

"The Mother of Us All" Friendless

showed her

that

women

willingly offered the professional

help she did not receive from men. Moreover, the financing of her

medical education in Cleveland demonstrated even more clearly her

dependence on the organized

efforts of

women. Blackwell provided

the books she needed. Caroline Severance, the president of the

Ladies Physiological Society in Cleveland, gave Zakrzewska free

room and board. 27 The Ohio Female Medical Education

Society, an

organization of women seeking to forward women's medical careers, paid her lecture fees. Having personally benefited from the collective efforts

ticism

of so

many women

she did not know, Zakrzewska's skep-

about woman's rights dissolved into deep appreciation. In

recalling her

change of heart, she explained, "the 'crowing hens' of

Cleveland," as she had originally perceived them, "had taken

under

their

wing

to shelter

me and

to

promote my

efforts." 28

me

This

personal experience ignited Zakrzewska's interest in woman's rights. In later years she

commitment

made her own

contribution to the cause, for her

women in medicine became New England Hospital.

to equal opportunities for

a central building block of the

Zakrzewska's experiences during her student days in Cleveland

opened her eyes

to

more than woman's

rights.

Through Caroline

Severance, Zakrzewska met the Reverend A. D. Mayo, an abolitionist

and woman's tion.

From

who led a small Universalist congregamen and women who made up Mayo's unorthodox

rights activist

the

group, Zakrzewska encountered a range of new ideas beyond abolition and woman's rights, including free love, free soil, spiritualism, and Fourierism. As a medical student in Cleveland, Zakrzewska began to receive what she termed her education in "American Civilization." "It was a most valuable episode of my life," she recalled, "turning all my views topsy-turvey, uprooting me, so to say, from all German conservatism, and throwing me into this chaotic medley of

contradictions." 29

While a medical student, Zakrzewska endured a major tragedy: The visit her, died aboard ship.

her mother, enroute to America to

news almost paralyzed me," Zakrzewska explained of perhaps the deepest personal loss of her father

became even more

imploring her in

life.

:U)

To make

matters worse, her

rigid in his opposition to her career plans,

letters to give

up her work and threatening 33

to

Hospital with a Heart

withhold financial assistance should she ever need

it. "If you were a one letter, "I could not find words in which to express my satisfaction and pride but you are a woman," he continued, "a weak woman; and all that I can do for you now is to grieve and to weep." 31 Despite the strength of his words, Zakrzewska's father never swayed her in her plan to become a doctor. When she graduated from Western Reserve in 1856, she joined the handful of women who were to open the medical profession to women. Returning to New York to set up a medical practice, Zakrzewska

young man," he wrote

in

.

quickly learned that for a

woman,

professional success.

tee

against female physicians.

.

a medical degree did not guaran-

Instead,

The

.

she

felt

the strong prejudice

prevailing view was that they had

overstepped the proper boundaries of womanhood. In addition, the public associated "female physicians" with abortionists. Indeed,

was during that the

this

very period

when Zakrzewska returned

infamous abortionist,

her notoriety. Her

Madame

name "was on

Restelle,

was

to

it

Xew York

at the

peak of

everyone's tongue as typifying the

Zakrzewska explained. Because of the widespread horror and mistrust of female physicians, Zakrzewska found that "people were afraid to employ a woman physician openly" and 'female physician,'

"

were even unwilling to rent office space to her. 32 Zakrzewska the back portion of her house. Zakrzewska moved into Blackwell's busy household of relatives, which included her brothers, Henry and Samuel, and their respective wives, Lucy Stone and Antoinette Brown Blackwell. The reunion between Zakrzewska and Blackwell reestablished their close friendship and rekindled their shared interests. In particular, it renewed their desire to resume their dispensary, or outpatient work, which Blackwell had terminated because of lack of funds. To reopen the dispensary required $500, a sum neither woman could raise. "It seems an impossibility," Zakrzewska wrote at the time, "to find friends for our cause. Nobody seems to feel the need that landlords

Finally, Elizabeth Blackwell offered

of a hospital or dispensary for the practical training of women physicians." Frustrated in

New

her unsuccessful attempts

to raise

money

in

York, Zakrzewska found encouragement from Dr. William

Channing, a Boston physician who had brought a female patient to New York to be treated by Blackwell. Channing was enthusiastic 34

'The Mother of Us All"

about the idea of a women's hospital, and he encouraged Zakrzewska to seek financial support in Boston, "the hothouse of all reforms." 33

Zakrzewska had been Cleveland.

Through

to

Boston once, during her student days in Hunt she had met such leading

Dr. Harriot

reformers as Sarah and Angelina Grimke, William Lloyd Garrison, Theodore Parker, and Wendell Phillips, as well as Dr. Channing. Remembering what she perceived then to be the relative tolerance for women doctors in Boston compared with New York or Cleveland, Zakrzewska took Channing's advice and went to Boston in 1856 "to beg for an institution for American women." 34 Through her friends Harriot Hunt and Caroline Severance, who had moved from Cleveland to Boston, Zakrzewska met men and women who were interested in her venture. Women such as Abby May, Lucy Goddard, and Ednah Dow Cheney, and men such as William Lloyd Garrison and Samuel Sewall, opened their homes for Zakrzewska to speak to small groups on behalf of the infirmary. These women and men, influential reformers in antislavery, woman's rights, and other causes, became Zakrzewska's new friends. Seven years later they

provided the nucleus of her support for the founding of the

New

England Hospital. After two visits to Boston in 1856, Zakrzewska returned to New York with pledges of $650 for the new infirmary. By the spring of 1857, Zakrzewska and Blackwell had raised the money they needed, and on May 1 1857, they opened the doors to the New York Infirmary for Women and Children. For two years Zakrzewska donated her energy and skills to the infirmary, serving as resident physician, superintendent, housekeeper, and instructor. The work was de,

manding and

barely supported her basic needs. "In truth," she re-

had to earn by outside practice, the money to buy a holiday or Sunday dinner, as the Institution was too poor to afford a decent table." 35 During the time Zakrzewska was at the New York Infirmary, she made another visit to Boston, calling on the friends she had made during the previous trip. Anxious to attract her to their city, they encouraged Zakrzewska to come to Boston to organize a clinical department in the New England Female Medical

called, "often

College.

I

Hospital with a Heart

The New England Female Medical

College was founded by Sam-

uel Gregory, a lecturer in physiology noted for his widely read

pam-

phlets on sexual morality and midwifery. Gregory studied at Yale

College in the early 1840s, and then embarked on his lecture career,

speaking throughout

New England on

a range of topics such as

phrenology, mesmerism, and licentiousness. In 1844 he published his first pamphlet, Facts and Important Information for Young Men on the Self-indulgence of the

Sexual Appetite.

The pamphlet

sold over

42,000 copies and established his reputation. In the mid- 1840s, Gregory began to express alarm about the growing numbers of male

accoucheurs and the threat he believed they posed

to

female virtue.

In a series of pamphlets including Man-Midwifery Exposed, Medical

and Letter to Ladies in Favor of Female Physicians, Gregory argued that only women should attend women in the delivery room. In a further attempt to banish men from the delivery room, he opened the New England Female Medical College in 1848 to pro-

Morals,

vide

women

with formal training in midwifery. Innovative in his

efforts to train

women in medicine, he was nonetheless rooted in women that emphasized modesty, piety, and

traditional views of passivity.

Moreover, though Gregory held an honory medical de-

gree from the Eclectic Pennsylvania Medical College, he not only

was outside the regular medical profession but was a vocal it.

critic

of

36

Zakrzewska ultimately views of

her

visit

women to

lost

patience with Gregory's traditional

as well as with his

Boston

in the winter

unorthodox medical

ideals.

On

of 1859, however, she saw the would have for women

potential value she believed Gregory's school

medicine once she had established a clinical department. Persuaded by her friends in Boston of their commitment to clinical training for women, and confident that the New York Infirmary was in

on firm ground, she seized this opportunity to organize her own clinical department in Gregory's school. While her friends in Boston applauded her decision, her father in Germany wrote her of his deep displeasure with her new course of action. "Whether or not I succeeded," explained Zakrzewska, he believed "I was disgracing the family and German womanhood in general, by accepting a position which caused

36

my name

to

come

— "The Mother of Us Air

prominently before the public." 37 In exasperation, Zakrzewska wrote a letter to her father demanding that he accept her decisions or never write her again. This

Zakrzewska

felt

letter,

from her

ration of her emancipation

father. Ironically,

with her father's death, and Zakrzewska never

read

when

written at a time

confident about her future, was an important declait

coincided

knew whether he

it.

The death of her father did not impede Zakrzewska and she began her work at the New England Female Medical College confident that she would be able to offer clinical training in medicine to women.

Her experiences

at the college,

however, did not

live

up

to

her

high expectations. Sharp differences quickly developed between herself

and Gregory. Zakrzewska,

en could succeed

in

like Blackwell, believed that

equal footing with the best male physicians.

doom women's

wom-

medicine only by entering the profession on an

To do

otherwise would

Gregory did not share Zakrzewand very quickly the two began to clash. From the beginning, Zakrzewska received little support from Gregory for the clinical department she was trying to build. Attendance in her department was not a requirement, and she found that only a efforts to failure.

ska's professional standards,

few students, the better ones, chose to

more, her requests for times with hostility.

When

ample, one of Gregory's

visit

it

regularly. Further-

apparatus were often rejected, some-

clinical

she petitioned for a microscope, for ex-

allies

described her request as "another one

of those new-fangled European notions which she

tries to intro-

duce." 38 In another instance, her disagreement with Gregory over

standards put Zakrzewska in the awkward position of obstructing the medical careers of two

performed poorly on

women. When two of Gregorys

port their graduation. In this

women, Zakrzewska did not support every woman only those

students

exams, Zakrzewska refused to supcase, as in all her medical work for

their final

who met her

in

medicine

standards of excellence.

Like Zakrzewska, the Lady Managers of the College also suffered

under the

dictatorial

hand of Gregory, who denied them any mean-

ingful influence in the business of the school. Ultimately, the strain

between Gregory and his allies on the one hand, and Zakrzewska and her allies on the other, became a struggle over who would have 3 7

Hospital with a Heart final authority at the college. According to Zakrzewska's supporters, Gregory was determined to keep all the power for himself. "His will is law," lamented one of Gregory's adversaries. "At first, he put down Mrs. G and now it appears to me that he has been determined to put down Dr. Zakrzewska." 39 But Zakrzewska would not let Gregory subdue her. Frustrated by her lack of autonomy, the obstacles to her clinic, and her inability to preserve her professional

—

Her

standards, she resigned in 1862.

supporters, including

Ednah

Cheney, Abby May, and William Lloyd Garrison, left with her. "The whole occurrence brought about a split in the college," Zakrzewska recalled,

orable

intelligent men, among whom was the Honsome of the men professors, also resigned." 40

"and the most

S. E.

Sewall and

In leaving the

New England Female

Medical College, Zakrzewska

preserved her professional integrity and her strong commitment to

women

standards of excellence for

doctors. Yet she was once again

without a vehicle for implementing them. "In 1862, after disconnecting myself from the

New England Female

Medical College in

Boston," she recalled, "I stood alone once more, time,

and

me.

was no longer needed

I

still

as the result

at the

of

my

in

my life's work, as it appeared to New York, yet nothing could I show

eight years' labor." 41 Zakrzewska did have a goal, at

Gregory's school strengthened her

importance of clinical training for women.

work again on the old

plan," she explained,

"Namely

"I

decided

to

to establish the

education of female students on solid principles, that

them

for the third

beginning of

however, for her experience belief in the

now

is,

to

educate

in hospitals." 42

This time, Zakrzewska had a strong nucleus of "A few friends Mr. George William Bond, Mrs. Ednah D. Cheney, and Miss Lucy Goddard true, firm friends of the educa-

—

support.

tion of

women

—

stood beside me," she recalled. Almost immediately

New England Female Medical College, they pooled energy and resources, "remnants of hospital furniture valued $150 which remained from our experiment in connection with

after leaving the their at

the

New England Female

England Hospital for

Medical College," and opened the

Women

and

Children. 43

New

Unlike Gregory's

school, Zakrzewska's hospital followed the standards of the regular

male medical profession. From

its

founding

er work, Dr. Zakrzewska devoted her

Even her private practice and her private 38

until she

life to

could no long-

the hospital.

life

overlapped with her

— 'The Mother of Us Air

work

at the hospital. In the hospital's earliest years,

Zakrzewska used

her private practice to demonstrate a woman's capabilities cine

and

to

consistently

medi-

so,

she

measured herself against the standards of the male phy-

emulated.

sicians she

in

win approval from male physicians. In doing "It

was

my

determination," she explained, "to

prove to the profession, as well as the only the same

(if

laity,

that a

woman

has not

not more) physical endurance as a man, while

thus created a good foundation of respect for

women

physicians." In

her effort to prove her endurance, Zakrzewska attended the night and day regardless of distance or weather.

I

"No

sick

cases could or

would I refuse," she recalled. She walked, even in the night, through Roxbury, South Boston, Dorchester, Brookline, and Cambridge in temperatures often below zero. This nighttime traveling "was absolutely

needed," she explained, "to dispel the prejudice against wom-

do night work." The following year, Zakrzewska bought a "second-hand buggy and a horse" to make her house calls easier and to improve her professional image. The buggy "became a an's ability

to

matter of necessity," she recalled, "to uphold the professional quette and dignity of a

woman

eti-

physician as an equal with men." 44

Like most nineteenth-century professional

women, Zakrzewska

never married. Her decision reflected the prevailing values of nineteenth-century American society, which denied middle-class

women

both career and marriage. Indeed, balancing the two was a feat few

women

of her day ever achieved.

Still,

Zakrzewska would have pre-

ferred to marry. Recognizing the limits she personally experienced as a single

younger woman doctor to marry: "I happiness that exists for us poor mortals

woman, she advised

want you to enjoy all which is by no means

a

in the single life." 45 Despite

her personal

preference for marriage, Zakrzewska remained single

—and

not

out of deference to nineteenth-century social values. She believed that the severe headaches from which she suffered all her solely

adult

life

were symptoms of an obscure hereditary nervous disorder.

Since marriage without children was unthinkable to her, she chose a

Zakrzewska's "brain trouble," as she called her condition. was a private tragedy and a bitter irony. While she dedicated her public life to medical science, her personal life was clouded by medisingle

cal

life.

ignorance and her suffering shared with practically no one. married, she headed a busy house-

Though Zakrzewska never

39

Hospital with a Heart

hold. In i860, she

house

in

borrowed S500 from Samuel Sewall

Roxbury. There she

settled with

to

two of her

purchase a sisters;

her

and the German radical, Karl Heinand son. She had the greatest affinity with Heinzen, a republican and a freethinker who had emigrated from Germany to America in the 1850s. In America he established himself as one of the leading German-American journalists. Throughout his publishing career, he espoused radical ideas and supported radical causes, including abolition and woman's rights. 46 As a child, Zakrzewska had learned about Heinzen, "the pioneer of Republicanism in Germany," from her father, who read his writings in secret. She met Heinzen in New York, and they became lifelong friends. When Heinzen moved to Boston, Zakrzewska longed to follow him there. Indeed, she confessed in a private letter at the end of her life that it was Heinzen, as much as any professional invalid friend, Julia Sprague;

zen, his wife,

interests,

who

attracted her to Boston. 47

and son became a permanent part of Zakrzewska's household when she moved to Roxbury in i860. Heinzen committed his time to his radical journal, Pionier, publishing essays on diet reform, education, music, and geography, as well as excerpts from the writings of Darwin, Dickens, Poe, and Harriet Beecher Stowe. Though clearly a vehicle for Heinzen's radical ideas, Heinzen,

his

wife,

the Pionier was, according to William Lloyd Garrison, "the ablest,

most independent, and high-toned of

all

German papers

in the

country." 48 Zakrzewska played a major role in keeping the journal

donating monev whenever she could. At the same time, Heinzen took every opportunity to use the Pionier to publicize Zakrzewska, her lectures, and the New England Hospital. Heinzen and his family lived with Zakrzewska until his death in her home in 1880. Until then, he and Zakrzewska formed the nucleus of a social center for their German and American friends. With the families of William Lloyd Garrison, Caroline Severance, and German radical Louis Prang living down the street, her various sisters moving in and out, and her hospital friends dropping bv, Zakrzewska led a busy private life. l9 Still, the New England Hospital was the center of Zakrzewska's life. "It was the object of her most intense affection, the child of her afloat,

4

'The Mother of Us Air

prime and of her old age," explained Emily Pope. Through every vicissitude," Pope continued, "from the poverty of its beginning to '

the time in 1900 beautiful

when she

rejoiced with us at the opening of our

was her pride and joy." 50 Dr. England Hospital her energy, drive,

new

surgical building,

it

Zakrzewska brought to the New and persistence; the wisdom of her personal experience; her strong

women

commitment to the highest standards in regular medicine; and her deep sympathy for poor women. She wove these concerns into the New England Hospital so that in principle and in policy it bore her stamp. As her friends at the hospital explained on the occasion of her seventieth birthday: "In her belief in

doctors; her

thought, the New England Hospital was born. Because of her zeal and untiring energy and the aid of a few earnest friends, it became a fact. And from that day to the present one, as wise woman, skillful physician, and faithful friend, she has been an inspiration to all." 51 There were many whose lives Dr. Zakrzewska touched. The mourners at her memorial service were testimony to her influence. The oldest members in the crowd, the ones who had known her the longest and worked with her the closest, would miss her most. But even they had found her stubborn, impatient, and tactless. Her old friend William Lloyd Garrison once warmly described her as "a woman of decided opinions and the frankest speech." 52 And Ednah Cheney described her as a woman with a "quick, impatient temper" who "sometimes gave offense." 53 Even Zakrzewska considered herself "too frank and candid" and wished she had been "brought up with more reserve." 54 Still, throughout her life, Zakrzewska held tightly to her principles, regardless of the consequences, and she paid the price of popularity for her convictions. The younger doctors were less tolerant of her than their predecessors. Thev respected her, but many of them had found her difficult to work with

and hard

to

understand.

To

them, Zakrzewska's persistence was

merely stubbornness, and her commitment to a separate all-women's hospital was both outdated and a sacrifice of professional standards.

Some had

recently collided with her on a variety of issues.

young doctors

at the

memorial service said goodbye and directors bade farewell

leader; the older doctors

friend

and comrade.

The

to their crust)

Ironically, only in death

to their loyal

was she able

to bring

41

Hospital with a Heart

them

had long been unable to agree. But the moment. To be sure, several of the original group, like Drs. Emma Call and Emily Pope, would continue to work at the hospital and give it a continuity with the past. But new leaders had emerged. Among the crowd stood younger doctors such as Mary Hobart and Sarah Bond who were ready to bring the hospital all

together, for they

unity was merely for a

into the twentieth century.

For the moment, however, the stage They planned the program, sat on

still

belonged

to the pioneers.

the platform,

and gave the

speeches. Moreover, at Dr. Zakrzewska's funeral only three months before,

it

was Zakrzewska herself who had commanded center

Prepared

as she

was

in life for the

she was prepared for this

last

many meetings

stage.

she attended, so

gathering with her friends and fellow

workers. Only weeks before her death she wrote her final goodbye, to

be read

Mrs.

her funeral. In death, as in

at

Emma

thirty years,

Butler, a

member

life,

she had the

last

word.

of the board of directors for over

read Zakrzewska's farewell

letter:

my whole lifetime, I have had my own way as much as any being can have it without entirely neglecting social rules or trespassing upon the comfort of others more than is necessary for During

human

self-preservation.

And now, upon this occasion, I wish to have my own way in taking who shall come for the last time to pay such respect as

leave of those

custom, inclination and friendship shall permit, asking them to accept the assurance that I am sorry to pass from them, this time never to return.

.

.

.

am

not speaking of fame, nor do I think that my name, difficult though it be, will be remembered. Yet the idea for which I have worked, the seeds which I have tried to sow here and there, must live and spread and bear fruit. 55 I

Dr. Zakrzewska was correct.

Her name was

all

but forgotten after

her death. Yet the successes of women doctors throughout the twentieth

century were testimony to the permanency of her accomplish-

New England Hospital was her legacy to women doctors, one which they could look

ments. In particular, the future generations of

back to with pride. As the younger William Lloyd Garrison declared in his eulogy:

42

"Now

her triumphs and services have become historic

"The Mother of Us All" records, while the

New England

Hospital, whose foundation she once her monument and the city's pride.

laid

more than

the

,,

in tribulation,

is

The death of

at

Dr. Marie Zakrzewska represented

death of a pioneer tors,

woman

doctor.

Two

generations of

" ,,i

women docwomen in

symbolizing both the hopes and the struggles of

remember this leader and her beloved hospital. moment, the memorial and eulogy of Dr. Zakrzewska kindled the women's nostalgia for the New England Hospital, its founder, and a bygone day when the hospital held a central place in the lives of women doctors. As they stood there together, they all knew that, for better or worse, the New England Hospital in 1902 was a very different place from what it had been when Zakrzewska medicine, joined to If only for a

founded

it

in 1862.

A}

—

2

"This All-Women's Hospital'

L>(hild

of

Gladly

we gave of our

promise,

fair

Grown comely

in figure,

Winning the way Disarming the

still

to

pleading for more,

love, thought,

and

store.

ripening in grace,

high honor and place.

confirming the friend, Boldly advancing, its right to defend. Faith for

its

foe,

motto, and truth for

its

guide,

Child of our hope, become child of our pride!

