At the end of February 1844, Elizabeth, now twenty-three, left her family for the first time and boarded a riverboat, watching with growing dismay as it slid west past Louisville and beyond what she recognized as civilization. “Madam, we have reached Henderson,” a crew member announced at last, pointing out Elizabeth’s new home: “three dirty old frame buildings, a steep bank covered with mud, some negroes & dirty white people at the foot.” The town of Henderson, Kentucky—four days down the Ohio River and across the border into slave territory—was in need of a schoolmistress.
Elizabeth was soon installed in the drafty brick house of one of Henderson’s first families, who were perhaps too assiduous in their hospitality. “I who so love a hermit’s life for a good part of the day,” she wrote, “find myself living in public & almost losing my identity.” Upon her arrival, they sat her by the fire to warm herself—and then, to Elizabeth’s horror, “placed a little negro girl before me as a fire screen.”
Her domain was a chilly, dirt-floored schoolhouse and twenty-one girls who regarded their new teacher with some awe. “I give as far as I can learn universal satisfaction,” Elizabeth wrote. “Indeed I believe the people are a little afraid of me, particularly when they see me read German.” She cultivated this imposing aura, as there was nothing worse than socializing with Henderson’s notables or, as she put it, “striving dreadfully to take an interest in their little miserabilities.” Elizabeth didn’t mind her students, but she was mightily bored by the tobacco-stained provinciality of Henderson, untouched by anything approaching Transcendentalism. “Carlyle’s name has never even been distantly echoed here,” she complained to Marian, citing her favorite Scottish satirist. “Emerson is a perfect stranger, & Channing I presume would produce a universal fainting-fit.”
She found comfort in solitary walks by the river, only to find, as the weather warmed, that her preferred destination was known to courting couples as Lover’s Grove. Not that she wasn’t courted herself, she was quick to point out. “I had many offers of an escort thither and as many beaux as I might desire,” she insisted, but she found carving initials and coy verses on the “unfortunate locust trees” unbearable and had no qualms about saying so. “I laughed at them & their sentimental doings & have had no invitation since,” she wrote, defiant. She may have forsworn marriage at seventeen, but as one who hated to be underestimated—or worse, pitied—she continued to assert that the choice had always been hers.
How could she possibly find a soulmate among people who owned human souls? Years of involvement in the antislavery cause had not prepared her for daily life among enslaved people. “To live in the midst of beings, degraded to the utmost in body & mind, drudging on from earliest morning to latest night,” she wrote, “blamed unjustly & without spirit enough to reply . . . with no hope for the future, smelling horridly & as ugly as Satan—to live in their midst, utterly powerless to help them, is to me dreadful.” She was dismayed by her own contradictory feelings—as much as she abhorred the institution of slavery, she found herself more comfortable, or at least less uncomfortable, in the company of Henderson’s slave owners, even as they prided themselves on their own benevolence. “I endeavor in reply to slide in a little truth through the small apertures of their minds,” Elizabeth wrote, but the effort of controlling her disgust took a toll. “I have an intense longing to scream,” she told Marian, “& everybody here speaks in a whisper.”
She lasted six months. But the experience of earning a salary, answerable only to herself, was formative. “I feel independent for the first time in my life,” she wrote.
Just before Elizabeth left for Henderson, Anna set off in the opposite direction, back to New York to teach music at St. Ann’s Hall in Flushing, a luxurious new girls’ school as grand and elegant as her own self-image. She sent ravishing descriptions of her new situation—a becolumned three-story mansion on grounds that included gardens, a riding ring, and an archery range—back to Cincinnati, mentioning in particular her employer, the Reverend John Frederick Schroeder, a prominent Episcopal figure.
Midway through her first term, Anna summoned Emily, now seventeen and struggling to continue her education in Cincinnati. The eminent Dr. Schroeder, Anna reported triumphantly, had enthusiastically seconded Anna’s suggestion that Emily come to St. Ann’s, being himself, according to Anna, “very fond of drawing out the talents of girls of Milly’s age.” Emily consulted Elizabeth in Henderson. Should she continue to teach and help at home or seize this rare chance to study? The Blackwells had moved to a house near the Beechers in suburban Walnut Hills, with more room but also more housework. Lately, Emily confessed to Elizabeth, “I have felt as though caught in a crime, if Marian found me before supper with a book in my hand.”
