This Life Has Never Been Lived Before
Despite the considerable knowledge she had accumulated in Europe, the announcement of her private practice in New York elicited very little business. During these slow times in her practice she occupied herself, and earned a small income, by writing essays and giving lectures on the health of children, specifically girls. Dr. Blackwell’s advice to parents was to allow exercise and ensure proper hygiene and most ailments could be avoided.
The idea of opening a free dispensary seemed to address the need for funds, as these public services were often supported by grants from the state and donations from wealthy patrons, could serve as a training ground for young female physicians, and were crucial to the promotion of public health. With in-put from her sister Emily, now in medical school, Dr. Blackwell established her dispensary in Little Germany. She was aided in her day-to-day efforts by a new acquaintance, Marie Zakrzewska, an exceedingly experienced midwife trained in Germany, whose clinical knowledge surpassed Dr. Blackwell’s.
The need for a hospital where women students could train was apparent, as was the noble cause of caring for the poor. Rallying their supporters to the cause, the Blackwells amassed the funds needed to establish an Infirmary, which would be the first and only institution that would treat poor women who couldn’t pay, and employ only women. The Board included eminent male physicians, but the doctors and nurses, and eventually the students at the Women’s College of Medicine, were all women who had succeeded in following in Dr. Blackwell’s footsteps.
The Infirmary building, located at Bleecker and Crosby streets, changed temperatures with the seasons; but it was clean and the staff were impeccable. The original dispensary was moved into the ground floor of the new building, and Dr. Zarkrewska served as attending physician. Dr. Emily Blackwell was in-charge of surgery, and the second floor was for inpatients, with maternity on the third. The attic level was used as sleeping quarters for students and nurses. The Infirmary grew slowly at first, and Dr. Blackwell would not take on debt. Until sufficient funds could be raised, and when there were not enough patients who could pay the $4 a day inpatient rate, the Drs. did not draw a pay check and had to maintain their private practice to off-set costs. The staff conducted house calls, knowing that it was cheaper to treat a patient without housing them, and found that poor women had few reservations about a female physician.
Even as the Infirmary maintained steady success, attracting more supporters and patients, it grew too slowly to satisfy Dr. Blackwell’s need for progress. Leaving management in the capable hands of her sister, who secured a State grant that solidified their financial footing, offered her own series of lectures that attracted more patients, and proved to be a highly capable surgeon, Dr. Blackwell decided to return to England. There she would embark on a lecture-tour intended to bring physiological knowledge to women from a woman. Despite her growing network of supporters, the success of her tour, and attracting a wealthy benefactress, medical education remained closed to women in England. Dr. Blackwell returned home to assist her sister with the logical next step, the creation of a medical college for women.
"These malicious stories are painful to me, for I am woman as well as physician, and both natures are wounded by these falsehoods. Ah, I am glad I, and not another, have to bear this pioneer work. I understand now why this life has never been lived before. It is hard, with no support but a high purpose, to live against every species of social opposition...I should like a little fun now and then. Life is altogether too sober."
Excerpt from unknown letter c. 1852
For every glowing remark, there was a rebuke. Each published accolade received a critical letter to the editor. All her friends and supporters could be drowned out by the reproaching stares and censure of the majority. Dr. Blackwell remained committed to her crusade, she believed it was crucial that women lift themselves out of obscurity and into roles suited to their capacities. Yet, despite the support of her family and the future comradery of a few other like-minded women, she was alone in the early struggle and felt the burdens of her often solitary day-to-day life.
“There is nothing in the preparatory studies themselves, that require so unusual an energy as to render women incapable of obtaining the necessary qualifications – all the difficulties which I have had to encounter, have been moral ones, which would exist no longer, when a College, Hospital, and all the necessary arrangements should exist to welcome the woman student as they do the man, instead of obliging her to force her way through opposition, and suspicion, and vulgar curiosity.”
Excerpt from letter to Baroness Anne Isabelle Milbanke Byron dated March 4, 1851.
Having completed her medical degree at a college for men, Dr. Blackwell could uniquely argue that none of the requirements for medical training were impossible for a woman to satisfy. She listened to the same lectures, attended the same demonstrations, and walked the same wards as her male counterparts and found nothing in the demands that was beyond her capacity.
"This first attempt to establish a hospital conducted entirely by women excited much opposition. At that date, although college instruction was being given to women students in some places, no hospital was anywhere available either for practice instruction or the exercise of the woman-physician's skill. To supply the need had become a matter of urgent importance."
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895), pg. 208
Even as the Infirmary grew and their reputation in the neighborhood expanded, any sign of alternative treatment or the inevitable death of a patient could incite anger. After the death of a maternity patient, members of the woman’s extended family, some armed with axes, pounded on the doors of the Infirmary. A crowd gathered and the staff were trapped inside the building. When police arrived, they remonstrated the mob, telling them the women did all they could for their patients and that no doctor could save everyone. This would not be the only instance the Infirmary had to rely on its supporters to disperse an angry mob.
"So little at that time was the importance of sexual education understood, and the necessity of its consideration accepted, that when I read my manuscript ['Counsel to Parents on the Moral Education of Their Children'] to a warm and enlightened English friend...she assured me that if I published that manuscript my 'name would be a forbidden word in England.' I sent the manuscript, however, to about twelve of the leading London publishers, who all decline the publication...Finally, a little consultation of elderly clergymen was called to consider the subject, and it was at last resolved that if the name of the work could be changed, and the distinct announcement made in the title that it was a medical as well as a moral work, the publication might be continued. Of course the change was made, and 'Counsel to Parents' became 'The Moral Education of the Young, considered under Medical and Social Aspects.'"
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895), pg. 251-252
By including medical and moral together, publishers felt that the topic would excite less ire, even if it did discuss issues of intimacy. The fact of the matter, as Dr. Blackwell saw it, was that girls were given no introduction to the topic of sex and by placing issues of the physicality of the topic in direct connection to the moral considerations, girls could be educated and protected from any degenerate intentions.