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Miss Blackwell Goes to Medical School

An excerpt from The Doctors Blackwell

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The young men of Geneva Medical College were some weeks into the new term of 1847 when the dean of faculty, Charles A. Lee, visited their lecture hall, a letter in his hand.

The worry lines in his perennially concerned expression deeper than usual, Dr. Lee cleared his throat. He held, he announced with a quaver, the “most extraordinary request which had ever been made to the faculty.” A young lady, studying privately with an eminent physician in Philadelphia, had applied, with her mentor’s endorsement, for admission to their school. Several prominent medical colleges had already refused her. The faculty at Geneva had decided to put the issue to a student vote, Lee continued, with the stipulation that a single nay could turn the decision against the unusual lady in question. Their prompt attention to this matter would be appreciated. Lee refolded the letter and departed.

Two things were clear to the assembled young men. First, their professors were cowards: too timid to reject this unprecedented request out of hand, not bold enough to embrace it. And second, the students had been handed the power to make serious mischief.

Tucked away among the Finger Lakes of western New York State, Geneva College was a modest institution, founded to offer the young men of the region a classical education in two graceful stone halls, Geneva and Trinity, perched above a prosperous village at the northern tip of Seneca Lake. A third building soon rose between the original two to house the medical department, but no one liked the idea of cadavers at the heart of the college. Middle Building became the library, and a spacious new medical building, topped with a domed skylight, was completed in 1843 at a discreet distance up the street.

Of the 113 students in the medical class of 1847–48, nearly all were local. They were boisterous boys with more energy than polish; young men with intellectual and social ambition generally migrated to cities and studied law. Medicine, as a profession, was considered more manual than cerebral, vulnerable to the taint of patent-remedy hucksters; surgery, when it was practiced at all, had not long since been the bloody craft of barbers. Though the elite medical colleges of New York and Philadelphia might include gentlemen on their rolls, tiny Geneva did not. It wasn’t uncommon for the dean to receive written complaints from townsfolk threatening legal action over the raucous behavior of his students. That fall the silence of the night had exploded when several overeager anatomy pupils, unsatisfied with the college’s supply of unclaimed bodies from nearby Auburn State Prison, tried to rob the grave of a recently interred Irishman. The dead man’s compatriots had driven them off with gunfire.

There were no absentees at a student meeting on the evening of Dr. Lee’s bizarre announcement. In speech after speech, the class clowns topped each other in extravagant support for the admission of a corseted classmate. What could be more ridiculous—or more entertaining—than a lady doctor? When the jokes were spent, the vote was called. All in favor? The roar of “AYE” rattled the windows. The air filled with tossed hats and waving handkerchiefs. Any opposed? There was a bemused silence, broken by a single, tentative “nay.”

Decades later a distinguished Geneva alumnus named Stephen Smith was still chuckling at the fate of the hapless dissenter. “At the instant, the class arose as one man and rushed to the corner from which the voice proceeded,” he recalled. “Amid screams of ‘cuff him,’ ‘crack his skull,’ ‘throw him down the stairs,’ a young man was dragged to the platform screaming ‘Aye, aye! I vote aye.’” The students bore their decision in triumph to the horrified faculty and promptly forgot about it. The whole farce was probably a prank cooked up by a rival school anyway, they told each other.

Three weeks later, on a dreary Monday morning, the yawning, slouching students of Geneva Medical College looked up to see their professor coming through the door of the lecture room followed by a slight feminine figure, dressed without ornament. She had a high smooth forehead, a firm set to her jaw, and fair hair parted in the center. She seated herself, placed her bonnet beneath her chair, and turned her penetrating stare toward the front of the room. A stunned silence fell like a curtain. Spines straightened; feet returned squarely to the floor.

“For the first time a lecture was given without the slightest interruption,” Stephen Smith remembered much later, “and every word could be heard as distinctly as it would if there had been but a single person in the room.” As if by magic, a classroom full of “lawless desperadoes” had been transformed into models of deportment by Elizabeth’s mere presence. Or had they? In the moment, the presence of a woman in the lecture hall was no one’s idea of a happy ending. At best, for Elizabeth, it was a vindication and a beginning. At worst, it was a freakish experiment her professors would live to regret.


