Women & Medicine
March is Women’s History month, and we’re taking a look at some of the many, many women in history (and even mythology) that have made the medical field what it is today.
Panacea and Hygieia
These goddesses appear in both Greek and Roman mythology as the daughters of the god Asclepius and granddaughters of Apollo, the god, and each were said to represent a facet of Apollo’s function. Panacea was the goddess of universal health, and Hygieia the personification of cleanliness and sanitation.
In Ancient Greece, the sick would flock to healing temples called Asclepieia to be cured. Ritual purifications were undertaken, and offerings and sacrifices made to Asclepius and his daughters. Non-venomous serpents called Asclepian Snakes were encouraged to roam freely, as they were considered an extension of the Gods’ power – all three are rarely found depicted unadorned by large snakes.
Modern medicine still evokes much of the symbolism from its ancient beginnings; the internationally recognized symbol for medicine depicts an Asclepian Snake wrapped around a sword, and the Hippocratic oath (which all doctors are required to take) still contains reference to the goddesses:
“I swear by Apollo the Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture.”
Although not making the types of monumental steps forward for women in medicine, help to illustrate the importance that women have had
Relief of Hygieia, Lviv, Ukraine
Mary Seacole
Born in Kingston, Jamaica in 1805 to a Jamaican mother and a white Scottish father, Mary Seacole’s upbringing was relatively comfortable. Her mother ran a hotel of great repute and was known to have been a healer. Mary observed her mother with enthusiasm and curiosity:
“I was very young when I began to make use of the little knowledge I had acquired from watching
my mother, upon great sufferer – my doll… and whatever disease was most prevalent in Kingston,
be sure my poor doll soon contracted it.”
While her mother inspired her to treat the sick, her father inspired her to travel. She visited London, Cuba, Haiti and the Bahamas, where she excelled in international trade. She returned to Jamaica to pursue her career in nursing, notably during the cholera and yellow fever outbreaks that struck Kingston.
When the Crimean War broke in 1853, Seacole travelled back to London, and requested to be sent as an army nurse, but was refused. Undeterred, she funded her own trip to Crimea, where she set up ‘The British Hotel’, a respite facility for sick and convalescing soldiers, and even visited the battlefield under fire to nurse wounded soldiers. She became known to the soldiers as Mother Seacole.
Although during this time, Seacole was as well known in Britain as Florence Nightingale, she was mostly forgotten here for the 100 years following her death. Nurses from the Caribbean, where she was still remembered and spoken about, visited her grave in Kensal Green. The local MP pledged to raise money for a statue to immortalize Seacole. In 2004, Mary Seacole was voted Greatest Black Briton, and in 2016, her statue was unveiled at St Thomas’s Hospital, London.
Statue of Mary Seacole, St Thomas’s Hospital, London.
Florence Nightingale
A name synonymous with nursing – Florence Nightingale’s contribution to the field was monumental, formalising nursing education and establishing the first scientifically based nursing school – the Nightingale School of Nursing at St Thomas’s Hospital, London.
Nightingale was born to an affluent family in 1820, and displayed enormous intellectual potential as a child, excelling in mathematics and language, with an interest in history, philosophy, literature and politics. A devout Unitarian, she was motivated to go into nursing to serve her God and mankind, although work was not considered appropriate for a woman of her social standing.
Despite her family’s objections, she enrolled in nursing school in Germany and learned basic skills, the importance of patient observation and the importance of good hospital governance. Although an excellent nurse, she showed proclivity for administration of hospitals and for training other nurses. She considered a role managing nurses at Kings College Hospital, London but the outbreak of the Crimean War took her talents elsewhere.
When Nightingale arrived in the warzone, she described the medical bays of the barracks as “the Kingdom of Hell”. Treating the soldiers was difficult; the staff were overworked, the medicine in short supply, and hygiene was all but forgotten. Fatal infections were common. Whilst caring for the sick with devotion, coming to be known as The Lady with the Lamp visiting the patients, she also sought to improve the conditions by petitioning the British government to improve the facilities. Her experiences in the war led her to advocate for the rest of her life for sanitation in hospitals and homes.
