I have a vague memory from elementary school that concerns me making Elizabeth Blackwell’s head out of a pumpkin. Not jack-o-lantern style, but painted, with a neat bun made out of gray yarn. I have to imagine a written report accompanied my creation, so presumably I learned that Blackwell was America’s first female medical doctor (M.D.). Like most people, that fact represented the entirety of my knowledge of the medical pioneer.
Nimura’s book complicates the basic fact of Blackwell’s fame, beginning with the title itself: The Doctors Blackwell. The pluralization of the profession reflects that the book is not just about Elizabeth, but also about her younger sister Emily, who followed in Elizabeth’s footsteps by also acquiring her M.D. and becoming her medical partner.
Nonetheless, the book is still largely Elizabeth's story, and Nimura seeks to paint a complex portrait of the doctor. Elizabeth did much good both by establishing hospitals for the indigent and, with Emily, opening a women’s medical college. But none of her actions were motivated by benevolence or altruism. She opened a hospital because she could get funding by the state and could not get work as a private physician. She opened the women’s college because the few women’s medical schools that existed were inferior, and she could not get qualified female doctors to work for her hospital. Elizabeth became a doctor to earn society’s—and men’s—respect. According to Nimura's portrait, Elizabeth was an idealist, not a pragmatist interested in the day-to-day work of caring for sick human bodies. She was ambitious, arrogant, and disdainful of others, just like so many male icons of history. She matched their bravado and found success—and censure—because of it. Ultimately, it was Emily who did much of the real physician work, including running the women's college for decades.
Aside from the sisters' fascinating history, one of the truths the book exposed for me is how misleading it is to focus on “firsts,” as doing so suggests a finality of accomplishment—in particular, overcoming discrimination—rather than a lifetime of struggle. For Elizabeth, acquiring the M.D. itself was, relatively speaking, easy. At the time, there were no admission requirements for medical school (beyond the ability to pay for it). Instruction consisted of two 16-week terms of (identical) lectures and examinations. There was no practical experience or continuing training. In that way, medical schools did little to actually train doctors. The male student body of the Geneva College of Medicine only agreed to admit Elizabeth because it seemed funny, a lark. But earning the M.D. did not clear the way for Elizabeth—she fought her entire life, often unsuccessfully, for the access, respect, and funding her male colleagues enjoyed. Even worse, her graduation did not clear the way for future female physicians either. Admitting one woman to medical school might be a publicity-earning novelty, but no male schools were ready to truly open to women. In fact, many—including Geneva—passed rules barring future women from entering. Emily’s first medical school barred women after Emily had completed her first year.
Sexism shaped every part of the Blackwells’ lives, and the book focuses especially on Elizabeth’s and Emily’s decisions not to marry. We know that many of their literary contemporaries—Louisa May Alcott, the Bronte sisters, Emily Dickinson, etc—were unmarried, and the Blackwells consciously chose the same. At the time, a woman’s success was completely incompatible with marriage, particularly since limited access to contraception meant a married woman would likely be burdened with children.
Interestingly, though the Blackwells’ time intersects with the burgeoning women’s rights movement, Elizabeth and Emily were somewhat skeptical. Elizabeth, in particular, looked down on most women, whom she found stupid, lazy, and silly. She blamed the women themselves—not men—for failing to rise from their station.
Ultimately, there was so much I found fascinating about the story. The Doctors Blackwell even reflects the Blackwells' time at an interesting point in medical history, a time before most modern advances or even basic hygiene practices, where physicians were as likely to do harm as do good. Doctors had to weigh what they were taught with their own experiences and observations in an attempt to do the most good.
In the end, the book paints a complicated picture of the Blackwells, of medicine, and of women's rights. I'd recommend.