The letter from Geneva College had arrived in Philadelphia at the end of October. Elizabeth opened it with a flickering mixture of resignation and stubborn hope. “At a meeting of the entire Medical Class of Geneva Medical College, held this day, October 20, 1847,” it began, “the following Resolutions were unanimously adopted:

Resolved—That one of the radical principles of a Republican Government is the universal education of both sexes; that to every branch of scientific education the door should be open equally to all; that the application of Elizabeth Blackwell to become a member of our class, meets our entire approbation; and in extending our unanimous invitation, we pledge ourselves that no conduct of ours shall cause her to regret her attendance at this institution.

Resolved—That a copy of these proceedings be signed by the Chairman and transmitted to Elizabeth Blackwell.

The faculty, Dr. Lee explained disingenuously, had decided to lay Elizabeth’s application before the young men among whom she would study. “I send you the results of their deliberations,” Lee wrote, “and need only add that there are no fears but that you can, by judicious management, not only ‘disarm criticism,’ but elevate yourself without detracting, in the least, from the dignity of the profession.” Elizabeth did not dwell on the lukewarm endorsement, or the fact that the term had already started. An acceptance was an acceptance. And if Lee chose to close by wishing her “success in your undertaking, which some may deem bold in the present state of society,” she would have to assume he wasn’t one of those “some.”

She had to tell Emily. “Dear Milly,” she began, and quoted all the best bits at length: principles of Republican government! entire approbation! unanimous invitation! “Isn’t that fine and liberal?” she crowed. “It is accompanied by a few words of encouragement from one of the Professors—oh really it was refreshing. I fairly jumped for joy—it seemed to me that I was the luckiest mortal on the face of the earth, & that henceforth no difficulty remained.” But giddiness was not Elizabeth’s natural state, and her “fit of rapture” soon subsided. Studying the circular Dr. Lee had enclosed, she reported to Emily on the college’s virtues: “well supplied museums & cabinet of Natural History, a library, plenty of material for dissection, clinical lectures, & surgical operations—the charges moderate & boarding reasonable.” She heaved a sigh of triumphant relief (“though not surprise,” she was quick to insist, “for failure never seemed possible”), packed her trunk, bought a train ticket, and left for Geneva, entirely unaware of the farcical circumstances of her acceptance.

Train travel, less than two decades old, was a grueling ordeal: the wooden cars jolted only slightly less than the stagecoaches they were replacing, the hard seats were like church pews, the floorboards were sticky with tobacco juice. A stove perched in a corner belched too much heat into the cramped box of passengers, but opening a window invited a choking blast of dust and smoke and sparks. The cars could make about twenty miles per hour, as long as the tracks remained clear of snow, mud, or wandering cows. Derailments were common.

In the chill and deserted darkness of a rainy Saturday night in November, the exhausted and soot-streaked twenty-six-year-old woman who stepped off the train in Geneva felt somewhat less confident than the one who had left Philadelphia two days earlier. The next day was the Sabbath, but she would have no leisure to observe it. She needed a place to live, she needed to learn her way around a new town, and she needed to present herself to a group of professors who had spent the last week dreading her arrival.

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—W. W. Norton & Company, Inc.

It was still raining on Tuesday, Seneca Lake a dull gray sheet beyond South Main Street. Now Elizabeth had an upper room at Hamilton’s boardinghouse, two doors down from the medical building. Though there were plenty of other lodgers, she had not yet spoken to any of them. A small stove kept off the chill. She shoved another stick of firewood into its belly and sat down to report her progress, this time to supportive Marian. She had no one to talk to and much to tell. “The weather is still gloomy,” she wrote, “but I feel sunshiny and happy, strongly encouraged, with a grand future before me, and all owing to a fat little fairy in the shape of the Professor of Anatomy!” The letter is a mixture of proud excitement and protective irony; here and henceforth, Elizabeth used the word little as a way of diminishing those who might obstruct her path.

The rotund anatomy professor, James Webster—unlike the ambivalent dean of faculty, Charles Lee—was delighted with his exotic new pupil. Of course, she would study surgery, Dr. Webster told his more cautious colleague. “Think of the cases of femoral hernia,” he enthused, “only think what a well-educated woman would do in a city like New York.” Women with complaints in unmentionable places would flock to her, her success would be ensured, her fame widespread—and her alma mater celebrated. Indeed, members of the public were already showing up at lectures to gawk at the lady student. Would she blush, or gasp—or faint? “Yes,” Dr. Lee grudgingly concurred, “we were saying today that this step might prove quite a good advertisement for the college; if there were no other advantage to be gained, it will attract so much notice.”