Elizabeth’s response was immediate. “Go by all means,” she wrote, for the first time expressing her high estimation of her younger sister’s potential. “When you’ve finished your studies, we may perhaps join together in some undertaking, & make the cash come in like a perfect Croton river, what fountains and baths we’ll establish in our domestic city, how we’ll wash away all trouble & annoyance & make all clean and fresh.” The undertaking in question had yet to present itself, but Elizabeth clearly saw Emily as a partner in it, whatever it might be.
And so in the late summer of 1844, just as Elizabeth returned from Henderson, Emily left for New York. Determined not to squander her good fortune, she toiled through compositions and Bible lessons, impressing Dr. Schroeder as a “ ‘crack’ Greek pupil” and losing herself in botanizing rambles around the school. (“Alas!” sighed her dutiful brother Sam, “I can but gasp aspirations after such an Elysium.”) Cheerful and pragmatic, Emily studied “pretty busily but by no means so as to fatigue myself,” she wrote to Elizabeth, “and I adhere constantly and in all things to my favourite proverb, ‘most haste worst speed.’ ” Anna, Emily’s patronizing patron, was gratified. “Her progress is really wonderful,” she reported to the family. “If she continue as at present, she will be a very different person from the young elephant you lost sight of last Fall.”
Elizabeth, upon her escape from hated Henderson, resumed the uninspiring Cincinnati routine that Emily had left behind and began to feel what Anna described as “the manifold uncomfortablenesses of such a state of betweenity.” That Christmas of 1844, short as always on cash but with literary creativity to spare, the Blackwells compiled an anthology of their own writings, to be sent to absent Anna and Emily and read aloud by all on Christmas Day. Henry, the comedian, contributed to this inaugural Annual a caricature of each Blackwell. Volatile, opinionated Anna was “Changeable Earnest”; serious Sam was “Sacred Awe.” Wisecracking, ever-hungry Henry dubbed himself “Voracious Noodle.” Emily, tall and easygoing, at least for a Blackwell, was “Lymphatic Carrot.” And Elizabeth, with her philosophical inclinations and musical abilities, was “Transcendental Nightingale.” “She may perhaps be the Lion of the family,” Henry added, “being a desperate and energetic sort of female.” Everyone recognized Elizabeth’s caged force.
It was at this frustrated moment, as Elizabeth remembered it, that “a lady friend,” stricken with a terminal illness “the delicate nature of which made the methods of treatment a constant suffering to her,” suggested that a woman of Elizabeth’s intellectual capacity should study medicine. “If I could have been treated by a lady doctor,” the friend confided, “my worst sufferings would have been spared me.”
The details of this formative conversation are lost; as an origin story, it is vague and abrupt. Why would a young woman enthralled by literature and philosophy, and painfully aware of her family’s financial instability, suddenly apply her considerable ambition to what was, essentially, still just a trade—and not even a particularly lucrative one?
Elizabeth at first scoffed at the idea. There was no such thing as a female physician, at least in any honorable sense. Women who claimed that title were peddlers of patent elixirs—or worse, of abortion, that “gross perversion and destruction of motherhood.” Even respectable male doctors, armed with little more than purgatives, laudanum, and lancets, tended to do more harm than good—she had seen this at her father’s bedside. And whereas in Europe the title “doctor” might connote a certain level of education and eminence, egalitarian Americans tended to resist such assumptions of privilege—and the prestige of American medical schools did not yet approach that of European ones. Some patients preferred an experienced lay practitioner to a man with an M.D.
On top of this, the general state of human health had rarely been worse. The explosive growth of cities had accelerated the evils that proliferate whenever too many people occupy too little space: contaminated water, accumulated garbage and manure, and the fleas and rats and lice that were the only beneficiaries of overcrowding. Babies died almost as often as they lived—even with the benefit of education and income, Hannah and Samuel Blackwell had buried at least three. Those lucky enough to survive childhood later succumbed to tuberculosis, cholera, typhoid fever, and influenza. No one had yet figured out why these plagues took hold, or how to help the afflicted. Confidence in the ability of doctors to preserve life had never been lower. In 1845 medicine was a strange choice for anyone who craved professional prestige, let alone a woman.