—Julia Sprague, for

The New England July

1,

1862.

doctors for

It

Hospital for

was the

women

Elizabeth Blackwell's

(and their children) tant strands in the

Women

first

"The New England Hospital and Children," 1896

Women

hospital in

patients

and Children opened on

New England run

and the second

by

women

in the country, after

New York Infirmary. As a hospital for women only, the New England symbolized two imporgrowth of

institutions in nineteenth-century

America. It was part of the nineteenth-century hospital movement one of a number of privately supported voluntary hospitals in Boston, including the Massachusetts General, the Children's, and the Boston Lying-in, which were founded to serve the medical needs of the sick poor and the professional interests of physicians. At the same time, it was one of the many separate institutions founded by women for women that constituted the nineteenth-century woman's movement. Zakrzewska's original reasons for founding the New England Hospital combined the purposes of voluntary hospitals with those of other all-women's institutions. She had three specific goals: to provide sick women with medical care from doctors of 1

44

"This All-Women's Hospital"

their

own

sex, to give

them

able to

women

doctors the clinical tiaining unavail-

at male-controlled hospitals in the city,

and

to train

nurses. 2

The combination of the made the New England a

and female dimensions its day. By offering women doctors hard-to-find professional opportunities and sickwomen medical care from doctors of their own sex, the New England made its own unique contribution to social change in nineteenth-century America. It expanded the woman's movement into the field of medicine and nudged the hospital movement into the arena of feminism. With a successful blend of the separatist ideals of the woman's movement and the principles of regular medicine, the hospital attracted the support of constituents from the woman's movement, the medical profession, and the inner circle of Boston's reformers. Under Dr. Zakrzewska's leadership, women doctors and benefactors became the hospital's central force, donating time, money, and professional commitment. Male reformers and physicians aided in the founding and running of the New England by lending their support to this hospital for women only. By the end of its first decade, the New England Hospital emerged as a premier women's hospital's medical

special institution in

women patients, providing clinical women interns, and opening up professional opportunities for trained women doctors. As an all-women's institution, the New England Hospital was both medical institution, treating

training for

unique and

was unique as a medical institution, but it was many organizations founded and run by women in the second half of the nineteenth century. This "female institution building" of the late nineteenth century was a long-term consequence of the changing status of women in antebellum America. 3 As typical;

it

only one of

commercialization and industrialization

moved production

outside

men followed the means of production into the women remained home to care for their families. This

the home,

public

world;

sexual

development of separate and the private world men work for "spheres" the public world of of the home for women. The development of the home as woman's sphere changed women's lives in the nineteenth century. Their exclusion from the public arena of politics and commercial production division of labor translated socially into the

—

15

Hospital with a Heart

caused them to lose economic and

political status.

Though some

women joined the industrial labor force, they were not equals with men and were generally felt to be out of place

working-class treated as in a

work environment.

The

relegation of

women

to the domestic sphere gave

them

a

separate identity apart from men. As daughters, wives, and mothers,

women

shared a set of experiences that brought them together in bonds of sisterhood. Mothers and daughters shared special relationships; married women were often more emotionally tied to

close

female friends than to their

But the separation of

own

women

spouses. into the private sphere did

more

than encourage close personal relationships and foster a sense of sisterhood

among women.

In addition, separatism became the

springboard from which nineteenth-century

change

their lives.

Throughout the second

women

sought to

half of the century, they

gathered together in separate, all-women's groups to reform society

and to improve their own lives. They began their own antislavery and temperance societies, organized their own literary and philanthropic clubs, and founded their own seminaries and colleges. Through their separate institutions, women sought to expand the boundaries of their lives beyond the home. Yet women sought more than simply to share the public sphere with men. They wanted to change it as well. In particular, they shared a vision of a society in which the piety, morality, and domesticity of the home would inform the world outside. Only the radical wing of the woman suffrage movement, led by Susan B. Anthony and Elizabeth Cady Stanton, sought total equality with men in the public arena. Most women modeled their institutions on the male counterparts from which they were excluded while simultaneously infusing them with the values unique to the private sphere. The all-women's

colleges, for

example,

offered training in traditional academic subjects as well as domestic skills;

the

Women's

Christian

Temperance Union sought

to abolish

drinking, eradicate the sexual double standard, and promote

wom-

an suffrage under the banner of Home Protection. The hundreds of organizations women founded around the country constituted the nineteenth-century woman's

movement and made

separatism the

cornerstone of contemporary feminism. 4

Born of the separatism 46

that

was fundamental

to nineteenth-cen-

"This All-Women's Hospital"

tury feminism, the

movement

of

its

New England

Hospital was part of the woman's

day. 5 Zakrzewska

may have shared Anthony's and

women with men, but she had own experiences in New York, Cleveland, and

Stanton's vision of full equality for

learned from her

Boston that integration with male doctors on any clinical training,

With

ble.

this in

or professional societies

level

women

women's hospital modeled

doctors: the creation of a separate

it

women

Boston

in

May, Caroline Severance, Lucy Goddard, and Ednah in the

all-

men. This was more than a grew naturally out of Zakrzew-

friendships with influential

were leaders

to clinical

after those of

pragmatic decision, however, for

All

—education,

practically impossi-

mind, she chose the only feasible route

training for regular

ska's close

—was

woman's movement and

Dow

— Abby

Cheney.

actively involved in

separate all-women's institutions. Cheney, for example, had helped

women. May was an execNew England Woman's Auxiliary of the United

establish a short-lived school of design for

utive

member of the

Commission. Severance had been

States Sanitary activist

when

a

woman's

rights

she lived in Cleveland. In 1868, Cheney, May, and

Severance were founding members and officers of the

Woman's Club,

the pioneer, with

New

New England

York's Sorosis, of women's

With the New England Woman's Club as their expanded their reform activities on behalf of women. They began a horticultural school for women, founded Girls' Latin School in Boston, sponsored lectures on dress reform, and orgaclubs in America. base, they

nized the Massachusetts School Suffrage Association to assure

wom-

en's participation in school-board elections/ 1

As leaders of

a range of all-women's organizations, these

women

eagerly supported the establishment of a medical institution for

women.

Initially

in their position as

primary responsibility was fund

when she tal,

came

to

Boston

raising.

to raise

they persuaded her to leave

clinic at flict

first

the

New England Female Lady Managers, their Impressed with Zakrzewska

they became involved in the

Medical College where,

money

New York

New England Female

for Blackwell's hospi-

in

order

Medical College.

to establish a

When

the con-

between Zakrzewska and Gregory led to Zakrzewska's resignafollowed her and helped her to found the New England

tion, they

Hospital.

While May, Severance, Goddard, and Chene) were

all

among 47

the

Hospital with a Heart hospital's earliest supporters, Goddard and Cheney, in particular, committed years of work to it. Born in Portland, Maine, Goddard lived most of her life in Boston. Daughter of a family of philanthropists, she "mingled in Boston's most cultivated society." At the same time, she developed a keen interest in medicine. When Gregory opened the New England Female Medical College, she brought her interest in medicine and her commitment to philanthropy to the school. When Zakrzewska's clinic at Gregory's school collapsed, Goddard threw her energy into the New England Hospital, serving as its president through its first quarter-century. Goddard helped direct and sustain the hospital, and despite her "brusque manners," she was highly respected for her work and for her "tender and sym-

pathetic" actions. Fittingly,

Goddard spent

the

last

days of her

life as

Though unaware of where she was, she said whom she had served for so many years: "Everybody

a patient at the hospital.

of the doctors is

so kind

and

it

seems

as if they loved to take care of you." 7

members of the original board of directors, Ednah Dow Cheney made the longest commitment to the New England Hospital. As a young woman in her teens, Cheney's personal contact with leading reformers such as Margaret Fuller, Theodore Parker, and

Of all

the

Bronson Alcott inspired her

zeal for reform.

One

of her early con-

women, and like Goddard, Severand May, she became a Lady Manager at the New England Female Medical College, then left with Zakrzewska to help establish the New England Hospital. She was the hospital's secretary at its founding in 1862, became its president when Goddard resigned in 1887, and continued in that capacity until 1902 when she resigned

cerns was medical education for ance,

because of

illness shortly

before her death.

The commitment of such women as Cheney, Goddard, Severance, and May to the New England Hospital attracted support from other woman's movement. As editors of the Woman's JourMary Livermore, Julia Ward Howe, and Lucy Stone gave the

leaders of the nal,

announcing its fund-raising events, introducing new staff members, and publicly praising the hospital's growth and success. 8 The relationship between Zakrzewska and Boston feminists was part of a network of support between women doctors and women in other areas of the woman's movement hospital valuable publicity,

48

1

"This All-Women's Hospital"

around the country. Sarah Josepha Hale, for instance, wrote on behalf of women doctors in her popular women's magazine, Godey's Lady's Book. Within its pages she argued that medicine was the "appropriate sphere for women" and kept her readers up to date on the progress of the New England Hospital as well as the New York Infirmary and the Woman's Medical College of Pennsylvania. 9 Sectarian physicians had their advocates as well. Elizabeth Stuart Phelps, a writer and advocate of dress reform, popularized the woman doctor in her novel, Dr. Zay, about a homeopathic physician and her weak male patient. 10 Elizabeth Cady Stanton aided a woman physician, Clemence Lozier, in founding the homeopathic New York Medical College and Hospital for Women. 11 The support women doctors received from the woman's movement was not one-sided. Women doctors participated actively in women's clubs, lecturing on health-related topics such as hygiene, exercise, and dress reform. Some were club organizers. Dr. Harriet Clisby, for example, helped to found the Boston Women's Educational and Industrial Union, and Dr. Eliza Newcomb-McGee of Washington, D.C., helped start the Woman's Anthropological Society of

In

America. 12

many

ways, Zakrzewska's connection to the woman's

movement

She helped found the New England Woman's Club, where she gave frequent lectures on female physiology and health, and she was active in the American Woman Suffrage Association. At the same time, Zakrzewska was tied to the woman's movement in a way that distinguished her from all other women doctors. At the request of her friend, Caroline Dall, a feminist and writer, Zakrzewska wrote a book describing her life up to her initial connection with the New England Female Medical College. This autobiography. .4 Practical Illustration of "Woman's Right to Labor," appeared in i860. Thousands of people read it, though mostly by passing copies among themselves, so that Zakrzewska derived little profit. 13 The book brought her no income, but it made Zakrzewska an important role model for other women and connected her publicly and intimately with the heart of the woman's movement. Equally important. it earned her the respect of influential men in Boston and even persuaded some skeptics that women could be good doctors. was

similar.

1

49

— Hospital with a Heart

Women

provided the backbone of Zakrzewska's support for the

New England

Hospital, but she depended as well on the goodwill, encouragement, and active participation of a group of men who were willing to stand behind an all-women's hospital. Leaders among Boston's inner circle of male reformers William Lloyd Garrison, Frederick W. G. May, and Samuel Sewall, among others eagerly came to the aid of the hospital. Garrison was one of Zakrzewska's first friends in Boston. He had been among those who encour-

—

aged her

to

open

a clinical

department

at the

New England Female

Medical Gollege, and he had announced the intention of creating

such a

clinic

in

his

antislavery newspaper,

Zakrzewska and her supporters

The

Liberator.

again used The Liberator to publicize the founding of the

gland Hospital.

mained her

A

neighbor of Zakrzewska's

close friend

When

Gregory's school, Garrison

left

and an advocate of her

in

New En-

Roxbury, he

re-

hospital throughout

his life. 15

The

abolitionist,

Frederick W. G. May, also loyally supported

May was one of her earliest friends in Boston. In fact, he was the First man to give her money for the New York Infirmary when she visited in 1856. The following year, with his sister, Abby May, he was the first man to visit the Xew York Zakrzewska. Like Garrison,

Infirmary, to which he offered his "sympathy and confidence.

From

the beginning,

tions of the first

fifteen

May

Xew England

played a crucial role in the internal operaHospital, as the hospital's treasurer for

member

years and as a

throughout the centurv. One of the most important Hospital was Samuel

Edmond

men

to

its

of the board of directors

New England

support the

Sewall. Sewall was a faithful backer of

the hospital from the very beginning, serving as

and good friend for almost

" l6

thirty vears.

its

legal counselor

Descended from

a long line of

New England whom he was

notable Bostonians, Sewall brought credibility to the Hospital.

His grandfather, Samuel Sewall, after

named, had been a noted colonial justice and diarist. His father, Joseph Sewall, a respected Boston merchant, had served as treasurer of Massachusetts. The younger Samuel Sewall followed the distinguished tradition of his grandfather and father, studying law at 5°

"This All-Women's Hospital"

Harvard, becoming a leading reformer, and fighting for abolition a senator in the Massachusetts legislature. Sewall's

commitment

reform extended

to

as

17

to the area of

woman's

He was interested in the issue of medical education for womAs a director of the New England Female Medical College, he encouraged Zakrzewska to start a clinic there. When she resigned her position at the college, Sewall, like Cheney, Goddard, and others, left to help Zakrzewska found the New England Hospital. rights.

en.

Sewall's support of

He

women

in

medicine reached into

his

own

family.

strongly encouraged his daughter, Lucy, in her early efforts to

obtain medical training, and she later became the

New England

sician at the

first

resident phy-

Hospital. Sewall's financial contributions,

legal counsel,

and influence among reformers

an invaluable

member

of the hospital's inner

In addition to male reformers,

in

Boston made him

circle.

who supported

the

New England

Hospital because of their ideological commitment to woman's rights, Zakrzewska also had the help of a number of male physicians in

Boston who were willing

to

put their professional reputations be-

women doctors. Drs. Henry BowSamuel Cabot, James Chadwick, Walter Channing, Benjamin Jeffries, Francis Minot, Maurice Richardson, and James Putnam were among a group of twenty-six men who served as consulting physicians to the New England Hospital in the nineteenth centurv. Educated at Harvard, leaders in the Massachusetts Medical Societv, staff members of the Massachusetts General Hospital, and facultv members at Harvard Medical College, these doctors were part of Boston's medical elite. They dominated the city's medical profession just as members of their respective families had done for hind a separate institution for

ditch,

generations.

Not

all

but they

18

these prominent medical all

men supported woman's

shared a professional interest

England Hospital. regular physicians

in the success

rights,

of the

New

When still

other sectarian doctors

Zakrzewska founded the hospital in 18(12. competed with homeopathic, eclectic, and

who had become popular

in the first half

of

the nineteenth century. Although the appeal of sectarian doctors

began

to decline

by the 1860s, they

still

threatened the prestige and

Hospital with a Heart

pocketbooks of regular physicians. As a

result,

many

leaders

among

the regular wing of the profession supported Zakrzewska's hospital

because of her identification with regular medicine. 19

Of

many male

course,

tors, regardless

physicians strongly opposed female doc-

of women's allegiance to regular medicine. They

women from their own medical institutions, including Harvard Medical College, the Massachusetts Medical Society, and

excluded

the Massachusetts General Hospital. Moreover, they shared the pop-

women were physically and mentally inferior to men women's proper place was in the home as wives and moth-

ular view that

and

that

ers.

Many

women

believed that

should not

—

in fact, could not

—be

good doctors. They agreed with the prominent Dr. Charles Meigs of Jefferson Medical College in Philadelphia that a woman's head was "almost too small for intellect but just big enough for love." 20 The consulting physicians at the New England Hospital did not share this point of view. Their affiliation with the hospital stood as

proof that not en doctors.

all

Still,

nineteenth-century male physicians opposed with

some motivated

wom-

exclusively by professional

concerns and others interested in the rights of

women

as well, the

commitment of the hospital's consulting physicians ranged along a spectrum from ardent supporters to fair-weather friends. Drs. Henry Bowditch and Samuel Cabot were two of the hospital's most loyal

New England blended professional sympathy for woman's rights. Both Cabot and Bowditch had known Zakrzewska since her early years in Boston when she worked at the New England Female Medical College. Though they supported the idea of women in medicine, they had little refriends.

Their support of the

interests with

spect for Gregory,

who

lacked their regular medical training as well

as their social standing.

As

a result, despite their admiration

and

respect for Zakrzewska, they refused to support her clinical efforts

while she "was connected with such an inferior school as they consid-

ered the

New England Female

cause they recognized her to

regular

medicine,

skill as

they

Medical College to be." 21

Still,

be-

a physician as well as her allegiance

willingly

offered

their

help

when

Zakrzewska severed ties with Gregory and started her own hospital. Moreover, as testimony to Zakrzewska's professional accomplish52

"This All-Women's Hospital"

ments, they supported her application to the Massachusetts Medical Society even before she left Gregory's school.

Dr. Cabot was the staff.

He

first

man

to join the

finding a

woman surgeon

operated

Of all est

when Zakrzewska had

for her staff, Cabot not only consulted but

the consulting physicians,

women

women

in

Henry Bowditch was

doctors. His interest in

medicine grew out of

tions.

especially to help

He

women gain

favored opening the

and Boston City

hospitals to

the strong-

championing the

commitment to reform, Throughout his life he

his

particularly to the abolition of slavery.

worked

in

trouble

at the hospital.

advocate of

cause of

Hospital

served as consulting surgeon from 1863 until his death

1885. In the hospital's earliest years,

also

New England

access to

clinics at the

male medical

institu-

Massachusetts General

women, and he worked

to

open the

Massachusetts Medical Society to women as well. As far back as 1852, Bowditch had supported the first request from a woman, Nancy Talbot Clark, for examination by the Massachusetts Medical Society. Several years later, after meeting Zakrzewska, he, along with Cabot and others, encouraged her to apply for membership as well. After Zakrzewska's petition was denied, Bowditch worked for the next two decades to change the society's exclusionary rules. In 1884 he put forth the motion that finally opened the Massachusetts Medical Society to men and women on an equal basis. Bowditch joined the staff of consulting physicians at the New England Hospital in 1865 and served the hospital until his death in 1892. 22

Not all the consulting physicians to the New England Hospital were as aggressive as Bowditch in their support of women doctors.

Some did not even support the general concept of women in mediThey saw Zakrzewska and a few other women doctors as excep-

cine.

Zakrzewska explained that Dr. John Ware, for example, 'accepted me as an exceptional women [and] laughed heartily when I told him that the exceptions would multiply by the huntions.

.

.

.

Henry E. Clark "could not sanction the study of medicine by women," but helped Zakrzewska in her private practice. sending her patients and recommending her to others. 23 dred." Similarly, Dr.

Nor did

all

the hospital's consulting physicians share Bowditch's

53

Hospital with a Heart

commitment

to

opening the all-male medical

Instead, most supported the idea of

women

women

studied and worked apart from men.

institutions to in

women.

medicine as long as

They threw

their sup-

port behind the New England Hospital in order to encourage the advancement of women in medicine apart from men. Dr. Edward H. Clarke most clearly represented those physicians who willingly

supported

women

fessor of materia

doctors in separate all-female institutions.

medica

at

A

pro-

Harvard Medical College, Clarke had

been one of Zakrzewska's earliest friends when she first came to Boston in the 1850s. He even considered briefly the idea of integration on her behalf, joining Bowditch and Cabot in supporting her application to the Massachusetts Medical Society. In the 1860s, however, Clarke began to modify his position on women doctors. While he continued publicly to support women in medicine, he expressed deep reservations about women's physical ability to be doctors and serious concern about the propriety of women doctors working with men. In 1873, ne published Sex in Education; or, A Fair Chance for the Girls, which elaborated his new ideas about women. In Sex in Education, Clarke argued against all coeducation, explaining that women's reproductive physiology made it unsafe for them to undertake any intellectual activity with the same rigor as men. Excessive study, he explained, diverted energy from the female reproductive organs to the brain, causing a breakdown in women's health and threatening the health of future generations. 24 Clarke's

book was widely read, going through seventeen

in thirteen years. Its success

editions

placed advocates of education for

wom-

en on the defensive. His dire warnings about the deterioration of women's health aroused concern among even the most ardent supporters of women's education. The president of Smith College, for example, anxiously defended the school against Clarke's arguments. In both 1876 and 1877, ne began his report to the trustees with a description of the excellent health of the Smith students. 25 Even M.

Carey Thomas, the first female president of Bryn Mawr, acknowledged decades after the school's founding that she did not know

when Bryn Mawr

first

opened "whether woman's health could stand We were haunted in those days by the clang-

the strain of education.

54

"This All-Women's Hospital"

ing chains of that gloomy

little

specter, Dr.

Edward H.

Clarke's Sex in

Education." 26

Many women were outraged by Clarke's book, seeing it as a dangerous attack on the movement for women's education and a threat to women's autonomy. They responded with an outpouring of counterattacks challenging Clarke and his ideas. Ednah Dow Cheney, Lucy Stone, Olympia Brown, and Julia Ward Howe were among the women who contributed to this literary campaign to discredit Sex in Education. 27 The most significant challenge was Mary Putnam Jacobi's The Question of Rest for Women During Menstruation. Jacobi had been a student at the Philadelphia Medical College for Women and an intern at the New England Hospital before she went to Paris, where she became the first woman to enter the Ecole Medecine. Graduating in 1871 with high honors, she returned to New York, where she joined the staff of the New York Infirmary and the Woman's Medical College. In response to Sex in Education, she sent a

questionnaire about menstruation to over 250

women. The

re-

sponses she received provided evidence that for most women, rest

during menstruation was neither desirable nor necessary. Jacobi's essay won Harvard's prestigious Boylston Medical Prize in 1877, the year the Harvard physicians decided to focus their annual competi-

on the controversy evoked by their own Dr. Clarke. 28 Clarke's book represented a serious attack on coeducation for women, but it was not a wholesale assault on women's higher education

tion.

