As the majestic copper dome of the Massachusetts State House receded in the sunset, and the first whiff of bilgewater reached Elizabeth’s nose through the stiffening breeze, all thoughts of her noble mission were replaced by more immediate preoccupations. “I gave myself a little convulsive twist,” she recorded later, “& told Kenyon in a very loud voice, that I had no expectation of being sea-sick.”
When the ship’s bell rang for dinner, she marched resolutely into the saloon, but the flash of mirrors and the clash of dishes; the waiters rushing to pour wine; the chattering diners, like “a herd of pigs come to be fed”—it was all overwhelming. She managed one bite, rose from her seat, and rushed to her tiny stateroom, reaching the washstand just in time.
As she collapsed into her berth, the door burst open to admit her assigned cabin mate: an elderly woman, staggering with each lurch of the ship, too overwhelmed by nausea to locate the necessary basin. “After a few minutes violent exertion,” Elizabeth recounted, “she tumbled upon a box, declared she had never been so ill in her life, & believed she was going to die.” The newly credentialed doctor clung mutely to her lower bunk, leaving the unfortunate old lady to call for the overworked stewardess’s help in boosting her up into bed. It was nearly a week before Elizabeth felt well enough to venture out on deck. Throughout the ordeal she maintained a stoic silence, though the poor soul in the upper bunk moaned loudly enough for two.
Too queasy to study, but well enough to feel the weight of idle hours, Elizabeth contemplated the uninspiring society on board. The gentlemen smoked and discussed horse racing and money, their voices rising with each glass of brandy. The ladies “gathered themselves into groups, & turned their backs on all solitary individuals,” talking of titles and dresses and the opera. “I listened in vain for one thought, one noble sentiment, or one mark of true refinement,” Elizabeth complained. “Oh I grew very very weary of those uncongenial people, who never spoke to me, but were all the time with me.” Kenyon, himself bedridden with an attack of rheumatism, was little help.
At last Elizabeth woke to see the banks of the Mersey on either side with Liverpool ahead, the ships at anchor in the harbor seemingly right up among the houses. At the customs house, Elizabeth held her breath anxiously for a moment—partly because she didn’t have the money to spare for duties, and partly because she had stashed her two largest and most expensive medical textbooks under her clothes to avoid paying tax on them. But the officials took little notice of the plainly dressed young woman and her ailing cousin. She exhaled, and on they went.
There wasn’t much time before the train that would take them to Birmingham, where Howard and Anna were now settled near Kenyon’s branch of the Blackwell family. Elizabeth could hardly bear to blink, there was so much to take in. The last time she stood on English soil, she had been a girl of eleven. She might have come of age among Americans, but despite her new citizenship, she still wasn’t sure she wanted to be one. She was ready to fall in love with England again. Liverpool was built on a noble scale; the buildings seemed so substantial, defying the march of centuries. But as her gaze descended from Liverpool’s elegant architecture to its consumptive-looking residents, ambivalence crept in. “Many of the people looked watery to me,” she wrote. “I wanted to expose them to a bright American sun & dry them.”
Still, as they rattled toward Birmingham, the countryside—neat hawthorn hedges and ancient stone churches, gardens full of cowslips and primroses—seemed verdant and perfect compared to the raw American towns Elizabeth had known. A chaise carried them the last few miles west from Birmingham to Portway Hall, home of Kenyon’s brother Sam Blackwell, an iron refiner, and his father, Uncle John Blackwell. Even here in the “Black Country,” Britain’s coal-fueled industrial heart—where the very leaves on the trees were darkened with soot, and the sun through the smoke “gave a pale light that resembled an eclipse”—Elizabeth found plenty to admire. Portway Hall, built in 1674, was like a castle from a fairy tale: entered through an arched door in a central tower ornamented with a sundial, festooned with ivy, and crowned with battlements. Three stories of mullioned windows commanded a view of lawns sloping down to gravel paths and a fishpond. There were greenhouses, galleries hung with paintings, and a sweeping stone staircase. For Elizabeth, veteran of drafty boardinghouses, daughter of a family eternally on the edge of penury, Portway Hall felt like the beginning of a better story.
