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Janice Nimura On Telling The Story Of The First Women Medical Doctors

AILSA CHANG, HOST:

These days, women make up just more than half of all medical students in the U.S. There are more than 48,000 of them now. But there was a time when that number was one. Elizabeth Blackwell entered medical school in the 1840s, back when bloodletting, leeches and blistering were common medical treatments. And yet, the idea of a female doctor back then was outrageous. But Elizabeth Blackwell roped in her younger sister Emily into becoming a doctor as well.

And Janice Nimura tells the story of their unusual childhood and complicated sisterhood in her new book "The Doctors Blackwell." When we spoke, I asked Nimura what was so offensive back then about a woman studying medicine.

JANICE NIMURA: The very idea of a woman sitting in a medical lecture hall studying the body in the company of men was appalling. On top of that, if you went to a medical school well-equipped enough to offer cadavers for dissection, the idea of a woman with her hands in a corpse was also impossible. What self-respecting woman would do that, would strive for that? People thought she was either wicked or insane.

CHANG: (Laughter) Well, Elizabeth becomes the famous Blackwell sister. She became more famous than Emily, of course, because she was the first woman doctor. But what's interesting that you point out is Emily ends up being the better practitioner, a fact that kind of gets lost in history. How did Elizabeth and Emily approach the practice of medicine differently?

NIMURA: Well, Elizabeth really chose medicine not because she was drawn to medicine, but because she wanted to make a point about what women were capable of. Emily, having been invited to join her, discovered that she really loved the science, loved the technique, loved the innovation, loved thinking about how to make medical health better, especially for women. Elizabeth was always oriented more toward healing humanity than healing individual humans. And then right at the beginning of her career, she had an accident, an illness that caused her to lose one eye, which further directed her toward policy rather than practice.

CHANG: She was also - Elizabeth, I'm speaking of - she was also rigid about morality in a way. Like, she believed that disease was the result of living a morally unclean life. Of course, this was before germ theory. Tell me, were Elizabeth's beliefs about the connection between health and morality considered backwards then, or were they actually right in line with the popular attitudes of the day?

NIMURA: I would say more the latter. Certainly, she spent a little bit of time in Philadelphia at Blockley Almshouse, a large public hospital, which was sort of a warehouse for the destitute. And the prevailing wisdom in Philadelphia was, you know, that is where you ended up if you were a sinner, really - that disease was the wages of sin. Elizabeth was right in line with that. And you know, throughout her path - it's interesting to watch her trying to sort of navigate between the establishment thinking, which she had to embrace if people were going to take her seriously, and thinking about innovation and new ideas in a way that wasn't going to drive away her supporters.

CHANG: Right.

What's also interesting about both Elizabeth and Emily is that neither of them really liked people.

(LAUGHTER)

CHANG: They were both short on empathy, as you write. Neither of them needed the company of many other people. How do you think that limited them as doctors?

NIMURA: I think it limited Elizabeth more. But then again, I think, you know, her level of rigid idealism kept her going forward. You have to be an extremist in a way to make the kind of change that she made. Emily, in the end, I think was a more emotionally healthy person and more connected in the end. She - you know, she had a female partner. She had colleagues and students who really respected her in the 40 years that she spent running the institutions that she and Elizabeth had founded together in New York.

By the time the two of them both died in 1910, Elizabeth had been back in England for 40 years, and she was more of a concept than a person to the institutions she had founded in New York. Emily was their fearless leader and much beloved.

CHANG: Right.

You know, one of the most fascinating things about Elizabeth that you portray in your book is the contradiction that she embodied. Like, she was in many ways progressive - right? - a woman who refused to let her gender deprive her of opportunities. But she also looked down on women. Can you talk about that, that contradiction?

NIMURA: Yeah. To me, that's a central message of this story that's absolutely relevant today, this kind of misogyny that we won't really acknowledge among feminists. I think if we were fed truth serum, we could all think of a moment where we might not have been as generous as we could have been to our sisters. The Blackwells were trying to make a point about what women could do in a man's world, and they were very wary of any woman who might taint them by association. So this is something that we all have to look squarely at and fight against because I think it's more prevalent than anyone wants to admit.

CHANG: Yeah. I mean, Elizabeth would write things, these letters that you found, talking about how women were gossipy, they were stupid, inane. It was just so interesting that she was talking about the gender that she was trying to prove was capable, as capable as men were.

NIMURA: Well, right. She really saw women as sort of enslaving themselves, that it wasn't up to men to break their shackles. It was up to women to cast them off, to want more, to raise themselves.

CHANG: So because of this misogyny that Elizabeth embodied to an extent, how would you say Elizabeth Blackwell fits into the feminist movement of the mid-19th century?

NIMURA: Yeah, it's a good question. I mean, she was very much out of step with the suffragettes. She really disagreed with the idea that the first order of business was the vote. She thought that if women were still sort of ideologically enslaved to their menfolk, giving them the vote would really only be giving more votes to the men who would tell them how to vote. And, you know, she sort of had a point there. The leaders of the women's movement, including her own sisters-in-law, Lucy Stone and Antoinette Brown, who married two of her brothers, really wanted to bring her in and have her join them and lend her achievements to their cause. And she really actively resisted that.

CHANG: So fascinating. So ultimately, what do you think each of the sisters, Elizabeth and Emily - what do you think they each gave to the practice of medicine?

NIMURA: I think Elizabeth is the one who kind of wrenched open the door, this idea that women belonged in the medical profession. And then Emily is sort of the one who held it open because by running the institutions they founded for the last three or four decades of the 19th century, she really was the bridge between the outrageous idea that women could be doctors all the way to sort of 1899, 1900, when medical schools like Cornell and Johns Hopkins started admitting women as a matter of course. Elizabeth kind of stormed the barricade, and then Emily held the pathway until the world kind of caught up with the idea of women doctors.

CHANG: I love it. Emily propped the door open.

NIMURA: (Laughter).

CHANG: Janice Nimura's new book is called "The Doctors Blackwell."

Thank you so much for talking with us today.

NIMURA: It was a great honor.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.