Besides, Elizabeth’s dedication was to the life of the mind. Since childhood, she had always hidden signs of illness from her family: Sickness was for the weak. “My favourite studies were history and metaphysics,” she wrote, “and the very thought of dwelling on the physical structure of the body and its various ailments filled me with disgust.”
But her metaphysical orientation eventually directed her toward the science of the body. During the winter of Elizabeth’s betweenity, Margaret Fuller—editor of the Transcendentalist magazine The Dial and confidante of Emerson and Channing—published Woman in the Nineteenth Century, a book that spoke directly to Elizabeth’s unsatisfied mind. Humanity would achieve a moral awakening, Fuller insisted, only when women enjoyed the same independence as men—a step that women must claim for themselves rather than waiting for men to grant it. “I think women need, especially at this juncture, a much greater range of occupation than they have, to rouse their latent powers,” Fuller wrote. “If you ask me what offices they may fill; I reply—any. I do not care what case you put; let them be sea-captains, if you will.” The Dial, in which Fuller’s ideas first appeared, was a fixture among the reading materials in the Blackwell parlor. “I believe that, at present, women are the best helpers of one another,” Fuller declared, her words reinforcing the suggestion of Elizabeth’s dying friend. Could it be that “doctor” was the office Elizabeth was meant to fill?
The allure of medicine may have been reinforced by her brother Sam, trapped in tedious bookkeeping jobs that left him no leisure for idealism. “If I had some noble, glorious aim, clearly defined before me in life, I think I could be truly happy,” he wrote. “I have thought that as a physician I might be happy, & truly well employed in a daily business of beneficence.”
Elizabeth was not drawn to the daily business of beneficence—that would involve uncomfortably intimate contact with individual sufferers—but becoming a doctor as qualified as any man was a noble ideological quest, a way of proving Margaret Fuller’s faith in woman’s equal aptitude. Elizabeth’s attraction to this challenge wrestled with her distaste for human biology and won. There was, moreover, the added incentive of the recognition that such an extraordinary accomplishment might bring. She had no use for most social interaction, but she had no objection to fame. “Eliz. is thinking seriously of studying Medicine,” Sam recorded that spring.
Embarking on such a quest would also give Elizabeth a conclusive answer to a tiresome question: what about marriage? Though her solitary circumstances might have been of her own choosing, her pride demanded a narrative that justified the choice. Falling in love, a “common malady” like any physical illness, was likewise a weakness, she decided. “I became impatient of the disturbing influence exercised by the other sex,” she wrote—a disturbance, she confessed, to which she felt particularly susceptible. “But whenever I became sufficiently intimate with any individual to be able to realise what a life association might mean,” she continued, “I shrank from the prospect, disappointed or repelled.” She loved the idea of love, not the reality of emotional connection—and physical connection was even harder to contemplate. Evidence of intimacy with another, at any stage of Elizabeth’s life, is scarce in the letters and journals she left behind, but whether her romances were real or imagined, the work of becoming a doctor would both forestall love and explain its absence. “I must have something to engross my thoughts,” she wrote, “some object in life which will fill this vacuum and prevent this sad wearing away of the heart.” Elizabeth considered medicine as a novice might contemplate the convent: as a noble vocation and a refuge from worldly entanglements.
Having decided what to pursue, the next step was how. Elizabeth visited doctors in Cincinnati and wrote to others in New York, receiving everywhere the same reaction: a female physician was an interesting idea, but given the long years and great expense of study, and the intellectual and physical endurance required to practice, not to mention the basic truth that no female would be welcome among male students in a medical lecture hall or operating theater, it was quite impossible. Frankly, what self-respecting woman would voluntarily expose herself to the naked realities of the body in the company of men? And then there was the unmentionable question of such a woman’s own body, incapacitated monthly. Bedrest was a common prescription for menstrual complaints, and what would a lady doctor’s patients do then? Even Elizabeth’s friend Harriet Beecher Stowe was dubious. Certainly a woman doctor would be “highly useful,” she conceded, but the forces ranged against Elizabeth, which she must “either crush or be crushed by,” were formidable.
