The Doctors Blackwell: An Interview with Janice Nimura

Interviewed by Katie Uva

Today on the blog, Gotham editor Katie Uva speaks to Janice P. Nimura, author of The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine. The book is a joint biography of Elizabeth Blackwell, the first woman to earn a medical degree in the United States, and her sister Emily Blackwell, the third woman to do so. The book examines the Blackwells’ struggle to obtain training and credentials in the increasingly professionalized field of medicine in the 19th century, and also provides insights into 19th century New York as a place of opportunity and obstacles for these groundbreaking women.

First off, can you give us an overview of the Blackwell family in general and the careers of Elizabeth and Emily in particular?

The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine
By Janice P. Nimura
W. W. Norton and Company, 2021
336 pages

The Blackwells hailed from Bristol, where their father was both a sugar refiner and an abolitionist — a Dissenter and an idealist who dreamed of finding a way to make sugar from beets, without enslaved labor. He gave his five daughters the same level of education as his four sons, he moved them to America and then all the way out to the frontier town of Cincinnati in 1838, and then he died, broke. His daughters learned early that a husband was no guarantee of security, and none of them ever married. Two of his sons married two of the most prominent feminists of the day, Lucy Stone and Antoinette Brown.

Elizabeth was a voracious reader who thrilled to Margaret Fuller’s idea that women could be anything they wanted to be, and that humanity would only achieve enlightenment if women unleashed their own power. She chose medicine not because she felt drawn to healing, but because earning a medical diploma was an unusually clear way to prove Fuller’s point. She anointed her sister Emily, five years younger, to follow her lead, recognizing the arduous loneliness of the path she had laid out for herself. Emily took to the profession and proved to be the more natural scientist and practitioner. Together they founded the New York Infirmary for Indigent Women and Children in 1857, and later its Women’s Medical College, in 1869.

As you mentioned, the Blackwells were originally from England, and lived and trained in various places before coming to New York. What drew them to the city? What opportunities and what obstacles did New York present?

Philadelphia’s august medical institutions had rejected both sisters, Boston’s brahmins presented a dauntingly steep social climb, and both of those cities had recently sprouted female medical colleges — a move the Blackwells disdained. Women, they thought, should study medicine alongside men if they were truly to prove their equal worth as doctors. New York was the first American city the Blackwells called home when they emigrated from Bristol in 1832. In 1851, as Elizabeth was finishing her European training and plotting her next move, she chose brash New York, where she hoped to benefit from the presence of prominent allies, like Horace Greeley and Henry Ward Beecher.

The problem was, for most New Yorkers the very phrase “female physician” meant something very different from “bright young woman with a medical degree.” For most, it meant someone like Madame Restell, the notorious Fifth Avenue abortionist — a woman who operated on the wrong side of the law, wreathed with scandal. The irony was that both Elizabeth Blackwell and Madame Restell were iconoclasts with a deep interest in women’s health — they were just coming at it from opposite directions. The presence of Madame Restell, female physician, made Elizabeth’s task harder, as any effort to advertise risked making her sound like a shady character. Upon arrival in New York, she waited in vain for private patients who did not come.

But New York also had its fair share of Quakers and freethinkers who were intrigued by the idea of women’s medical education. Even if many of those same matrons chose not to consult a female doctor themselves, they were eager to support the Blackwells’ mission, and became major donors to the institutions the Blackwells founded.

What was their medical practice in New York like? Can you tell us a bit about what their goals were, what the neighborhood they worked in was like, who they treated, and who was part of their social and professional circle in New York?

After Emily Blackwell received her own medical degree in the United States and finished her training abroad, the sisters joined forces to found the New York Infirmary for Indigent Women and Children. Its first location was in a building that still stands, at the corner of Bleecker and Crosby Streets, just east of Broadway — a building whose façade faced toward the wealthy neighborhoods of its donors, and whose back end looked toward the overcrowded tenements of the immigrants who were its patients. It was the first hospital staffed entirely by women, and its purpose was both to offer free care to the women of the neighborhood and to provide a site of practical training for the slowly growing ranks of female medical graduates. Those young residents formed a cadre of “sanitary visitors,” who worked outside the hospital as well, bringing progressive ideas about hygiene, prenatal care, and parenting to poor women in their homes. Among them, eventually, was Dr. Rebecca Cole, one of the first Black female doctors.

Despite the support of wealthy donors, the Blackwells had to contend with mistrust and threats, often from the menfolk of the very women they were treating. In extreme cases they were forced to call upon the help of prominent male physicians who backed their endeavors and whose second opinions helped soothe the suspicions of doubters. Even as their institution found sounder footing, they chafed at the disdain in which they were held by many members of the city’s elite. Elizabeth, who had always craved social recognition alongside her professional achievement, never found satisfaction in New York, and spent her last four decades in England. Emily, who cared more about the challenge and practice of medicine than the esteem of high society, remained to steward the institutions they had founded.

At one point in the book you have a quote from Elizabeth describing herself as “too conservative for the reformers, too progressive for the conservatives.” How did that affect her career in the city? How did Emily diverge from Elizabeth politically or professionally?

Elizabeth marched to her own drum, out of step with the women’s rights movement, whose suffrage goals she thought wrongheaded. Why give women the vote if their husbands and fathers still had the power to tell them how to use it? She believed women needed to prove their independence first. She had a healthy sense of her own self-worth, and didn’t waste time wondering if people approved of her opinions. Her determination and drive helped her become the first woman doctor, but her rigid idealism also alienated people who might otherwise have become her allies. She craved recognition as a pioneer, and felt frustrated that New York’s elite didn’t celebrate her achievement the way they celebrated someone like Florence Nightingale.

Emily was better at human connection, at being part of a team. In 1870, when Elizabeth returned permanently to England, Emily came into her own as the leader of the institutions they had founded in New York, and proved herself not just a talented surgeon and medical professor, but also an able fundraiser and lobbyist.

What would you say is the lasting impact of Emily and Elizabeth Blackwell’s work? Where is their legacy visible in New York today?

The Blackwell sisters paved the way for women in medicine, not just as the first women doctors, but also as leaders who opened a pathway for women to study alongside men. Believing women’s medical colleges to be woefully inferior, they reluctantly opened their own but made it more rigorous than the male institutions, with a more progressive curriculum and more emphasis on practical training. As soon as institutions like Cornell and Johns Hopkins began to admit women at the turn of the century, Emily shut down the Blackwell college, declaring there was no longer a need for it. The Infirmary, meanwhile, thrived for a century, until it was absorbed into Downtown Hospital, now part of New York-Presbyterian.

The building at Bleecker and Crosby has become part of the Greenwich Village Society for Historic Preservation’s Civil Rights and Social Justice map, with a plaque commemorating the founding of the Infirmary. And at all of New York’s excellent medical schools, the fact that more than half of the students are female is part of the Blackwells’ legacy.

Janice P. Nimura received a Public Scholar Award from the National Endowment for the Humanities in support of her work on The Doctors Blackwell. Her previous book, Daughters of the Samurai: A Journey from East to West and Back, was a New York Times Notable book in 2015.