Clarke insisted that he favored education for

not interfere with their health and

if

it

women

if

it

did

was conducted separately

from men's. His ideas complemented the separatist ideals of educawoman's movement, such as Catherine Beecher and Emma Willard, who believed that women needed special education

tors in the

in separate all-women's schools. 29

Perhaps to prove

his

commitment

to education for

women

as long

was apart from men, Clarke joined the consulting staff of the New England Hospital in 1873, precisely the year Sex in Education

as

it

first

appeared, and he maintained

through 1878. Despite the

his affiliation with the hospital

conflict Clarke's

book aroused. Zakrzew-

ska did not join the feminist attack against him.

To

be sure, she 3 3

Hospital with a Heart

looked toward a day

when women would

gain admission to the male

medical schools and hospitals. Yet her pragmatism superseded her

She quietly welcomed Clarke's support and that of all other influential physicians who came to her aid, even if simply to preserve the separation of men and women in medicine. 30 idealism.

Among

the

men who

joined Zakrzewska's consulting

staff,

Dr.

Horatio Storer stands out as the only real traitor to the hospital. Storer was an attending physician at the Boston Lying-in Hospital until

it

closed in 1856.

When Zakrzewska founded

the

New England

Hospital, he joined the consulting staff, simultaneously his general practice

and making the

diseases of

women

abandoning his specialty.

In 1866, however, he severed his connection with the hospital, angry

about a new resolution that restricted the doctors' surgical freedom. 31 Storer expressed his anger in his letter of resignation. While his "highest respect and esteem" for Zakrzewska and several other women doctors at the hospital, he claimed that women were physically and emotionally incapable of being good doctors. Storer's letter was a deep insult to the women doctors with whom he had worked for several years, and it took on far graver implications when he published it in the Boston Medical and Surgical Journal. As she had done in the case of Clarke, Zakrzewska avoided controversy and declined to defend her hospital and medical staff against Storer's accusations. Instead, the Annual Report for 1866 publicly thanked Storer for his service to the hospital and wished him well. 32 Storer's antagonistic relationship to the New England Hospital was certainly the exception. For the most part, the consulting physicians and female staff of the hospital worked well together. Indeed,

he acknowledged

the support of the consulting staff was critical to the success of the

These men gave valuable medical advice and help in diffiThey also encouraged and praised Zakrzewska and her staff, who were starved for words of support. Zakrzewska never forgot the praise she received from Walter Channing in 1864 after her performance of a difficult surgical procedure. "It was a very difficult operation and ... I do not think it could have been done better," he told her. 33 Finally, as influential members of Boston's

hospital.

cult cases.

56

"This

medical

imacy

the consulting physicians brought dignity and

elite,

to the

All-Womens Hospital"

New England

legit-

Hospital.

Zakrzewska placed high value on the support she received from her consulting staff. She had learned the importance of powerful male allies when she was a young midwife in Berlin. She well understood that the tal

of her consulting staff protected her hospi-

elite status

from public opposition. Reflecting

on the

early resistance to the

hospital, she explained that while "the profession at large

ed

to find fault,

[it]

three professional

.

.

.

want-

did not dare to do so openly so long as the two or

men

stood as a moral force behind me." 34

The

names of Cabot and Bowditch, she explained, were "sufficient guarto the public for the honor and usefulness of our

antee

institution." 35

The

prestigious consulting staff and the influential board of direc-

brought more than legitimacy and respectability to the New England Hospital. From the beginning, Dr. Zakrzewska relied on them to help her raise much-needed money. Fund raising on behalf of the hospital was extremely difficult in 1862. With the nation in the midst of the Civil War, many potential subscribers had committed their resources to the Union cause and were unable to make even the smallest financial donation to the hospital. "Everyone here is absorbed in the war and so busy working for the hospitals that I cannot interest them in your excellent hospital," explained one Springfield, Massachusetts, woman to director Louisa Bond. "So I can only send you my mite," she continued, "and regret the failure of my efforts." 36 Others, whose personal finances were severely restricted by the wartime economy, were also unable to help. "I cannot tell you how sorry I am that I cannot say yes at once to all you tors

"The war has

woman

Bond in done what occasionally a money

propose," wrote another

to

the

summer

of 1862.

pressure would do for

a passing time before." 37

Despite the obstacles before them, the directors and consulting doctors persisted. In 1864, Drs. Cabot, Bowditch, Channing, and

Putnam endorsed

a public appeal, written ironically by Storer. re-

questing financial contributions to the hospital. 38 Meanwhile, the directors busily collected donations.

Some, such

as

Lucy Goddard 5 7

Hospital with a Heart

sums up to $120 from came from contribuIn letter a to Cheney, a director, John H. tors outside the hospital. Stephenson, proudly reported the sums he and other directors collected in 1864. "The battle for the hospital goes bravely on, I have some money, Mr. May has some, Miss Goddard has some and with the $1,000 we expect you will get, we shall come off with flying and Samuel their

own

Sewall, gave substantial annual

pockets. But most of the donations

colors." 39

While everyone participated in fund raising, it was the women of New England Hospital who played the crucial role. The families

the

of several

made

substantial contributions. In the hospital's first five

years alone, Goddard's relatives gave $805, Louisa Bond's family

donated $320, and Abby May's family contributed an impressive $2,2 4 1. 40

^

Of course, tions

the

women

They wooed

circles.

directors reached

beyond their own family and attracted dona-

a wider female audience

from hundreds of women who were unattached

In appealing for contributions, the ately articulated the hospital's

particular, they

tunity

it

women

to the hospital.

of the hospital deliber-

unique commitment

to

women. In

emphasized the charity and professional oppor-

offered to

women. Linking

sisterhood with charity, for ex-

ample, Dr. Zakrzewska concluded her report as attending physician in

1865 "with the wish and hope that some rich lady may remember sisters in suffering, and give her name and means to an

her poorer

institution so useful first

secretary's report

of a comfortable

and

much needed." 41 Similarly, Cheney's appealed to "all women who know the value

and

home

so

what it is to be homeless At the same time, the found-

in sickness to think

friendless in the day of sorrow." 42

emphasized the professional advantages the hospital offered women doctors, explaining that it was the only hospital in New England where women could receive clinical training. 43 The women of New England took up the banner of the hospital. Leading advocates of reform for women such as Elizabeth Peabody and Lucretia Crocker, wives of well-known male reformers including Mrs. James Freeman Clarke and Mrs. Theodore Parker, and lesser-known women joined hands to donate money, gifts, time, and energy to the hospital. A few contributed substantial sums, but most ers also

58

"This All-Women's Hospital"

of the donations ranged between five and ten dollars.

Some

support-

annual Roxbury Ladies' Fair on behalf of the hospital; others gave miscellaneous items ranging from sheets and linens to ers ran the

soap and matches. With the hospital surviving on a shoestring budget,

gift, large and small, counted. "One, out of ample wealth, hundreds and thousands," explained Cheney. "Another

every

gives us

drips in her mite, rich with the wealth of self-sacrificing love." 44

Sharing the belief of most nineteenth-century of separatism, the

women

New England women only.

of

they could to a hospital for

women

in the benefits

gave as generously as

Despite the hard financial times brought on by the Civil War, Zakrzewska and her supporters raised enough money to sustain the New England Hospital in its early years. Though the budget fluctu-

grew steadily throughout the hospital's first decade. When the New England Hospital first opened at 60 Pleasant Street, it had only ten beds and assets amounting to a meager $150 worth of hospital furniture from the clinic at the New England Female Medical College. In 1863, the year of its incorporation, the hospital had a budget of $6,700. By 1864, when it moved to a nearby estate on Warrenton Street, the budget was over $21,000. In 1871, it was $47,000, and in the hospital's tenth year, when it moved into new and larger quarters in Roxbury, the budget had climbed to over $1 46,000. 45 Though the hospital never had the resources of larger Boston hospitals such as Massachusetts General and Children's, its steadily growing purse and the diversity of its financial support were testimony to the faith of many in Zakrzewska and in her vision of a separate all-women's hospital. Separatism in medicine also shaped Zakrzewska's commitment to the people she sought to serve female patients and female physicians. In her concern for poor, sick women, Zakrzewska modeled ated from year to year,

it

—

New England Hospital on other voluntary hospitals that offered poor but "deserving" patients a respectable alternative to the public almshouse. Laborers from poor and immigrant neighborhoods of Boston could go to Massachusetts General, and their children could go to the Children's Hospital, to receive medical care at a nominal the

charge or for

free. Similarly,

poor

women

with no other institutional

59

Hospital with a Heart

option but the almshouse could get free or low-cost medical care for themselves and their children at the

New England

Hospital.

The women who went to the New England came from the same economic and ethnic groups as patients at other voluntary hospitals in Boston. In the New England Hospital's first ten years, the majority of patients were foreign-born. Irish women made up between a third and a half of all the patients at the hospital. 46 By the 1880s the numbers of American-born patients surpassed foreign-born ones, while at the Boston Lying-in foreign-born patients outnumbered American-born women throughout the 1880s. Although proportionately fewer immigrant women went to the New England than to the Boston Lying-in, the patients at the New England Hospital came from the bottom of the economic ladder. Throughout the last quarter

of the nineteenth century, almost half the patients treated

at the

hospital labored in typically female working-class jobs such as do-

and factory worker, and another Most were charity cases.

mestic, seamstress,

housewives. 47

As

a charity institution the

hospitals of the time, ential citizens to

had

New

a strong

England,

like

third

other voluntary

moral component. Wealthy,

supported voluntary hospitals

in part

were

influ-

out of their desire

maintain a social order threatened by growing numbers of immi-

At the Children's Hospital, for example, the directors sought poor and immigrant children to the traditional American values of cleanliness, order, virtue, and hard work. 48 The founders of the New England Hospital had similar concerns. "We are deeply interested in every effort to dispel ignorance, promote temperance, banish licentiousness and other vices," they explained. 49 As at other voluntary hospitals, the process of admission to the New England reinforced this commitment to morality and virtue. For example, Zakrzewska and the directors always encouraged some sort of payment from patients, believing that it reinforced the "self-respect of the patient to pay if she possibly can." 50 Those who could, paid the full rate of eight dollars per week. Others paid a reduced weekly fee grants.

to socialize

of four dollars; the poorest received free treatment. last

Women

in this

group, however, did not gain admission to the hospital indis-

criminately. In keeping with the strong concern for moral guardianship, hospital rules required that every

60

nonpaying patient have a

"This All-Women's Hospital"

letter

from an

established, reputable individual attesting to her

worthiness for medical charity. 51

The same charity

prerequisite of morality for the benefits of medical

shaped policy

provided medicines to Initially,

women

The

in the hospital's dispensary.

women who

dispensary

did not require hospitalization.

received these medicines free. Gradually, however,

the founders grew uneasy with this lenient extension of charity.

Though

they continued to justify

they feared in fact,

it

for truly impoverished

women,

among women who

could,

pay for medicine. In 1868, they decided to "draw the

They charged women who were cents for each prescription. solute

it

discouraged responsibility

line."

"able to pay something" twenty-five

Women who could

prove that their "ab-

need required gratuitous service" continued

to receive

medi-

cines free. 52

The on

link

between charity and morality

at the

New England

Hospi-

while similar to that at other voluntary hospitals of the day, took

tal,

a particular character because the patients

en. ple,

A man who might have

sought charity to

at

were exclusively wom-

Massachusetts General, for exam-

prove he was an honest worker.

applied for charity at the

New England

A woman who

demonstrated her worthi-

ness by her marital status, piety, or appearance.

This particular measure of respectability was especially important for

women

seeking admission to the hospital's maternity ward.

Throughout in the lives

its first

decade, the

New England

played a crucial role

of pregnant women. With the Boston Lying-in Hospital

closed between 1856

and 1872, the New England was the only

pri-

women in childbirth. A woman unable to home could deliver her baby at the New poor woman who wanted a free maternity bed first

vate hospital in the city for

arrange for confinement

at

England. But a had to establish her worthiness, usually by proving she was married. Wives often brought their husbands with them; widows provided death

certificates.

simple.

One

For some, however, proof of marriage was not so woman who had been

nineteen-year-old pregnant

abandoned by her husband sought the help of an overseer of

the

poor. "I have seen her marriage certificate," he wrote to the board of directors. "I think she is very honest in all her statements.*' 5

Marriage was not an invariable prerequisite for admission 61

to a

Hospital with a Heart

free maternity bed, however, Zakrzewska

had learned from her

mother's lying-in patients in Germany, as well as from the

New

she exmployed in her tenement apartment in

married pregnant

women were

depraved sinners. Hoping

women

York, that un-

often innocent victims rather than

to save

them from

the public disgrace of

the almshouse, she often accepted unmarried pregnant

women

into

her hospital as charity patients. However, she admitted only unmar-

women who were

ried

deemed nant tal's

to

pregnant for the

time, for they

first

were

be innocent victims. She rejected unmarried but preg-

women who had

children already as "unworthy" of the hospi-

charity.

for unmarried women pregnant for the first time, admission was not automatic. They still had to demonstrate their worthiness. In these cases, where marriage could not be the standard, piety was often the measure of respectability. One typical woman sought the

Even

aid of her clergyman. In a letter requesting "kindness

and charity"

on her

have seen

it,

in the discharge

of

behalf, he wrote that "her conduct, so far as

has been praiseworthy, and she has been exact

I

her religious duties." 54 Dr. Zakrzewska and her supporters demanded a particular standard of morality and respectability from their female patients, and they provided special services designed to preserve and protect the patients' virtue. A board of lady visitors, composed of volunteers among the directors, visited patients twice a week in an effort to "exert a good influence over them." This was similar to the moral

persuasion directors exerted at other voluntary hospitals, but the lady visitors at the

New England combined

it

with a particular brand

of practicality suited especially to the needs of women. They found safe shelters for single, homeless

unmarried mothers.

When

women and

possible,

respectable

work

for

unmarried mothers were pro-

vided with jobs in rural areas, where they brought their babies and often married sons of farmers. 55 Dr. Zakrzewska and her supporters provided a unique atmo-

sphere

at the hospital that

clientele.

They were quick

was especially suited to its all-female out that whereas male patients

to point

often played cards or swore on the wards of other hospitals in the city,

the

62

New England

offered

women

a quiet, homelike environ-

"This All-Women's Hospital"

ment. "The husband and father can be cared for Hospital," explained

one

director, "but

the General

at

we have testimony of experi-

enced physicians that the wife in her hour of sickness needs a retirement and isolation not to be had there." 56 Male physicians referred their

own female

patients to the

New England

Hospital for these

A

Boston physician, Dr. Francis Starkey, for example, sent one of his married female patients there, hoping that "the very reasons.

and the regular treatment she will receive good health and to her family." 57 With even more confidence, Zakrzewska and her co-workers claimed that women went to the New England Hospital precisely because of its separateness from men. They argued that because it was the only hospital in New England to provide women with medical care from doctors of their own sex, it could best protect women's modesty and virtue. Moreover, they claimed that many women, out quietness of [the] hospital will

restore her to

of a "delicacy of feeling," preferred to suffer privately than to seek

medical care from a man. As one doctor explained

many I

a case of long-standing

and great

suffering,

1867: "In

in

my colleagues and

have inquired how the patient could have so long remained with-

out treatment and have been answered, 'Oh,

I

could not go to a

from consulting physicians even when the women doctors recommended them. "Some have objected much against our will," explained one doctor, "to the presence of medical gentlemen whose occasional visits we ourselves were man.'

"

Sometimes patients refused

visits

glad to welcome." 58

According

to Dr.

Zakrzewska and her supporters, the concern

women sufA twenty-two-year-old German

about preserving propriety was particularly acute when fered from gynecological problems.

immigrant, for example, suffered privately for months before she finally

entered the

New England

Hospital. In the early

months of

her pregnancy, she had taken "a violent cold, which finally settled in her genital organs. From a delicacy of feeling as well as ignorance of consequences, she concealed her suffering until near confinement" when she finally sought treatment at the hospital. 59 Sometimes

women

sacrificed

medicine for morality with tragic

owed English immigrant endured

results.

A

wid-

"sufferings inexpressible" from

uterine cancer and neglected the malignancy until the

last

stages of

63

"

Hospital with a Heart

When she finally sought help at the New England Hoswas too late. She "died after a fortnight grateful for the care and sympathy afforded her." 60 the disease. pital,

it

The appeal of a

separate all-women's hospital spread throughout

to Massachusetts and beyond. Over 80 percent of the mediand surgical patients admitted throughout the century came from within the state; 50 percent lived in Suffolk County, where the hospital was located, but only 7 percent came from its immediate vicinity of Roxbury. The overwhelming majority of local patients lived in other parts of Boston. They traveled up to seven miles to reach the hospital and were testimony that the New England was not simply a "neighborhood" hospital. In fact, patients came from every county in the state, and one-fifth of the women traveled twenty to eighty miles. Women from other New England states sought out the hospital as well, and about 5 percent came from other parts of the country or Canada. 61 As one ex-patient explained: "We had patients from the West as well as from the East, from Michigan and from

Boston

cal

Maine." 62 Just as separatism shaped hospital policy toward sick also defined the professional opportunities available to tors.

As an all-women's

training to

women

only.

hospital, the

New England

For Dr. Zakrzewska, the

women,

women

provided

doc-

clinical

clinical training

offered was the backbone of a sound medical education. "It possible," she asserted, "to

it

is

she

im-

have a thorough medical education with-

out actual experience at the bedside of the patients. 63 Zakrzewska

derived her model for quality medical education from Europe,

where "the lecture room for the study of medicine had become secondary to the hospital." 64 To her, American medical education was inferior to its European counterpart precisely because so few hospitals in America offered clinical training to young physicians. Zakrzewska's own experience at the New England Female Medical College, where Gregory had refused to recognize the value of her clinical efforts, reinforced her criticism of American medical education. In fact, clinical experience was not a standard part of American medical training throughout most of the nineteenth century. The typical medical student spent most of his time in lectures, with only a 64

"This All-Women's Hospital"

rare

visit to

the laboratory or dissecting room. Most would-be doc-

experience through an apprenticeship. 05

tors received practical

In deciding to open a hospital rather than a school for

Zakrzewska made tors.

clinical

Her emphasis on

Throughout

first

women,

women

doc-

practical experience placed her in the fore-

front of contemporary

the

experience her priority for

American thought on medical pedagogy.

half of the century, a minority of physicians

argued that medical schools should include their standard curriculum.

Still,

practical training in

by the early 1860s, when Zakrzew-

opened the New England Hospital, most schools continued to resist this innovation. Only a few, such as Harvard and the University of Pennsylvania, had implemented the idea by affiliating with hospitals where students could gain clinical experience. In doing so, they initiated a trend away from apprenticeship and toward schoolska

centered

clinical

training.

University-affiliated

hospitals such

as

Massachusetts General and Pennsylvania Hospital became educational institutions for

young

doctors, offering the clinical experience

individual practicing physicians once provided. Doctors

nated their services to these hospitals reaped vantages.

Young

many

who

do-

professional ad-

physicians gained valuable clinical training. Older,

found a volume and range of cases unavailthem in private practice. All enjoyed a reputation for clinical expertise and benevolence that distinguished them from most doctors, brought them respect and prestige, and ultimately expanded established practitioners able to

their private practices. 66

Zakrzewska opened the New England Hospital to make these professional advantages available to women doctors. Indeed, to Zakrzewska, this was the most important aspect of her hospital, tran-

scending even the medical charity

it

offered

women

patients.

"The

most striking feature in its character," she explained of the hospital, "is, that it is designed to give to educated women-physicians, an equal chance of proving their capacity as hospital attendants, with

and to admit only female students to its wards as all other hospitals close their doors to women students."'" With clinical experience so difficult for aspiring medical women to their medical brethren,

find,

Zakrzewska had no trouble attracting interns

to

her hospital. 68

6*

Hospital with a Heart

In

its first

year alone, five

women

Gregory's school to take ad-

left

vantage of the practical training Zakrzewska offered

England Hospital. Between the

hospital's

New

at the

founding and

its

move

in

women trained at the hospital. Fifteen were from the Northeast: six from New York and New Jersey, and nine from Massachusetts and other states in New England. Of the latter group, six were residents of Boston. The other fourteen women traveled significantly further to work at the New England Hospital. Twelve 1872, twenty-nine

left

homes

in states

throughout the country, including Michigan, came from overseas, one

Indiana, Missouri, and California; two

from England and the other from

India.

For these early interns, separatism shaped almost every aspect of

New

their professional lives, not simply their clinical training at the

England Hospital. Ten interns had been students

at the

gland Female Medical College before they worked

New

En-

at the hospital;

another one enrolled there directly after leaving the hospital. these eleven, six went

on for further study

at

Of

other medical schools,

perhaps out of dissatisfaction with their education

at

Gregory's

Three attended the separate Woman's Medical College of Pennsylvania, which had been founded in Philadelphia in 1850 because male medical colleges did not accept women. The other three studied among men. Two went to Switzerland, where the medical schools in Zurich and Bern admitted women; one graduated from Chicago Medical College just before it closed its doors to women. Only one additional intern, who never went to Gregory's school, received her medical education with men. She attended the medical school.

department of the University of Michigan, which began

women

in 1870. It

is

likely that the other,

to accept

seventeen interns never

graduated from any medical school. This was not unusual even for

male physicians of the day. The absence of regulations standardizing medical training around the country meant that ticed

many men

medicine without any medical school experience.

of medical education

among

Still,

the seventeen interns at the

prac-

the lack

New

En-

gland Hospital probably also reflected the dearth of medical schools

open

to

women

in the 1860s.

Separatism continued to define the interns' professional they completed their training at the

66

New England

lives after

Hospital.