Of course, women had always served as healers—whether revered as angels at the bedside, or reviled (though still, quietly, consulted) as uncomfortably powerful initiates into the secrets of witchcraft. American colonists, among whom doctors were scarce, had depended on wives and mothers and sisters to provide first aid and nursing, not to mention assistance at childbirth. But as eighteenth-century Enlightenment ideas introduced empirical science and new techniques into the healing arts—like the use of forceps during delivery—female practitioners were replaced by male professionals. As the establishment of medical schools and societies created new frameworks of legitimacy, women were pushed further toward the margins. However: in the last few decades, as medical schools began to proliferate in the United States, led by physicians who hoped to raise the profession to the same level of dignity it enjoyed in Europe, it was perhaps easier to argue for a woman’s right to be a doctor. If she attended the same lectures and passed the same examinations as a man, who could deny her qualifications?
There remained only the daunting fact that no woman had ever gained admittance. It had nothing to do with entrance standards. Newly minted American medical schools, unlike liberal arts colleges and law schools, often had none: any student who could pay the fees was welcome. Any male student, that is. And Elizabeth had no money. As someone who scorned the easy path, however, these apparently insurmountable obstacles only hardened her resolve. “The idea of winning a doctor’s degree gradually assumed the aspect of a great moral struggle,” she wrote, “and the moral fight possessed immense attraction for me.”
It was Anna, bestowing largesse from the superior vantage of age and secure employment at St. Ann’s in Flushing, who propelled Elizabeth forward with word of a teaching position in Asheville, North Carolina. There were better reasons than a teacher’s salary to venture so far away. It would be another chance to take abolitionist ideas into slave territory, and more important, the proprietor of the school in question, the Reverend John Dickson, had previously been a doctor. Medical students usually studied with an established physician before enrolling in formal lectures. In Dr. Dickson’s employ, with access to his medical books, Elizabeth would be able to save money toward her education even as she began it.
The 350-mile journey, by cramped stagecoach on jolting, ungraded roads over the Alleghenies and the Appalachians, would take more than a week. Elizabeth had heard terrifying reports of “drunken drivers galloping their horses at full speed down perpendicular mountains,” and the prospect of unaccompanied nights at lonely roadside inns was unattractive. Sam, however, was only too happy to leave his uninspiring duties, hire a wagon, and drive his sister to her new post. In June 1845, less than three weeks after receiving Anna’s suggestion, Elizabeth and Sam were on their way to Asheville, with thirteen-year-old Howard tagging along for the adventure. They packed the wagon with Elizabeth’s books and trunks and carpetbags and added a chessboard and two loaded pistols.
It was to Emily, still studying in New York, that Elizabeth wrote the fullest account of her journey, after taking “Miss Student” to task for failing to write. (“What a very unnatural sister you are,” she scolded, “to take no more notice of my existence than if I were a toad or President Polk.”) The first day on the road, Elizabeth confessed, she had felt “as blue as a forget-me-not,” drenched by a torrent of rain and a relentless stream of Sam’s painful puns. But her mood lightened with the skies, and she proved a more intrepid traveler than her brothers. Reaching a ford across Kentucky’s Cumberland River in the gathering dusk, the little party was dismayed by the expanse of tumbling water, darkened by close-growing trees climbing the valley’s steep sides and made eerie by the “goblin groans of myriad frogs.” Hallooing across, they heard an answering hail encouraging them to march straight from bank to bank, but Sam couldn’t muster the nerve. “Shall I say there’s a lady in the carriage?” he asked Elizabeth. In response to this fiction of a frightened female, a boy on horseback splashed over to guide them toward dinner and a warm bed.
Asheville was a tiny dot in the grandeur of the Blue Ridge Mountains. Elizabeth found the landscape inspiring and the people less so: to her critical eye, they were another batch of “country boobies and boobyesses.” Though the Dicksons’ green-shuttered residence was undeniably attractive, and their Female Academy one of Asheville’s proudest institutions, Elizabeth’s mood plunged as her brothers’ departure approached. “I grew so doleful that I almost meditated suicide, it seemed to me that the world was one vale of gloom,” she wrote. “I must lead a cold lonely life, on the confines of barbarism, amid totally uninteresting people.” And her mattress was full of fleas, who “all turned out to welcome me, with true Southern hospitality.”
Elizabeth would remember this nadir as a catalyst for revelation. “I had many causes of deep suffering that I had never imparted to anyone, & I felt lonely & forsaken by every friend,” she wrote.
