Book Review

The Excellent Doctor Blackwell: The Life of the First Female Physician

N Engl J Med 2007; 356:2118-2119May 17, 2007

Article

The Excellent Doctor Blackwell: The Life of the First Female Physician
By Julia Boyd. 336 pp., illustrated. Thrupp, England, Sutton Publishing, 2006. $22.95 (cloth); $16.95 (paper). ISBN: 978-0-750-94140-2 (cloth); 978-0-750-94141-9 (paper).

With the approach of the 150th anniversary of the opening of the New York Infirmary for Indigent Women and Children, the publication of Julia Boyd's definitive biography of Elizabeth Blackwell could not have been more timely. It is a continual source of amazement to me that most medical students and physicians have no idea whom Elizabeth Blackwell was — for those of you who are no wiser, she was the first female physician in the United States.

Blackwell was born in Bristol, England, and came to the United States with her family in 1832, when she was 11 years old. Her parents were puritanical Sunday-school teachers and rabid abolitionists. Most of their social life centered around abolitionist activities, which was ironic given that Elizabeth's father was in the business of sugar refining, an enterprise that relied heavily on slavery. Nevertheless, the Blackwell family attended many antislavery meetings, and it was through these gatherings that Elizabeth met luminaries such as John Jay and William Lloyd Garrison. These charismatic nonconformists had a deep influence on her. As a teenager, Elizabeth was also inspired by William Henry Channing and Margaret Fuller, both of whom were leaders of the budding women's rights movement.

Elizabeth desperately wished to avoid an ordinary life, but she contemplated a career in medicine only when a friend of her mother received a diagnosis of uterine cancer. The friend complained to Elizabeth that being examined by crude, inept male physicians was as bad as having cancer; had a woman doctor been available, the friend said, her final weeks would have been eased considerably. She then suggested that Elizabeth should become a doctor. Elizabeth initially recoiled from this idea because she found the human body repellant. Try as she did, however, she couldn't shake it. Becoming a physician would allow her to support herself as well as provide a distraction from what she called the “disturbing influence of the other sex.” William Henry Channing and others in the Transcendentalist movement encouraged women to think boldly, and so Elizabeth began to seriously consider becoming a physician. She was attracted more by the opportunity to improve society than by any desire to heal the sick. Being rebellious by nature, she found great appeal in the outrageousness of the idea. She also knew that there were untold numbers of women in need of care and advice who were too modest to see a male physician.

Boyd uses a wealth of sources to paint a portrait of a complex and passionate woman who wrought enormous changes on the practice of medicine in the United States and abroad. Blackwell fought tenaciously for the right of women to become doctors — clashing with Florence Nightingale in the process — but she was also a fierce critic of feminism and relegated her adopted daughter to a life of servitude. Boyd analyzes these contradictions in an engaging manner that makes Blackwell accessible.

Boyd gives an accurate description of how Blackwell was admitted to just one of the medical schools to which she applied, Geneva Medical College in Syracuse, New York. The faculty passed off responsibility for the decision to the students, who agreed to accept her only because they thought the application was a hoax. When she returned to New York City, she struggled mightily to attract patients, despite having graduated at the top of her class and receiving the unqualified support of prominent New Yorkers such as Horace Greeley. Seeing no alternative, she decided to create a fully equipped hospital for women and children, which would be staffed by women. In this way, she could deliver quality medical education and clinical training to women. With the help of Blackwell's sister Emily, and Marie Zakrzewska (both of whom became doctors), as well as the Quaker community, enough money was raised to purchase a house on Bleecker Street in 1857, and in less than 2 months it was transformed into a small hospital. The New York Infirmary for Indigent Women and Children opened its doors on May 12, 1857. Blackwell's hospital survives today as the New York Downtown Hospital in Lower Manhattan.

Boyd recounts how Elizabeth continued to shock society even after realizing her dreams of becoming a physician and opening her own hospital. When she returned to England, where she spent the final four decades of her life, Blackwell wrote and lectured about venereal disease, masturbation, and prostitution and published a guide for parents on sex education. She also inspired Elizabeth Garrett Anderson to become England's first female physician.

Elizabeth Blackwell was a remarkable woman whose ideas and struggles changed the status of women as well as the practice of medicine. The profound effect she had is commemorated in the vast number of female physicians practicing today. One can only hope that this excellent biography of an excellent doctor will help garner Blackwell the renown she has always deserved.

Steven G. Friedman, M.D.
New York Downtown Hospital, New York, NY 10038
steven.friedman@downtownhospital.org