 Greetings from the National Archives. I'm David Ferriero, Archivist of the United States, and it's my pleasure to welcome you to today's virtual book talk with Janice Nomura, author of The Doctor's Blackwell. Before we begin, I'd like to tell you about two upcoming programs you can view on our YouTube channel. On Tuesday March 9th at noon, we will welcome Jane Zagline, author of The Girl Explorers, the story of the founding of the Society of Women Geographers, and how key members served as early advocates for human rights and paved the way for today's women scientists. And on Thursday, March 11th at noon, Bruce Levine will be here to tell us about his new biography of Thaddeus Stevens, one of the foremost abolitionists in Congress before the Civil War and firm proponent of equal rights for black Americans during Reconstruction. In 2020, we observed the 100th anniversary of the ratification of the 19th Amendment, which secured women's right to vote in the United States Constitution. In the months leading up to the actual anniversary date, we looked at the history of the suffrage movement and learned about milestones in the pursuit of women's rights. We often start discussions about women's suffrage in 1848 with the First Women's Rights Convention in Seneca Falls, New York. A year earlier and about a dozen miles away, however, a young woman entered Geneva Medical College on her way to becoming the first woman in the United States to get a medical degree. Dr. Elizabeth Blackwell and her sister Emily, who joined her in her practice, brought medicine to women and women to medicine as a subtitle of Namora's book, Declares. Not only did they break into a profession dominated by men, they also opened an infirmary specifically for women and staffed entirely by women. Janice Namora's biography of the Blackwell sisters has already won national praise in The New York Times, The New Yorker, The Wall Street Journal, and The Washington Post. Joanna Scutz of The Times calls the book a richly detailed and propulsive biography of Elizabeth and her sister Emily Blackwell. Janice Namora is the author of Daughters of the Samurai, a journey from east to west and back, which was a New York Times notable book in 2015. She received a public scholar award from the National Endowment for the Humanities and support of her work on The Doctor's Blackwell. Her work has appeared in The New York Times, Smithsonian Magazine, among other publications, and she's been interviewed on National Public Radio's Fresh Air and All Things Considered. Now let's hear from Janice Namora. Thank you for joining us today. Thank you so much, and it's a real honor to be here with you today. I'm going to share my screen because this story is much more fun with pictures. Okay, so the Blackwells. If you are familiar at all with the name Elizabeth Blackwell, it's probably just Elizabeth and not Emily. And it's usually followed by the phrase First Woman Doctor. As you just heard, she was the first woman to receive a medical degree in 1849. Her sister Emily followed her to that distinction in 1854, and together they founded the New York Infirmary for Indigent Women and Children and the Women's Medical College of the New York Infirmary. I encountered the Blackwell story for the first time five years ago, despite the fact that I am born, raised, and live in the city where they practice, New York. I grew up at a proudly feminist girls school from the age of five. I was the math science kid there. I graduated with the intention of pursuing medicine, although I swerved. And I had never heard of them. How was that possible? Well, I went hunting for them. And discovered that the Blackwell story is not hard to find on the children's biography shelf. There are many editions of the story there. This one is from the 1940s. They all feature a young, slim, attractive, well-dressed woman with a stethoscope, bending solicitously over a grateful patient. This is the middle grade version. Same stethoscope. Nice clothes. Here's the picture book version with a younger, perky Elizabeth, but still there's that stethoscope peeking out of the bag, waiting for her to grow up. Well, these books were fun and inspirational and incomplete. Elizabeth and Emily Blackwell looked like this. In the 1840s and 50s, when they were as young and attractive as the women in these picture books, even stethoscopes would have looked like this. There was so much that was missing from these sort of lives of the saints, inspirational tales. And as I moved more deeply into the archives and started to listen to Elizabeth and Emily's voices in their own letters and journals, I discovered how much complexity and contradiction is part of this story. And I became really eager to retell it, to reintroduce these women to the present with all of their ragged edges, not just as picture book heroines. I wanted to know the whole story and not just what fits in the picture book. So what is that story? Briefly. The Blackwells, eight out of the nine Blackwell siblings were born in Bristol, England and came to this country in 1832. They were the sons and daughters of a man who was a paradox. He was both a sugar refiner and an abolitionist. Think about that for a second. He gave his five daughters the same education as his four sons, which was an extraordinary