It was joyful to see her little brother and eldest sister again. Howard seemed to be flourishing, though Anna was her usual valetudinarian self. “This morning she stood for 10 minutes, rubbing a magnetized dollar over the back of her neck, to cure nervousness, & drank a tablespoon of magnetized water, which has a special tendency to the heart,” Elizabeth wrote, bemused but open-minded.
Kenyon, still ailing, had meanwhile become a lesson in the limitations of heroic medicine. The doctor from the neighboring town of Dudley arrived daily with “all manner of drugs & absurd directions” that only weakened the patient. In the doctor’s absence, Elizabeth and Anna took matters into their own hands: “For a few days the medicines were regularly thrown away, & bread pills & flavored water substituted, & with judicious diet, cleanliness, & kind cheerful nursing he improved rapidly.” But then, disaster: “Uncle Blackwell discovered the plot & all was over, with the unfortunate effect of making Kenyon suspicious of his kind nurses—he gives himself up with the strangest blindness to the Doctor.” It didn’t occur to anyone that the Dudley physician was unnecessary. There was already a doctor in the house—still green but possessed of good instincts.
A visit to Dudley Castle was an opportunity for Elizabeth to express the pent-up energy that drove her. The ruined keep stood at the top of a hill, its thick curving walls pierced by arrow slits. “I began to imagine how grandly an army would approach, & how noble a defence the Castle would make,” she wrote, “till I longed to revive one of the antient conflicts, & almost frightened my companion by my martial demonstrations.” The excursion inspired her to resume her own crusade. Touring Birmingham’s hospitals, she found a familiar mixture of shock and gratifying courtesy. “Mr. Parker, Surgeon to the Queen’s Hospital, had some difficulty in believing that it was not an ideal being that was spoken of,” Elizabeth wrote dryly, “but when he found I was really & truly a living woman, he sent me an invitation to witness an amputation.” She borrowed Anna’s velvet and sables for the occasion—modern crusaders’ armor—and was pleased to see young male faces “peeping through doors & windows” to catch a glimpse of the fabled lady doctor.
Impatience for the work ahead soon overwhelmed Elizabeth’s limited appetite for family reunions. By the middle of May she had moved on to London, accompanied by her cousin Sam’s friend, the amiable Charles Plevins. “I parted from Portway friends with great regret,” she wrote home. “We are getting used to one another, a home feeling was growing up there to me, & so—it was time to be off.” Domestic contentment was the enemy of progress.
London was wonderful. Charles Plevins took Elizabeth to Sunday luncheon at the home of his formidable aunt near Regent’s Park, where they were announced by a footman in velvet breeches, white stockings, and a burgundy vest with gold buttons—Elizabeth wasn’t sure whether to curtsy or laugh. Museums and hospitals, paintings and pathology; one day she was admiring a Rembrandt at the National Gallery, the next attending a dinner party thrown by a doctor with an exquisite collection of microscopes, through which Elizabeth beheld “the lung of a frog most minutely injected” and the innumerable tiny teeth of a piece of sharkskin. The attention was intoxicating, though Elizabeth, dressed in serviceable black, felt uncomfortably outshined by the begowned beauties she met at soirées. “The English ladies have very beautiful busts,” she wrote, with mingled irony and awe, “as round & white & full as gelatinous marble.” If this was more human interaction than she had ever sustained in her life, the former teetotaler had luckily discovered a helpful social solvent. “Iced champagne,” she told her family, “is really good.”
She felt more at home at the Royal College of Surgeons, among the jars of preserved limbs and organs at the Hunterian Museum, where she was unintimidated by the towering forehead and protuberant stare of its notoriously difficult curator, Richard Owen: “Mr. Owen is a man of genius, & the hour passed away like a minute.” Racing through the galleries of the British Museum at top speed, she had time only to regret that “a certain Emily B” couldn’t be there to enjoy the cultural riches on display. Elizabeth walked the wards with a senior physician at St. Thomas’s, one of London’s most illustrious hospitals, and proudly heeded his insistence that she sign her name followed by the hard-won “M.D.” in the hospital ledger. She received more medical invitations than she could possibly accept during her week’s visit. “I thought such excitement would have bothered me intensely—it did at first bewilder, but now I’ve roused to meet it,” Elizabeth exulted. “The more I have to do, the more I can—I believe I’ve never yet even begun to call out my power of working.”