I stood one starlight night at my window—I shall never forget it—the mountains stood round black & gloomy, the wind sighed mournfully in the oak trees, & the stars seemed to mock me with their cold quiet twinkling. I cried in deep sorrow, “Jesus have you too forsaken me!” and in the instant a peaceful happiness, that I had never known before seemed to take possession of me; it was as if some bright spirit had shed its atmosphere around, & entered with every breath I drew.
She echoed the words of Jesus on the cross without apparent irony. Elizabeth had always yearned to see herself as the protagonist of an important story; now, officially embarked on her medical quest, she could. Henceforth “I knew that, however insignificant my individual effort might be, it was in a right direction, and in accordance with the great providential ordering of our race’s progress.”
Whether or not the world yet acknowledged it, she was a medical student. An elderly housemaid thanked her for soothing away a headache—“my first professional cure,” Elizabeth wrote gaily—and the household affectionately took to calling her “Dr. Blackwell,” a title she penned with an extra flourish in her letter. When someone found a large dead beetle, she decided to perform her first dissection. “I thought it would make a capital beginning,” she wrote, but the intention was easier than the act. Spreading out a clean sheet of paper, she staked the insect to her desk with a hairpin, opened her penknife, grasped the mother-of-pearl handle, and—hesitated. The place where the head joined the body, being narrowest, seemed like the easiest place to start, and soon the beetle was in two pieces. Finally, with a shudder of disgust, she sliced the body in half—but the creature having died some time ago, all she found within was yellowish dust. “The anatomy was by no means interesting,” she wrote wryly, “but the moral courage exercised was of a high order.”
Dr. Dickson borrowed an articulated human skeleton for her to study—“a great treat”—and seemed to support her outrageous plans, though she found it difficult to discuss them. “I only wish he were one with whom I could converse freely,” Elizabeth wrote, “but I think it would be too hard a trial to subject him to.” It was less daunting to discuss Dickson’s politics. Though a slave owner himself, he professed an antipathy to slavery strong enough that Elizabeth deemed him “one of the most right minded men I have ever known.” It was hard to condemn him for his ideals when he was at that moment helping her to realize her own.
Elizabeth had returned to the south “determined,” she wrote, “to teach all the slaves I could to read & write & elevate them in every way in my power, as the only way in which I could reconcile it to my conscience to live amongst them.” Dickson applauded her idealism, but it was illegal in North Carolina to teach slaves to read, and he refused to break the law. Instead, with the help of Mrs. Dickson, Elizabeth organized a Sunday school providing “oral instruction” on moral ideas. “I assure you it felt a little odd,” she wrote, “sitting down in front of those degraded little beings, to teach them a religion which their owners professed to follow while violating its very first principles.”
The “strong electric friendship” she craved, the kind of idealized communion “where deep calleth unto deep,” would not be found in Asheville, but Elizabeth was not bothered. “I always have had somewhat of the anchorite in my composition,” she wrote. As one of her colleagues put it, “Miss Blackwell is never less alone, than when alone.” Between her job, her studies, and her Sunday school, Elizabeth’s life was, for the moment, satisfyingly full. “I feel very wakeful, just at present,” she wrote. “My brain is as busy as it can be, & consequently I’m happy.”
Emily and Anna were not. On the same late July afternoon when Elizabeth was describing her busy days in Asheville, Anna was writing a grimmer letter home from St. Ann’s in New York. “It is so painful to be convinced that one whom one has loved and admired is really unworthy of confidence,” she began. She had abruptly resigned, she announced, as a result of her employer Dr. Schroeder’s inappropriate behavior. “All his kind professions of respect,” she wrote, “have been succeeded by a system of petty persecution, general annoyance, and unbearable insolence, which have fairly martyrized me.”
Emily scrawled a postscript across Anna’s last page. “I assure you that she has not spoken of it half as severely as it deserves,” she insisted. “His conduct toward her almost ever since I have been here has been very doubtful, but for the last three weeks it had been equally unworthy of a Christian and a gentleman.” Their brother Henry’s outraged reaction shed some light on Schroeder’s unmentioned transgressions. “A most unscrupulous liar & consummate scoundrel!” he exploded. “In short, a perfect Onderdonk.” Benjamin Treadwell Onderdonk, Episcopal bishop of New York, had recently been brought to trial on multiple charges of groping female parishioners. (“He thrust his hand in my bosom,” one plaintiff testified.) Whether or not Schroeder’s crime matched Onderdonk’s, from this point on Anna would be increasingly debilitated by vague and chronic ill health, and drawn irresistibly toward whatever new fad promised to relieve her. She never held a classroom teaching job again.
