Elizabeth Blackwell (1821–1910)

In the nineteenth century, Elizabeth Blackwell was a women’s healthcare reformer and the first woman to receive her medical degree in the United States. She practiced medicine as a primary care physician in both the United States and the United Kingdom. Blackwell graduated medical school from Geneva Medical College in Geneva, New York, where she was the first woman to receive a medical degree in the US. Throughout her career, Blackwell focused on her patients’ rights to access healthcare and education pertaining to healthcare, particularly the rights of women and children, whom she treated in a hospital she cofounded. Blackwell influenced the medical care during the Civil War in the United States by training nurses to treat soldiers injured in battle. In her lifetime, Blackwell educated women on their health and careers as healthcare providers, and as the first woman to receive a medical degree, made it easier for other women to become physicians in the United States.

Blackwell was born on 3 February 1821 to Hannah Lane and Samuel Blackwell in Bristol, England. She was the third of eight children. Her father was a sugar refiner, whose business suffered a large loss in the early 1930s. Due to their resulting financial struggle, Blackwell and her family sailed for seven weeks from Bristow, England, to New York City, New York, in 1832. In New York, Blackwell received her primary education and joined the anti-slavery movement with her family, attending lectures and meetings organized by abolitionists of the time.

In 1838, Blackwell and her family moved to Cincinnati, Ohio, where her father died a few months later. After losing the financial income of their father, the three eldest sisters, including seventeen-year-old Blackwell, founded the Cincinnati English and French Academy for Young Ladies in Cincinnati, Ohio. The Academy was both a daytime school and a boarding school for women only. Blackwell taught at the Academy and continued her own education simultaneously, and Blackwell cited in her autobiography that her favorite subjects were German, history, and metaphysics. In 1842, the boarding school was closed and Blackwell taught students privately for a short period. Soon after, she received a job offer to teach at a school in Hendersonville, Kentucky. Blackwell accepted the offer and traveled to Kentucky alone, without her family for the first time. However, after witnessing slavery for the first time at the school, Blackwell returned to Cincinnati, Ohio.

In 1843, after returning to Ohio, Blackwell visited one of her mother’s terminally ill friends. Her mother’s patient told Blackwell that her suffering would have been lessened if a woman physician had treated her, rather than a man. According to historian Nancy Kline, that comment prompted Blackwell to consider becoming a physician. Blackwell cited in her autobiography that though she found human anatomy distasteful, she knew that pursuing a career in medicine would prevent her from being forced to have an ordinary marriage. She found herself disappointed and repelled by the thought of marrying any man, and instead desired to devote her life to an absorbing occupation such as medicine.

Soon after the death of her mother’s friend, Blackwell wrote to local physicians to ask for their input on her goal to attend medical school. Most women at the time who practiced medicine did so without a degree. During the mid-1800s, many women practicing medicine were abortionists, such as Madame Restell. Reportedly, Blackwell did not want to be associated with such medical providers. Using the term ‘woman physician’ while writing to local doctors, Blackwell stated that she was intending to apply to medical school and not to become an abortionist. The doctors told Blackwell that though it was a good idea, her applying to medical school was an impossible feat and that it would be too expensive and time-consuming to be worth her while. However, Blackwell persisted in contacting doctors until one would take her on as an apprentice. Through those letters, Blackwell connected with John Dickson, a physician turned preacher in Asheville, North Carolina. He helped her acquire a teaching position in Asheville in 1845, where she taught music to schoolchildren. In her spare time, Blackwell read the doctor’s medical books to prepare herself for medical school.

At the age of twenty-five, Blackwell traveled to Charleston, South Carolina, to live with the doctor’s brother, Samuel Dickson, a physician and professor of medicine in 1846. Dickson helped Blackwell secure a job at a boarding school where she worked and saved money for medical school. Blackwell learned Greek and the fundamentals of medicine from Dickson in her spare time. In 1847, Blackwell applied to medical school. She received rejections from twenty-nine schools before receiving an acceptance letter from the Geneva Medical College in Geneva, New York. Unable to reach a decision on Blackwell’s application, the dean asked the class of 150 male medical students to vote on Blackwell’s admission to the university. All 150 men had to vote unanimously to accept Blackwell into the college.

Upon the unanimous response to admit her, Blackwell entered medical school in August of 1847. According to Blackwell, despite her previous disgust of anatomy, she soon began to enjoy her anatomy lab, though her anatomy professor did not allow her to attend certain labs. Historians today argue that the professor did not want to corrupt Blackwell by seeing the anatomy of the male cadavers. Blackwell wrote a note to the professor that she had earned the right to sit in on all of the anatomy classes when she was accepted to the school. Because of that letter, she was allowed to attend every lecture she desired until she graduated.

During the summer between her school terms, Blackwell worked at the Blockley Almshouse in Philadelphia, Pennsylvania. There, she treated patients with syphilis and typhus infections. Blackwell graduated as the first in her class in 1849, making her the first woman to receive a medical degree in the US.