To work, then—though the best place for that was not London. Elizabeth might have enjoyed a warm reception among the city’s most open-minded physicians and surgeons, but they considered her an American oddity, not a medical pioneer. Her sober dignity and unique achievement made her a piquant presence at dinner or in a lecture hall, but even the most genial of her hosts would have blanched if she had asked for a place to hang her shingle.
In France, however, the February Revolution of 1848 and the birth of the Second Republic had renewed a commitment to liberté, fraternité, and above all, égalité. It was time to push onward to Paris, where the already arduous pursuit of medical training would have to be conducted in Elizabeth’s rudimentary French.
Elizabeth parted from the generous and genial Charles Plevins with heartfelt gratitude. “He must be no longer a stranger to you all,” she wrote home. “I could not thank him, words seemed too absurd.” Absurd or not, her words suggested an unprecedented depth of feeling. Plevins escorted her all the way to Dover and onto the boat that would carry her across the Channel. “He would neither let me thank him for the great pleasure his companionship had been to me,” Elizabeth wrote, “nor would he admit that he had rendered me the slightest service.”
Her letter, circulated to siblings and friends, raised eyebrows. William Elder in Philadelphia, among the staunchest of her supporters, reacted immediately. “I have not time to make any remarks upon Elizabeth’s letter,” he wrote with bemused alarm, “except to intimate my jealousy of that Mr. Charles Plevins, whom she has grown so very poetical about.” What was the man doing, escorting Elizabeth all over England? How dare he distract her from her destiny? “Women are not reliable,” Elder continued, exposing the limits of his own liberal-mindedness. “If Elizabeth bolts from the course, the starch is taken out of the enterprise and the cause will be at a discount for good.” There was no room for a romantic partner on Elizabeth’s narrow and perilous path. “Plevins!” Elder spluttered. “Why the word sounds like swearing—it’s a very bad word, we must see to it.”
He needn’t have worried. If Elizabeth’s departure caused either Charles Plevins or herself pain, it was not enough to deflect her from her course. She sailed from Dover in the rain on May 21, 1849. “I cannot give any patriotic description of the white cliffs of England,” she wrote, having had “just sufficient sensation of a queer nature to make me wish to lie down on my berth.” It was her nose rather than her eyes that told her she had arrived at Calais: “a strong smell of fish.” The downpour continued as she stumbled over the stone pier in the dark, the lighthouse above raking the night. For the first time—as gruff bewhiskered officials checked her passport, demanding “où allez-vous, Madame?”—Elizabeth felt herself truly among strangers. Sticking closely to an Englishwoman from the ferry who had warned her of the French predilection for cheating foreigners, she spent a night in Calais (“miserable little town”) followed by a day on the train, and then finally, alone, “launched boldly into the sea of Paris.”
She was not impressed. London had exceeded expectations, but Paris, which she had expected to embrace, repelled her. “I am utterly disappointed in Paris as far as I have yet seen it,” she reported, having found “small & gloomy” rooms on the narrow rue de Seine, not far from the medical institutions she intended to explore. Her rosy-cheeked landlady cheerfully volunteered to help with everything from breakfast to French pronunciation but could not dispel Elizabeth’s sense of anticlimax. Where was the sophistication, the beauty, the intellectual sparkle she had expected to find? “Paris is a place altogether overrated,” she announced after one day of residence. “The city looks as if it had suffered.” Her outlook was perhaps colored by the sudden absence of her companion. “I miss my friend Charles very much,” she wrote to Anna.