The

"This

All-Womens Hospital"

twelve whose career paths remain visible chose one of two options:

they

left

tions,

the

New England and worked in other all-women's instituNew England for the rest of their

or they remained at the

professional walls. Drs.

lives.

Anita

Six forged their careers

beyond the

Tyng and Mary DeHart opened

hospital's

dispensaries for

in Rhode Island and New Jersey, respectively. Helen B. W. Webster worked briefly at the New England Hospital and eventually went to Vassar College. Mary Thompson pioneered in opening medicine to women in Chicago. In 1865 she founded the Chicago Hospital for Women and Children, and in 1870 the Woman's Hospi69 Sophia Jex-Blake became a champion of womtal Medical College. en doctors in Great Britain. Only Eliza Mosher deviated from an

women

exclusively separatist career path.

of hygiene

at the University

As dean of women and professor

of Michigan from 1896 to 1902, she

became the first woman to join the previously all-male medical faculty. Even so, separatism defined much of her professional life, for she spent most of her career working exclusively among women. She was a resident physician and associate professor of physiology and hygiene at Vassar College from 1883 to 1887, president of the Women's Medical Society of New York, and senior editor of the Medical Woman's Journal from 1905 to 1928. 70 The other six interns Lucy Sewall, Helen Morton, Susan Dimock, Emma Call, and sisters Emily and C. Augusta Pope devoted their careers to the New England Hospital. They were a highly qualified group. Dimock graduated with honors from the medical

—

—

school at the University of Zurich in 1871. Call graduated

among

first

eighty students in her medical school class at the University

of Michigan in 1873.

New England

They

all

went

to

Europe

to get additional clinical

after training at the

experience

in hospitals in

London, or Zurich. When manent members of Zakrzewska's medical staff. With two other phvsicians, Elizabeth Keller and Mary Smith, who joined the staff in Paris,

71

they returned, they became per-

1875 an d 1880, respectively, they led the hospital for the next quarter century.

For these women who spent their professional lives at the New England, the hospital served as a center for their social lives as well. Zakrzewska's home was a meeting place where they gathered to

Hospital with a Heart

enjoy each other's company. Sometimes they took picnics or outings

1878 they created a formal group, the New England Hospital Medical Society, which provided them with a way to in the country. In

on a regular

socialize

The

friendships

basis as they discussed their professional lives.

among

the

women

doctors at the

New England

Hospital were similar to the relationships in the nineteenth and early twentieth centuries lives

were

among many women whose

closely linked. 72 Zakrzewska, for

of one of her

public

and private

example, became

inti-

Lucy Sewall, Samuel Sewall's daughter. Zakrzewska and Lucy Sewall first met when Zakrzewska visited Boston in 1856 to raise money for the New York Infirmary. When Zakrzewska began to work at the New England Female Medical College, Lucy Sewall enrolled as a student. She stayed throughout the three years of Zakrzewska's affiliation, workmately involved in the

life

staff,

ing closely as her assistant in the clinical department.

zewska

left

When

Zakr-

Gregory's school, she urged Sewall to go to Europe for

further clinical training.

Zakrzewska wrote frequently

London and

to Sewall

during the

Some of her

latter's

year of

letters

focused on the

goings-on at the hospital or the status and future of

women in mediown "domestic

study in

cine. In others, she affairs," discussing

Paris.

shared some of the details of her

her health, plans for

social events,

or her stock of

and vegetables for canning. 73 Other letters, however, were far more intimate and revealed the intensity of Zakrzewska's feelings toward Sewall. "I am sure I never missed any person more than I do you," she confessed in one letter. "I never before have felt such strong attachment for a woman, that is, so 'tenderly' strong." 74 Such uninhibited expressions of affection between women were not unfruits

common

in the nineteenth century.

women's

lives

women

encouraged

The

separatism that informed

close female relationships

to express their feelings to

Zakrzewska's case, her love for Sewall was

her daughter. "You are feelings of love

and

my

and permitted

each other without reserve. In like that

of a mother for

child," she explained, clarifying her

loneliness for Sewall. In a motherly

manner,

Zakrzewska advised Sewall to marry, but only a man with whom she was compatible, and looked forward to the "grandchild" she would then have for herself. 75 While Zakrzewska's relationship with Sewall

68

"This All-Women's Hospital"

was probably unique

among

the medical staff at the

New England

and support all the women doctors derived from each other was an important component of their lives at the Hospital, the friendship

hospital.

Under spite the

New England grew and thrived deBy the end of the i8Gos it was no longer

their leadership, the

odds against

it.

accommodate all the women who sought medical care or to accept the growing numbers of women doctors who sought clinical training. The pressing need for new and larger facilities coincided with a growing desire among the hospital's supporters to move the hospital to a more remote section of Boston. Throughout the 1860s the immediate neighborhood around Warrenton and Pleasant streets grew increasingly crowded and commercialized. As the neighborhood changed, it became less desirable as a location for a hospital, and more appealing as a business site. As Cheney explained: "By alterations in the streets and increase of business in that part of the city, our lot of land has become of more pecuniary value, and yet less desirable for use. The noise and dust and crowded able to

condition of the street

make our

present place quite unfit for ner-

patients." 76

vous chronic

In 1869, Zakrzewska, Cheney, and the other doctors and directors

inaugurated a building campaign. In

less

than three years, they

enough money to purchase a new home for the hospital. when Zakrzewska moved the New England Hospital into

In

new, larger, specially designed quarters on Columbus Avenue

in

raised

1872,

its

Roxbury, she had reason to be proud and optimistic. Her all-women's hospital

The

had survived and thrived

key to the early success of the

in

its first

ten years.

New England

was

its

embodi-

ment of both the separatism of the nineteenth-centurv woman's movement and the professional standards of Boston's leading male physicians. In

its

early years the hospital's separation

from the male-

dominated profession and its simultaneous identification with it were complementary. At a time when women in other areas of the woman's movement met apart from men in separate clubs, reform societies, and colleges, women doctors eagerly supported a hospital of their own. For similar reasons, the hospital's separatism found favor among influential male reformers and physicians. Drawing 6g

Hospital with a Heart

the line at integration,

many

willingly

helped

women

doctors in this

separate professional venture.

At the same time, as a medical institution in the 1860s, the New England Hospital embraced the professional standards of Boston's most prestigious male doctors. Zakrzewska's emphasis on clinical training and her connection with influential male physicians in the city meant that women doctors, even as they worked apart from men, could retain their professional identification with Boston's medical elite. Moreover, the support they received from leading male physicians represented a professional alliance among regular physicians against irregulars.

On

the tenth anniversay of the hospital's founding, Dr. Zakrzew-

ska could proudly review her accomplishments of the

last

decade.

She had brought the New England Hospital through its earliest, most tenuous years and had won public acceptance for her allwomen's venture. As the doors to the new hospital building opened in 1872, a ers.

new

challenge confronted Zakrzewska and her co-work-

They faced

interns,

the task of treating their patients, training their

and sustaining the

medical institution for

70

hospital's reputation as

women

only.

an important

3

"The Sick

We Would

We would bless with our gifts, The

Heal"

lo the givers

were

blest.

we would heal; we were healed with the rest Great truths we would teach; ourselves too were taught While for women, with women, as women we wrought. sick

—Julia Sprague, for

The women of meeting

the

in their

Women

New England

"The New England Hospital and Children," 1896

Hospital held their tenth annual

newly completed building

With

in the fall of 1872.

the patients comfortably settled and medical services in

full

opera-

Zakrzewska and her co-workers proudly announced that their hospital stood "like a beacon set on a hill where all may see it." Run by women for women, the New England Hospital publicly symtion,

1

bolized

the

success

of

separatism

Zakrzewska and her colleagues

now

women

for

in

medicine.

faced the challenge of putting

their principles into practice.

women doctors emphasized the adwomen patients of medical care from doctors of their own sex. Dr. Ann Preston, for example, dean of the Woman's Medical College of Pennsylvania, told her students that women brought Typically, nineteenth-century

vantages for

"womanly tact and inand "quick sympathies." 2 Other female doctors said that women, with their special "instinct for reform," were better suited than men to caring for poor, sick women. W hile there was a "great gulf between the "poor woman of the tenements and the busv

special qualities to the practice of medicine,

sight"

r

medical man," explained Dr. Louise Bryson. "maternity [made]

women

sisters." 3

7i

all

Hospital with a Heart

Zakrzewska and her medical staff endorsed the claim that, as women, they were uniquely suited to treat women patients. But

gender alone did not define

daily life within the hospital walls. In

every aspect of hospital affairs

—architecture, the medical hierarchy, —concerns for women

the nursing program, and care of patients

were very strong. These concerns influenced rather than replaced the prevailing scientific and professional standards of the day. Indeed, the women doctors of the New England Hospital strongly believed in the compatibility of their moral and political views with their medical practice. Given the aspirations of Zakrzewska and her co-workers to create a regular medical hospital equal to the best their

male counterparts had produced, the

that at times contradicted

women's

and

and the functions of the

interests

result

was a relationship

times complemented the ideals of

at

hospital.

Zakrzewska and her co-workers played an important role in denew hospital. Their active involvement in the archictec-

signing the

new building was not unusual

tural planning of the

for nineteenth-

century women. During the second half of the century, some

began

to

tions of

women

design structures that would improve the material condi-

women's

Catherine Beecher, Melusina Fay Pierce,

lives.

Charlotte Perkins Oilman, and others proposed alternatives to the

They designed

traditional use of domestic space.

public kitchens, facilities.

community dining

In doing

so,

space and domestic

facilities,

kitchenless homes,

and public child-care

they demonstrated the link between domestic

life

and made

a

unique contribution

to

Ameri-

can architecture. 4

The women

at the

New England

Hospital shared this concern for

creating an environment that would suit women's special needs. At the

same

time, they

had

their

ideal medical workplace.

own

With

particular goal: the building of an

this in

mind, they carefully tried

to

balance comfort and esthetics with economy, efficiency, and the

most up-to-date medical theories. To implement their vision of the ideal hospital for women, they turned to experts the prominent Boston architects, Charles Amos Cummings and Willard T. Sears. The Cummings and Sears partner-

—

and in their more than thirty number of noteworthy Massachu-

ship dated back to the early 1860s, years together, they designed a

72

We Would Hear

"The Sick

new Old South Church on Boylston Church in Lynn, and the library and chapel at Phillips Exeter Academy in Andover. In the 1890s after Cummings retired from professional practice, Sears went on to design both the chapel in Mount Auburn Cemetery in Cambridge and his most noteworthy achievement, the home of Mrs. Isabel Cardner setts

buildings including the

Street, the First Unitarian

in the

The

Boston Fenway. 5

Cummings and From the choice of

doctors and directors worked closely with

Sears in planning their

new

hospital building.

location to the final details in the patients' rooms, the building was

testimony to their desire to construct an ideal hospital for women.

The new

building was purposefully situated in Roxbury, away from

the expensive at the

and congested business center of Boston. Remaining

periphery of the

city limits, the

new

hospital enjoyed the

urban conveniences of gas and water as well as the countrylike benefits of fresh air and quiet. Sited on several acres of wooded grounds, the New England Hospital offered sick women a bucolic retreat within the

The

city.

brick structure was typical of the Victorian architecture of

its

end of the building, reflecting the contemporary Gothic revival. A Dutch gambrel dormer in the center gave the building a point of focus, enhancing its symmetry and bestowing an eclectic quality. 6

day. Turrets flanked either

The new

building followed the popular pavilion plan that domi-

The pavilion plan was the commonly accepted miasmic theory of

nated nineteenth-century hospital design. architectural response to the disease.

According

to this theory of contagion, the air

harbored and

transmitted disease particles. Based on this notion, a major goal of

nineteenth-century hospital design was to create structures that would permit clean air constantly to replace contaminated air. To encourage this steady circulation of air, architects designed long, low buildings that impeded air movement between floors, but facilitated circulation from one end of a building to the other.' The New England Hospital followed this model. Each feature of the building reflected the concern for maximizing air flow. The three-story structure had spacious halls, numerous large windows throughout, and open porches at one end that wrapped around to 7:


Hospital with a Heart

house that evening, ten shared an affiliation with the hospital. The Drs. Zakrzewska, Sewall, Call, E. Pope, A.

—

entire medical staff

Pope, Morton, Berlin, and Richardson

— was there,

along with Dr.

Mosher, a former intern, and Dr. Sarah Crawford, the incomThe name of the medical organization did more than reflect the composition of its membership, however. FolEliza

ing resident physician. 10

lowing the advice of several male medical supporters, the doctors deliberately

named

women

their society after the hospital. Just "as

New England Hospital set standards for women doctors in New England Hospital Medical Society would be the standard bearer for women doctors' organizational activity. 11 At times the women doctors used their society to perpetuate their the

Boston," so the

professional separation

from men. In 1893, for example, they

jected an opportunity for integration by turning

down an

merge with the predominantly male Gynecological

to

re-

invitation

Society of

Boston. Recognizing that such a merger could signal the demise of their

the

of

own

society, they

New England

esprit de corps

chose to preserve the all-female character of

Hospital Medical Society and the "strong feeling

among women

The New England

physicians." 12

Hospital Medical Society also preserved

wom-

from their male colleagues. Like many nineteenth-century women's clubs, it provided women with valuable opportunities to meet and socialize apart from men. Gathering monthly in a member's home, the women spent friendly, informal evenings together. As Emily Pope recalled several decades later: "There was a feeling of home-iness about the meetings as most of en doctors'

the

social distance

members saw each other

teenth-century club so the doctors as they carried

women

frequently."

made bandages and on

just as

many

nine-

their business.

other supplies for their hospital

"Hands used

often busied themselves making tampons,

At the same time that the

And

knitted or sewed during their meetings,

New England

took on a distinctly female character,

it

being employed, Pope explained. 13

to

etc.,"

Hospital Medical Society

also purposefully sought to

duplicate the standards of the prestigious, exclusively male MasIt excluded sectarian doctors and accepted only women "of good moral character holding a legal diploma from a regular medical college." 14 "We mean to be as careful and as

sachusetts Medical Society.

1

26

"We Must Get Them and Keep Them" stringent as possible," Dr. Zakrzewska explained about the society's

admission

policies. 15

This exclusion of sectarian doctors was important, designed to preserve the respect and credibility of both the society and the hospital.

Indeed, the doctors

defended

at the

New England

sectarians. In the fall of 1877, the

medical school at Boston University pital ... as

dents." 16

a place

open for the

Though Boston

program

to accept

its

yearbook of the homeopathic

named

"the

New England

instruction of

University was the

Massachusetts to admit both ical

Hospital had recently

their status as regular physicians against the claims of

first

its

Hos-

medical stu-

medical school in

women and men, its homeopathic medNew England Hospital to refuse

led the doctors at the

graduates. Like their policies regarding patient admis-

and professional hierarchy, their Boston University demonstrated the

sion

policy regarding graduates of limit

of their commitment to

female solidarity as well as their ultimate allegiance to the regular

wing of the medical profession. Initially Zakrzewska and her medical staff concluded that little could be done about the fact that Boston University had "wrongfully used" their name. 17 The problem deepened, however, when they learned that the Woman's Medical College of Pennsylvania, from which they drew their largest number of interns, accepted students who had done part of their training at Boston University. 18 Communication with the Pennsylvania institution became one of the first orders of business for the doctors in the New England Hospital Medical Society. After a discussion of the matter in their October 1878 meeting, Emily Pope wrote to Rachel Bodley, dean of the college to communicate Bodley's "mistake." She explained that the Boston University faculty were members of the Massachusetts Homeopathic Medical Society, that some had been expelled from the Massachusetts Medical Society, and that the New England Hospital refused to accept any of their students "in spite of all that their catalogue implies." Finally, Pope reminded Bodley of the importance of maintaining professional standards equal to those of the

male medical institutions. "We know that time spent there would not count in Harvard Medical College, nor we believe in any elite

first class

college in the country." 19 1

27

Hospital with a Heart

While Bodley supported the

New

England's exclusion "of stu-

dents from irregular schools," she explained that the ical

Woman's Med-

College of Pennsylvania accepted one year of study

University just as ary institution." 20

it

The

doctors at the

New England

Bodley's policy unacceptable. After discussing

meeting of the

Boston

at

accepted "a college year in any respectable

New England

it

liter-

Hospital found

January

at the

Hospital Medical Society and again in

the board of physicians' meeting later that week, they "unanimouslv

voted that students of Philadelphia

who count

in their

ing time spent in the Boston University (unless extra time in

it

medical train-

was made up by

some regular school of medicine) could not be accepted

as students in the

New England

Hospital." 21

The consistent rejection of homeopathic physicians illustrated the women doctors' attempts to emulate regular male doctors; they also used the New England Hospital Medical Society to further professional integration with their male colleagues. One of their early concerns was the discriminatory policies of the Medical Register of Mashile the Register listed male physicians under the

sachusetts. 22

W

T

headings of their respective medical society distinguish

among women

doctors. Instead,

affiliations,

it

it

failed to

either omitted

women

doctors entirely or listed

them under the heading "female

Under this system, found their names next to

the doctors at the

cians."

but nurses, midwives,

England,

New England

women who were not physicians, and phrenologists. To the doctors at the New those of

this failure to distinguish

them from other "female

cians" was a professional insult that threatened their

and

physi-

Hospital

own

phvsi-

respect

With the creation of the New England Hospital Medical Society, they persuaded the editors of the Register to list them under the heading of their organization, thereby achieving equal professional status with regular male credibility as well as those of the hospital.

physicians within the pages of the Register. 2:

The

doctors used the

New England

*

Hospital Medical Societv to

further their quest for professional integration in other ways as well.

For example, they petitioned the Boston Board of Health

women

doctors as well as

schools. 24

Throughout the

tors in Philadelphia,

128

New

men

to

appoint

as medical inspectors in the

1880s, they cooperated with

women

city's

doc-

York, and Baltimore to persuade a large

"We Must Get Them and Keep Them" university to admit

women

into

its

medical school. They continued

work toward this goal until the Johns Hopkins Medical School opened in 1893, welcoming men and women on an equal basis. 25 to

One of the primary professional goals of the dctors at the England Hospital was admission to the Massachusetts Medical ety.

Despite the existence of their

own medical

New Soci-

organization, exclu-

sion

from

The

Massachusetts Medical Society included the most respected and

influential

the all-male association was a major professional

male physicians

in Boston. Its

members enjoyed

professional advantages as well as significant respect

Members could count on

referrals

Directory of Greater Boston, the official city, listed

their

Women

names.

were denied these

privileges.

from each

certain

prestige.

The

Medical

doctors, excluded

from the

in the

society,

At the same time, by a process of

women

doctors identified the

whom the society also New England Hospital, as the benefits of mem-

erroneously with sectarian physicians

denied membership. therefore, the

bership

other.

and

annual medical directory

association, the society's exclusion of

women

liability.

made

To

liabilities

the doctors at the

of exclusion as well

the society an important institution to open. 26

Women doctors' attempts to enter the Massachusetts Medical Socifounding of the New England Hospital. In 1852 Nancy Talbot Clark, a graduate of Dr. Zakrzewska's alma mater, the medical school of Western Reserve, became the first woman to peti-

ety predated the

tion the society for examination. Its

and

members

for decades thereafter, the prestigious

tion refused entrance to

New England

women. For

rejected her request,

and powerful organiza-

thirty-two years, doctors at the

Hospital persistently sought to break into the Mas-

sachusetts Medical Society. Dr. Zakrzewska sought eral times. In 1859,

York, she

made her

having recently arrived first

in

membership

Boston from

sev-

New

unsuccessful attempt. In 1864, encouraged

by several of her male supporters, including Drs. Bowditch, Cabot,

and Channing, she reapplied for admission. Though her supporters were prominent members of the Massachusetts Medical Societv, they were in the minority on this issue. The society once again turned down her petition because of her sex, though she recalled years later that she "was not so decidedly refused." Because the

opposition seemed to have declined, Zakrzewska once again pre1

29

Hospital with a Heart

pared for the examination, hoping the society would reverse

its

decision. "But," she explained, "I again received a refusal." After

her third unsuccessful attempt, Zakrzewska gave up her campaign, resolving that this Society

.

.

"when the time comes this

.

for

women

to

venerable Society cannot have

be received into

me

as a

candidate

for examination." 27

Although Zakrzewska abandoned her campaign refusal, other

1872, Susan

women

at

after this third

the hospital continued to seek entry. In

Dimock applied for membership. Her petition revived membership among the doctors in the Mas-

the debate over female

sachusetts Medical Society.

mock and other

Some supported

women

the admission of Di-

on the men." Others, led by Dr. George C. Shattuck, opposed such a step, arguing that it was impossible for men and women to discuss medical matters together. 28 For over a decade after Dimock sought membership, Shattuck and his supporters successfully thwarted efforts to admit women to the society. 29 In the early 1880s, however, the tide began to turn in favor of women's admission. A survey conducted by Dr. James Chadwick in 1880 showed that seventeen state medical societies around the coun-

same terms

try

"well-qualified

... to fellowship

as

accepted a

total

men. Published

of 115

in 1882,

women

doctors as equal

members

with

Chadwick's survey pointed out the striking

conservatism of the Massachusetts Medical Society. 30 In 1883, the to push for reform. An article in the Boston acknowledged that women doctors were "here to stay" and argued that the issue was no longer "one of sex, but of capacity." 31 Most of the members of the Massachusetts Medical Society agreed, claiming their society had a duty to the profession and to the public to regulate women doctors just as it regulated men. By 1883, 709 members supported the admission of women and 400 did not. Even more striking, 939 did not object to consulting with women doctors, and only 146 were opposed. 32 On June 10, 1884, Bowditch, Chadwick, and other proponents of female membership overcame the opposition and, by a vote of 63 to 47, opened the Massachusetts Medical Societv to women doctors on an equal basis with men. 33 The women at the New England Hospital, who had worked over

Boston press began

Herald, for example,

130

"We Must Get Them and Keep Them" thirty years for this

women

for

reform, hailed the decision as a major advance

doctors that symbolized their final acceptance into

Boston's male-dominated medical establishment.

announced the

event. "It

is

Cheney joyously we

with amazement," she wrote, "that

look back over our past history and see what progress has been in

.