legacy at the time. And he moved them from Bristol all the way via New York to the wilds of Cincinnati in search of a way to pursue his dream of making sugar from sugar beats in the north without enslaved labor. Having gotten them all the way out to the edge of the known universe in Cincinnati, he promptly died, broke, leaving a widow and nine children to fend for themselves, and leaving his five daughters with the clear message that having a husband, however beloved, is no guarantee of security. None of his five daughters ever married. So the nine Blackwell siblings now orphaned at the edge of civilization. They really became a tribe and therefore a great gift to a biographer because they were rarely all in the same place at the same time. And they were very closely bonded to each other. So they were constantly writing to each other. And this is a glimpse at the challenges of writing 19th century biography because when when postage and paper were expensive. And for this family, they certainly were. This is what you did. This is called cross writing. This is a letter from Elizabeth from Henry Blackwell, Elizabeth's brother to her in 1844. As you can see, he has filled the page and then turned it 90 degrees and filled it again. You do get used to writing to reading this kind of cross writing and Henry especially had lovely handwriting. So this is actually not a not a bad version of it, but you can see how how it can be a daunting project. Here's a close up. Elizabeth was born in 1821. She was voraciously brilliant, socially quite awkward and blessed with a healthy sense of self worth. She admired the transcendentalist writer and editor Margaret Fuller, who in the mid 1940s had just published a bestselling book called Woman in the 19th century. This would have been very prominently placed in the Blackwell parlor. Margaret Fuller was the kind of writer they all enjoyed, excuse me. And Margaret Fuller in her book argued that humanity would not reach the next level of enlightenment until women unleashed their own power and proved their independence. According to Margaret Fuller, women could do anything. It was a matter of talent and toil. It was not a matter of sex. Women could be sea captains if they wanted to be. And young Elizabeth, hearing this, it really resonated with her. She thought of herself as someone whose life could prove Margaret Fuller's point, whose life could be a beacon to other women and help raise humanity to a new level. So she chose medicine, Elizabeth did, and it was an interesting choice. It wasn't because she loved science or particularly wanted to heal the sick. She thought sickness was a sign of weakness. She thought bodily functions were disgusting. But medicine in this moment was an unusually clear way to prove her point. Medicine was redefining itself both scientifically and institutionally in the mid 19th century. Hitherto it had been considered more of a trade, the trade of midwives and barber surgeons. Now increasingly it was a profession, a profession of men who were credentialed by virtue of having attended a medical school. And increasingly there were medical schools in America. So Elizabeth thought if I can find my way to a medical school and attend all the lectures and pass all the examinations, who can argue that I am not as qualified as any man to be a doctor? And as this cartoon from the 1820s suggests, medical education at this moment was not the daunting academic challenge that it is today. Medical school consisted in that moment of two identical consecutive 16 week terms of lectures. If you were lucky you got to do a little bit of dissection, but you could graduate from medical school without ever having interacted with a living patient. Elizabeth had some confidence that given her own intellectual abilities if she found her way to a medical school, she would have no trouble succeeding once she got there. So at the age of 26, Elizabeth Blackwell wanted mission to a tiny rural medical school in Geneva, New York, as you just heard in the Finger Lakes region of Western New York State. This campus has since evolved into Hobart and William Smith colleges, if you are familiar with them. On the left, the medical department, as it would have looked when she was there, that building no longer stands, and on the right is the spot where it once was. Elizabeth's admission to Geneva College was something of a farce. She had been studying privately with a prominent physician in Philadelphia who had written her a letter of recommendation. She had already amassed a sheaf of rejections from all of the more mainstream medical schools. And when her letter of application and her letter of support from this Philadelphia doctor reached Geneva, the faculty of tiny Geneva College wasn't quite brave enough to reject the word of this Philadelphia physician out of hand. So they punted, they punted the question to the students and said, here's this outrageous request for a woman to come and study among us. We think you students should decide whether it is all right for her to come or not. If one of you has any objection, she won't come. And they figured that would keep them safe and kick the ball down the road. The students, recognizing that this was an opportunity to have some serious fun, unanimously returned the answer that yes, she