After returning from war, Nightingale’s career was dedicated to social reform and nursing education. She mentored Linda Richards, “America’s first trained nurse” who spread the scientifically based training across the United States and Japan. Although primarily known for her nursing work, she was also a talented statistician, and in fact is credited with the invention of a type of pie chart called a polar area diagram. Florence Nightingale legacy within the field of nursing cannot be overstated, and nurses in the USA still make ‘The Nightingale Pledge’ on qualification, which like the Hippocratic oath for doctors upholds ethics and principles in the profession.
Florence Nightingale tending to the injured soldiers at Scutari during the Crimean War
Elizabeth Garrett Anderson
This remarkable physician and suffragist’s career was truly groundbreaking in many ways; the first woman to qualify in Britain as a physician and surgeon, co-founder of the first hospital staffed by women, first dean of a British medical school, and the first female mayor in Britain.
Born to a decidedly non-academic family (her father was a pawnbroker and silversmith) in London’s East End in 1836, later relocating to Suffolk, she was homeschooled by her mother and later a governess. The family were known locally as “the bathing Garretts”, due to her father’s insistence that Elizabeth and her brother Louie should take a hot bath once a week.
Inspired by lectures given by Elizabeth Blackwell, the first woman to receive a medical degree in the United States, at the Society for Promoting the Employment of Women, Garrett set her sights on a career in medicine. Despite rejections from Harley Street physicians and the universities of Oxford, Cambridge, Glasgow, Edinburgh, St Andrews, and the Royal College of Surgeons, she took work as a nurse at Middlesex Hospital, privately obtained certificates in anatomy and physiology, making herself unpopular with male medical students who presented a petition to the school to bar her admittance.
Garrett was able to obtain her credentials by exploiting a loophole in the charter of the Worshipful Society of Apothecaries that could not block her based on gender, and finally took her exam and received her licence. Although she would not immediately find work at any hospital, she established a practice in London, focusing on delivering treatment to poor women. The 1965 cholera outbreak in London eventually led to her acceptance among the medical community – in desperate times, a female doctor is better than none.
Throughout her life, Garrett fought for female suffrage and education, and along with Sophia Jex-Blake, founded the London School of Medicine for Women, which later became the London Free Hospital (now part of University College London).
The Elizabeth Garrett Anderson and Obstetric Hospital, part of University College London.
Sophia Jex-Blake
Sophia Jex-Blake’s family was somewhat more illustrious than that of Elizabeth Garrett Anderson. Her father was a lawyer and proctor of Doctors’ Commons, her brother would go on to become the Dean of Wells Cathedral, and her niece would be a noted classicist and Mistress of Girton College, Cambridge. Born in 1840 and educated at Queen’s College, she accepted an unpaid position as a mathematics tutor there; her father had considered it indecent for their daughter to earn a living and had refused permission for her to accept a salary.
A trip to the United States, where women were beginning to qualify as physicians, inspired Jex-Blake; particularly Dr Lucy Ellen Sewell, whom she assisted at the New England Hospital for Women and Children. She wrote directly to the President and Fellows of Harvard University requesting admission, and received the response:
“There is no provision for the education of women in any
department of this university”
Although she had wanted to enroll in a new medical school being established by Elizabeth Blackwell, the death of her father necessitated her return to Britain. She applied to University of Edinburgh’s medical programme, and although the faculty voted in her favour, the University Court rejected the application, believing that the University could not make the necessary arrangements ‘in the interest of one lady.’
Undeterred, Jex-Blake put out a call to action for more women to join her, and made another application in 1869, with 6 sisters-in-arms, the Edinburgh Seven, and was admitted. She wrote to Dr Sewell:
"It is a grand thing to enter the very first British University ever
opened to women, isn't it?"
Her time studying and training was marked by great resistance among the male medical establishment; obscene letters, intimidation and literal mudslinging all culminated in a riot at Surgeons’ Hall when the women came to sit an anatomy exam. Although media attention won new supporters, the University eventually bowed to pressure and withdrew the women’s degrees, and they were forced to finish their studies elsewhere in Europe, Jex-Blake qualifying in Berne, Switzerland and again in Dublin, which allowed her to finally be registered with the GMC.