Leaving Emily with friends in New York, Anna retreated to Brook Farm, the utopian community near Boston founded by Transcendentalists and frequented by William Henry Channing. Brook Farm had recently embarked on an ambitious plan to remake itself according to Charles Fourier’s principles of Associationism, thanks in part to the arrival of Albert Brisbane, the man responsible for popularizing Fourier’s ideas in America. Unfortunately, this was the beginning of the end for the Brook Farm experiment, but Anna developed a warm regard for the persuasive Brisbane. By the fall of 1845, she was back in New York, and so was Brisbane, taking a personal interest in instructing her on Fourier’s ideas regarding free love.
Emily lingered in New York with Anna, the two women moving among generous friends and furnished lodgings. Anna was earning a little as a journalist, writing reviews for magazines, and both women took private pupils. Having had a taste of concentrated study during her year at St. Ann’s, Emily was desperate to continue her work in languages and mathematics, and she continued to be intrigued by the utopianism she was hearing from Anna and her friend Mr. Brisbane. She explored Fourier’s ideas not with Elizabeth’s idealism or Anna’s impulsive passion but with her own considerable intellectual focus, “reading,” Elizabeth reported approvingly, “a work in five volumes, of 500 pages each.” Emily was too practical to be swept away by Fourier’s vision, but her seriousness resonated with Elizabeth—surely Emily was the most kindred of her siblings. “Your letters always come to me like a puff of fresh North wind in a Summer’s day,” she wrote to Emily. “I generally brush my hair & straighten my things after reading them.”
In the spring of 1846, after nearly two years away, Emily returned to Walnut Hills, impressing the home folk with her gains in both height and maturity. “So our young giantess is actually arrived,” Elizabeth wrote. “Why didn’t some of you let me know?” She had heard from Cincinnati friends that Emily was now “quite a genius,” though “this I won’t mention, lest Emily should see it.”
The Dicksons’ school in Asheville closed at the end of 1845, but Elizabeth had accepted an invitation from John Dickson’s brother in Charleston. Dr. Samuel Henry Dickson had received his medical degree at the University of Pennsylvania—the oldest and most elite American medical school—and helped found the Medical College of South Carolina. His library held over a thousand volumes, and his sister-in-law ran a fashionable boarding school for girls that was in need of a piano teacher.
Samuel Dickson was the most eminent physician Elizabeth had yet encountered. It took her months to muster the courage to consult him directly about her ambitions. “The more I thought of the conversation, the more nervous I became,” she wrote, worrying that she “might perhaps lose a friend without gaining a teacher.” But Dickson, when she at last confided in him, surprised her. “He thinks my desire of obtaining a thorough scientific education quite feasible,” Elizabeth exulted. “When we finished the conversation my head burned with pleasure, I felt it to be the first step gained, and an all important one.” Fueled by optimism, she began to enjoy the pursuit of science. “I trace out the wonderful nervous fibres of the body,” she wrote, “with the same interest that I once sought for the links that unite the finite with the infinite.” She felt increasingly confident that she could reach the summit of her chosen mountain and become an example to the world; after that, she wrote, “whether I devote my life to the practice is another question that experience must determine.” But it was her aptitude for the work that would determine her future, not her gender. “I think I have sufficient hardness to be entirely unaffected by great agony,” she mused. “I do not think any case would keep me awake at night.”
What did keep her awake was the irritating proximity of giddy schoolgirls. “Do listen,” she cried to a fellow teacher, jerked awake again one night by agonized shrieks, “they must be whipping a poor negro; isn’t it abominable?” But the noise was coming from across the corridor. Yanking open the dormitory door, Elizabeth was mobbed by “six girls, all screaming at the top of their voices, as pale as their nightgowns, and some of them almost in fits.” The original source of their terror, it emerged, was the sound of a hairbrush falling to the floor.