For the next few days, Elizabeth set aside medical pursuits in favor of her garrulous landlady’s company. They walked together through the neighborhoods of the Left Bank, the noble dome of the Panthéon appearing and disappearing as they turned corners. Elizabeth tried to tune her ear to Parisian chatter—“I have great trouble in expressing myself with any elegance”—and took advantage of her companion’s help in buying a decent bonnet. This proved unexpectedly challenging. “I found that my unfortunate organs were totally unable to squeeze themselves into a Parisian headdress,” Elizabeth wrote with a touch of phrenological humble-brag. In the end, she had a milliner make one in gray silk, ignoring horrified protestations that no one in Paris wore that color. She had not come for the fashion.
Once in possession of her new headgear, she was ready to resume her campaign. The consul at St. Germain invited her to Sunday dinner and took her for a stroll on the Grande Terrasse with his daughters; it seemed likely he would provide useful letters of introduction. A visit from another official bearing a form for Elizabeth to complete was a more awkward encounter: when she listed herself as étudiante, the man’s eyes widened “until the whites showed all round them.” Noticing her discomfort, he explained his own.
“Mon enfant, you must not put yourself down as student,” he instructed her. “Rentière is the word you must use!” A female student was a contradiction in terms, but a rentière was a woman of independent means—far more respectable. Elizabeth declared herself a rentière without delay. No one in Paris knew her well enough to question it. Then again, no one in Paris knew her well enough to be of much help, either.
It was discouraging. “I have nothing as yet to tell you of Paris medicine,” Elizabeth wrote to Emily, “though I have been here three weeks.” Maddeningly, medical instruction was everywhere—free lectures at the imposing École de Médecine and the Jardin des Plantes with its endless twisting beds of exotic specimens; dozens of eminent physicians offering private instruction; vast and venerable hospitals full of patients to observe—as long as you were a man. There were more students at the École de Médecine than there were in all the medical schools in America combined, yet there was no room in the Grand Amphithéatre, with its gorgeous coffered ceiling, for a woman. And for Elizabeth, concealing her sex remained out of the question. It wasn’t enough for a woman to study medicine in secret—the world needed to witness her doing it. “Well,” she sighed to Emily, “we must have patience with the age while we work hard to bring about a juster arrangement.”
The medical community of Paris reacted to her determination along a spectrum with which Elizabeth was growing familiar: “Some of them are certain that Miss Blackwell is a Socialist of the most furious class, and that her undertaking is the entering wedge to a systematic attack on Society by the fair sex,” reported the correspondent for the New York Journal of Commerce. “Others who have seen her, say that there is nothing very alarming in her manner.” It was the women who were most appalled. “Oh, it is too horrid!” one lady was quoted. “I’m sure I could never touch her hand! Only to think that those long fingers of hers had been cutting up people.” The correspondent’s favorable verdict had little to do with Elizabeth’s medical skill. “She is young, and rather good-looking; her manner indicates great energy of character; and she seems to have entered on her singular career from motives of duty.”
Welcome encouragement arrived in the form of Anna, seizing the opportunity of her sister’s residence in Paris to escape the gritty damp of Birmingham and pursue another adventure in medical tourism. This time she sought the attention of Jules Denis, Baron du Potet, an owlish and renowned mesmerist. Frustrated for the moment in her pursuit of conventional medicine, Elizabeth joined Anna at Baron du Potet’s magnetic séances, held in a darkened room “hung round with curious pictures & lined with very curious people.” The motley assemblage of “believing heretics” vied for a chance to regard themselves in du Potet’s magic mirror and whispered about the last meeting, during which a young man had actually floated up toward the ceiling!
Fully aware of the absurdity of the scene, Elizabeth refused to dismiss it completely—du Potet might claim to be able to communicate with the dead, but he had also successfully demonstrated his magnetic therapies at the Hôtel-Dieu, the largest hospital in Paris. “I am obliged to laugh at it,” she wrote, “& yet I have a true respect for M. Du Potet.” She might not share his faith in “antient magic,” but she honored his single-minded passion—as did many of the most prominent thinkers of the day. Who could say that magnetism wasn’t a promising addition to the pharmacopeia? Or at the very least, she recognized wisely, a comfort for her chronically unhappy sister. “He will pursue a mild soothing treatment for her,” Elizabeth reported, “& I think her residence here will be beneficial.”