should definitely come. They assumed it was a prank being cooked up by a rival medical school. The very idea of a woman studying the processes of the body in the company of men was so outrageous that most people couldn't imagine that this was a genuine request. Then they promptly forgot about it until three weeks later when Elizabeth Blackwell walked into the lecture hall. She graduated at the top of her class in 1849 and her thesis was the lead article in the Buffalo Medical Journal. Her thesis on ship fever, which she had received some exposure to by virtue of spending time at Blockley Alms House in Philadelphia in between her two medical terms. She needed some practical training though because as I mentioned, you could graduate from medical school without very much. So like many American medical graduates, she went to Europe, which was where the real centers of medical education were. She went to Paris to a public maternity hospital called La Maternité, which still stands. It was housed in this convent. It was here in a public hospital where serving the destitute because if you had any money at all, you would have delivered your child at home serving a population of poor women that she began to make a connection between poverty and disease and to have a growing sense of the importance of public health. It was also here that she underwent a crisis that changed the shape of her career, if not its direction. She contracted from a patient an infection that led to the loss of one eye. Many of the women in this in the patients in this hospital were infected with venereal disease and an infant that was born to one of them contracted gonococcal conjunctivitis. Elizabeth was tending to this infant and some of the washing water splashed into her own face and she was quickly confined to a bed in the hospital in which she had been working because although today with antibiotics, this would not have been a terribly serious thing to heal. In 1849, when it occurred, it was a catastrophe. She was confined to bed and put under the care of the wonderfully named Hippolyte Blow, an attending physician at the maternity hospital that she had become friendly with. This is one of those moments where the biographer has different accounts to draw from and needs to kind of braid together different perspectives in order to arrive at something that approximates the truth. Elizabeth was friendly with Dr. Blow and 50 years later in her own memoir she wrote about this crisis of health this way. How dreadful it was to find the daylight gradually fading as my kind doctor bent over me and removed with an exquisite delicacy of touch the films that had formed over the pupil. I could see him for a moment clearly but the sight soon vanished and the eye was left in darkness. It sounds almost like a romance novel. However, at the same time in Paris happened to be Elizabeth Blackwell's eldest sister Anna, another pioneering Blackwell sister who as this portrait suggests wonderfully was something of a drama queen. She was a journalist and rushed to Elizabeth's bedside to help look after her. She spent all day looking after Elizabeth in the hospital and then at night she would go home to write letters reporting on her sister's condition to all the rest of the Blackwells back in America. This was what she wrote. The pupil presents just now the appearance of one of those little misshapen Blackberries of three granulations and half dried up that one sees so often on some scrubby little bush. If you can fancy one such in dull looking lead you have just the appearance of this poor eye. A very different account and that it becomes the job of the storyteller to braid these together. Elizabeth eventually lost one eye was fitted for a glass prosthetic. If you look closely at this portrait you can see that there's an asymmetry in her gaze but most people were not aware of her disability. She never spoke of it. But it did orient her more and more toward public health and policy and away from practice. Surgery was now not an option for her with her reduced vision and even reading could be painful sometimes. So more and more she was moving away from practical medicine and toward public health. Did she go home to convalesce with the rest of the Blackwells in America? She went on from Paris to London to seek further training at St. Bartholomew's Hospital, another large public institution. And there introduced by mutual friends she made a fateful acquaintance. She met Florence Nightingale. This is 1851 so Florence Nightingale is not yet the global celebrity that she became after the Crimean War. She is a young woman from a wealthy family chafing against the expectation that she settled down and get married. And I like to think of her encounter with Elizabeth Blackwell as a catalyst for her own extraordinary career because here is a young woman come from America turning her back on marriage and motherhood with a medical degree studying medical practice all over Europe. To Florence Nightingale this must have seemed like an amazing confirmation of her wildest dreams. The two hit it off and really enjoyed spending time together and discussing their big ideas for the future. Although they did quickly hit a divergence in their opinions. Florence Nightingale really believed that the place of women in health