Elizabeth Blackwell: the pioneering ‘first female doctor’, who entered medicine to prove a point

He gave his five daughters the same educational opportunities as his four sons, and moved them from Bristol to New York in 1832 and then all the way to Cincinnati in 1838, hoping to replace Caribbean cane with northern-grown sugar beets. Then he died, broke, his final lesson that a husband was no guarantee of security. None of his daughters ever married.

Who was Elizabeth Blackwell?

Blackwell, the third child and third daughter, was brilliant, socially awkward and blessed with a healthy sense of self-worth. She agreed with the Transcendentalist writer and editor Margaret Fuller, who had proclaimed that humanity would not achieve enlightenment until women proved that they were capable of anything they chose – that achievement was a matter of talent and toil, not sex. Elizabeth wanted to be someone whose life embodied Fuller’s idea.

She chose medicine, not because she loved science or cared about healing (in fact, she thought sickness was a sign of weakness and found bodily functions disgusting) but because it was an unusually clear way to prove her point. If a woman managed to take a seat in a medical school lecture hall and pass all the examinations required for a diploma, who could argue she wasn’t qualified to be a doctor?

After a sheaf of rejections, Blackwell enrolled at the tiny, rural Geneva Medical College in western New York State. Her acceptance was something of a farce: the faculty punted the appalling idea of admitting a woman to the students, who found it hilarious and – assuming it was a practical joke – voted unanimously to welcome her. She graduated at the top of the class in 1849, having won the unequivocal respect of her classmates by virtue of her brilliance and discipline.

Outside the college, people tended to think one of two things: either she was wicked, or she was insane. What kind of woman would choose to study the body in the company of men? Acutely aware of the loneliness of her professional path, Blackwell recruited her sister Emily, five years younger, to follow her into medicine.

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Elizabeth Blackwell, the ‘female physician’

Medical school included little if any exposure to actual patients, and graduates emerged with a frightening level of ignorance. Blackwell left for Europe in April 1849, three months after graduating, to pursue practical training in Paris, where she studied at a public maternity hospital and was left blind in one eye after contracting an infection from a patient. She moved on to London, where she walked the wards of St Bartholomew’s hospital and found a fascinating new friend in the young Florence Nightingale.

Returning to New York in 1851, she discovered that the very phrase ‘female physician’ alienated her from potential patients. A female physician, in the parlance of the time, was an abortionist, someone operating in the shadows and on the wrong side of the law. The thriving practice she had hoped for did not materialise. But Emily soon joined her, with her own medical degree – as hard-earned as her sister’s – and together they opened the New York Infirmary for Indigent Women and Children in 1857. Poor women weren’t as picky about the sex of their doctor, and the infirmary would also come to provide a place for the slowly growing numbers of female medical graduates to finish their training. It was the first hospital entirely staffed by women.

Immediately after the outbreak of the American Civil War in 1861, the Blackwell sisters called a meeting of their donors and supporters, and drafted an appeal to the women of New York. In response, thousands attended the first organisational meeting of the Women’s Central Association of Relief, which evolved into the United States Sanitary Commission, the largest civilian organisation of the war. The Blackwells supervised the selection and training of nurses to send to the front – but eventually withdrew from the war effort when it became clear that male doctors were not willing to acknowledge their participation on equal terms.

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They turned their attention to their next achievement: the opening of the Women’s Medical College of the New York Infirmary in 1869, with an emphasis on academic rigour and practical training that set it above the schools for men from which the Blackwells had received their degrees.

Once the infirmary and its college were solidly established, Elizabeth left Emily – the more dedicated practitioner ­– to run them and returned to England, the place that she had always thought of as home, and where she had become the first woman to be included in Britain’s Medical Register. Having inspired pioneering female doctors including Elizabeth Garrett Anderson and Sophia Jex-Blake, she veered away from practice and toward public health advocacy, campaigning against the Contagious Diseases Acts – which forcibly hospitalized prostitutes instead of focusing on the men who infected them – and becoming a founder of the National Health Society, with its motto being “Prevention is better than cure”. She came to believe that a woman doctor should be a teacher armed with science, and spent the last decades of her life ensconced in a seaside cottage in Hastings, faithfully attended by her adopted daughter Kitty.

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Why is Elizabeth Blackwell famous?

It’s tempting to read the Blackwell story simply as a tale of trailblazing women, but the reality was more complicated. Elizabeth Blackwell looked askance at the emerging women’s rights movement. She believed that it was foolish to give women the vote before they had wrested their own ideological independence from their menfolk. She disagreed with Florence Nightingale’s belief that the true role of women in health was as nurses, and disagreed with her own physician sister, Emily, about the proper role of a female doctor. Elizabeth came to see her mission more in terms of public health, while Emily strove to be a physician, surgeon, and medical professor the equal of any man.

But Elizabeth was not interested in being adorable or pleasing anyone. She was a complicated, prickly, imperfect, very real heroine, and her flaws are inseparable from her world-changing achievement.

Janice P Nimura is the author of The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine (WW Norton & Company, 2021)

This content was first published by HistoryExtra in 2021