Anna was not the easiest roommate—Elizabeth wished it could be Emily at her side instead—but it was good to have a sister near as she contemplated her next step. At Geneva College, she had grown accustomed to pursuing her strange quest with an audience; the anonymity of Paris had caused her momentum to waver. Having another Blackwell at hand helped dispel her self-consciousness, and her rising spirits enabled her to embrace a new plan: to surrender her freedom and enter La Maternité, France’s largest public maternity hospital, not as a qualified doctor but as a student.
Every year each territorial department in France—in 1849 there were eighty-six of them—sent two female students to La Maternité to train as midwives at government expense. It was a more progressive approach to obstetric training than anything to be found in England or America, and an unusual benefit of France’s high degree of state control in the field of education. A stay of several months would expose Elizabeth to a thousand cases—vastly more than she might see anywhere else—as well as the tutelage of Paul Antoine Dubois, a distinguished professor of obstetrics. In this one branch of medicine, there was no better practical education.
But neither would there be any allowance for Elizabeth’s accomplishments or her maturity. She would enter as an élève like any other, subject to the same constraints: sleeping in a dormitory when she wasn’t on call through the night, eating in a refectory, working long hours at menial tasks, and forbidden to leave. The other students were country girls, “ignorant and degraded” in Elizabeth’s estimation. The patients, like the ones she had known at Blockley Almshouse in Philadelphia, were society’s outcasts. After all her insistence on studying medicine on the same terms as men, she now seemed to have no choice but to study obstetrics and gynecology among women. Then again, this particular opportunity would not have been available had she been male. La Maternité was housed in the old walled convent of Port-Royal, and the setting hadn’t changed much. “I shall take the veil on the first of July,” Elizabeth wrote sardonically, “& be seen no more in the world.”
She devoted the rest of June to enjoyment of the freedom she was about to surrender. Paris was not as overrated as she had first thought. She visited Notre Dame, imagining the “fearful descent” of Victor Hugo’s hunchback, and spent two hours completing one circuit of the main gallery at the Louvre—“you stand at one end, and the other is lost in the distance.” Versailles seemed to her a “living church,” wherein all French citizens could refresh themselves at the altar of history, art, music, and nature. And no one touched any of the treasures, she marveled, or even picked a flower in the gardens! Surely this was a manifestation of a better society. Indeed, Elizabeth told her cousin Kenyon, “there is a constant effervescence of life in this great city,” although she found Parisians at once “the most brilliant and the most conceited people in the world.”
The early summer of 1849 was a tense moment to be a tourist in Paris. With the unseasonable heat—thirty-two degrees, though the centigrade measurement meant nothing to Elizabeth—came cholera, the “summer complaint,” killing thousands. (Five years later the English physician John Snow would at last connect the disease to contaminated drinking water.) The political temperature was rising as well, as the city’s workers began to agitate against a government that had failed to deliver on its revolutionary promises. The Louvre and the Tuileries were full of soldiers, with more lining the streets, bayonets fixed. Agitators shouted on street corners. “We passed through hurrying crowds full of excitement,” Elizabeth wrote, “hearing fearful reports of what had happened and what was to come.” It was not a bad moment to retreat behind the walls of La Maternité.
Elizabeth could remove herself from society with the satisfaction of knowing that her reputation continued to grow. In response to her arrival in Europe, Punch, the London satirical paper, published a seven-stanza mock-epic poem of praise under the title “An M.D. in a Gown.” “Not always is the warrior male,” it began, and though it hewed to the ponderous witticism that a medically trained woman saved her husband the expense of calling the doctor, it nevertheless concluded on a note that must have appealed to Elizabeth, despite its tortured rhymes.
Young ladies all, of every clime,
Especially of Britain
Who wholly occupy your time
In novels or in knitting,
Whose highest skill is but to play,
Sing, dance, or French to clack well,
Reflect on the example, pray,
Of excellent MISS BLACKWELL!
Confident that the English-speaking world, at least, would not forget her, she prepared to enter La Maternité, determined to see it not as a prison but as an opportunity.