.

.

the recognition [of the

the community.

.

.

broken down the

.

to

made

physician] by the best classes in

This year the Massachusetts Medical Society has

last

ing her admission to

True

woman

barrier against her equal recognition by offerits

ranks on the same terms as men." 34

her word, Zakrzewska did not seek membership when the

opportunity finally opened to her. Drs. Sewall and Morton joined

her in refusing to seek membership; together, the three oldest doctors at the

New England

Hospital chose not to submit themselves to

competence "after their long years of activity." 35 Zakrzewska spoke for all three when she called the society's invitaa test of their

tion for her examination in her twenty-seventh year of practice a

"condescending proposal." She explained emphatically: "This ven-

must give me an honorary membership if it wants me and Morton concurred, and the rest of the New England Hospital staff supported their stand. 37 While Zakrzewska turned down the opportunity for membership for herself, she recognized its importance as a step forward in the integration of women and men doctors. She advised "young beginners," with their professional careers ahead of them, to seek "this

erable Society

.

.

.

at all." 36 Drs. Sewall

privilege." 38

Though

firmly established in their professional work,

Augusta and Emily Pope and Emma Call were young enough to from membership, and they became the first doctors at the New England Hospital and the first members of the New England

Drs.

benefit

— —

Hospital Medical Society

to seize the opportunity.

Preparation for the examination was no simple matter. Having been out of school well over a decade, the candidates not only had to relearn much they had forgotten, but faced a new body of scientific knowledge as well. And as full-time physicians, they had to squeeze study time around their busy schedules. In 1928 Dr. Emily Pope looked back on the challenge they had faced forty-four years before.

in

"It

took

much

to

years of practice.

prepare for such exams after more than a dozen .

.

.

Nomenclature of Chemistry had changed, J3

1

Hospital with a Heart

Physiology and allied subjects [were] almost

new

Adding

sciences."

were well aware that their performances would on themseh es as indi\iduals but would stand as a test

to the pressure, thev

not onlv reflect

of the capabilities of

women

They knew

doctors as a group.

the

doctors at the hospital were counting on them. 'The knowledge that

we had worked with were looking to us indiyidualh was try39 ing."' Emih Pope remembered. The studying and preparation, difficult as they were, "were soon of the past." 40 On September 25. 1884, Dr. Call became the first those

woman

to

be accepted into the Massachusetts Medical Society, and

within two years eight other

women

doctors, including

Emih and

Augusta Pope, joined her. Throughout the 1880s and 1890,

women

membership in the Massachusetts Medical Society. In Suffolk County where the New England Hospital was situated and most of its staff resided, a total of twenty-four women doctors joined in the first ten years after the society opened to womdoctors increasingly sought

en.

Twice

as

many joined

in the next ten years, bringing the total

female membership in Suffolk County 1903.

to seventy

by the end of

41

Despite the appeal of the Massachusetts Medical Society to the

women

at

the

New England

Hospital, the

Medical Society continued to grow

New England

as well. In

its

membership of twehe more than doubled

initial

first

Hospital

decade, the

to twenty-eight.

B\

1891 membership expanded to forty-four, and b\ 1908 there were sixty ety. 42

both

women doctors in the New England Hospital Medical SociTo most of the women doctors at the hospital, membership in the Xew England Hospital Medical Society and the Mas-

sachusetts Medical Society was the most desirable professional option. 43 It

permitted them to reap the benefits of separation as well as

of integration. With dual membership, they could preser\e their

female solidarity and simultaneously enjoy the colleagueship of Boston's most influential male physicians.

Xew England Hospital Medical Society, spurt at the Xew England Hospital in the

Like the building

the century represented a gration. logical

On

and

132

commitment

the one hand, the building financial

imestment

to

the impressi\e last

decades of

both separation and

program

inte-

reflected an ideo-

in the all-women's hospital.

On

the

"We Must Get Them and Keep Them" other hand, expansion of the hospital demonstrated a commitment to preparing women doctors to work effectively within the maledominated medical profession. The building program at the New England coincided with an era of expansion at other voluntary hos-

Boston. By the 1880s, the

facilities at the Boston Lying-in, were no longer sufficient. With an eye to expansion, that hospital's trustees purchased three neighboring houses in the last years of the decade. A fund-raising drive in 1889 brought in $100,000 in just a few months, enabling construction to begin. 44 In 1892, a new, significantly larger hospital building opened, encompassing the three recently purchased houses and the original hospital structure. The new Boston Lying-in could accommodate seventy patients. It had six large wards; three medium-sized wards; two

pitals in

for example,

an operating room; offices for trustees, visiting phy-k sicians, and house officers; as well as waiting rooms, store rooms, and sitting rooms. 45 Expansion at the Lying-in and other hospitals in the late nineteenth century was not without growing pains, however. The transformation of American hospitals from institutions of charity to institutions of modern medicine often brought conflict between doctors and directors. Before the end of the century, when patients had gone to hospitals for medical charity, food, and shelter, directors had exercised final authority over a range of hospital procedures from patient admissions to medical purchases. As hospitals evolved into more scientific and professional workplaces, directors encountered growing resistance from doctors, whose scientific and professional priorities conflicted with the directors' social and finanisolation wards;

cial

concerns. 46

This clash of values shaped the course of the building program the

New England

Hospital as well.

The

at

doctors had to fight for

expansion, and the price they paid for success was a deterioration of

between themselves and the directors. The conflict between the doctors and directors at the New England assumed greatrelations

from the dissension at other New England was inseparable from the hospital's dual commitment to separation and integration and made its building program unique.

er meaning, however, distinguishing hospitals.

The impetus

it

for expansion at the

133


regardless of race or creed."

affair revealed the extent to

New England were

compromise

willing to

the twentieth century to save the hospital. dissatisfaction

among

interns

and doctors

overt rejection of the hospital nationwide,

doctors beyond their

limit.

which the doctors

at

in the early years

of

Coming

alike it

at a

time

was escalating

when to

an

threatened to push the

Faced with the threat of rebellion by

and patients, they seriously considered sacrificing the hospital's founding principle of equal opportunity for women in medicine simply to keep the institution going. The doctors ultimately resolved interns

the

Thompson

affair in favor of "equal opportunity for all." Yet

difficult as this decision was,

by the hospitals

easier for the doctors to treat

women

all

women

fiftieth year,

it

was

equally than to provide

with equal professional opportunity with men. Zakrzewska

once imagined what

it

would be

after a twenty-year sleep." 106

like to

Had

she died, she would have found that the years after

its

wake

"like

Rip van Winkle

she awoken only ten years after

New England

Hospital,

founding, had become a very different place.

/

/

fifty

7

"We

Tor is

Will Lose

Our

Hospital"

compromise on the principle that this Hospital women, by women, to train women would mean

us to

for

complete annihilation

in the future

and treachery

to the

founders.

— Blanche Ames to Dr. Amelia Brown, November

Ames

On

9,

1951, box

1,

folder 10,

Collection

"a glorious October day" in 1912

all

the doctors and directors

New England Hospital on its fiftieth anniverwas a happy day of celebrating and reminiscing. Everyone wore a boutonniere of yellow rosebuds and a badge of white satin ribbon with "1862-1912 New England Hospital for Women and gathered to honor the sary. It

Children, October 29" printed in gold.

The

doctors hosted a

luncheon for the directors and the consulting physicians

room of

Goddard Home

in the rec-

and plants decorated each of the twelve tables. A large panel with the names of the hospital's founders, Marie E. Zakrzewska, Lucy Goddard, and Ednah D. Cheney, printed in gilded letters, adorned one wall. After lunch, the festivities continued in the Cheney Surgical Pavilion, where doctors and directors filled the upper and lower halls and the long, winding staircase to capacity. reation

the

for Nurses. Flags

1

Amid

all

the

festivities, a

the hospital in the it

to a point

of

first

sadness pricked the

air,

crisis in its fiftieth year.

doctors and directors tried to recoup

moment, the They used Zakrzewska and

Seizing the

some of their

the fiftieth anniversary to praise the legacy of Dr.

178

for the decline of

decade of the twentieth century had brought losses.

"We

Will Lose

Our

Hospital"

her loyal co-workers who had built the New England Hospital. Helen Kimball, the hospital's third president, set the nostalgic theme. Speaking to the familiar faces crowded into the surgical building,

remember

the founders of the

well," she continued, "to look

back with gratitude

she invited them "to join the past and Hospital. ...

It is

what has been accomplished." 2 One by one, the doctors and directors followed her lead. They took each other on a journey through the hospital's history, starting with its humble beginnings. "It began with struggle," spoke one of the directors; "it has

and

rejoicing to

achieved success." 3

They remembered

women" who founded

with pride the "noble trio of

the hospital, the "pioneer doctors"

who

dedi-

and the " 'grand old men' of Boston who stood behind them and made it possible for the women to do things." 4 They applauded the hospital's impressive growth, its excellent medical record, and its reputation among the women and men of Boston and beyond. Most of all, they remembered Dr. Zakrzewska and the principles for which she stood: "loyalty to this Hospital .. and to the wider cause of the education of women cated their lives to

it,

.

.

.

.

physicians." 5

Even

as they

dwelled on the glories of their past, they looked

ahead, challenging the younger Zakrzewska's work. Smith.

"We

women among them

"And now what of

on Mary

to carry

the future?" asked Dr.

shall leave this task to [our successors] in the confident

hope and assurance that the record of the next fifty years may be one of even greater prosperity and achievement, and that the Hospital

may

ever stand as a

monument

to

Women

Physicians." 6 Dr. Eliza

Mosher spoke with greater urgency and less optimism "to you younger Doctors." Zakrzewska and her co-workers, she told them, have left you a great heritage, and with it a great responsibility. You cannot afford to let this work fall which was established and perfected at such a cost. It must go forward," she asserted, "and, if you continue to minister to its needs with zeal and fidelity, to you also will come success and the high praise that we today have awarded its founders." 7

But the

New England

Hospital did not "go forward" as Mosher

— unresolved over —confronted the women who remained

hoped. Instead, a bittersweet legacy gration and separation

conflict

inte-

179

at

Hospital with a Heart

the hospital through the twentieth century. As the century progressed, this tension led to a

lenge

—the

new and

hospital in the twentieth century.

women

more

ultimately

task of justifying the very existence of

New England

By

serious chal-

an all-women's

the hospital's centennial year,

were

at odds over the purpose most devoted supporters seriously considered closing the New England Hospital forever. The second half-century of the New England illustrated the trans-

the

at the

many of

of their institution, and

still

its

formation of the meaning of separatism for 1860s

when

Zakrzewska had no choice but

By turn of the century,

women

women

separatism defined the contours of

doctors, the

to establish

as integration

doctors. In the

all

women's

an all-women's

became

younger and older women

lives,

institution.

a viable option for at the

New England

debated the merits of separation and integration for their medical careers. Fifty years later, integration

more

was the preferable, indeed the

respectable, route. Separatism, once the only acceptable ave-

nue for women doctors

—and

for

all

American women

— repre-

sented either a reversion to the past or a radical path into the future.

This transformation of separatism at the New England Hospital had its roots in the ideal of a science of society that had permeated American culture by the second decade of the twentieth century. 8 The advocates of a science of society sought to replace the moralism of Victorian American culture with a value-free concept of society. This faith in objectivity and empirical study changed the self-image and behavior of many women. 9 Whereas nineteenth-century women took pride in their moral superiority over men, women in the 1910s and 1920s began to discard this notion of sexual difference to claim equality with men. Some joined the ranks of the new social scientists. In the best scientific tradition of the times, they conducted studies of women's attitudes and behavior to disprove the notion of sexual differences. The research of Helen Thompson Woolley and Leta Hollingworth, for example, challenged the belief in female intellectual inferiority; the studies

Bement Davis demonstrated behavior.

of Clelia Mosher and Katherine

the similarity in male and female sexual

10

Other women took the ideal of a science of society beyond the academe. Settlement-house workers began to lose interest in

walls of

180

"We

Will Lose

The women

at

Hospital"

embraced the

the moral imperative of social reform and

notion of research.

Our

scientific

Hull House in the 1890s, for

example, went "to do something about the

social disorder." Their Jane Addams observed, went "to investigate something." 11 Other young women rejected the virtuous behavior of their mothers and emulating men, began to smoke, drink, and engage freely in sex. 12 In the wake of the woman suffrage victory, many veterans of the suffrage movement seized the banner of objec13 tivity to campaign for an equal rights amendment. Of course, not all women were so enthusiastic about the implica-

successors,

tions of a science of society for their lives.

Many

ism and absolutism of the nineteenth century.

clung to the moral-

The proponents

of

protective labor legislation, for example, clashed bitterly with equal rights advocates as they harnessed the notion of sexual differences to fight for special protections for

club

women

working women.

Similarly,

many

held fast to their commitment to social reform and in

particular to their special concerns for the family.

But even club

women began

to

14

adopt the ideals of science. For

example, they accepted the new idea of a science of child development,

first

childhood.

suggested by G. Stanley Hall's theories on the stages of

Through

the National Congress of Mothers, the anteced-

ent of the Parent-Teachers' Association, hundreds of thousands of

women women in

advocated university chairs in child study and courses for in

domestic science. 15 Club

women

also played a

major role

supporting the establishment of a juvenile court system. While

their

concern for the delinquent child stemmed from their

tradi-

tional role as mothers, their interest in juvenile courts revealed their

agreement with Hall that only systematic and skilled attention could adequately help young delinquents. Louise Stanwood, president of the Illinois Federation of Women's clubs, for example, argued that the juvenile court would move "away from the old ideas of a mere surface charity which relieves distress for the moment, to a deeper and more scientific interest in doing away with the sources of poverty and crime." 16 By the 1910s the new emphasis on objectivity, equality, and science was firmly embedded in the minds of women doctors as well. Integration of the medical profession, specialization, membership in 18]

Hospital with a Heart

male-dominated medical societies, and affiliation at male-dominated hospitals, as well as the growing tendency among women doctors to marrv, represented

women

doctors' attempts to shed the traditions

of their past and to achieve professional equality with men.

At the same time, many distinctiveness even as thev

women

doctors strove to preserve their

embraced the new professional

values.

They continued to organize professional institutions for women onlv. The Woman Medical Journal for example, encouraged women doctors to work for "higher scientific standards'" by publishing in Similarly, the American Medical their own professional journal. Women's Association brought women together into their own na's

1

'

tional medical society. Its founding in 1915. the same vear American Medical Association first opened its membership

en,

that the to

wom-

was a vivid svmbol of the persistence of female separatism in an

when women sought sexual equality. The tension between separatism and integration, and more

era

gener-

between moralism and objectivity, shaped the history of the women at the New England Hospital throughout its second halfcenturv. Thev divided into two groups: those who sought to accommodate the nineteenth-centurv tradition of female virtue and morality to the new objective and scientific values in the medical profession, and those who believed that objectivity should totally replace politics and moralism in their professional work. The former group sought to preserve separatism at the New England: the latter group was willing, even anxious, to integrate the hospital. From the hospital's fiftieth anniversary through the 1940s the advocates of separatism at the hospital managed to retain the upper ally

hand. In 1913, for example, thev voted not to extend full consulting privileges to male doctors, even though some patients wanted to call in their private physicians.

While some of the

women

ported the patients' requests, longtime physicians

Emma

doctors sup-

Stella

Tavlor and

Culbertson persuaded the majority against the idea.

"It

may

not be wise," Tavlor argued, "to jeopardize the onlv hospital run entirely by

women, bv

ticipation by

182

men

too often." 18 Just

agreed to continue their policv of limited parmale physicians, thev voted to extend their facilities to doctors, inviting all women who belonged to the Mas-

five vears after thev

women

the habit of calling in

"We

Will Lose

Our

Hospital"

sachusetts Medical Society to bring their private patients to the hospital. 19

Even

as the doctors held fast to their separatist tradition, they

strove to keep

up with new

professional standards. In 1913, for

example, Drs. Culbertson and Smith joined the newly organized College of Surgeons and urged their colleagues to do the same. 20

That same

year, the doctors negotiated a formal relationship with

the medical school at Tufts. In return for salaries equal to those of

Tufts instructors of obstetrics, they agreed to Tufts's request to struct

the

its

New England sounded

They pointed to their represented more than half of the

integration.

women

in

New

at

a familiar theme: their hospital's separa-

tism was successfully contributing to

to

in-

female students in obstetrics. 21 In the 1920s the doctors

women

doctors' professional

eight hospital internships, which fifteen rotating internships

open

England. Similarly, they singled out their friendly

relationships with their consulting staff,

who

in

sending many

pri-

New England brought the hospital "nearer the men and women working together." 22 Moreover,

vate patients to the

modern

ideal of

from the 1910s through the 1930s, the doctors employed their separatism to expand the hospital. Twice during this period they called on the public to support women doctors' special efforts on behalf of women and children. In 1917 and again in 1931 they raised enough

money

to enlarge the hospital, constructing first a

wing and later a new pediatric building. The earned important professional legitimization

new maternitv

New England in

the

also

1930s and

American Medical Association instituted boards and monitor specialty training programs in the 1930s, the New England received approval for .its residencv programs in obstetrics, surgery, and anesthesiology; approval for its pediatric program was granted in the i940s. 2; Despite these signs of progress and growth, other evidence suggested that the New England was in serious trouble. As early as 1913, Dr. Taylor privately acknowledged that the hospital was "practically at a standstill." Patient usage, for example, had declined steadily since 1908. The "empty beds so continually in evidence" created an "embarrassing" public relations problem for the doctors, who had "to explain the why of it to visitors." 21 A modest rise in the 1940s. Just after the

to standardize

*

183

Hospital with a Heart

numbers of

patients in subsequent years did not solve the problem. At a physicians' meeting in 1920, Dr. Margaret Kleinert addressed

"the distressing condition of the Hospital. " She explained that while

Boston hospitals were

six private

week, "we had

filled to capacity in

the previous

30 to 40 idle beds." One source of the probKleinert, was the decline of hospital management

at least

lem, according to

and housekeeping standards, despite the efficiency campaign of 1915. Rooms were so dirty "that patients [were] ashamed to receive their friends." In addition, patients often did not receive

any lunch,

and when they did, their trays often had no cups or were set with mixed patterns of china. "Why shouldn't china be bought in large quantities, all of one pattern?" Kleinert asked, revealing the inadequacy of the hospital's recent efficiency campaign. "That

is

surely

the cheapest and most efficient way of buving for an institution." 25

Others, however, believed that the problem lay in the hospital's tradition of separatism. sibility

Some even began

to investigate the pos-

of integration. In 1926, the treasurer of the hospital sought

advice to determine

if

the

Xew England and

could legally admit

men

as

According to one lawyer, a simple revision of the by-laws would permit male phvsifull-time staff physicians, interns,

cians

on the

patients.

but a change in the act of incorporation was

staff,

necessary before male interns and patients could legally be accepted. 26

Though

there were no policy changes in the next five years, in

1931 a public relations pamphlet announced the hospital's break

"The trees are about all that remain of the old regime the trees and the tradition. All else has kept abreast of the times." Making the most of the hospital's limited integration its male consulting staff and the male doctors who sent private physiwith past traditions. .

.

.

—

cians to the hospital

—the pamphlet boasted that "the old rule which

restricted practice in the hospital solely to

women

phvsicians has

gone the way of Marie Zakrzewska's horse and buggy. Both have outlived their usefulness; both have been modified and improved upon to suit the needs of a newer age." 27 Neither this new emphasis on integration nor the persistence of separation

stemmed

the hospital's decline. Instead,

its

problems

es-

and 1940s. Expansion stopped in 1932, after the construction of the children's building. By the end of the 1940s, all

calated in the 1930s

184

"We

Our

Will Lose

Hospital"

the buildings, including the newest ones, were sorely inadequate in

desperate need of replacement or repair.

situation

grew

steadily worse.

hospital exhausted

1949,

it

had a net

its

Through

working

The

and

hospital's financial

the 1930s

capital simply to

and 1940s the keep going. By

$79,000 and bills of almost $150,000 tradespeople. 28 Moreover, in the 1940s the probdeficit of

were owed to local lem of patient disuse, which first emerged in the 1910s, became particularly acute as fewer patients entered the hospital and for shorter stays. 29

The

hospital's

of the sudden increase in professional options

The

entry of

that

women

War II as a result for women doctors.

problems escalated during World

men

into the

armed

services left a

readily filled. In industry

and

gap

in the

workforce

in the professions,

women

found opportunities that had been unavailable to them only a few years before. The doors of medical schools and hospitals opened suddenly to women. In 1934, 28 percent of the medical schools in the country had never graduated a woman; by the war's end, all but 30 As women gained entry into 9 percent had graduated a woman. more medical schools, they began to constitute a larger proportion of the nation's medical students. Whereas in 1941, they represented 5.4 percent of the medical students in the country, in 1945, they

accounted for 8 percent. In each successive year of the war,

women

made up a larger proportion of the entering classes at medical schools. They represented 4.5 percent of the students beginning medical school in 1942, and 8 percent of the students who entered in 1945.

