ASRA Celebrates Women in Medicine

By Tina Doshi, MD, MHS, Eleanor Trousdale, MD, Priyanka Ghosh, MD, and Melissa R. Kenevan, MD    Sep 18, 2018

Tina Doshi, MD, MHS @dr_tinadoshi

Throughout much of the history of our distinguished profession, women have sadly been a small minority. Nevertheless, a long line of remarkable women dating back to antiquity have paved the way for women in modern medicine. The earliest recorded female physician was Merit-Ptah (c. 2700 BCE), chief physician of the pharoah’s court during the Second Dynasty of ancient Egypt. The legendary figure Agnodice (c. 4th century BCE) is said to have studied under Herophilus and practiced medicine in ancient Athens disguised as a man, at a time when women were forbidden from becoming physicians. As the story goes, when other physicians became jealous of her popularity with female patients, Agnodice was accused of seducing them, only to be discovered as a woman. The women of Athens came to her defense and attested to her abilities as a physician, leading Athenians to revoke the ban on female physicians. Although some have questioned whether Agnodice was a genuine historical figure, her story still resonates as a parable of the trials and tribulations of women in medicine, the valuable contributions that women can provide to the field, and the power of women’s voices in driving culture change.

During the Middle Ages, societal pressures prevented most women from practicing medicine. Much of the work of women in medicine during that time occurred in convents, one of the few places for women to become educated and participate in scholarly activity. The German Benedictine abbess Hildegard of Bingen (1098-1179) was a prolific writer, philosopher, composer, and naturalist who conducted extensive studies in medicine and botany. She is considered Germany’s first female physician and founder of natural science. Centuries later, her many accomplishments would be cited in support of allowing women to enroll in modern medical schools.

As modern medicine developed, women remained a minority. When Henry VIII of England granted the charter for the Company of Barber-Surgeons in 1540 to establish the formal specialization of healthcare professions, women were barred from practice. Consequently, for the next several centuries, women practiced medicine in the shadows, without formal training or recognition. It was not until the 19th century that women slowly gained acceptance into a few medical schools, and women’s medical schools were founded in response to the vast majority of medical schools that barred admission to women. Over the following decades, women have slowly broken down barriers to obtaining medical education, and they continue to make lasting contributions to the science and practice of medicine.

Today, women make up approximately half of all medical school graduates. However, many specialties still have a significant gender gap, and female physicians in all specialties continue to grapple with difficult issues, such as discrimination, sexual harassment, and a considerable pay and prestige gap compared to our male peers. ASRA and the WRAPM SIG recognize the challenges facing women in medicine, but we hope that together, our members can carry on the important work of our predecessors to foster diversity and inclusion in the field of regional anesthesia and pain medicine.

In honor of Women in Medicine Month, ASRA and the WRAPM SIG are highlighting the accomplishments of women in medicine.  We’re sharing profiles of three female pioneers in medicine and anesthesia: Elizabeth Blackwell, Isabella Herb, and Rebecca Lee Crumpler. These women are just a few examples of extraordinary female physicians, and we encourage you to learn more about other icons, such as Ann Preston, Helen Taussig, Virginia Apgar, and Mary Botsford.  We also invite you to check out the @ASRASociety Twitter feed for more facts and share your own appreciation for women in medicine with #WRAPM #WIMMonth.

Happy Women in Medicine Month!


Elizabeth Blackwell, MD

Elizabeth Blackwell (1821-1910)
First Woman to Receive an MD in the United States

by Eleanor Trousdale, MD 
Mayo Clinic, Rochester, MN

Dr. Elizabeth Blackwell, the first woman to receive an MD degree from an American medical school, was inspired to pursue a career in medicine after a close friend who was dying suggested she would have been spared her worst suffering if her physician had been a woman.[1]

Born in Bristol, England in 1821, Elizabeth Blackwell was the third of nine children. Her family emigrated to America when she was just 11 years-old. A few years later, following several teaching pursuits, she applied to all of the medical schools in New York and Philadelphia. She was rejected from every school except Geneva Medical College in western New York.  As the story goes, the faculty of Geneva Medical College, assuming an all-male student body would never agree to a woman joining their ranks, allowed them to vote on her admission. As a joke, the student body voted “yes,” and Elizabeth gained admittance.[1] Two years later in 1849, graduating first in her class, Elizabeth Blackwell became the first woman to receive an M.D. degree from an American medical school. When the dean, Dr. Charles Lee, conferred her degree, he stood up and bowed.[2]

While Dr. Blackwell is credited with the creation her own hospital, the New York Infirmary for Women and Children, as well as the establishment of the National Health Society, an organization aimed at educating people about the benefits of hygiene and healthy lifestyles, no doubt some of her greatest contributions involve promoting women in medicine. During the 1860s and 70s Dr. Blackwell would rally support in the US and Britain for the acceptance of women in medicine both through political advocacy as well as opening some of the very first medical colleges for women.[1, 3] Dr. Blackwell would proceed to publish several books on the issues of women in medicine including “Medicine as a Profession for Women” and “Address on the Medical Education of Women.”

May we learn from Dr. Elizabeth Blackwell the power of tenacity in the face of resistance and the importance of chasing dreams in the name of “sparing suffering” for our patients.

References

  1. Blackwell, E. Pioneer work in opening the medical profession to women. London: J.M. Dent & Sons. 1914.
  2. “Dr. Elizabeth Blackwell’s Graduation: An Eye-Witness Account by Margaret Munro De Lancey.” Hobart and William Smith Colleges. Dec 2003. https://www.ncbi.nlm.nih.gov/pubmed/19928645 Accessed September 18, 2018.
  3. Michals, D. “Elizabeth Blackwell.” National Women’s History Museum. 2015. https://www.womenshistory.org/education-resources/biographies/elizabeth-blackwell Accessed September 18, 2018.

