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Women -- Or the Female Factor

During the Gay 'Nineties, women were generally considered too frivolous and delicate to handle full-strength medical education, with its gory emphasis on human anatomy and disease. So people were understandably shocked when word spread in 1893 that there were three women in Hopkins' first medical school class. The step was revolutionary - except for a few women's colleges, very few American medical schools of any stature then allowed a woman to take a degree.

Not that Hopkins' founders intended from the start to be so egalitarian. Late 19th century America was a sexist society. Although Daniel Coit Gilman, the University's first president, did push strongly for first-class schooling for women (he helped found Goucher College in Baltimore), he sided with his friend Charles Eliot, president of Harvard University, who called coeducation "a thoroughly wrong idea which is rapidly disappearing."

(Pressed by Hopkins University trustees, who in 1874 called on him as a consultant to explain why he disapproved, Eliot ticked off four reasons: students might fall in love, which could produce disastrous, socially unequal marriages; women would have trouble keeping up with the academic pace and hold up instruction for the men; the stress could prove so severe that the women might fall ill and destroy their chances of good marriages; and finally, a woman's future was so different from a man's that there was no point in educating them together.) For his part, Gilman admitted in his University inaugural address that he did not want to expose women "to the rougher influences which I am sorry to confess are still to be found in colleges and universities where young men resort."

Likewise, the medical school's first professor and dean, the bachelor William Henry Welch, privately told friends he would be too embarrassed to discuss medical matters with a woman sitting in his lecture hall. And the idea of admitting women never seemed to have occurred at all to the medical institutions' chief planner, John Shaw Billings, who, in all his writings of the future medical school, consistently referred to medical students as "young men."

But practicality, unforeseen events and even desperation forced these men to rethink their views in 1890. The medical school was supposed to have opened at the same time as the Hospital, in 1889, but it turned out there was no money for it. Income from the University's B&O Railroad stock, which founder Johns Hopkins had expected would cover operating costs, had dried up the year before. Despite the delay, Hopkins trustees had lined up the school's four premier professors. When the doctors showed up but found no school to teach in, Harvard, McGill and the University of Pennsylvania kept trying to woo them away.

So Hopkins leaders listened when four of the original University trustees' daughters - Martha Carey Thomas, Mary Elizabeth Garrett, Elizabeth King and Mary Gwinn, all unmarried, wealthy, well-educated and devoted to the new feminist movement - offered a deal. They would raise the $500,000 needed to open the school and pay for a medical school building, but only if the school would open its doors to qualified women. Arguments ensued, the pragmatists won out, and the women were given the go-ahead to try.

When the money was in hand by Christmas Eve, 1892, the Women's Fund Committee added a strategic twist, making new demands that even the staunchest opponents of a coeducational school could not reasonably refuse. Garrett - who as daughter of the head of the B&O was able to donate about $350,000 to the effort herself - presented a list of stiff entrance requirements that would have to be met by any Hopkins applicant, male or female: proof of a bachelor's degree, proficiency in French, German and Latin, and a strong background in physics, chemistry and biology. Hopkins' leaders were taken aback; most of the demands appeared to have been lifted directly from an early letter by Welch to University President Gilman - suggestions that even Welch, after he hired on, admitted he thought were impossible goals.

"She naturally supposed this was exactly what we wanted," Welch wrote of Garrett to his colleague, Harvey Cushing, in 1922.

"It is one thing to build an educational castle in the air at your library table, and another to face its actual appearance under the existing circumstances. We were alarmed, and wondered if any students would come or could meet the conditions, for we knew that we could not. As Osler said, 'Welch, it is lucky that we got in as professors; we could never enter as students.' "

Thus, the women revived ideals that were almost shoved away in some dusty library-table drawer, and assured that Hopkins would set a new, unprecedented standard in American medical education.

But first they needed help, on a national scale. The committee, which had been joined by another friend, Julia Rogers, had recruited fund-raising help from among the nation's most influential and wealthy women: Mrs. Grover Cleveland, Dr. Elizabeth Blackwell (the first woman ever to graduate from an American medical school, the Geneva College of Medicine in upstate New York, in 1849), Julia Ward Howe, Alice Longfellow, Clara Barton, Mrs. Alexander Graham Bell and Mrs. J. Pierpont Morgan.