After graduating with her medical degree, Blackwell moved to Liverpool, England, where she attended medical lectures. After a few months in England, Blackwell traveled to Paris, France, on the advice of her mentors in the US. Her mentors told Blackwell that Paris was a place that would be more welcoming of her as a female physician. In Paris, she worked at La Maternité, a hospital for pregnant women and those giving birth. During her time at the hospital, Blackwell contracted a bacterial eye infection. Blackwell had been washing a patient’s eye infection with a saline solution when some of the contaminated solution splashed into Blackwell’s eye. Fellow physicians quickly treated Blackwell’s infection with hourly saline cleanses, cauterizing her eyelashes, applying leeches to her temples, and administering opium and purgatives to cleanse her body. However, she lost sight in her left eye and was forced to have her eye surgically removed. That loss of vision prevented Blackwell from becoming a surgeon. She instead focused on primary care.

In 1851, Blackwell returned to New York City, New York, where she began to focus on making healthcare more accessible for women. In 1852, she taught classes in a church basement on sexual physiology and reproduction for young women. She later published the lectures as “The Laws of Life in Reference to the Physical Education of Girls.” The women who attended those lectures requested that Blackwell be their personal physician. In response, Blackwell opened a small private practice in a single room in a poor part of town in 1853, where she began to treat women and children. Later, a friend lent Blackwell money to purchase a house to see her patients. In 1854, Blackwell treated a young orphan girl named Katherine Barry and decided to adopt her. Blackwell acknowledged in her autobiography that her daughter found it strange to ever refer to a man as a doctor, because she spent her childhood calling Blackwell doctor rather than mother.

In 1857, Blackwell and two other female doctors, her younger sister, Emily Blackwell, and social reformer Marie Zakrzewska, opened the New York Infirmary for Indigent Women and Children in New York City, New York. The hospital was run entirely by women, and only saw female patients and their children. In response to opposition by male doctors in the area, Blackwell argued that the aim of the hospital was to provide a female-centered patient care model and an avenue for young graduated female physicians to obtain work.

While her peers ran the new hospital in New York, Blackwell returned to England in 1858 to advocate for more women to join the medical profession. Blackwell delivered three lectures at a university in England on why more women should be admitted to the medical field and what women had done for the field. In her first lecture, Blackwell self-described her belief that women are capable of healing others better than men. She also emphasized the necessity of hygiene in medical practice and in everyday life. The second lecture that Blackwell delivered was on the value of medical knowledge and the third lecture was on the practical value of the work done by women in the medical field in the US. Blackwell later gave lectures in 1859 on a proposal she had for a hospital that only treated special conditions that affected women. Because of those lectures, more women became aware of hygienic practices in medicine, and a proposition was made for a woman-run hospital to be created to treat diseases specific to females.

Blackwell responded to the outbreak of the Civil War in the United States by assembling a workforce of nurses in 1861. Blackwell and the other doctors at the New York Infirmary for Indigent Women and Children organized a meeting at the beginning of the war to discuss what they could do to help. The New York Times published the date and time of the meeting unbeknownst to the meeting organizers, and the hallways and rooms of the entire hospital were filled with women eager to help. As a result of that meeting, Blackwell helped form the National Sanitary Aid Association, or NSAA, in New York City, which trained nurses to deliver medical care in a war setting. In 1865, the United States legislature ordered the NSAA be chartered by a medical school in the area. Because she wanted to ensure the nursing training policies remained unchanged, Blackwell cofounded the Women’s Medical College headquartered out of the New York Infirmary for Indigent Women and Children. That was so that the policies they had created for the nurse training would not be altered by another college. Blackwell taught at the Women’s Medical College until 1869.

By the 1870s, Blackwell became ill and stopped practicing medicine, but she continued to teach and campaign for women’s rights in the medical field. She returned to London, England, in 1870 where she lectured on the necessity of women physicians. Blackwell also worked to repeal the Contagious Diseases Acts in England. Those acts were passed in response to the spread of sexually transmitted infections in England. The acts enabled police officers to arrest women who they assumed to be prostitutes, forced any women suspected of being prostitutes to be checked for sexually transmitted infections, and later, allowed police to lock up those women who did test positive to be quarantined in small rooms for up to a year. At the time, physicians assumed that only women could transmit sexual infections. Blackwell spent seventeen years in England educating the public on sanitary guidelines to prevent sexually transmitted infections and pushing for repeal of the Contagious Diseases Acts. Also, during her time in England, Blackwell delivered speeches at the Working Women’s College on how women could maintain their own health and the health of their families.

Through the late 1870s, Blackwell traveled throughout Europe to lecture to new audiences. In 1878 in Nice, France, Blackwell wrote “Counsel to Parents on the Moral Education of their Children,” a book on the moral responsibility of parents to teach their children about reproductive health and wellness. The book summarized the knowledge that Blackwell wanted parents to teach their daughters about masturbation, menstruation, and sexual intercourse. Twelve publishers declined to publish the work and, in 1878, Blackwell published it herself.

Through the late 1800s, Blackwell continued to lecture and write. She lectured at the London School of Medicine for Women in London, England, on gynecology, the study of the female reproductive system. She also consulted at the New College for Women in London, England, later called the Elizabeth Garrett Anderson and Obstetric Hospital. At the New College, Blackwell mentored Elizabeth Garrett Anderson, who later became the first female surgeon in the United Kingdom. Blackwell never married. In 1895, she published her autobiography, Pioneer Work in Opening the Medical Profession to Women.

In 1907, Blackwell fell down a flight of stairs, which permanently disabled her. She died from a stroke on 31 May 1910.