was as nurses and Elizabeth Blackwell wanted to demonstrate that a woman could be a doctor. But Nightingale's ideas about hygiene and sanitation became very important to Elizabeth Blackwell's work and they always kept in touch throughout their lives. After finishing her training Elizabeth Blackwell chose to return to New York where she assumed that she would have a thriving practice of women who wanted to consult a female doctor. But in this she was wrong because in 1851 when she returned to New York the very phrase female physician did not mean bright young woman with a medical degree. It meant someone like Madame Rastelle the notorious Fifth Avenue abortionist. Someone who worked on the wrong side of the law in the shadows. This is a caricature of her in the National Police Gazette showing her as a demon eating a baby. You did not as a respectable woman you did not consult a female physician that had a taint of scandal. So nobody came to call upon Elizabeth and consult Dr. Blackwell. Meanwhile Elizabeth had sort of anointed her younger sister Emily five years younger to follow her into medicine. Elizabeth realized that medicine was going to be a lonely and arduous path for a woman and she wanted some company. She esteemed her own family more than just about everyone else in the world and so she chose Emily as her most brilliant sister and next youngest one to follow her. And Emily who was already showing inclinations towards science decided to say yes to this and actually became the more brilliant scientist and practitioner because she was really drawn to medicine itself the practical side of it not just the idealistic side. Emily who was actually the more talented one had to fight even harder for admission because in the wake of Elizabeth's success the male medical schools closed their doors ever more tightly against women and meanwhile female medical colleges had begun to emerge so no men's medical college needed to accept a woman anymore. Emily however wanted a credential as impressive as her sisters and eventually fought her way toward study at Rush in Chicago. After a year at Rush they asked her not to come back because the discomfort of having a woman with them was too great. Undaunted she continued and finished up at Cleveland Medical College which has now evolved into Case Western. Then she too needed practical experience so off she went to Europe to Edinburgh where she became one of the assistants of the prominent physician James Young Simpson he was an obstetrician and gynecologist he was a physician to the Queen he was a professor at the University of Edinburgh he was the man who had discovered the anesthetic properties of chloroform he was a very big deal he was also something of a showman and it was pretty clear that he enjoyed the shock value of having a woman among his assistants. At the same time he very much respected Emily as a medical talent and taught her a great deal. He taught her some of the tools of his trade including instruments like these a stem pessary which would have been used in cases of uterine prolapse for women who had had too many pregnancies the instrument below that is one that he invented Simpson's uterine sound an instrument used to measure the dimensions of the cervix Emily is learning how to use these and writing about them constantly home to Elizabeth who is languishing in New York waiting for patients who do not come you can see on the left side of this letter Emily's sketches of the instruments that you just saw in the previous slide teaching her sister everything that she is learning in Edinburgh from the start it was important to me to make this book a story of both sisters and not just Elizabeth Blackwell first woman doctor but it's difficult when you are writing a double biography when one subject is more prominent than the other Elizabeth wrote more, more was written about her being first will always draw the attention toward you so what do you do when the material about your second subject is not quite as robust one of the things you can do is read their writing and then go and follow them around Emily Blackwell was writing copiously about her experience in Edinburgh so I went to Edinburgh and followed in her footsteps as much as I could to try to expand on what I understood about her experience which was both fascinating and extremely fun this is 52 Queen Street James Young Simpson's home which still stands it's the only one in the row with an extra story because his household was bursting at the seams this is where Emily would have come every day to his consulting rooms to assist with his patients the day I walked by the door was open so in the spirit of following in the footsteps I walked in it's now a I think it's a drug counseling centre so I wasn't exactly trespassing on private property but I was able to wander around on the bottom floor a little bit and get a sense of what Emily would have confronted every day when she walked in including James Young Simpson's initials still worked into the banister of the staircase it's these details I think that really enlighten what you know about someone's experience the Royal College of Surgeons in Edinburgh has a wonderful pathology museum full of artifacts I wasn't allowed to take photos but this is a sense of my notebook in the middle there on