Elizabeth’s dim view of females was not limited to teenagers. In Charleston she was introduced to Emma Willard, founder of New York’s Troy Female Seminary, the first school to offer girls a secondary curriculum comparable to what their brothers could expect. Now approaching sixty, “the famous Trojan” traveled the country as an advocate for women’s education and wrote extensively on history and geography. “I did not know till nearly the close of her short stay,” Elizabeth reported with breathtaking scorn, “that she was a pretender to medical knowledge.” Willard had spent years investigating the intricacies of the human circulatory system and was about to publish her findings. “I fear however that the book will not add to Mrs Willard’s reputation,” Elizabeth scoffed. “I should judge her, not very profound, though possessed of much varied information.” Willard enjoyed national recognition and was venerable enough to be her grandmother, but Elizabeth dismissed her as a dilettante in danger of undermining her own more serious-minded quest. “A grand discovery by her is not very probable,” she wrote, “on a subject to which intelligent men have devoted their whole lives.”
Willard, fortunately, felt no such wariness. She referred Elizabeth to her friend Dr. Joseph Warrington, a sympathetic Philadelphia Quaker. Though he was inclined to believe that Elizabeth would find the pursuit of nursing smoother, he added, “I beg thee to believe with me that if the project be of divine origin it will sooner or later surely be accomplished.”
In May 1847, after a year and a half among the schoolgirls of Charleston, Elizabeth left for Philadelphia, the first city of American medicine, ready to put all her energy toward the pursuit of medical school admission. Her mentor Samuel Dickson was well connected at the University of Pennsylvania; Dr. Warrington, cautiously encouraging, had declared himself an ally. And Anna was already there.
Anna—who, unlike Elizabeth, had no qualms about discussing her aches and pains—had grown enamored of unorthodox routes to wellness. Scientific observation and experimentation had fostered a growing skepticism regarding the authority of doctors. Several schools of alternative practice had emerged in response to the excesses of medical orthodoxy, dependent as it was on bloodletting and drugs whose effects were often more debilitating than the original complaint. The body was as mysterious in its workings as ever, but what if the highest authority on its well-being was the individual who inhabited it? “Know thyself,” said the Transcendentalists. While alternative practices might have been less painful, however, it was unclear that they were any more effective.
The Thomsonians, taking their name from New Hampshire farmer Samuel Thomson, held that all disease arose in cold and was dispelled by heat; the Thomsonian pharmacopeia consisted almost entirely of red pepper, steam, and lobelia, an emetic commonly known as “pukeweed.” Thomson’s ideas had been subsumed into the Eclectic school, a botanical approach that aimed to reform the excesses of medical orthodoxy while preserving its grounding in empirical scientific knowledge and training, combining the soundest ideas from a variety of perspectives. Poised to overtake the Eclectics in popularity was homeopathy, which viewed disease in a more spiritual light and prescribed minute doses of mostly botanical preparations according to the “law of similars”: the correct medication for a given illness would be the one that caused the symptoms of that illness in a healthy person.
Other techniques strayed further from convention. Mesmerism—named for the German physician Franz Anton Mesmer—had emerged a decade earlier. Mesmer believed that a form of energy he called “animal magnetism” emanated from every creature; illness resulted from blockage of this flow and could be removed by a practitioner skilled in directing his or her own vital energy toward the sufferer. Mesmerists staged popular demonstrations, hypnotizing headaches away and reorienting the body’s energy with the application of magnets or simply by touch. While recovering at Brook Farm, Anna had experimented with magnetic treatments, lamenting in the wake of her trauma at St. Ann’s that she was “thin as an aspen leaf, and just about as nervous.” And then there was hydropathy, or the “water cure,” which prescribed restorative bathing, sweating, and drinking, under the assumption that flooding the body with pure water would flush away whatever might be poisoning it.
Anna had come to Philadelphia to seek treatment at Dr. Schifferdecker’s Hydropathic Institute, renting a room in the home of William and Sarah Elder, a Quaker doctor and his wife. Elizabeth liked the encouraging Elders, “a thinking talking couple,” but thought Dr. Schifferdecker was a charlatan. “Poor A,” wrote her brother Sam. “I am very glad E. is near her with her cool, unimpassioned judgment.” Elizabeth’s criticism, however, was more for the man than for his method. She remained steadfast in her pursuit of a medical credential from a regular, allopathic school—she could hardly expect to win societal approval otherwise—but her oldest sister’s alternative fascinations would have a significant impact on her own approach to medicine. She was, paradoxically, seeking legitimacy in a field whose legitimacy was currently in flux. She would not rule out techniques that seemed effective, whatever their provenance.