On July 1, 1849, Elizabeth presented herself at a low door in a high wall and left Paris behind. Port-Royal Abbey, home of La Maternité for the last half century, consisted of a quadrangle of two-hundred-year-old buildings around a courtyard of flowerbeds and gravel paths, with a garden and a small wood adjacent. Those gazing up and out over its tiled roofs could glimpse only the highest domes of the city as proof that the wider world was still there: the Panthéon to the northeast, the Observatory directly south.
A colonnaded cloister surrounded the courtyard, but instead of the deliberate tread of contemplative nuns, the walkways now echoed with the hurried steps and birdlike chatter of dozens of young women swathed in aprons of coarse white toweling: the élèves, or midwives-in-training, among whom Elizabeth would live and study. Elizabeth followed an old woman up stairways and along corridors, all bare stone and plain wood, to the “funniest little cabinet of curiosities” as ornate as the rest of the building was austere: a small chamber overstuffed with chintz sofas and china figurines, embroidery and mosaic-topped tables. This was the parlor of Madame Madeleine-Edmée Clémentine Charrier, La Maternité’s chief midwife, who had the curved spine of a crone and the twinkling blue eyes of a fairy godmother. Madame Charrier in turn conducted the new arrival to Madame Blockel, supervisor of the dormitories and the dining hall: red of face and squint of eye, with “tremendous projecting teeth” as well as “a tremendous vocal organ,” which she put to constant use keeping the lively élèves in line.
Before Elizabeth had a chance to unpack, Madame Charrier was back with a crowd of students and a question: would the new arrival care to spend the night on duty in the salle d’accouchements? Someone handed over a clean apron (“with the injunction not to lose it, or I should have to pay three francs”), and Elizabeth plunged into her first shift on the labor and delivery ward.
Eight babies were born that night in a large room full of shadows, with a hearth at one end, candlelight winking off copper and tin implements, two rows of beds, and cabinets stacked with linen in the corners. In the center rose “a large wooden stand with sides, on which the little new-comers, tightly swathed and ticketed, are ranged side by side”: wrinkled red faces peeking from beneath peaked caps bearing labels with name and gender, each infant wrapped like a mummy in black serge. Elizabeth’s first letter home evokes an orderly scene of quiet competence—“very little crying” from the newborns, their student attendants “pretty and pleasant.”
She left out the screaming pain of labor, not to mention the peril of giving birth in 1849. Even wealthy women, well attended in the comfort of their own bedrooms, died in childbirth. Only the most desperate—those rejected by their families or by society—gave birth in a hospital, where even if the wards were swept and scrubbed, no one washed hands, aprons, or instruments between patients. Puerperal fever was a permanent resident. So were rats. And while linens might be changed, mattresses that were repeatedly soaked in the fluids of childbirth stank, especially in July. The eight new mothers, exhausted, drenched in sweat, supine on blood-soaked sheets, appear nowhere in Elizabeth’s account. “It was really very droll,” she wrote.
Perhaps she meant to spare her family—mindful of her younger brothers—the pain and fear that preceded the tidy row of newborns. Perhaps she dismissed the new mothers—many of them beggars or prostitutes—as a category of nameless, faceless women rather than a collection of individuals. Perhaps she had already absorbed the French attitude toward patients as teaching tools. Or perhaps, after this shocking introduction, she was trying to reassure herself by projecting professional nonchalance. To her journal, she confided what was not for general consumption: watching the student midwives trying to turn a breech baby while the mother writhed and moaned in agony, “I almost fainted.”
After such a beginning, it was no challenge to sink into sleep the following night, despite the close proximity of the fifteen young women with whom Elizabeth now shared a room. Her dortoir, up a twisting stairway with a massive, rough-hewn wooden banister, was a smaller echo of the labor ward she had just left, with rows of iron bedsteads and wooden chairs under facing walls of windows, a gilded crucifix at one end, and two small pendant oil lamps that radiated barely enough light to read by—if she had time or energy left for reading. There would be no privacy for the next three months, or however long Elizabeth could bear to stay.