The demonstrator of anatomy, Corydon La Ford—Dr. Webster’s deputy, in charge of dissections—had at first balked at the idea of a woman among the specimens; now, following Webster’s lead, he showed “the utmost friendliness” and even met with Elizabeth individually to help her make up the material she had missed. Working with colleagues on actual specimens—“Oh, this is the way to learn!” she rejoiced.

Things were looking up. “Today when I came home so happy and encouraged,” she told Marian, “I blessed God most heartily.” Whatever else Elizabeth lacked, self-esteem was never in short supply; where others might seek God’s blessing, she blessed God, who seemed at this moment less a deity than another kindly old gentleman who might assist her. “I wanted to throw my arms round him & mend his stockings,” she continued, “or do something in return if I only knew what.” She felt the same kind of gratitude for Dr. Webster. “The little fat Professor of Anatomy is a capital fellow; certainly I shall love fat men more than lean ones henceforth,” she wrote. “He gave just the go-ahead directing impulse needful; he will afford me every advantage, and says I shall graduate with éclat.”


Éclat did not wait for Elizabeth’s graduation. The Boston Medical and Surgical Journal was already gossiping about the appearance of “a pretty little specimen of the feminine gender” at medical lectures. The writer was surprisingly respectful, going so far as to ask, “Why should not well-educated females be admitted?”—though this may have been a rhetorical flourish. A month later there was a second notice in the same journal, confirming that the jury was still out: “Nothing has transpired as yet to disprove the propriety of the action taken by the Faculty and class.” Geneva College may have been the first medical school to admit a woman, but who could tell whether such a distinction would prove “meritorious or otherwise”? Other schools were not rushing to follow Geneva’s example. Harriot K. Hunt, a Boston woman in her forties who had been treating women and children with alternative therapies for more than a decade, was sufficiently emboldened by Elizabeth’s success to apply to Harvard’s medical school. The response was immediate and unequivocal: The president and fellows of Harvard College found the admission of a woman “inexpedient.” Hunt would continue to practice and go on to prominence in the women’s rights movement, but she would never earn a medical degree.

Even Austin Flint—editor of the Buffalo Medical Journal, lecturer at Geneva College, and one of Elizabeth’s earliest supporters in print—was careful to qualify his enthusiasm. Flint applauded the advent of women in certain “special branches” of medicine—obstetrics and gynecology—and hoped that they might “conduce to the diminution of quackery” by debunking the latest medical fads for their sillier sisters. A woman’s “appropriate sphere” was of course “the domestic hearth, and the social circle,” though he saw no reason why medicine should be “the exclusive prerogative of the lords of creation.” But here his courage failed: “The discussion of the subject would, however, lead us too deeply into the metaphysics of woman’s rights, and we therefore waive it for the present.”

In England, commentators hailed the achievement of this daughter of Bristol with less discretion. The satirical newspaper Punch pounced on the news with acidic glee. “We admire MISS BLACKWELL, though we have never seen her,” it announced. “She is qualifying herself for that very important duty of a good wife—tending a husband in sickness.” The writer hoped a thorough medical education would provide Elizabeth with “very useful information—a knowledge of the distinction between real and fanciful ailments: also, of the consequences of want of exercise, damp feet, and tight lacing.” Such information to be used only within the home, of course.

Elizabeth ignored such publicity as resolutely as she did the smirks of her classmates, and tried to shut out the “flat, heavy feeling” that encroached like a quiet fog. The task she had set herself required a degree of self-control beyond anything she had attempted and more isolation than she had ever felt among the townsfolk of Asheville and Charleston. “I sit quietly in this assemblage of young men,” she mused, “and they might be women or mummies for aught I care.” In order to reach her goal, she needed to hold herself above the whispers and fidgety curiosity that surrounded her in the tiered rows of the lecture hall. “In the amphitheatre yesterday a little folded paper dropped on my arms as I was making notes; it looked very much as if there were writing in it, but I shook it off,” she wrote at the end of her second week. “I felt also a very light touch on my head, but I guess my quiet manner will soon stop any nonsense.”

Excerpted from The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine by Janice P. Nimura. Copyright (c) 2021 by Janice P. Nimura. Used with permission of the publisher, W. W. Norton & Company, Inc.