While Anna took the water cure, Elizabeth sought interviews with Philadelphia’s leading physicians and sent letters of inquiry to medical colleges in both Philadelphia and New York. At the University of Pennsylvania, the oldest and most august American medical school, Dr. Samuel Jackson burst out laughing at her request. Dr. William Darrach stared at her for a disconcertingly long pause, then refused either to admit her to his lectures or to explain why. “The subject is a novel one, madam,” he ventured at last. “I have nothing to say either for or against it.” Dr. William Ashmead sent word that his feelings on a woman studying medicine were so outraged he would rather not meet the woman in question face to face. All of Elizabeth’s applications were rejected.
The objections of the medical establishment followed divergent tracks. On the one hand, no true lady would leave the purity of the domestic sphere to study the corruptions of the human body. On the other, what if female doctors were a resounding success, and female patients preferred them? The dean of one school summed up these fears: “You cannot expect us to furnish you with a stick to break our heads with.” Even those rare men who approved of Elizabeth’s goal balked at the notion of a woman studying anatomy alongside men. Her only way forward, they told her, was to pose as a man—somewhere far away, perhaps in Paris, where the excellent medical instruction was free, and attitudes less puritanical. The scandal of a cross-dressing woman, apparently, was nothing compared to the horror of a female in the lecture room.
But to Elizabeth, achieving a diploma in disguise missed the point. “It was to my mind a moral crusade on which I had entered,” she wrote, “and it must be pursued in the light of day, and with public sanction, in order to accomplish its end.” If she was to be a beacon, she could not hide herself. She had never wanted to be a man—she wanted, as a woman, to enjoy the same level of respect and freedom men took for granted.
“I cannot tell you how much I would like you to be studying with me,” she wrote to Emily in Cincinnati. “I have calculated again & again, but find no way to obtain such an end.” She reported excitedly on the chance to observe Dr. Jonathan Moses Allen’s private anatomy class, on hernia. “That is to be my introduction,” she wrote. “Rather formidable is it not?” (More formidable than she knew: Allen would go on to write The Practical Anatomist, a classroom bible for medical students.) He led her through a dissection of the human wrist: the eight tiny bones with their lacing of ligaments that were the mechanism of so much graceful expression, whether the flourish of a paintbrush or the striking of a chord at the piano. “The beauty of the tendons and exquisite arrangements of this part of the body struck my artistic sense,” Elizabeth wrote, “and appealed to the sentiment of reverence with which this anatomical branch of study was ever afterwards invested in my mind.”
She also made the acquaintance of Paulina Kellogg Wright, a young widow known for her lectures on physiology to female audiences, using a papier-mâché model imported from France. Though Wright’s purpose was different—she promoted basic knowledge of the body as a foundation for public health—she and Elizabeth joined forces briefly in search of anatomical specimens. The trade in cadavers was largely unregulated, and the visceral horror most felt at the idea of dissection—linked to a Christian belief that only intact bodies had a chance at resurrection—meant that bodies were in chronically short supply. Grave robbers, known sardonically as “resurrectionists,” quietly supplied the most august institutions. A large proportion of the specimens on American dissecting tables were black: the bodies of both enslaved and free black people, buried, often uncoffined, in segregated ground outside the security of churchyards, were easier to steal. The bodies of babies, easier to transport and plentiful in an era of high infant mortality, were cheapest. In a letter to Sam in late summer, Elizabeth mentioned casually that she and Mrs. Wright were hoping “to purchase a black baby & dissect.” The grisly collision of her two pursuits, abolition and anatomy, went unacknowledged.
Rejected by every institution to which she had applied, Elizabeth acted on a whim and traveled to New York, where Marian was visiting, for a rare holiday with her clear-sighted older sister. “I determined not to study or think or do anything that I had been accustomed to,” she wrote, “but walk & bathe eat sleep laugh & flirt.” The vacation was refreshing, but self-indulgence—not to mention flirting—was not in Elizabeth’s nature. “I must accomplish my end,” she had written to Emma Willard. “I would sooner die than give it up.”
Upon her return to Philadelphia, she sent off a new flurry of applications to a dozen provincial medical colleges across New England. It was already August, and the next term would start in October; there was hardly enough time for good news she could act upon. But it was too late now to turn back.