The days were closely scheduled. The bell perched on the ridgepole clanged at five each morning, but Elizabeth kept her head on the pillow on principle. “Of course I lie ten minutes longer pretending to sleep,” she wrote, “partly from anger at the noisy bell, partly to display to the angel, the remnant of independence that still remains to me.” She was grateful for her Protestantism, which excused her from morning and evening prayers and the daily infant baptisms in the lofty stone chapel at one corner of the quadrangle. (What had once been the nuns’ choir, separated from the rest of the chapel by an imposing iron grille, was now in constant use as a laundry.) After a quick wash and a hastily bolted bit of bread saved from the day before, Elizabeth rushed from infirmary rounds, to classes with Madame Charrier, to a lecture from the eminent Monsieur Dubois—“a little bald gray haired man, with a clear gentle voice, & very benevolent face.” These were followed by study groups outside on the grass or at the heavy trestle tables in the salle d’études, once the nuns’ chapter house. Elizabeth found these sessions far beneath her medical ability but excellent for French language practice, as each student in turn parroted the instruction of the leader. When the bell rang for the midday meal, the students repaired to the round tables of the refectory, where the plain hearty fare was always accompanied by something stronger than water. Elizabeth had left the temperance pledge far behind. “I am learning to take wine,” she wrote. “Everyone advises me to do so, and I shall soon be able to drink my bottle a day.”
VIEW FROM THE STUDENTS’ DORTOIR AT LA MATERNITé.
COURTESY DANIEL CLARKE
After lunch there followed another lecture, slightly more soporific after the wine, and then the hour for receiving visitors in the students’ parlor. Surrounded as she was by unseasoned girls with more enthusiasm than intellect—“we have every variety of temper,” she wrote, “like dry & wet gunpowder”—Elizabeth thirsted for a draught of Blackwellian conversation. Anna visited occasionally but was easily deterred by bad weather or another magnetic séance. More often Elizabeth skipped the closely supervised visiting hour in favor of a self-prescribed course of hydropathy: she took a bath, though there was no more privacy to be had there than anywhere else. Six tubs stood side by side in a double row, presided over by a wrinkled old woman who scolded the bathers in an impenetrable patois. Elizabeth created her own solitude by closing her eyes, submerging her ears, and imagining herself “deliciously reposing on the heaving waters of some soft summer lake.”
With each passing day, Elizabeth’s level of active experience rose vertiginously—and in the absence of English-speakers with whom to discuss her new knowledge, she poured the details of her daily life into letters home. “I have been handling leeches for the first time,” she wrote, “disgusting little things.” France was a leader in the farming of medicinal leeches, which were particularly useful for bloodletting in inaccessible areas, like the vagina, where a lancet might do unnecessary harm. A leech could be introduced via a speculum and withdrawn when it had its fill of blood by pulling on a thread passed through its tail.*
Elizabeth’s diligence left little room for the luxury of friendship, but one of the senior midwives, Clarisse Mallet, “a very intelligent ladylike young woman,” took every opportunity to draw Elizabeth out of her reserve. “She cannot bear to see me alone,” Elizabeth wrote. “It seems to the French a sign of deplorable melancholy.” For once, Elizabeth found nothing to disparage, and began to take pleasure in her colleague’s company. She appreciated Mademoiselle Mallet’s observations on the wards and her cheerful tolerance of her own stilted French, though she did wish her new friend would stop touching her: “I have to welcome with a good grace, the pinches, shakes, & similar tokens of French affection.” Intellectual communion was always more comfortable than an actual caress. Friendship was awkward, and writing about it was worse. “Shall I describe to you a little private dinner, given me by Mlle. Mallet?” she wrote to Henry. “I think it will suffice to say that it was very peculiar & very merry.”
There was one other individual whose company Elizabeth enjoyed. This was Claude Philibert Hippolyte Blot, an attending physician a year younger than herself, slender and sleepy-eyed, with an elegant aquiline profile. She had the opportunity to sit by him every Tuesday while he supervised smallpox vaccinations—one of the few truly beneficial public health advances of the early nineteenth century—pressing his scalpel to each infant’s arm. Elizabeth’s awareness of Blot was mutual; when she ventured to ask him a question, she noticed, “he colours, or passes his hand through his hair and looks intently at the baby, in a very un-Frenchmanlike manner.” Within a month of her arrival, Blot was sharing medical journals and pointing out unusual cases in the infirmary. Combining ambition with a lively wit, he earned from Elizabeth what was currently her highest compliment: “His sentiments seem to be good, but his character is certainly not French.” After another month, he surprised her with a bashful request: would she help him with his English? “I think he must have been meditating this request for some time; it had hardly the air of spontaneous thought,” she wrote in her journal. “I like him. I hope we may come a little more closely together.”