Dr Jex-Blake’s career was devoted to helping other women to receive medical attention – her outpatient clinic in Edinburgh offered treatment for poor women for just a few pence. The clinic went on to become the Edinburgh Hospital and Dispensary for Women, Scotland’s first hospital for women staffed entirely by women.
Plaque memorialising Sophie Jex Blake at University of Edinburgh. Credit: womenofscotland.org.uk
Rebecca Lee Crumpler
If becoming a doctor in the 19th century was hard for a woman, it was exponentially harder as an African-American woman, and Rebecca Lee Crumpler was the first. Born in Delaware and raised in Pennsylvania by her aunt, who acted as a community doctor, although unqualified, she was inspired to join the medical career. Crumpler worked as a nurse before being accepted to the New England Female Medical College, the only African American woman in attendance.
Although becoming a doctor was rare for women or black men, the casualties from the Civil War necessitated more physicians than ever. Crumpler moved to Richmond, Virginia to contribute and gain experience learning about diseases affecting women and children. She said:
“During my stay there nearly every hour was improved in that sphere of labor. The last quarter of the year 1866, I was enabled... to have access each day to a very large number of the indigent, and others of different classes, in a population of over 30,000 colored.”
After a time working for the Freedmen’s Bureau, which provided medical attention to freed slaves denied cared by white doctors, Crumpler established a practice in an predominantly African-American area of Boston, treating children of impoverished families for little or no fee.
Crumpler was a victim of intense racism and sexism during her career, ignored frequently by male and/or white physicians and often struggled to get her prescriptions filled by white dispensers. Although struggling with these challenges, she published A Book of Medical Discourses, a text that concentrated on the treatment of women and children, with a focus on preventative medicine.
Cicely Saunders
While much of medicine’s history focuses on the healing of the sick, Cicely Saunders is credited with birth of the modern hospice movement, and providing care where healing is not possible.
Born in Herfortshire, Saunders was well educated at the Roedean School and studied politics, philosophy and economies at St Anne’s College, Oxford. However, before completion of her degree, she decided upon a career in medicine, and trained at the Nightingale School of Nursing, and eventually qualified as a doctor at St Thomas’s Hospital Medical School.
Saunders was converted to Christianity by her classmates, and her faith motivated her to take work at St Joseph’s Hospice, in Hackney, East London, where she researched pain management. There, she fell in love with a patient, whose eventual death showed her that “as the body becomes weaker, so the spirit gets stronger”. She was inspired to establish her own hospice.
St Christopher’s Hospice, in Sydenham, London, was the world’s first purpose-built hospice, and continues to thrive today. It was founded on principles of pain management and symptomatic relief, as well as holistic care that attends to the physical, social, psychological, and spiritual needs of the patients, their friends and their families, and led to the development of a new medical specialty – palliative medicine.
As well as being instrumental in the development of what we know recognize as end-of-life care, Saunders contributed greatly to the discourse around medical ethics in Britain. Notably, her lecture to the London Medical Group titled “The Nature and Management of Terminal Pain” in 1972 was one of the first discussing the topic of pain and remains one of the most requested and repeated of the LMG and other medical groups.
Postage stamp showing portrait of Cicely Saunders
These days, being a woman in medicine is not remarkable in and of itself. Data from UCAS shows that in 2017, 59% of medical school acceptances were female (compared to 56.7% of acceptances across all subjects).
However, there are still gender imbalances within certain medical specialties and positions; the BMJ reports that 64% of consultants are male, and that in certain specialties such as cardiology and stroke medicine, male doctors outnumber women three to one.
But women are still breaking down these barriers. In 2019, Professor Caroline Moore became first woman in the UK to be made a Professor of Urology, and her research into prevention of prostate cancer has been supported by Prostate Cancer UK, the Movember Foundation, the National Institute for Health Research and the Department of Health, among many others.