the left is James Young Simpson's pill case which says please return to 52 Queen Street under the lid on the lower left his monoral stethoscopes in Ivory and Rosewood I liked to think that maybe Emily had held these very instruments in doing examinations on the patients who came to Queen Street they even had the decanter in which the chloroform had been held when James Young Simpson discovered its properties of anesthesia Emily is learning to be a doctor in Edinburgh and a very good one but it doesn't protect her from the same kind of satirical snark that her sister Elizabeth has previously come in for this is a cartoon from the London satiric newspaper Punch from the end of Emily's time in Edinburgh it is meant to depict Emily on the right wearing the scandalous bloomer costume of the women's rights activists and a ridiculous hat a rather mannish profile peering through spectacles at the only patient who would ever consult a woman doctor, namely a lap dog being clutched in the arms of a much more conventionally feminine and appropriate young woman the accompanying article said something about women doctors only really being good for taking care of their husbands and children because what they should really do is get married Emily and Elizabeth happily were fairly immune to this kind of ill will Emily finishing her time in Edinburgh joins Elizabeth in New York City and together they found the New York infirmary for indigent women and children in a building that still stands in Greenwich Village as it was on the left and as it is today it was the first hospital staffed by women and their intention was not just to give women a place to consult doctors of their own sex but also to be a place for the slowly growing numbers of female medical graduates to consult to get the practical experience that they couldn't find otherwise without having to go to Europe I was privileged to get to know the woman who owns this building and see inside it I actually wrote the chapter about the infirmary inside the building it's undergoing a restoration and so you can see the original sash windows the original hearths, the brick work, the rafters being inside the spaces where the history takes place it makes it feel a bit like the veil between past and present is especially thin as you might expect the Blackwells played a prominent role in the Civil War just after shots rang out in Fort Sumter in 1861 the sisters called a meeting at their infirmary of their donors and supporters and drafted this appeal for the New York Times to the women of New York and especially to those already engaged in preparing against the time of wounds and sickness in the Army in response to this appeal thousands of women gathered at Cooper Union another building that still stands in Lower Manhattan out of this incredible meeting grew an organization called the Women's Central Association of Relief and out of that organization called the U.S. Sanitary Commission so if you like you can draw a fairly straight line from Elizabeth and Emily Blackwell's living room to the most important civilian organization of the Civil War Elizabeth and Emily became the ones in charge of the committee that whose job was to vet and train young women to be nurses at the front they threw themselves into this work they thought at last this felt very much like the world Margaret Fuller had imagined of men and women alongside each other for the greater good but they were quickly disillusioned because it became clear that New York's male physicians were not all that interested in working alongside female doctors as colleagues they preferred women to stay in more familiar roles of nurses or organizers and the Blackwells began to feel a bit slighted in Washington the lead leadership role for a woman named Dorothea Dix who was not a medical professional in any way she was a lobbyist and an organizer but the Blackwells did not have a whole lot of respect for her Elizabeth Blackwell was known to refer to her as the meddler in chief because of all this the Blackwells eventually withdrew their support for the war effort and turned their attention to a new project a rather ironic project Elizabeth and Emily Blackwell had no real respect for the women's medical colleges because they thought they turned out an inferior product but they believed firmly that women should study medicine alongside men but as long as inferior women's medical colleges existed the men were not going to accept women to study alongside them and so this was a frustrating impasse and in the end they changed their minds and the Blackwells sisters decided yes they would open their own women's medical college they were more rigorous than even the ones they themselves had attended it had a degree of rigor that was far higher it was a longer program the courses did not repeat they built on each other there was more practical bedside experience so that's the arc of the Blackwell sisters professional lives but personally their lives were just as interesting both sisters adopted daughters Emily lived with her partner and female and fellow surgeon Elizabeth Cushier two of the Blackwells brothers married two of the most prominent feminists of the day Lucy Stone a suffrage activist and Antoinette Brown the first woman to receive to be ordained as a minister in this