HIPPOLYTE BLOT.
COURTESY SCHLESINGER LIBRARY, RADCLIFFE INSTITUTE, HARVARD UNIVERSITY
These sympathetic colleagues aside, it was still a strain to spend every waking and sleeping hour among girls whom Elizabeth found at best picturesque and at worst simpleminded. As long as the élèves paid her the respect she felt was warranted, all was well, “and it sounded not a little droll to hear the scientific terms flowing so glibly from their laughing lips, which were busily employed in talking nonsense” whenever they were off duty. “Everything delights them,” she wrote. “They are perfect children in their full, unthinking enjoyment of the present.” In sunnier moods, Elizabeth endeared herself by phrenologizing them, or sharing a few English words with a giggling group.
It was just like her teaching days, only this time she had no authority over the students, and no room of her own. After a long day of strenuous medical effort—often preceded by a sleepless night on duty—their high spirits could drive her to distraction. Games of tag and wild dance parties broke out after the lamps were extinguished. Worst of all was something called “promenading the bedsteads.” The heavy iron bed frames stood on casters, and the floor of polished tile was smooth enough that a gentle push turned each bed into a vehicle. A shove at the end of a row had a domino effect, and a bed launched down the center aisle with enough force could sail the length of the dormitory. Until the élèves ran out of energy and collapsed onto their pillows, sleep was impossible. But so was sustained irritation—not even dour Elizabeth could remain angry at these cheerful creatures for long, especially when, upon waking, “they begged me to excuse them because they were so young!”
The indignities of her accommodation were balanced by the undeniable value of the education she was receiving, as well as the gratifying recognition of her aptitude. Monsieur Dubois more than once lingered after a lecture to confer praise, which Elizabeth drank in like sunlight. “He wished I would stay a year and gain the gold medal,” she crowed to her journal, “[and] said I should be the best obstetrician, male or female, in America!” A year at La Maternité, he insisted, would expose her to a volume of cases equal to what most physicians saw in a lifetime.
She believed him; she was feeling more like a real doctor and less like an impostor every day. “I am actually hand in hand with nature,” Elizabeth told Marian. “I have had a dozen patients under my own care, I have aided in delivering more than a hundred—I have seen all that is remarkable in a thousand—I have bled & leeched & poulticed with my own hand, & watched disease daily.” As the three-month mark approached, Elizabeth signed on for three more—personal discomforts could not outweigh the benefits of staying. And it would be easier now that she had established a definite finish line. “As I look forward to my departure the last of December,” she reassured Marian, “I feel almost joyous.”
A buoyant optimism gilded everything Elizabeth recorded. She was granted a precious day out with Anna, and for once gave herself up to “the pleasure of looking & moving & eating & everything that was natural, & nothing that was wise.” She was proud to receive a visit from Charles Lee, the dean of faculty from Geneva College, though she was irritated that La Maternité’s regulations forbade her from showing him around.
Madame Charrier, whom Elizabeth respected as “a woman of great experience,” presented her with a lithograph of her historical namesake. The eighteenth-century Elizabeth Blackwell—a Scotswoman and no relation—was famed for her beautiful illustrations of medicinal plants, which had earned her enough to bail her doctor-husband out of a London debtors’ prison. “I imagined a whole romance out of the picture,” Elizabeth mused, “a romance of a beautiful, true spirit, struggling with a society too strong to be turned from its ancient habits of evil. But the pure spirit is not lost, it is working bravely still.” She was beginning to feel like the engineer of her own journey, gathering momentum.
* Though bloodletting has been discarded as a relic of the barbarous past, leeches are still in use. They secrete natural anticoagulants and are effective in draining congested blood from wounds to facilitate healing.