 

 


Isabella Herb, MD

Isabella Herb (1863/4-1943)
Female Pioneer of Anesthesiology

by Priyanka Ghosh, MD
Beth Israel Deaconess Medical Center, Boston, MA

Isabella Herb was the first “physician-anesthetist” at the Mayo Clinic in Rochester, MN, and developed the department of anesthesiology at the current Rush-Presbyterian Hospital in Chicago, IL. Herb was born in 1863 or 1864, in Clyman, WI, where she spent her early childhood with her parents and three siblings. She married a musician, "Professor" Charles Albert Herb, but was sadly widowed when he died July 2, 1888. She obtained her MD from the Northwestern University Woman's Medical School in Chicago in 1892, which eventually merged with Northwestern University.

After graduation, she served a one-year internship at Mary Thompson Hospital for Women and Children in Chicago, then was an anesthetist and pathologist at Augustana Hospital in Chicago. This is where she collaborated with and published numerous scholarly articles with Dr. Lawrence Prince, a major developer of open drop ether and chloroform anesthesia. In 1897, Dr. Herb published the first study in anesthesia written by a woman, surveying 1,000 cases of anesthetics at the hospital, “Observations on One Thousand Consecutive Cases of Anesthesia in the Service of Dr. A. J. Ochsner.”

In 1899, she joined the medical staff of the Mayo Clinic in Rochester as the first “physician anesthetist” for Dr. Charles Mayo and the hospital’s only pathologist. She briefly went to Europe during her tenure at Mayo for further research work. In 1909, she was asked by Dr. Arthur Bevan, the head of surgery at Presbyterian Hospital and Rush Medical College, to become the chief anesthetist. From 1909 to 1941, the time of her retirement, Dr. Herb was head of the department of anesthesia at Presbyterian Hospital, the first woman to join its medical staff. In 1922, she became the first woman president of the American Association of Anesthetists, the first nationwide anesthesia society.

Dr. Herb developed an outstanding reputation and garnered immense respect, which played a large role in attracting female medical trainees to Chicago. By the 1920s and 1930s, a large proportion of female anesthesiologists in Chicago had been trained by Dr. Herb.  She was an incredible academic anesthesiologist, authoring numerous papers on multiple topics—including morbidity and mortality in anesthesia, evaluating old and new anesthetics, and medicolegal problems—developing anesthesia equipment, and promoting the rise of women in anesthesia.

Priyanka Ghosh, MD

Bibliography

  1. Strickland R. Isabella Coler Herb, MD: An early leader in anesthesiology. Anesth Analg. 1995 Mar; 80(3):600-5. https://journals.lww.com/anesthesia-analgesia/Fulltext/1995/03000/Isabella_Coler_Herb,_MD__An_Early_Leader_in.29.aspx Accessed September 18, 2018.
  2. Christie AJ, Horlocker TT, Bacon DR. A fascinating relationship: Isabella Herb, M.D., and William J. Mayo, M.D. Bull Anesth Hist. 2007 Oct;25(3)6-9,12. https://www.anesthesiahistoryjournal.org/article/S1522-8649(07)50033-8/abstract Accessed September 18, 2018.

 


Rebecca Lee Crumpler (1831-1895)
The First African-American Female US Doctor

by Melissa R. Kenevan, MD
Mayo Clinic, Rochester, MN

Imagine dreaming to achieving the impossible. It’s the early 1800s, many years before the 13th Amendment was passed to abolish slavery. You want to become a doctor, but not only are you a woman (and thought of by many as lacking both the physical strength and mental capacity to practice medicine), but also you are black. To even fathom the thought of becoming a doctor in this setting, where not one single person with a medical degree looks like you, seems out of this world. Yet somehow Dr. Rebecca Lee Crumpler realized this dream and became the first African-American woman in the United States to earn her M.D.

Born Rebecca Davis in 1831, Dr. Crumpler grew up in Pennsylvania with her aunt just north of the Mason-Dixon line. After working for many years as a nurse, Rebecca was accepted to the New England Female Medical College in Boston, MA, the first medical school for women. In 1864 she became the first and only African-American woman to graduate from the school.

At the end of the Civil War, Dr. Crumpler worked for the Freedman’s Bureau for the State of Virginia. This department was charged with helping more than 4,000,000 slaves make the stunning transition from bondage to freedom. She is reported to have vigilantly ignored daily episodes of racism, sexism, and rude behavior to caring for freed slaves who had no other access to healthcare.

In 1883, Dr. Crumpler publish a text titled “A Book of Medical Discourses in Two Parts.” This book highlighted her specialty in the care of children and pregnant women and made her one of the very first African-Americans to publish a medical text. Although little information and no images of Dr. Crumpler survive, this book serves as a symbol of her achievements as a remarkable physician and medical writer.

Melissa Kenevan, MD @KenevanMelissa

Bibliography

  1. Markel H. Celebrating Rebecca Lee Crumpler, first African-American woman physician. PBS News Hour. March 9, 2016. https://www.pbs.org/newshour/health/celebrating-rebecca-lee-crumpler-first-african-american-physician. Accessed September 18, 2018.
  2. U.S. National Library of Medicine. Changing the face of medicine: Dr. Rebecca Lee Crumpler. (Last reviewed: June 3, 2015). https://cfmedicine.nlm.nih.gov/physicians/biography_73.html Accessed September 18, 2018.