country to complicate matters further Elizabeth and Emily didn't really agree all that much with these women's rights activists who had now joined their own family the Blackwell sisters were somewhat out of step with the women's rights movement as it emerged largely because they didn't believe that suffrage should be the first priority according to Elizabeth was fairly vocal in saying that giving the vote to women before they had established their own independence was essentially giving more votes to men who would tell their women how to use the vote she thought that was wrong headed that's part of the complication of this story is that it isn't necessarily what you'd expect as a story of emerging trailblazing women Elizabeth and Emily didn't agree with their sisters in law and they didn't always agree with each other either they even though they built the infirmary and the women's medical college together they disagreed somewhat about what it meant to be a woman doctor but Elizabeth again public health was more important she believed that a woman doctor should be a teacher armed with science while Emily really believed that a woman's role as a doctor was to be a physician and surgeon and medical professor as talented as any man so after these institutions were founded and with some relief the sisters parted ways and spent the last four decades of their lives on separate continents Elizabeth went back to England where she had always wanted to return and did a lot more lecturing and writing than actually seeing patients Emily remained in New York and ran the institutions that they had founded with great skill until the end of her career ironically supporting her sister's legacy it's usually just Elizabeth so that's the outline of the story and please if you have any questions about it please do feel free to put them in the chat and I'll get to them in a minute this moment as we celebrate the inauguration of our first female vice president and as we all focus intensely on public health it feels like a particularly good one for the Blackwell story I like to finish with this photo as a meditation on what the Blackwell story can mean in this moment if you Google Elizabeth Blackwell and you go to images this photo comes up every time it graces the covers of biographies it's on websites and articles documentary films it comes up all the time it is a beautiful photograph of a woman who seems to be contemplating an exciting future it is not Elizabeth Blackwell how do I know that? well if you flip it over you know that it was taken by Dana's photo portrait gallery in New York on 14th Street and 6th Avenue a studio which did not exist until the mid 1880s when Elizabeth Blackwell would have been in her 60s this clearly is not a woman in her 60s it's probably one of her nieces but it's interesting to me that the misidentification persists why is it that everyone wants this to be Elizabeth Blackwell? I think it's because this is how we like our heroines to look we like our heroines to be adorable we like them to be likeable and I think the Blackwell story is about women who really didn't care what the world thought of them they wanted to prove a point they wanted to be excellent they wanted to change the world and they were prickly and contradictory and complicated and very real heroines so I think it's a wonderful moment to reflect on them and to try to do a little better at accepting at admiring women women and men who aren't necessarily always admirable but are always human I'm gonna stop the share right now and take a look and see if we have any questions here's one Elizabeth became a doctor to move society to the next level of enlightenment but resisted women's suffrage and contraception do you have any sense of how she thought enlightened society would work? that's an excellent question Elizabeth Blackwell lived at a level of idealism that was often out of touch with anything that was practical the questioner points to the fact that she resisted the idea of contraception it's true, she believed that it was important to limit family size but that women should just do that by saying not tonight, dear which was impractical she, you know, as someone who remained unmarried did not have children of her own stayed sort of to one side of a mainstream experience for a woman women's suffrage was often a little bit out of step with what practical life really looked like I think having read Margaret Fuller she really believed in a world in which men and women would eventually walk shoulder to shoulder sharing work and leisure she was very interested in the work of Charles Fourier who espoused a kind of utopian philosophy called associationism in which people would form ideal communities called phalanxes and she was always talking and thinking about that but in fact I think she had trouble ever finding the people who were perfect enough in her opinion to join her in such a community her idealism kept her from being able to collaborate and that was sort of both her triumph and her tragedy in a way I wonder if there are any more questions or comments well I appreciate the time and I'm hoping that you enjoyed this and to know that there are so many more stories that I did not have time to get to and I hope you'll explore them in the book thank you so much for having me