Even Punch, a magazine frequently hostile to the emancipated woman, felt grudging admiration for Elizabeth Blackwell (1821-1910), the first woman doctor to be registered in Britain. From a 21st-century perspective, with women doctors now in the majority, it’s difficult to appreciate just how hard it was for these indefatigable pioneers, who encountered considerable hostility and even violence when pursuing their vocation.
Blackwell’s early years were less combative, growing up part of a loving family in Bristol. Her father’s sugar refining business provided a good standard of living, although its reliance on slavery proved difficult to reconcile with his liberal politics. The liveliness of the household was tempered somewhat by the Blackwell grandparents, who are described as a “gloomy presence”. Blackwell Snr once nailed up all the cupboards, condemning them as “slut holes”, and his domineering behaviour was an early lesson in gender politics for Elizabeth and her sisters.
In 1828 the sugar refinery burned down and a series of poor business decisions exacerbated the repercussions. Relishing the prospect of a new start, and perhaps prompted by the political unrest that gripped Bristol, the Blackwells decided to emigrate to New York. Eleven-year-old Elizabeth seems to have accepted this momentous change philosophically, but it must have been disruptive for a girl approaching the ghastliness of adolescence.
Unfortunately, the Blackwells’ arrival coincided with the publication of Fanny Trollope’s mischievous Domestic Manners of the Americans, which did little to ease their transition into another culture, where those from the mother country were now viewed with suspicion. Notwithstanding this tension, the family soon established themselves in business and were able to move to prosperous Long Island. Any hopes of respectability were dashed, however, when Elizabeth’s Uncle Charles plunged into a bigamous marriage with the governess.
Renewed financial problems and the death of Mr Blackwell left the family penniless and struggling for survival. Like many women who found themselves in similar circumstances, the Blackwells had no option but to seek teaching work, despite having no liking for children. Aged only nineteen, Elizabeth Blackwell was stuck in a job she hated, and with no prospect of escape. A move to Kentucky made matters worse for the passionate opponent of slavery. There she was appalled when a young black girl was placed as a screen between her and a fire.
It was the publication of Margaret Fuller’s seminal work Woman in the Nineteenth Century (1845) that prompted Blackwell to think about her future direction. When a dying friend told her she would much rather consult a woman doctor, Blackwell started to seriously consider medicine as a career. While this decision seems straightforward, it was mainly thanks to a series of oversights that she realised her ambition, and her choice of profession remained deeply controversial during her lifetime.
Blackwell’s application to New York’s Geneva Medical College in 1847 was accepted in principle, although on the cunning proviso that the final decision rested with the students (who, it was assumed, would reject her outright). As it happened, there was only one voice of dissent and its owner was quickly beaten into submission. While this might appear a refreshingly enlightened episode, the students thought it all an elaborate hoax and were merely playing along. Before they knew what had happened, Blackwell had registered and her studies were underway. When she graduated, on 23 January 1849, the Dean marked the occasion with a speech to honour their unusual student’s achievement. He spoiled it, however, by adding that “Such cases must ever be too few to disturb the existing relations of society.”
The newly qualified Dr Blackwell decided to move back to England, settling in London so as to gain valuable experience at metropolitan hospitals. While treating a baby infected with gonorrhoea, contaminated fluid squirted in Blackwell’s eye, leaving it sightless, disfigured and protruding. It was a cruel irony that a woman who probably remained a virgin should have her life blighted by a sexually transmitted disease. On that fateful day, her hopes of becoming a surgeon were dashed and she was obliged to wear a glass eye.
Determined to make a difference nonetheless, Blackwell returned to America with her sister Lucy and established the New York Dispensary for Poor Women and Children. Their insistence on treating black patients made the clinic a target for segregationists, and Blackwell found life tough. Meanwhile, her brother Henry married Lucy Stone, an impressive feminist who refused to take his name or to include the word “obey” in the marriage service. Henry himself became a proud feminist, publicly renouncing his masculine privileges. This extraordinary family was extended when brother Sam married Antoinette Brown, the first woman in America to be ordained a minister.
Although the Blackwells did so much to challenge convention, Elizabeth herself had no interest in the formal women’s rights movement and declined to be involved in Seneca Falls Convention of 1848. She enjoyed being a figurehead in the world of medicine, believing that to be a more effective contribution to female emancipation. It’s hard to disagree with her – a decade after her graduation, there were 200 women doctors practising in America. She also inspired Elizabeth Garrett Anderson, the first woman to qualify as a doctor in Britain. A certain George Eliot was so impressed that she sent a letter, expressing how much she would like to know Dr Blackwell. Florence Nightingale remained unconvinced, finding only a strong-minded woman who dared to contradict her.
In 1858 Blackwell became the first woman to be placed on the newly formed British Medical Register, which permitted the inclusion of doctors holding foreign degrees. The authorities were aghast to discover that they had failed to specifically exclude women, quickly closing the loophole. When Blackwell returned to England in 1869, there was still considerable hostility against women doctors. The opposition was led by Professor Robert Christison, whose sound scientific reasoning was that original sin rendered women unfit to practice medicine. Women who attempted to attend anatomy lessons had both mud and abuse hurled at them, although this loutish behaviour actually helped the cause of women doctors, who conducted themselves with dignity throughout.
Blackwell’s return to England also coincided with the passing of the third Contagious Diseases Act, legislation that allowed authorities to confine and forcibly treat prostitutes suspected of carrying venereal disease. Blackwell sensibly pronounced that the government should be addressing the causes of prostitution, rather than its effects. Although in many ways a moral conservative, Blackwell was outspoken on female sexuality, challenging the convenient misconception that women were sexless creatures. She was also ahead of her time in recognising the concept of marital rape, an abuse not outlawed until 1991.
Elizabeth Blackwell was a formidable woman whose outspoken and often idiosyncratic behaviour made her an uncomfortable role model for feminists. It is hard to overstate her achievements, however, and her impact on the course of social history is equalled by only a handful of luminaries. Julia Boyd’s superb biography reveals Blackwell as a complex, tenacious and often frustrating character whose extraordinary single-mindedness changed our world. Like all skilled biographers, Boyd celebrates Blackwell’s achievements without becoming overly deferential to her subject. We see Blackwell’s faults, but cannot fail to be cheered by her brilliance.
The Excellent Doctor Blackwell is available in hardback