31

In Boston alone, Tufts, Boston University, and Harvard

increased significantly their

numbers of women medical

The proportion of women

entering medical school

all

students.

at Tufts, for

example, rose from 4 percent in 1942 to 15 percent in 1945. The increase was even more dramatic at Boston University: from per1

cent in 1942 to 19 percent in 1945. 32 Perhaps the most vivid symbol of women's wartime inroads into the Boston medical establishment

occurred in 1945, when Harvard's medical school finally broke its all-male tradition and accepted twelve women into its freshman class. 33

Women

also

found greater opportunities for hospital work as a were avilable to women in

result of the war. In 1941, internships

185

Hospital with a Heart

only 105 hospitals. By the end of 1942, 358 additional hospitals had accepted women as interns. 34 An article in the New York Tunes sum-

marized the trend: "Hospitals are hanging out the welcome signs to women physicians these days. Fledgling women doctors, once excluded

.

.

.

now being snapped up

are

as fast as the ink dries

on

their diplomas." 35 In Boston, the Massachusetts General Hospital,

which had accepted a total of only seven women interns between 1917 and 1940, appointed nine women between 1942 and 1945. 36 This change had a serious impact on the New England Hospital, which had previously provided available to

thirteen

them

women

women

with most of the internships

in Boston. In 1941, for

example, eleven of the

interns in that city were at the

New

England. Dur-

when such hospitals as Massachusetts General readily welcomed women, the New England had trouble attracting appliing the war,

cants

had only two interns instead of the usual ten or became so desperate that the hospital temoffered honorariums to attract women to train there. 37 Ul-

and

at times

The

twelve.

porarily

situation

wartime trend intensified the growing feeling among women as well as men that women no longer needed the

timately, the

many

—

—

New England

Hospital.

number The advice

In the immediate postwar years, the hospital underwent a of studies to determine the best strategy for

its

survival.

New England Hospital should abandon its tradition of separatism, accept men on its active staff, and redefine itself as a community hospital. The recommendations brought to a head the unresolved debate over the benefits of separatism and integration for women doctors. As the debate unfolded, however, it became clear that below the arguments on behalf of of each was essentially the same: the

either separatism or integration lay an even deeper cleavage

women

among

doctors. Supporters of separatism sought to preserve the

moral principle of the nineteenth century that

women had

right to medical training simply because they

were women. Advo-

a special

on the other hand, embraced the twentiethcentury notion of ethical neutrality and sought to abolish special cates of integration,

considerations for

women

in

medicine.

Of course,

neither stand was

value-free, but within the context of twentieth-century objectivity

186

"We and empiricism, the

integrationists

Will Lose

Our

appeared neutral

Hospital"

in contrast to

the supposedly idealistic separatists.

The United Community and

Services, Boston's

"community

chest"

major financial supporter of the hospital, rekindled the dereforms brought on by the war, it asserted that the "changed attitude of 1948 on the subject of women in medicine raises a serious question of the wisdom of continuing separate and designated hospitals for women in training and medical practice." 38 a

bate. Referring to the

Making the twentieth-century argument for equality rather than women and men, it defined the New England as an "unnaturally exclusive institution" and called for "open competition between men and women." 39 To demonstrate the seriousdifferences between

ness of

its

reduced

recommendation, in 1950 the United Community Services annual allotment to the hospital from approximately

its

$60,000 to $34,000. In response to the United Community Services' pressure, the hospital's

directors willingly adopted

changed the

institution's official

one of

recommendations and New England HosEngland Hospital. This

its

name from

the

pital for Women and Children to the New change indicated their willingness to accept men as patients, a reform they had adopted with little fanfare years before. Yet disagreement was still strong over the recommendation to change officially the hospital's policy regarding male doctors. Those in favor of such a change found their opportunity in 1950: the chief of surgery suddenly resigned, and a longtime courtesy physician, Dr. Edward Young, was appointed as her temporary replacement. Not since Horatio Storer had served as the hospital's surgeon in the 1860s had a man been on the active staff of the New England Hospital. While Young, like Storer, assumed his position as chief of surgery as a "temporary expedient," a group among the doctors and directors seized the moment to turn Young's appointment into a new policy of integration at the hospital. 40 Within a year, Young added fourteen men to the eight-woman surgical staff, and by the end of 1951 at least thirty men were on the hospital's active staff. 41 Doctors and directors supported this change as one that would pull the New England Hospital out of its past. One staff surgeon,

187

Hospital with a Heart

Rosemary Nelson, warned that women doctors could no longer "remain isolated and maintain the necessary high standards of professional efficiency." Arguing against the nineteenth-century tradition of separatism, she charged:

am

"I

wholeheartedly resent segregation

woman." Impatient with those who

"fail to comprehend the end of struggle," she asserted vehemently that the "battle for equality of the sexes has been fought and won." Nelson's faith in integration stemmed from her personal experience in medical school. A graduate of the coeducational Rush Medical College, she claimed she had competed on equal terms with her "brother students" and never experienced any discrimination. Based on her medical school experience, she looked forward to working at the New England Hospital with men who, she believed, would "definitely" improve her professional ability and attract women doctors away from other hospitals. 42 Nelson was not alone in her views. At least two other doctors, Annella Brown and Grace Rockford, shared her enthusiasm for working with men. Rockford argued that integration would "save" the hospital for women doctors. Similarly, a group of directors believed that male physicians would offer women doctors the "best teaching" and attract more patients to the hospital. 43 Pragmatic support for integrating the New England came from influential people outside the hospital as well. The assistant dean of Harvard Medical School, for example, argued that since women could train at male-dominated hospitals, the demand for internships in women's hospitals like the New England "cannot be great." In September 1951, an editorial in the New England Journal of Medicine echoed this support. Likening the New England Hospital's tradition of separatism to the Indian custom of secluding women from men, it applauded the end of the hospital's "self-imposed purdah." But beneath the editor's support of equal opportunity for women and men at the hospital lay a new version of inequality that

because

I

a

*

threatened to lock the hospital into the outdated practice of

medicine and specialization.

isolate it from the twentieth-century trend toward While larger hospitals accommodated to medical spe-

cialization, the small

New England would

succeed, according to the

editor, as "the hospital that trains family doctors.'

188

holistic

13

"We

Will Lose

Our

Hospital"

more

Despite the hopes of Young's supporters, integration created

problems than

men

it

solved at the

to the active staff, for

New England

Hospital.

The addition of

example, did not increase significantly the

hospital's patient population. From January through May 1951, they brought only eighty-nine patients, increasing the total number by barely 5.5 percent. 46 At the same time, the tripling of the surgical

reduced the

staff drastically

Whereas each of the

women

doctors' surgical opportunities.

original staff of eight

women had performed

approximately forty-one operations a year, Young's expanded surgical staff

reduced their operating load

many men

to the surgical staff

to fifteen. 47

The addition of so

women

doctors feel "anx-

made

the

and "unrest" intensified when Dr. Young, with several sympathetic directors and women physicians, including Drs. Grace Rockford and Marjorie Woodman, made a blacklist of uncooperative doctors. 48 "They tried to travel to victory as the 'four horsemen' fear, ignorance, bigotry and smear," recalled one woman doctor. As a result, "firm supporters" of the hospital left. 49 Esther ious."

Their

feeling"

"ill

—

the

Bartlett,

"dropped

as

hospital's

anesthesiologist

1939,

was simply

an example," while Dr. Rockford made other older

women doctors most valuable

"feel

unwelcome." As a

staff

members

Blanche Atwood, for example,

result, several

resigned.

left after

service. 50 Sixty-two-year-old Dr.

two years

since

Dr.

twenty-nine years of surgical

Bernadette Ryder

in the hospital's obstetrical

of the hospital's

Fifty-nine-year-old

left after thirty-

department. Sixty-two-year-old

Dr. Eliza Melkon, one of the hospital's most active surgeons with over

150 patients a year, resigned after thirty-three years

England five

to

women

work

at

Mount Auburn

doctors resigned or

was chief of surgery. ing. Dr. Bartlett's

dency approval

lost their positions

The implications

surgery,

approval, only the surgical

New

the

for the hospital

Of

were devastat-

the four departments

—which

and anesthesiology department retained

its

all,

Young

while Dr.

departure, for example, cost the hospital

in anesthesiology.

obstetrics,

atrics,

at

Hospital in Cambridge. 51 In

its

resi-

—

pedi-

had

AMA

rating after

men

52

joined the active staff in 1950. To make matters worse, Young's policies also created

among staff,

patients. In the 1860s,

when Horatio

Zakrzewska encouraged her

ill-will

Storer was on the active

patients' female

modesty by per-

189

Hospital with a Heart

mining them

to request a

woman

doctor

at

any time. Young,

reflect-

ing the twentieth-century belief in the objectivity of medical practice,

"whoever is on duty [or] get out." 53 His intolerance of many women's preference for a female physician cost the New England significant numbers of patients, as, increasingly, would-be clients left the hospital without seeing any doctor at all. 54 As a result, the patient census began to drop an average of ten per month. By the end of December 1950, there were only fifty patients and one hundred empty beds. 55

demanded

that his patients see

In response to the hospital's general decline, a majority of the

women

doctors began to speak out on behalf of the hospital's tradi-

tion of separatism.

of the

"Reasons for maintaining the original purposes

New England

Hospital are as cogent today as they were in

1863," they argued. Referring to the postwar reemergence of dis-

crimination against

women

in

male-dominated

hospitals, they con-

"More women need the opportunities here than ever before. Nowhere else in New England can women rise to the top appointments." 56 As an example, they complained that in some Boston hospitals women surgeons had to sign "an agreement" that they

tinued:

understood that they would never receive an appointment above the level

of junior visiting surgeon. 57 Moreover,

tunities simply for staff positions at

New England. In New England

the

hospitals

hospitals

women

lacked oppor-

Boston hospitals other than the

women were active staff physicians at Of the 723 staff physicians at nine other in the city, only 27 were women. The situation in Boston was not unique. An article in the Journal of the American 1952—53, 66 Hospital.

Medical Women's Association complained that there were "few

in-

where a women could even hope to become chief of staff in a male-run hospital. 58 Another article, in the New England Journal of Medicine, acknowledged that women's opportunities for hospital training and postgraduate work were fewer than for men "all along the line." 59 This resurgence of discrimination extended from hospistances"

tals

into medical schools.

While

women

constituted 12 percent of the

nation's medical school graduates in 1949, they represented barely 5 percent in 1955. The decline at Tufts was even sharper than the

national decline.

Whereas women made up

15 percent of

ing medical class in 1945, they represented only

190

1

its

enter-

percent of

its

"We

Will Lose

Our

Hospital"

medical graduates in 1955. 60 A three-year study by research experts at the prestigious Brookings Institute summed up the situation, reporting simply that

women

doctors

still

"face discriminations." 61

New England Hosgroup of directors was passionately committed to returning the hospital to its historical commitment to women. The leader of this group was seventy-five-yearold Blanche Ames, a longtime advocate of woman's rights, who had worked for suffrage and birth control and had actively supported the New England Hospital since the 1920s. 62 Ames quickly emerged The

doctors were not alone in denouncing the

pital's policy

of integration.

as the leading ist

past. "It

An

active

spokesperson for returning the hospital to

is

no good trying

to

compromise

its

separat-

sex," she wrote in a

passionate defense of the hospital's original purpose. 63 Challenging the

modern notion

that

open competition between men and women

doctors was "the road to progress," she praised the hospital's eighty-

seven-year tradition of "cooperation" where women doctors only were on the active staff and men doctors aided them as consultants and referring physicians. 64 With a majority of the doctors and directors, Ames called for a new executive committee sympathetic to the "old traditions of the hospital." 65

committee resigned

Under

pressure, the entire execu-

January 1952, ending temporarily the New England Hospital's experiment with integration. 66 The new regime, under Ames's direction, promised to "preserve

tive

in

the [hospital's] heritage for future physicians." 67 Yet saving separa-

suddenly became even more difficult, for new problems emerged almost immediately. First, another study, conducted this tism

time by Dr. Philip Bonnet, director of the Massachusetts Memorial Hospital, concluded that the hospital's depleted treasury, deteriorat-

ed physical plant, and state

loss

of credit standing had created a "tragic

of affairs." Arguing that the hospital's historical commitment to

women had "ceased to have widespread public appeal," Bonnet recommended that it merge with a larger teaching hospital. 68 Ames and her allies voted to reject Bonnet's report. 69 Still, they could not so easily dismiss the new threat by the United Community Services to exclude the

campaign and $8,io3. 70

its

New England

Hospital from

its

"final allotment" to the hospital in

Ames immediately

assailed the

Red Feather 1953 of only

United Community Ser1

9

i

Hospital with a Heart

women doctors, which She was not alone in her outrage. The United Community Services' announcement provoked vices for

"resurgence of prejudice against

its

years." 71

would turn the clock back 100 a public outcry. Ex-patients

came

to the hospital's defense.

wrote to the Boston Herald that the doctors saved her

life.

72

Heart," another,

at the

One

New England had

In a letter to the editor entitled "Hospital with a

who had been

a patient at five hospitals,

ranked the

New England as best. 73 Others argued that women still preferred to see women doctors and that women doctors still needed a hospital of own. 74 Male physicians echoed this support. Twenty-five wrote letters to the United Community Services on the hospital's behalf. 75 One longtime courtesy physician publicly accused the United Community Services of being "woefully misinformed" on the opportheir

tunities for

women doctors

in hospitals other

than the

New England.

Another courtesy doctor publicly praised the hospital for its excellent record of medical care and for its dedication to the "entire community" not just to women. 76 Joining the hospital's defense, the ministers of Roxbury expressed their collective "distress" to the United Community Services, and wealthy Bostonians spoke with

—

their pocketbooks, withholding their annual contributions to the

Red Feather campaign. 77 Despite the impressive public support for the

United Community Services decided

New

England, the

December 1953 to exclude the hospital from its Red Feather campaign. Whereas Ames had cast the controversy in political terms, charging the United Community Services with "antifeminism," the United Community Services characterized its position as purely neutral. "It makes its decision on facts and not on rumors," asserted its president, Philip Theopold. 78 Brushing off charges that it had taken the "heart" out of charity, the United Community Services defended its decision on objective criteria: deteriorating buildings, declining patient census, and unresolvain

ble financial difficulties. 79 Ironically,

Ames and

they did not take

her supporters had an opportunity

—to find a middle ground between these polarized

views. In early 1953, just after the United

nounced

its

Community

Services an-

intentions regarding the hospital, they hired a public

relations consultant, Mrs.

192

—which

Hugh

Cabot, to help them regain United

"We

Community

Services support.

Will Lose

Our

Hospital"

On the surface, Cabot appeared to agree

Community Services that politics no hospital. The "feminist element," she ar-

wholeheartedly with the United longer had a place at the

gued, "couldn't guarantee any future." 80 Moreover, she concluded its very commitment around the all-woman staff," she explained, "not the most competent women." 81 Cabot's evaluation was not as one-sided as it appeared, however. She proposed to modify rather than to destroy the hospital's historical commitment to women and to "translate it into terms of contem-

that the root of the hospital's current crisis was to

women. The "standards were

built

porary society." Ironically, she suggested a new version of separatism that was strikingly similar to that of the nineteenth century.

Zakrzewska had based her all-women's hospital on the argument

women

patients had special needs and women doctors had speCabot proposed a modern variation of this theme. Adolescence, marriage, menopause, and old age still caused unique probthat

cial skills.

lems for women, she explained, but within a different

social context.

The

"protected woman" of the nineteenth century had become the working woman of the twentieth. Work, according to Cabot, created a range of unique health problems for women of all ages. With this in mind, Cabot proposed that the New England Hospital become a "woman's medical center" dedicated to the special needs of the twentieth-century working woman from adolescence through old age. 82

A

few doctors and directors were enthusiastic about Cabot's pro-

new direction. Most, however, were more upset by her critique of the hospital's "tenacious clinging to past glories" and rejected the plan to build a "woman's medical posal to lead the hospital in a

center." In doing so, they lost the opportunity to turn the

New

—

England once again into a pioneer medical institution this time for what Cabot called "today's woman" of the twentieth century. 83 Instead, they tried to resurrect the female solidarity of Zakrzewska's

day.

Ames

called for "a revival of the feminist

She drew up a

them

to give

list

of "friend[s] of

money

women" and sought to "rouse" women doctors ap-

to the hospital. 81 Several

pealed to other medical sisters in

Group Movement."

women

"to take a stand in defense of

your

the profession." 83

193

Hospital with a Heart

Some responded to this renewed effort. who worked for the important 'causes'

lies

In particular, the "fami.

.

.

[such as] anti-slavery

and women suffrage were the very generous supporters" of the hospital. 86 But they could not support the hospital on their own, and most women in the 1950s did not respond to the call for renewed sisterhood. Indeed, in an era when the "feminine mystique" defined the parameters of most women's lives, Ames and her allies could not resurrect the female solidarity that had once sustained the hospital. 87

way to despair, and the morale among the women doctors plummeted to an all-time low. Dr. Ilia Galleani, staff surgeon for thirty-two years, spoke with deep feeling about the hosFrustration soon gave

pital's decline:

very badly about my hospital because it is my hospital. I call it it is my professional home. It had a wonderful atmosphere. It has become cold. People are insecure. Nobody knows I

feel

mine because

when there is a change here and wrong somewhere. 88

a

change

there.

There

is

something

Dr. Elizabeth Kleinman, on the staff for twenty-seven years, echoed

her colleague's sentiments even more dramatically. Describing the hospital as "very dear" to her, she explained that she

had "watched

it

go down for a number of years, but the last year," she emphasized, "I would say 'this hospital is in a state of coma and gasping for breath.'

" 89

As the

situation worsened,

many grew

increasingly impatient with

the attempts to preserve the hospital's separatism.

When

the chief of

and gynecology resigned suddenly in 1958, the advocates of integration were able to appoint a consulting physician, Dr. Harold Rubin, to replace her. 90 Though Ames, Kleinert, and others obstetrics

tried to block Rubin's

appointment, by 1958 they were an aging

minority at the hospital. As Kleinert acknowledged: "Some of us

defend the hospital for women will not be here to defend it much longer." 91 Their waning influence was part of a larger trend that extended beyond the New England Hospital. By i960, there was a consensus among the women at the New York Infirmary and the Woman's Hospital of Philadelphia that the all-

who want

194

to

"We women's

hospitals "were

three hospitals appointed

Will Lose

men

New England

forever as a women's hospital and became a

England Hospital did not symbolize us

it

closed

community

who hold

One

its

failure. Rather,

it

fast to tradition

women, could not

mitment

to

Yet

moral commitment

sustained the

New England

separatists to find

it

doors

health cen-

New

was their only

longtime supporter explained that "those of

would

like to see the hospital close

rather than go over to the men." 93 Separatism, with

this

Hospital;

the point of view of the separatists, the closing of the

remaining option.

all

to their staffs.

continued to decline through the 1960s. In 1969

From

Hospital"

no longer necessary." 92 In the 1960s,

Integration, however, could not save the

ter.

Our

meaning

prevail at the

to

its

moral com-

New England

Hospital.

women, which had conceived and

for a century, ultimately helped the

in the hospital's final demise.

l

95

Conclusion

The women

doctors at the

New England

Hospital did not shake the

world. But for over a century they shook free from the constraints

imposed upon the women of their day to forge proGuided by the opportunities of nineteenth-century separatism, their path to professionalism in modern America led them ultimately to confront the paradox of that very separatism. In the nineteenth century, the women doctors at the New England Hospital dared to defy the conventional wisdom that the home was the center of a woman's life. They gave up the comfort of confor-

and

limitations

fessional careers.

mity to

make

own home

their

professional careers. Faced with the choice

between a life at or a life in the world outside, most chose medicine over marriage and motherhood. In this way, the doctors at the New England were a unique and special group among women in nineteenth-century America. All the women at the New England Hospital and all nineteenth-century women doctors were pi-

—

oneers.

women

They stood

—

as proof, against the skeptics of the day, that

could be doctors and could practice medicine competently. Most outstanding among this impressive group of women was Dr. Marie Zakrzewska, the founder and leader of the -New England Hospital for Women and Children. Dr. Zakrzewska did not have the popular following of temperance leader Frances Willard or the po-

196

Conclusion

impact of suffrage activists Susan B. Anthony and Elizabeth Cady Stanton; she belongs, nevertheless, among these pioneer advocates of woman's rights. She shared their ambition to expand woman's rights and to improve the conditions of women's lives; and her accomplishments measured up to theirs. Her own particular commitment was to professional opportunity for women in medicine. In her lifetime of work at the New England Hospital, she expanded the nineteenth-century woman's movement beyond its focus on such political and social causes as suffrage and temperance into the arena of the professions. Not only did Zakrzewska help bring women doclitical

tors into the nineteenth-century medical profession.

make medicine

the

first

male profession open

to

She helped to in a mean-

women

ingful way.

The tal,

passion of Dr. Zakrzewska's

life

was the

one of the most important all-women's

New England

institutions

Hospi-

and one of

the most unique medical institutions in nineteenth-century America.

Zakrzewska founded the hospital in 1862 as a medical workplace modeled after the prestigious male-run hospitals of the day but for women only. The New England Hospital belonged both to women

—

and

to the medical profession.

From

the

start,

it

successfully fused

the interests of these divergent groups.

The women

went there

separatism, the linchpin of

almost

all

in

its

early years sought out

its

nineteenth-century women's

the thousands of other middle-class

lives.

women

doctors

who

They were not unlike who founded

of the day

separate all-women's organizations to work for temperance, moral purity, sanitation,

New England

woman's

rights,

and other

social reforms.