In the end, Welch was the only Hopkins doctor who declined to sign a letter asking the trustees to accept the women's offer of financial help, and he doubtless felt vindicated when one of the three women who enrolled in the first class, Cornelia 0. Church, dropped out in her third year after deciding to become a Christian Scientist and another, Mabel Glover, became engaged to her anatomy professor, Franklin Paine Mall. (This prompted Osler to joke in an 1895 lecture at Harvard about Hopkins' experiment in medical education: "As to the women students it has been a great success, 33 1/3 percent of them were engaged to their professors at the end of the first year.") Mary S. Packard, a Vassar graduate, was the only woman in that class to get her medical degree.

By the turn of the century, though, Welch had come around.

"The necessity for coeducation in some form," he wrote later, "becomes more evident the higher the character of the education. In no form of education is this more evident than in that of medicine ... we regard coeducation a success; those of us who were not enthusiastic at the beginning are now sympathetic and friendly."

Welch even chaired a women's suffrage meeting, though he couldn't bring himself to say outright that he believed women ought to be able to vote.

Ironically, the standards of excellence and equal treatment of women that assured high-quality medical training for Gertrude Stein appear in the end to have played against her when it came to getting a degree in 1902. Stein is said to have had a reasonable grasp of science but also an incorrigible habit of weaseling out of course requirements. Her final research assignment, on development of an embryo brain, was to determine whether Stein would graduate. She was failing obstetrics, and this was her last chance to redeem herself. According to Dorothy Reed, who had graduated two years earlier, "She could do nothing with her hands, was very untidy and careless in her technique and very irritating in her attitude of intellectual superiority which was marked even in her youth."

The rather astounding results of Stein's research project so confounded her examiners that they asked a woman resident, Florence Sabin, to review them.

"Either I am crazy or Miss Stein is," said Franklin P. Mall, the anatomy professor, who apparently had wanted to give Stein the benefit of the doubt. "Will you see what you can make out of her work?"

Sabin, who had completed a similar project when she was a student, saw that Stein had made a major technical mistake that distorted the entire experiment; her work landed in a trash can and she was out of school.

Among the illustrious female students and faculty at Hopkins:
Florence Sabin (Hopkins M.D.- 1900), first woman appointed full professor in the School of Medicine, in 1917. A bronze statue of Sabin stands in the gallery of the U.S. Capitol, from the state of Colorado, where she headed the state's public health department from 1944 to 1953, honoring her many contributions to anatomy and histology. Sabin had, early in her career, raised the ire of fellow anatomists by presenting experimental results that cast doubt on the prevailing theory of how the lymphatic system is formed. She refused to back down, and her indisputable demonstrations, using tiny pig embryos, forced worldwide acceptance of a corrected view of lymphatic development. Sabin was the first woman elected to the National Academy of Sciences, in 1925, and the first woman president of the American Association of Anatomists.

Helen Taussig (Hopkins M.D.-1927), the pediatric cardiologist who came up with the idea for the "blue baby" operation for defective hearts, which launched the field of modern heart surgery. Noted for her gentleness and warmth with young patients and their parents, Taussig overcame dyslexia to become perhaps the best-known woman physician in the world. She made basic contributions to understanding how normal and congenitally abnormal hearts function, and her warnings in 1962 are largely responsible for preventing a thalidomide disaster among American newborns.

Ironically, if Taussig's father, an economics professor at Harvard, had had his way, she would have received a doctorate from the Harvard School of Public Health, which he felt was more appropriate for a woman than a medical degree. But when his daughter dutifully applied to that school, the dean told her she could only take courses; he wouldn't admit her into the program.

"Who is going to be such a fool," she remembered asking him, angrily, "as to spend two years studying medicine and two years more in public health and not get a degree?"

"No one, I hope," the dean replied, to which she retorted:

"Doctor, I will not be the first to disappoint you."

Years later, in 1949, she told a group of women medical students what she thought it was like to work in a field dominated by men:

"If your work is good enough, men will respect you and will grant you what is due you. Hitch your ideals to the stars. Although you will never attain them, they will carry you a long way and you will go farther and with greater joy."

Taussig was the first woman member of the Association of American Physicians and the first to be awarded its Kober Medal. She received the Presidential Medal of Freedom from President Lyndon Johnson.

Caroline Bedell Thomas (Hopkins M.D.-1930), the cardiologist who developed the first preventive treatment for a major form of heart disease by using the drug sulfanilamide to break the destructive cycle of rheumatic fever. Thomas also designed one of the nation's longest-running studies to find early predictors of disease, suicide and long life. Thomas was one of the first women elected to the Association of American Physicians.

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