The Doctors Blackwell: How two pioneering sisters brought medicine to women--and women to medicine

Nimura, Janice

Primary Category: Literature / Nonfiction

Genre: Biography

Annotated by:
Martel, Rachel
  • Date of entry: Feb-19-2021


The Doctors Blackwell begins with an account of an auspicious new beginning—the opening of The New York Infirmary for Indigent Women and Children, the first women’s hospital staffed by female physicians. Founded in 1857 in New York City by Drs. Elizabeth and Emily Blackwell with the express purpose of providing clinical experience to female physicians, the hospital was a landmark achievement in the long struggle for parity in medical training. The Doctors Blackwell goes on to trace the history of the institution and of its two founders, themselves trailblazing members of the medical profession as the first and third women to earn medical degrees in the United States.

Two of nine children born to abolitionist, Protestant dissenters in Bristol England, Elizabeth and Emily Blackwell were the recipients of a strict moral upbringing. While successful in instilling the values of education and hard work, their childhood also left them socially awkward and with the sense that they were both morally and intellectually superior to those outside of their family. When the Blackwells emigrated to New York City in 1832 and then on to Cincinnati in 1838, their social circles were confined to religious and abolitionist advocacy. Yet soon after the family arrived in Cincinnati their lives were upended by the passing of their father, Samuel Blackwell. With their mother and six siblings to support, the three eldest Blackwell daughters-- Anna, Marian, and Elizabeth-- took up teaching until their younger brothers were old enough to support the family.               

Elizabeth, morally principled to a fault, studious, and determined to succeed intellectually, found teaching to be an unfulfilling means of channeling her energies. Having forsworn marriage at the age of 17, she longed for something challenging and admirable upon which to focus her formidable intelligence. When a dying friend suggested that she become a physician, because she herself would have appreciated a female doctor tending to her disease, Elizabeth’s interest was piqued. Yet her attraction to medicine was rooted not in a desire to help the ailing (indeed she viewed illness as a form of weakness), but in an ideological quest to prove that women were capable of achieving the same distinctions as any man. She saw herself as a moral crusader with the goal of uplifting all of womankind.              

Beginning in 1844, Elizabeth leveraged her teaching connections to gain the backing of several prominent male physicians. Yet the all-male world of medicine remained stubbornly closed to her, and it wasn’t until 1847 that she was admitted to the Geneva Medical College in upstate New York, an event that caused a stir in the medical community and beyond. Isolated both from her male classmates and from laypeople, who viewed her at best as an oddity and at worst as a dangerous anomaly,  Elizabeth nonetheless became a figure equally admired and reviled by the public.  Her reputation as the first “lady doctor” preceded her, even as she gained the respect and admiration of the faculty at Geneva College and distinguished herself with additional training in Europe.                    
Meanwhile, the trials of Emily Blackwell, whom Elizabeth encouraged to follow in her footsteps, illustrated that far from breaking down the doors that barred women from medicine, Elizabeth’s admittance may only have served to seal them more tightly. Elizabeth was viewed as a notable exception to the general rule that women were unfit to practice medicine, and her male colleagues were uneasy at the thought of being replaced. But after a prolonged struggle, Emily succeeded in obtaining her medical degree from Cleveland Medical College and joined Elizabeth to hang up her shingle in New York City.              
Increasingly frustrated by the difficulty in recruiting private patients to be seen by female physicians and by the dearth of clinical opportunities for the growing number of women in the field, Elizabeth and Emily opened their own hospital and medical school with the help of female philanthropists. Elizabeth’s philosophical zeal combined with Emily’s true love and aptitude for medicine proved to be a dynamic combination. Their contributions to the field not only changed the way that medicine is practiced, but also paved the way for generations of female physicians. Today, just over fifty percent of the nation’s medical students can trace their acceptance into the profession to the dogged determination of these two extraordinary women.   


In telling the story of the Blackwell sisters, Nimura explores what it means to be a women’s rights activist, and whether intention matters when examining the legacy of an historical figure. While Elizabeth Blackwell was steadfast in her belief that women are inherently as intelligent and capable as men, she continually disparaged the character of most women she met. Rather than examining the male-run and -propagated institutions that enforced female subjugation, Elizabeth blamed other women for being silly and frivolous and thereby making their own advancement an impossibility. She placed the blame squarely on her female counterparts and not on men, even rejecting the burgeoning women’s rights movement as “anti-man.” In working to succeed within existing institutions rather than striving to dismantle the foundations of sexism from the ground up, Elizabeth presents an example of a visionary who remained blinded by the confines of society’s existing power structures. And she presents a quandary for readers—should we revere someone who demonstrated heroic levels of courage and perseverance in the face of gargantuan obstacles to success, but who nonetheless subscribed to the archaic ideas that raised those obstacles in the first place? Ultimately, Nimura presents a nuanced picture of a woman who was by no means perfect, but whose ideas were the catalyst for enormous positive change.              

Nimura also touches on several issues that remain relevant for today’s medical students who identify as underrepresented in medicine. As a student at Geneva College Elizabeth was extraordinarily isolated. She recruited her sister Emily to follow in her footsteps partly because she simply longed for the companionship of another woman who shared her aspirations and interests. Elizabeth’s struggles highlight the need not only for support and mentorship for women and underrepresented minorities in fields that are traditionally dominated by white men, but also for the comfort that comes with recognition of a shared identity. Additionally, both sisters strove for perfection because they knew that in order to succeed there was no alternative. Nimura writes that Elizabeth’s “strategy for acceptance was to leave no opening for criticism” (Nimura 123). And when Elizabeth and Emily founded their women’s medical college, they pioneered a curriculum that that was far more rigorous than that of any male medical school in existence, knowing that was the only way for their graduates to have any hope of legitimacy. The constant stress of isolation and of having to prove themselves was exceptionally taxing for the Blackwell sisters, and demonstrates the disproportionate toll that is placed on all minorities in the medical field. The fact that nearly 200 years later these issues remain salient for a growing number of medical students is indicative of work that remains to be done.            

Nimura also examines the ways in which the image of the female physician was sanitized so as to be acceptable to men and to the general public. Elizabeth and her supporters made the argument that women were ideally suited to be physicians because of their naturally compassionate nature and because women would be more comfortable presenting obstetrical and gynecologic complaints to other women. Additionally, as female physicians were expected not to marry, the field of obstetrics was a way in which they could maintain their respectability by remaining identified with motherhood. Yet as soon as Elizabeth and Emily are introduced, Nimura makes it clear that the sisters are interested in medicine as an intellectual exercise, not out of an abundance of empathy towards the ill. They inwardly stood in almost complete opposition to the societal ideal of a female physician, but outwardly conformed in order to gain financial backing. Again, the parallels that can be drawn between the experience of female physicians today and that of the Blackwell sisters is dishearteningly striking. Women remain overrepresented in the fields of pediatrics and obstetrics and gynecology and underrepresented in fields such as surgery. It remains disproportionately difficult for female physicians to both have families and practice medicine. And many women find themselves in a work environment that prioritizes a traditionally male standard to which they must conform.            

The Doctors Blackwell is a tale of enormous progress that also serves to highlight the boundaries that remain to be broken. While certainly not the ideal feminists that many have painted them to be, the Blackwell sisters’ audacious pursuit of a better life for themselves and for all women is a moving testament to the powers of persistence and resolve. They withstood enormous pressure in order to continue on the path that they knew was right. In this respect, every physician would do well to emulate them as we push medicine towards a more just and equitable future.  


W.W. Norton & Company

Place Published

United States

Page Count