The

Hospital was part of this network of women's groups

and institutions. It duplicated the all-female dimension of other contemporary women's organizations and gave women doctors a place to practice medicine apart from men. But even as the New England Hospital fit comfortably into the nineteenth-century woman's movement, it was part of the medical profession of the day. Like other voluntary hospitals, the

New

En-

gland provided medical charity to the sick poor and professional

To be sure, by most contemporary stanwas not a major medical showplace. It did not compare with

opportunity to physicians. dards,

it

large, influential hospitals

such as Massachusetts General or Chil-

197

Hospital with a Heart

dren's in Boston.

These other

hospitals, staffed bv the leaders in the

medical profession and supported bv society's for

all

elite, set

nineteenth-centur\ hospitals. In contrast, the

the standards

New England

was a small hospital with a tight budget, modest prestige, and an allfemale staff which was never among the profession's inner circle. But viewed through the lens of the nineteenth-century woman's

movement, the New England Hospital was an extremelv important medical institution. For almost a centurv.

New England

it

was the onlv hospital

in

women doctors with hard-toand sick women with medical care

dedicated to providing

find professional opportunities

from doctors of

their

own

sex.

With

a

handful of other all-women's

New York Infirmary and the of Pennsylvania, the New England Hospi-

medical institutions, including the

Woman's Medical College tal

formed

a separate inner circle

teenth-centurv America.

Its

of women's medicine

in nine-

existence assured that the nineteenth-

centurv regular medical profession, though male-controlled,

in-

cluded women.

Under Zakrzewska's firm leadership, the New England Hospital maintained its commitment to providing women with medical training equal to that enjoved bv the regular male medical profession, but in

an all-female environment. This combination of separatism and

equality provided the

the verv start.

It

backbone of the New England Hospital from

represented a uniquely successful blend of the two

divergent strains of the nineteenth-centurv woman's movement.

Most advocates of woman's rights agreed that women, because of their unique female nature, deserved a separate, though equally important place in the world with men. Others shared the opinion that women, as human beings, should have equal and identical rights w ith men. Thus. Catherine Beecher devoted her life to elevating and professionalizing the duties of domesticity, while Susan B. Anthonv and Elizabeth Cady Stanton sought equality for women in the public arena through suffrage. For years women debated the merits of these respective positions; Dr. Zakrzewska did not participate in this dialogue. Rather, her importance to the nineteenthcenturv woman's movement was her ability to bring these divergent visions of woman's rights together successfully at the New England Hospital. At the same time that her hospital was a separate, alli

98

Conclusion

had close connections with men among and was committed to opening the medical profession to women on an equal basis with men. Indeed, the key to the New England Hospital's early success was its position simultaneously apart from, and yet a part of, the mainstream of American

women's

institution,

Boston's medical

it

elite

medicine.

embraced the spectrum of concerns of most nineteenth-century woman's rights advocates, Zakrzewska hoped to turn the New England Hospital into a lasting monument to women in medicine. Throughout the four decades of her leadership, her hospital held a central place in the lives of women doctors in America. Its very existence turned any woman's idealistic dream of a career in medicine into at least a possibility. At the more concrete Having

level,

it

skillfully

provided

women

with important clinical training in general

medicine, obstetrics, gynecology, surgery, and pediatrics. This expe-

them

rience prepared

work.

own

And

for private practice or for other professional

the hospital did even more.

It

gave

women

doctors their

where they could find the colleagueship and support most male doctors denied them. As a result, the hospital had a special, symbolic place in nineteenth-century American culture, standing as proof of women's impressive capabilities and professional workplace

accomplishments

in medicine.

But the New England was not simply a symbol of success for women in medicine. In the 1870s, "whisperings of discontent" among younger doctors shattered the spirit of cooperation Zakrzewska and her colleagues had nurtured since the hospitals founding.

By the end of the century,

dissatisfaction

had

filtered into all levels

Many doctors openly rebelled or young medical women were hard to attract.

of the hospital's medical heirarchy. left

the hospital; bright

To

a large extent, the

problems

at

the

New England Hospital were women doctors began to

the product of the professional advances

make

in the last

quarter of the nineteenth century.

all-male hospitals, medical schools,

encouraged younger

and medical

women doctors women in

the discrimination against

The opening of women

societies to

to believe thev

had overcome

medicine. Enticed bv the pro-

fessional opportunities they envisioned

in

these male-controlled

medical institutions, thev turned away from the separate all-wom-

1QQ

Hospital with a Heart

en's institutions such as the

New England Hospital. By the end of the New England Hospital reached its

nineteenth century, even as the

peak of popularity and prestige, it became clear that a younger group of women doctors was no longer willing to accept the hospital's once successful, though delicate, balance between separatism and equality for women in medicine.

The

professional aspirations of younger

women

doctors for total

equality with male physicians sparked a debate at the

over the place of separatism in

women

New England

doctors' professional lives.

While Zakrzewska and her contemporaries did not question the ultimate importance of integration, they believed that a strong separate institution such as the New England Hospital was the best strategy

women

and survival, and ultimatemen. Convinced that the surest path to integration was through separation, Zakrzewska and her supporters worked to save the New England Hospital for women doctors. An ambitious building program, careful selection of interns, and a commitment to active professional involvement in both separate and integrated medical societies were all part of the strategy for saving for

ly

doctors' professional stability

for their integration with

the hospital.

But there were

limits to this plan.

nineteenth century

—

The

given way by the end of the century to a

and improving

women

in the

profession

— had

task of

breaking into the medical

new

their professional position.

challenge: sustaining

The

solutions of the

nineteenth century could not answer the problems of the twentieth. separate world Zakrzewska built at the New England Hospital no longer met the needs of younger women doctors at the turn of the century as they prepared to enter an era of integration in medical training and practice. In the last years of her life, Zakrzewska began to see the limits of

The

her strategy for

women

doctors in the twentieth century.

Still,

she

dawn of the new century, holding tightly to her longtime convictions and unable to comprehend fully the ways of younger died

at

the

women

doctors. Symbolically, Zakrzewska's death in 1902

turning point in the history of the

New England

Hospital.

out the twentieth century, the hospital never regained or central position in the professional

200

lives

of

women

its

marked a Throughpopularity

doctors.

Conclusion

Nevertheless, the decline of the

twentieth century was

due

nineteenth-century leader.

to

New England

more than

the death of

Hospital in the its

founder and

The opening of male-dominated

medical

women doctors gave them the luxury of professional To many younger women, the larger, better-equipped, and

institutions to

options.

more

prestigious male-dominated hospitals offered greater oppor-

tunities for clinical

experience and professional advancement than

the smaller all-women's hospitals. The irony is inescapable. Embedded within the New England Hospital's foundation of separatism were the seeds of its own decline. The closer women doctors came to attaining professional equality with

men — the

goal for which Zakr-

—

zewska founded the New England Hospital the more they turned away from the hospital and chose the path of professional integration. Once the symbol of success for women doctors, the New England Hospital became for many an obstacle to professional advancement. Whereas separatism and professional opportunity originally reinforced each other at the hospital, by the end of the nineteenth century, many younger women doctors believed that the separatism upon which the hospital depended was incompatible with their professional goals.

While male-dominated medical institutions represented formidable competition for the

New England

Hospital,

its

decline was also a

consequence of the new notion of a science of society that blossomed at the

dawn of

the twentieth century. In the quest for a value-free

Americans rejected the moralism that informed Victorian American culture and sought to rebuild American society on a foundation of empiricism and objectivity. This search for a science of society was all-encompassing, transforming institutions, professions, even women's lives. In medicine, the focus on objectivity, combined with the development of the germ theory of disease and the concept of asepsis, transformed medical practice from the holistic art of healing to the reductionist science of diagnosis and treatment. Hospitals, once havens of medical charity, became monuments to medical science. Within this changing world, women began to reject the notion of sexual differences. The early advocates of an equal rights amendment, women social scientists, even club women began to seize the banner of sexual equality. society,

20

1

Hospital with a Heart

Set against this in the

background of scientific

New

medical profession, the

became an insurmountable

obstacle for

twentieth century. Nevertheless,

who

ultimately

tion,

they closed

had the it,

final say.

it

objectivity

and integration

England's tradition of separatism

many women

was the separatists

doctors in the at

the hospital

Rather than integrate their

proudly invoking the

institu-

historical tradition of sepa-

ratism and idealism that were the heart of the

New England

Hospital.

In the

last analvsis,

the

women

doctors of the

New England never women doc-

balanced separation with integration. While the pioneer tors

made

their professional lives apart

teenth century

many women

from men, by the

late nine-

doctors courageously strove to weave a

and the opportunities of integration. began to unravel. A century of separatism at the New England Hospital tells a storv of struggle, success, and eclipse but most poignantly it depicts the paradox of separatism that confronted all professional women in tapestrv of the old traditions

By the twentieth century,

this delicate tapestry

—

modern America.

202

Abbreviations

The Ames

following short forms are used for often-cited material: Collection

Blanche

Ames

Papers, Arthur and Eliz-

abeth Schlesinger Library on the History

of

Women

in

America, Radcliffe College

Annual Report of the New England Hospital

Annual Report(s) of the New England Hospital for Women and Children, 1862—1967

Blackwell Family Papers

Blackwell Family Papers, Arthur and Elizabeth Schlesinger Library on the History

of Dall Collection

Women

in

America, Radcliffe College

Caroline Healey Dall Papers, Massachusetts Historical Society,

Hamilton Collection

Alice

Boston

Hamilton Papers, Arthur and

Eliz-

abeth Schlesinger Library on the History

of

Women

in

America, Radcliffe College

Kleinert Collection

Margaret Noyes Kleinert Collection, Arthur and Elizabeth Schlesinger Library on the History of Women in America,

NEH

New England

Radcliffe College

Collection/Countway

A.

Hospital Collection, Francis

Countway Library of Medicine, Har-

vard University

203

Abbreviations

NEH

Collection/Schlesinger

New England Hospital Collection, Arthur and Elizabeth Schlesinger Library on the History of

Women

in

America, Radcliffe

College

NEH

Collection/Smith

Notable American

Women

New England Hospital Collection, Sophia Smith Collection, Smith College Notable American

Women, 1607—1950: A

Biographical Dictionary, 3 vols., ed.

T. James (Cambridge, University Press, 1973)

204

Mass.:

Edward Harvard

Notes

Preface

The

example of the sexual discrimination interpretation is Mary ''Doctors Wanted: No Women Need Apply": Sexual Barriers in the Medical Profession, 183 5-197 5 (New Haven: Yale University Press, 1977). This is the first major history of women doctors in modern America. While Walsh devotes chapter three, entitled "Feminist Showplace," to the New Enclearest

Roth Walsh,

gland Hospital, she depicts it solely within the discrimination perspective. Richard Shryock suggested the importance of the woman's movement to women doctors in "Women in American Medicine," in Richard Harrison Shryock, Medicine in America: Historical Essays (Baltimore: Johns Hopkins University Press, 1966), pp.

177-199. Regina Markell Morantz argues that women doctors employed the popular notion of female nurturance, modesty, and domesticity to justify their professional careers. See "The 'Connecting Link': The Case for the Woman Doc tor in igth-Century America," in Sickness and Health in America: Readings in the History of Medicine and Public Health, ed. Judith Walzer Leavitt and Ronald L. Numbers (Madison: University of Wisconsin Press, 1978), pp. 17-28. In an earlier work I examined the ways in which these qualities of nurturance, modesty and domesticity shaped women doc tors' medical ideas and practice. See Virginia Ci. Drachman, "Women Doctors and the Women's Medical Movement: Feminism and Medicine, 1850-1895." (unpublished Ph. 1). dissertation, SUNY Buffalo. 1976). Laurie Crumpacker argues that women doctors' medical therapeutics were safer and more sensitise to women's special needs than the medical practice of male physicians. See Laurie Crumpacker, 1

2

o

5

Notes

to

pages

"Female Patients

13-14 in

Four Boston Hospitals of the 1890's" (paper presented at on the History of Women, Radcliffe College,

the Berkshire Conference

Cambridge, Mass., October, 1974).

Some

women were the "vicand ideas of male doctors. See Ann Douglas Fashionable Diseases': Women's Complaints and Their Treat-

historians take a different tack, arguing that

tims" of the medical practices

Wood, "The ment in Nineteenth-Century America," Journal of Interdisciplinary History, 4 (1973), 25-52; Carroll Smith-Rosenberg, "The Cycle of Femininity: Puberty and Menopause in 19th Century America," Feminist Studies, (1973), 58-72; Carroll Smith-Rosenberg, "The Hysterical Woman: Sex Roles and Role Conflict in 19th-century America," Social Research, 39 (1972), 652-678 and G.J. 1

Barker-Benfield, The Horrors of

Women and

the

Half-Known

Sexuality in Nineteenth-Century America

Life:

Male

Attitudes toward

(New York: Harper & Row,

1976).

Morantz disagrees, defining male physicians' medical practice toward wommen as shaped primarily by the limits of medical science. "The Lady and Her Physician," in Clio's Consciousness Raised: New Perspectives on the History of Women, ed. Mary Hartman and Lois W. Banner (New York: Harper & Row, 1974), pp. 38-53; see also Regina Markell Morantz and Sue Zschoche, "Professionalism, Feminism, and Gender Roles: A Comparative Study of en and

Nineteenth-Century Medical Therapeutics," Journal of American

History,

67

(1980), 568-588.

See Morantz and Zschoche, "Professionalism, Feminism, and Gender Roles: A Comparative Study of Nineteenth-Century Medical Therapeutics". Despite the emphasis on professionalism, Morantz and Zschoche, acknowledge the dimension of female uniqueness at the New England Hospital. For an earlier statement of this synthesis, see Virginia G. Drachman, "Female Solidarity and Professional Success: The Dilemma of Women Doctors in Late Nineteenth-Century America," Journal of Social Histoiy, 15 (1982), 607-619. While each essay by Regina Morantz focuses on a single category of analysis, taken together they combine the various approaches to the history of women doctors and provide us with a much fuller picture of women doctors in modern America. Morantz fuses these interpretations in a recent essay which provides a general overview of the history of women doctors. See In Her Own Words: Oral Histories of Women Physicians, edited by Regina Markell Morantz, Cynthia Stodola Pomerleau, and Carol Hanses Fenichel (Westport, Conn.: Greenwood Press, 1982), pp. 3-44. See also Regina Markell Morantz, "Feminism, Professionalism, and Germs: The Thought of Mary Putnam Jacobi and Elizabeth Blackwell," American Quarterly, 34 (1982), 459-478. On the impact of the doctrine of separate spheres on the lives of women in nineteenth-century America see Nancy F. Cott, The Bonds of Womanhood: "Woman s Sphere" in New England, 1780-1835 (New Haven: Yale University Press, 1977) and Carroll Smith-Rosenberg, "The Female World of Love and Ritual: Relations between Women in Nineteenth-Century America," Signs, I (1975), 1-30. For an analysis of the phenomenon of women's institution building, see Estelle Freedman, "Separatism as Strategy: Female Institution Building and American Feminism, 1870-1930," Feminist Studies, 5 (1979), 512-29. There have been several important studies of the woman's move-

206

Notes

to

pages

15—23

merit in the late nineteenth century. See, for example, Karen J. Blair, The Clubwoman as Feminist: True Womanhood Redefined, 1868—1914 (New York: Holmes and Meier, 1980); Ruth Bordin, Woman and Temperance: The Quest for Power and Liberty, 1873-1920 (Philadelphia: Temple University Press, 1981); and Marijo Buhle, Women and American Socialism, 1870—1920 (Urbana: University of Illinois Press, 1981). For an insightful study of the quest for integration

among

professional

women

see Rosalind Rosenberg, Beyond Separate

(New Haven: Yale University Press, Margaret W. Rossiter, Women Scientists in America: Struggles and Strategies to 1940 (Baltimore: Johns Hopkins University Press, 1982). On the transformation of the hospital in America, see: Morris J. Vogel, The Invention of the Modern Hospital: Boston, 1870-1930 (Chicago: University of Chicago Press, 1980); Charles E. Rosenberg "Inward Vision and Outward Glance: The Shaping of the American Hospital, 1880-1914," Bulletin of the History of Medicine, 53 (Fall, 1979), 346-391; Charles E. Rosenberg, "And Heal the Sick: The Hospital and Patient in 19th-century America, "Journal of Social History 10 (1977), 428-477; David Rosner, A Once Charitable Enterprise: Hospitals and Health Care in Brooklyn and New York, 1890-1914 (New York: Spheres: Intellectual Roots of Feminism

1982). Also

Cambridge University Press, 1982). On the rise of the modern medical profession in America see: William G. Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore: Johns Hopkins University Press, 1976), Paul Starr, The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry (New York: Basic Books, 1982) and Rosemary Stevens, American Medicine and the Public Interest

(New Haven: Yale tion of medicine in

Chapter 1.

University Press, 1971). The literature on the transformaAmerica pays little attention to the role of women doctors.

'The Mother of Us All"

1

Though Marie Zakrzewska was known Zak,

I

refer to her throughout the

to many on an informal basis as Dr. book by her formal surname, Zakrzew-

ska. 2.

Boston Globe, October 30, 1902, p. 1 1, and Boston Herald, October 30, 1902, p. 9. For a description of Dr. Zakrzewska's funeral, see Boston Herald, May 19,

1902, p. 10. For a description of both the funeral Marie Flizabeth Zakrzewska: A Memoir (Boston:

service, see

Hos-

Women

and Children, 1903), pp. 26—30. Following the custom of the day, Marie Zakrzewska used the feminine version of her family name. There are several sources for information on Zakrzewska's life. The most accessible include an autobiography of her early pital for

3.

and the memorial

New England

life

in

Labor";

A Practical Illustration of "Woman's Right to a Letter from Marie Elizabeth Zakrzewska (Boston: Walker, Wise.

Caroline H. Dall, ed., or,

i860). This autobiography was written in the form of a letter to Zakrzewska's friend Mary L. Booth. "Woman's Right to Labor" is reprinted along with Zakrzewska's later letters in Agnes C. Vietor, ed., -4 Woman's Quest: The Life of Marie E. Zakrzewska, M.D. (New York: Arno Press, 1972). Agnes C. Vietor joined the staff of the New England Hospital in 1897. Her

207

Notes

to

pages

23-32

"biography" of Zakrzewska is based on letters and materials given her by Zakrzewska. It is the most complete and accessible source of information about the life of Marie Zakrzewska, but must be understood as a sympathetic portrait. For other sympathetic accounts, see Marie Elizabeth Zakrzewska: A Memoir, and [Dorothy B. Seccomb], The Sew England Hospital, 1862-1962: Ojie Hundred Years (Boston: privately published, [1962]), ch. 1. For a biographical sketch of Marie Zakrzewska, see John B. Blake, "Marie Elizabeth Zakrzewska," in Notable American Women, III, 702-704. See also Mary Roth Walsh, "Doctors Wanted: No Women Need Apply": Sexual Barriers in the Medical Profession, 1835-1975 (New Haven: Yale University Press, 1977), ch. 3. 4.

Vietor, Woman's Quest, p.

6. 7.

Ibid., p. 24.

8.

Ibid., p. 25.

9.

Ibid., p. 22.

10.

Ibid., p. 36.

1

7.

Marie Zakrzewska to Caroline Dall, March Woman's Quest, pp. 8, 22. Vietor, Woman's Quest, pp. 20, 21,9.

5.

1.

12.

Ibid., p.

1869, Dall Collection; Vietor,

15.

Ibid., p. 19.

13.

Ibid., p. 28.

14.

Ibid., p. 34.

15.

6,

Harvey Graham, Eternal Eve: The

History of Gynecology

16.

Doubleday, 1951), pp. 238-241. Vietor, Woman's Quest, p. 52.

17.

Ibid., p. 62.

18.

Ibid., p. 67.

19.

Ibid., p. 72.

20.

Ibid., p. 71.

21.

Ibid., p. 93.

and

Obstetrics

(Garden

City, N.Y.:

22.

Ibid., pp. 105, 70.

23.

The most

recent full-length biography of Elizabeth Blackwell

is

Nancy Ann

M.D., 1821-1910: A Biography" (unpublished Ph.D. dissertation, University of Pennsylvania, 1974). See also Elizabeth H. Thompson, "Elizabeth Blackwell," in Notable American Women, I, 161—165. Older, more anecdotal biographies include Ishbel Ross, Child of Destiny (New York: Harper, 1949), and Peggy Chambers, A Doctor Alone (London: Bodley Head, 1956). Margo Horn has studied Elizabeth Blackwell within the context of the Blackwell family in "Family Ties: The Blackwells; A Study of the Dynamics of Family Life in Nineteenth-Centui v America" (unpublished Ph.D. dissertation, Tufts University, 1979). 24. Vietor, Woman's Quest, pp. 108, 109-110. 25. Elizabeth Blackwell to Emily Blackwell, May 12, l8[54], reprinted in Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (New York: Schocken Books, 1977), p. 201. See also Vietor, Woman's Quest, p. 109. 26. The medical department of Western Reserve College was popularly known as Cleveland Medical College. Elizabeth Blackwells sister, Emily Blackwell, Sahli, "Elizabeth Blackwell,

208

Notes

to

pages

33—39

graduated from there in 1854. The relationship between Elizabeth Blackwell and Marie Zakrzewska was not without strain. Nancy Sahli suggests that Blackwell was relieved when Zakrzewska finally left the New York Infirmary, that she was jealous of Zakrzewska's successes in Boston, and that she disliked what she saw as Zakrzewska's "egoisms'' ("Elizabeth Blackwell," pp. 184, 190, 413). 27.

For a biographical sketch of Caroline Severance, see Joan M. Jensen, "Caroline Severance," in Notable American Women, III, 265-268.

28.

Vietor,

29.

Ibid., p.

159.

30.

Ibid., p.

147.

31.

Ibid., p.

140.

32.

33.

Woman's

Quest, p. 135.

179-180. On Madame Restelle and on abortion in general, see James C. Mohr, Abortion i)i America: The Origins and Evolution of National Policy (New York: Oxford University Press, 1978), esp. ch. 3. Ibid., pp.

Vietor, Woman's Quest, p. 186.

34.

Ibid., p.

35.

Marie Zakrzewska to Pauline Pope, October 28, 1901, box

190. 1,

folder

2,

NEH

Collection/Smith. 36.

The discussion of Samuel Gregory is drawn from a number of sources. See Jane B. Donegan, Women and Men Midwifes: Medicine, Morality, and Misogyny in America (Westport: Greenwood Press, 1978), and Richard W. Wertz and Dorothy C. Wertz, Lying-in: A History of Childbirth in America (New York: Free Press, 1977). Both Donegan and Wertz and Wertz place Gregory in the context of the history of obstetrics. For a history of the New England Female Medical College, see Frederick C. Waite, History of the New England Female Medical College (Boston: Boston University School of Medicine, 1950). See also,

Walsh, "Doctors Wanted," ch.

2.

Gregory's

own

writings include

Man-

Midunfery Exposed and Corrected: The Employment of Men to Attend Women in Childbirth (Boston: Samuel G. Gregory, 1848); Medical Morals, Illustrated .

.

.

and Extracts from Medical Works; Designed to Show the Pernicious Social and Moral Influence of the Present System of Medical Practice, and the Importance of Establishing Female Medical Colleges, and Educating and Employing Female Physicians for Their Own Sex (New York: published by the author, 1853); and Letter to Ladies in Favor of Female Physicians (New York: Fowler with Plates

37.

and Wells, 1850). Vietor, Woman's Quest, pp. 268—269.

38.

Ibid., p. 251.

39.

Mr. Delano to Mrs. Bond

[c.

spring 1862], box

9,

folder 28,

NEH

Collection/

Smith.

For a discussion among the directors of the Medical College about the impending split between Gregory and Zakrzewska, see Mr. Delano to Mrs. Bond, July 1, [1862], and

40. Vietor,

Woman's

Quest, p. 285.

New England Female

1

December 41. Vietor, 42.

15, [1862],

Woman's

box

9,

folder 28,

NEH

Collection/Smith.

Quest, p. 291.

Ibid., p. 292.

43.

Ibid., p. 293.

44.

Zakrzewska

to Pope,

October

28, 1901.

209

.

Notes

to

pages

39—45

Woman s Quest, p. 303. discussion of Karl Heinzen

45.

Vietor,

46.

The

is

drawn from the following

sources: Carl

Wittke, Against the Current: The Life of Karl Heinzen, 1809-80 (Chicago: Uni-

Chicago Press, 1945), pp. 102-104, 107-108, 112-114, 134-138, 214, 220, 225, 310-311, 317-318, 320; Carl Wittke, Refugees of Revolution: The German Forty-Eighters in America (Philadelphia: University of Pennsylvaversity of

nia Press, 1952), pp. 47.

1

16,

164-165, 275-276, 310, 363; and Vietor, Woman's

Quest, pp. 297, 300, 303, 304, 458, 459, 460, 477, 487, 488. Zakrzewska to Pope, October 28, 1901.

48. Wittke, Refugees of Revolution, pp. 275-276. 49. For a brief description of Zakrzewska's social activities at her

home, see The

Anniversary of the New England Hospital for Women and Children (Boston: Geo. H. Ellis, 1913), p. 48. 50. Marie Elizabeth Zakrzewska: A Memoir, p. 22. 51. Annual Report of the New England Hospital, 1899, p. 22. Fiftieth

52. Vietor, 53.

Woman's

Quest, p. 459.

Ednah Dow Cheney,

Reminiscences of

Ednah Dow Cheney (Born

Littlehale)

(Boston: Lee and Shepard, 1902), p. 60. 54. Marie Zakrzewska to Caroline H. Dall, March 6, 1869, Dall Collection. 55. Vietor, Woman's Quest, pp. 474—478. Also Marie Elizabeth Zakrzewska:

A

Memoir, pp. 29—30. 56. Boston Herald,

Chapter 2 1.

May

16, 1901, p. 10.

"This All-Women's Hospital"

Recent studies of the hospital in America by social historians include Morris Vogel, The Invention of the Modern Hospital: Boston, 1870-1930 (Chicago: University of Chicago Press, 1980); Charles E. Rosenberg, "Inward Vision and Outward Glance: The Shaping of the American Hospital, 1880-1914," Bulletin of the History of Medicine, 53 (Fall 1979), 346—391; Charles E. Rosenberg, "And Heal the Sick: The Hospital and Patient in 19th-century America," Journal of Social History, 10 (1977), 428—477; and David Rosner, A Once Charitable Enterprise: Health Care in Brooklyn, 1885— 1915 (New York: Cambridge University Press, 1982). See also William H. Williams, America's First Hospital: The Pennsylvania Hospital, 1J51-1841 (Wayne, Pa.: Haverford House, 1976), and Leonard K. Eaton, New England Hospitals, 1790-1830 (Ann Arbor: University of Michigan Press, 1957). For useful data on hospitals in the early twentieth century, see E. H. L. Corwin, Ph.D., The American Hospital (New York: Commonwealth Fund, 1946). Annual Report of the New England Hospital, 1863, p. 2 For a discussion of female institution building, see Estelle Freedman, "Separatism as Strategy: Female Institution Building and American Feminism, 1870-1930," Feminist Studies. 5 (Fall 1979), 512-529. On the emergence of separate spheres and its impact on women's lives, see Nancy F. Cott, The Bonds of Womanhood: "Woman's Sphere" in New England, 1780-183^ (New Haven: Yale University Press, 1977); Carroll Smith-Rosenberg, "Beauty, the Beast and the Militant Woman: A Case Study in Sex Roles and Social Stress

J.

2.

3.

1

2

1

o

Notes

to

pages

46—49

injacksonian America," American Quarterly, 23 (1971), 562-584; and Gerda Lerner, "The Lady and the Mill Girl: Ghanges in the Status of Women in the Age of Jackson, 1800-1840," Mid-Continent American Studies Journal, 10 (Spring 1969), 5-15. On the importance of female friendship in the lives of nineteenth- and early twentieth-century women, see Garroll Smith-Rosenberg, "Female World of Love and Ritual: Relations between Women in Nineteenth-Gentury America," Signs: A Journal of Women in Culture and Society, 1 (1975), 1-29, and Blanche Wiesen Gook, "Female Support Networks and Political Activism: Lillian Wald, Grystal Eastman, Emma Goldman," Chrysallis, 3 (1977), 4.

On

43-61.

woman's movement in the Gilded Age, see Karen J. Blair, The Clubwoman as Feminist: True Womanhood Redefined, 1868-1914 (New York: Holmes and Meier, 1980); Ruth Bordin, Woman and Temperance: The Quest for Power and Liberty, 1873-1920 (Philadelphia: Temple University Press, 1981); and Mari Jo Buhle, Women and American Socialism, 1870-1920 (Ghicago: University of Illinois Press, 1981). On the early suffrage movement, the

see Ellen Garol DuBois, Feminism and Suffrage: The Emergence of an IndepenWomen's Movement in America, 1848-1869 (Ithaca, N.Y.: Gornell Univer-

dent

On

feminist-abolitionists, see Blanche Glassman Hersh, The 1978). Slavery of Sex: Feminist- Abolitionists in America (Ghicago: University of Illinois women and prison reform, see Estelle B. Freedman, Their Press, 1978). sity Press,

On

Sisters'

5.

Keepers: Women's Prison Reform in America,

1830—1930 (Ann Arbor:

University of Michigan Press, 1981). A brief study of the New England Hospital's early years

is

in

No Women Need Apply": Sexual Barriers

Mary Roth

Medical 1835-19'] 5 (New Haven: Yale University Press, 1977), ch. 3. See also Agnes C. Vietor, ed., A Woman's Quest: The Life of Marie E. Zakrzewska, M.D. (New York: Arno Press, 1972). Though my overall interpretation of the hospital and women doctors differs from Walsh's, there are obviously points of agreement, and I have relied on her book where appropriate. For biographical information on Ednah Dow Cheney, see her autobiography, Reminiscences of Ednah Dow Cheney (Born Littlehale) (Boston: Lee and Shepard, 1902); Shirley Phillips Ingebritsen, "Ednah Dow Littlehale Cheney," in Notable American Women, I, 325-327. For information on Lucy Goddard, see Cheney, Reminiscences, and The Souvenir (n.p.: Committee on the Fair Paper, 1896), in NEH Collection/Smith. On Abby May, see Shirley Phillips Ingebritsen, "Abigail Williams May," Notable American Women, II, 513-515, and Vietor, Woman's Quest, pp. 186, 244, 245. On Caroline Severance, see Joan M.Jensen, "Carolina Maria Seymour Severance," in Notable

Walsh's "Doctors Wanted:

in the

Profession,

6.

American Women, 7. 8.

III, 265—268. Cheney, Reminiscences, p. 62. For articles on women doctors, see Woman's Journal, 17

18 (October 29, 1887), 345; 2 (July 29, 1871), 235; 10

(July 7. 1886), 252;

(November

8, 1879).

356; and 5 (December 12, 1874), 348. For articles specifically relating to the New England Hospital, see Woman's Journal, 18 (December 3, 1887), 386: 8 9.

(April 14, 1877). 113; and 14 (May 26, Quoted from Thomas Woody, History

1883), 165.

of Women'* Education in the United States, 2 vols. (Lancaster. Pa.: Science Press, 1929), II, 344.

2

1 1

Notes 10.

to

pages

49—33

Houghton Mifflin, 1886). For a Douglas Wood, "The Fashionable Diseases: Women's Complaints and Their Treatment in Nineteenth-Century America," Journal of Interdisciplinary History, 4 (Summer 1973), 25—52. For a biographical sketch of Clemence Lozier, see Milton Cantor, "Clemence Sophia Harned Lozier," Notable American Women, II, 440—442. See also Elizabeth Cady Stanton, Susan B. Anthony, and Matilda Joslyn Cage, eds., History of Woman Suffrage, 4 vols. (Rochester: Susan B. Anthony, 1886), III, pp. 68, 1 17, 41 1, 415—416. For Elizabeth Blackwell's response to the founding of Lozier's school, see Elizabeth Blackwell, Address on Medical Education of Women (New York: Baptist and Taysor, 1864), p. 8. For other examples of the participation of women doctors in the woman's movement, see Blair, Clubwoman as Feminist. Marie Zakrzewska to Caroline Dall, October 16, 1866, Dall Collection. Zakrzewska's autobiography was published as Caroline H. Dall, ed., A Practical Illustration of "Woman's Right to Labor"; or, a Letter from Marie Elizabeth Zakrzewska, M.D. (Boston: Walker, Wise, i860). John Ware to Marie Zakrzewska, December 15, i860, reprinted in Vietor, Woman's Quest, pp. 255—256. See also Mr. Delano to Mrs. Bond, December Elizabeth Stuart Phelps, Dr. Zay (Boston:

discussion of Phelps's Dr. Zay, see

11.

12.

13.

14.

15, i86[2], 15.

box

9,

folder 24,

The Liberator, 29 (July

1,

NEH

Ann

Collection/Smith.

1859); 32 (October 3, 1862);

and 32 (November

14,

1862). 16.

Marie Zakrzewska

May— Goddard

17.

to F.

W. G. May, Jamaica

Plain,

December

4,

1901,

Arthur and Elizabeth Schlesinger Library on the History of Women in America, Radcliffe College. On Samuel E. Sewall and the Sewall family, see Shirley Phillips Ingebritsen, "Lucy Ellen Sewall," in Notable American Women, III, 268-269. Collection,

Vogel, Invention of the Modem Hospital, esp. ch. 1. For a discussion of sectarian medicine in the nineteenth century, see Martin Kaufman, Homeopathy in America: Rise and Fall of a Medical Heresy (Baltimore: Johns Hopkins University Press, 1971), and William G. Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore: Johns Hopkins University Press, 1976). 20. Charles Meigs, Lecture on Some of the Distinctive Characteristics of the Female, delivered before the class ofJefferson Medical College, January 184J (Philadelphia: Blanchard and Lea, 1847), p. 67. For a discussion of male doctors' opposition to women doctors, see Walsh, "Doctors Wanted," esp. ch. 4, and Virginia G. Drachman, "Women Doctors and the Women's Medical Movement: Feminism and Medicine, 1850-1895'' (unpublished Ph.D. dissertation. State University of New York, Buffalo, 1976). For discussion of the relationship between the female reproductive cycle and women's sexual role, see Carroll Smith-Rosenberg and Charles Rosenberg, "The Female Animal: Medical and Biological Views of Women in Nineteenth-Century America." Journal of American History, 55 (1973), 325—356. 18.

19.

21. 22.

Vietor, Woman's Quest, p. 256. Annual Report of the New England

Hospital.

1892, p. 8;

II.

I.

Bovvditch,

A

of the Bowditch Fund, 1872); Vincent Y. Bowditch, Life and Correspondence of Henry IngersoU

History of the Massachusetts General Hospital (Boston: Trustees

2

1

2

Notes Bowditch, 2 vols. (Boston:

ed" 23. 24.

p.

26.

Mifflin, 1902),

I;

pages 53 — 57

Walsh, "Doctors Want-

149-

Vietor, Woman's Quest, p. 254. Edward H. Clarke, Sex in Education;

James 25.

Houghton

to

R.

or,

a Fair Chance for the Girls (Boston:

Osgood, 1873).

Annual Report of Smith College, 1877, p. 3. M. Carey Thomas, "Present Tendencies in Women's Colleges and UniverEducation," Educational Review, 25 (1908), 68. In 1874, the year after Sex in Education was originally published, four books challenging Clarke appeared: Anna C. Brackett, ed., The Education of Amerisity

27.

can Girls Considered in a Series of Essays (New York: G. P. Putnam, 1874); Julia Ward Howe, ed., Sex in Education: A Reply to Dr. E. H. Clarke's "Sex in Educa1874); George Fisk Comfort and A. M. Comfort, Woman's Education and Woman's Health: Chiefly in Reply to "Sex in Education" (Syracuse: Thomas W. Durston, 1874); and Eliza Bisbee Duffey, No Sex in Education; or, an Equal Chance for Both Boys and Girls (Philadelphia: J. M. Stoddart, 1874). The outrage of many nineteenth-century women at Sex in Education has been echoed by historians who have interpreted Clarke's book as a dangerous threat to woman's rights. See, for example, Walsh, "Doctors tion" (Boston: Roberts,

Wanted," ch. 28.

4.

Woman's Medical

Association of

New York

City, ed.,

Mary Putnam

J acobi,

from Her Autobiography and a Complete Bibliography (New York: G. P. Putnam's Sons, Knickerbocker Press, 1925); Mary Putnam J acobi, The Question of Rest for Women During Menstruation (New York: G. P. Putnam's Sons, 1877). Roy Lubove, "Mary Corinna Putnam Jacobi," in Notable American Women, II, 263-265. 29. On Catherine Beecher, see Kathryn Kish Sklar, Catherine Beecher: A Study in American Domesticity (New York: W. W. Norton, 1973). On Emma Willard, see Alma Lutz, Emma Willard, Daughter of Democracy (Boston: Houghton

M.D., a Pathfinder

in Medicine, with Selections

Mifflin, 1929).

Woman's Journal, 5 (February 21, 1874), 59; and Annual Report of the New England Hospital, 1876, p. 6. A formal statement of the new resolution is in a hospital report of August 13, 1866, box 6, folder 1, NEH Collection/Smith. For Storer's letter of resignation, see Boston Medical and Surgical Journal, 75 (1866), 191-192. On Storer, see Frederick C. Irving, M.D., Safe Deliverance (Boston: Houghton Mifflin, 1942), and Walsh, "Doctors Wanted" ch. 4. Storer elaborated on his attack against women in Horatio Robinson Storer and F. F. Head, Criminal Abortion: Its Nature, Its Evidence, and Its Law (Boston: Little, Brown, 1868), and H. Robinson Storer. The Causation, Course and Treatment of Reflex Insanity in Women (Boston: Lee and Shepard, 1871). Storer's resignation from the New England Hospital is referred to in Annual Report of the New England Hospital, 18(H), p. 11. See also Vietor, Woman's

30. See Zakrzewska's letter in

31.

32.

Quest, pp.

338-339. Walter Channing to Marie Zakrzewska, Boston, June Woman's Quest, p. 332. 34. Vietor, Woman's Quest, p. 330. 35. Annual Report of the New England Hospital. 1892. p. 8. 33.

2.

1864. in Vietor,

2

13

Notes 36.

to

pages 5 7- 64

Mrs. E. Farrar to Louisa Bond, September

folder 28,

NEH

1862, box 9, folder 28,

NEH

1862, box

3,

9,

Collection/Smith. 37.

Harriet Holland to Louisa Bond, August

7,

Collection/Smith. 38.

Annual Report of

the

New England

Hospital, 1866, pp. 3-4; Vietor,

Woman 5

Quest, p. 332.

39. J.

H. Stephenson to Ednah D. Cheney,

NEH

May

17, 1864,

DOX

2 6, folder 63,

Collection/Smith.

40.

Annual Report of the New England Hospital, 1863, pp. 16-18; 1864, pp. 13—15; 1865, pp. 23-25; 1866, pp. 19-21; 1867, pp. 23-25.

41.

Ibid., 1865, p. 20.

42.

Ibid., 1863, p. 8.

43.

Ibid., 1868, p. 7.

44. Ibid., 1864, pp. 8-9. 45. Ibid., 1863, p. 14; 1864, p. 12; 1871, p. 17; 1872, p. 21. 46. This evidence is calculated from nationality lists in the annual reports of the

New England

Hospital, 1863-1873.

is calculated from a random sample of 345 patients between 1873 an d !895- For comparisons, see Vogel, Invention of the Modern Hospital, ch. 1, and Rosenberg, "Inward Vision." For data on the ethnicity of patients at the Boston Lying-In, see Annual Reports of the hospital, 1881 — 1890. 48. Vogel, Invention of the Modern Hospital, pp. 23-25. 49. Annual Report of the New England Hospital, 1871, p. 11.

47. This evidence

50.

Ibid., 1865, p. 6.

51.

At times

this

system of charity was a serious financial drain on the hospital.

became so severe that the directors regretfully termiand limited admissions to those patients paying the full eight-dollar weekly charge. The measure was only temporary, however, for by the next year, they had replenished the treasury so that free and halfIn 1866, the drain

nated

52.

all

charitable care

paying patients could once again enter the hospital. Annual Report of the New England Hospital, 1868, p. 4. For a recent history of the dispensary in America, see Charles E. Rosenberg, "Social Class and Medical Care: The Rise and Fall of the Dispensary," Journal of the History of Medicine, 29 (1974), 32—54. For an earlier study, see Michael M. Davis, Jr., and Andrew R. Warner, Dispensaries: Their Management and Development

(New York: Macmillan, 53.

Mr.

Newmarch

NEH 54.

to

26, 1863,

box

9,

folder 28,

Collection/Smith.

Edward Welch

NEH

1918).

board of directors, March

to

board of directors, October

4,

1862, box 9, folder 28,

Collection/Smith.

Ednah Dow Cheney,

Memo

57.

on the duties of the lady visitor, n.d., box 9, Van Hoosen, Petticoat Surgeon (Chicago: Pellegrini and Cudahy, 1947), p. 93. Annual Report of the New England Hospital, 1863, p. 15. Francis Starkey to resident physician [Elizabeth Keller], September 6, 1875,

58.

Annual Report of the New England

59. 60.

Ibid., 1864, p.

55.

folder 28,

56.

NEH

Collection/Smith. Bertha

Collection/Countway.

Ibid., p.

214

NEH

12.

1

1.

Hospital, 1867, p. 12.

Notes

to

pages

64—71

This evidence is calculated from a random sample of records of 2 1 2 surgical and medical patients at the New England Hospital in the years 1872 through 1895. 62. S.L.S., "Life in the N. E. Hospital," The Hospital Visitor, 2 (December 9, 61

.

1887), 2, box 8, folder 15, NEH Collection/Smith. Annual Report of the New England Hospital, 1870, p. 7. 64. Vietor, Woman's Quest, p. 292. 65. On American medical education in the nineteenth century, see Martin Kaufman, American Medical Education: The Formative Years, 1765-1910 (Westport, Conn.: Greenwood Press, 1976); Joseph F. Kett, The Formation of the American Medical Profession: The Role of Institutions, ij8o-i86o (New Haven: 63.

Yale University Press, 1968); Rothstein, American Physicians in the 19th Cenand Paul Starr, The Social Transformation of American Medicine: The

tury, ch. 5;

Rise of a Sovereign Profession

and

the

Making of a

Vast Industry

(New York:

Basic

Books, 1982). 66. Vogel, Invention of

the Modern Hospital, ch. 1; Rosenberg, "Inward Vision." Annual Report of the New England Hospital, 1865, p. 12. 68. The following discussion of the interns at the New England Hospital is drawn from the hospital's Annual Reports from 1862 through 1875, an