In the 19th century upper class and middle class women were not expected to earn their own living. Women rarely had careers and most professions refused entry to women. In the middle of the 19th century it was virtually impossible for women to become doctors, engineers, architects, accountants or bankers.
After a long struggle the medical profession allowed women to become doctors. Even so, by 1900 there were only 200 women doctors. It was not until 1910 that women were allowed to become accountants and bankers. However, there were still no women diplomats, barristers or judges. Women were allowed to become teachers. In 1861 over 72% of teachers were women, but teaching was a low status job and was also very badly paid.
At first he was very discouraging, to my astonishment then, but now I fancy he did it as a forlorn hope to check me; he said the whole idea was so disgusting that he could not entertain it for a moment. I asked what there was to make doctoring more disgusting than nursing, which women were always doing, and which ladies had done publicly in the Crimea. He could not tell me. When I felt rather overcome with his opposition, I said as firmly as I could, that I must have this or something else, that I could not live without some real work, and then he objected that it would take seven years before I could practise. I said if it were seven years I should then be little more than 31 years old and able to work for twenty years probably. I think he will probably come round in time, I mean to renew the subject pretty often.
Mr. Hawes advised Elizabeth to go into a surgical ward at the Middlesex Hospital for a preliminary period of six months. He could arrange this, he said. It was to test her resolution that Mr. Hawes suggested a surgical ward where conditions at that time, even in the best hospitals, were bad. Mr. Hawes knew that the sights, sounds and smells in a surgical ward would provide a searching test. In 1860 bacteriology was in its infancy and the connection between living germs and wound infection had occurred to no one. The mortality after major operations was appalling, and even in trivial cases infection might occur. For ward visits a frock-coat was worn and for the coat's sake it was exchanged for an old one before the surgeon entered the theatre. Usually he washed his hands after operating, not necessarily before. Gloves were not worn. Sterilization of ligatures and instruments was unknown.
The presence of a young female in the operating theatre is an outrage to our natural instincts and is calculated to destroy the respect and admiration with which the opposite sex is regarded.
I have had a letter from my mother… she speaks of my step being a source of life-long pain to her, that it is a living death, etc. By the same post I had several letters from anxious relatives, telling me that it was my duty to come home and thus ease my mother's anxiety.
Elizabeth obtained a certificate of honour in each class examination; she did so well indeed that the examiner in sending her the list added, 'May I entreat you to use every precaution in keeping this a secret from the students?' In June trouble arose. The visiting physician asked his class a question, none of the men could answer and Elizabeth gave the right reply. The students were angry and petitioned for her dismissal. A counter-petition was sent to the committee but she was told she would be admitted to no more lectures although she might finish those for which she had paid fees.
I must decline to give you instruction in Anatomy… I have a strong conviction that the entrance of ladies into dissecting-rooms and anatomical theatres is undesirable in every respect, and highly unbecoming… it is not necessary for fair ladies should be brought into contact with such foul scenes… Ladies would make bad doctors at the best, and they do so many things excellently that I for one should be sorry to see them trying to do this one.
We dined at six (excellent dinner) delightful general talk, it was most pleasant. The talk was of Comte, George Eliot and her new book Felix Holt… on Herbert Spencer's theory of the sun coming to an end and losing all its force.
At ten John Stuart Mill sent us and Miss Garrett home in his carriage and we had a nice talk on the way home. Her dispensary opens next week. She had much difficulty in becoming a doctor from want of facility for women to learn. She would not mind attending men but does not do it, on account of what would be said. We got home at eleven having enjoyed our day immensely.
Our hearty congratulations on the brilliant success at Paris which has at length crowned your many years of arduous work - work whose difficulties perhaps no one can estimate so well as ourselves. And while congratulating you on receiving the highest honour of your profession from one of the finest medical schools in the world, we desire to express also our appreciation of the example you have afforded to others, and the honour you have reflected on all women who have chosen medicine as their profession.
One argument usually advanced against the practice of medicine by women is that there is no demand for it; that women, as a rule, have little confidence in their own sex, and had rather be attended by a man… it is probably a fact, that until lately there has been "no demand" for women doctors, because it does not occur to most people to demand what does not exist; but that very many women have wished that they could be medically attended by those of their own sex I am very sure, and I know of more than one case where ladies have habitually gone through one confinement after another without proper attendance, because the idea of employing a man was so extremely repugnant to them.
I have indeed repeatedly found that even doctors, not altogether favourable to the present movement, allow that they consider men rather out of place in midwifery practice; and an eminent American doctor once remarked to me, that he never entered a lady's room to attend her in confinement without wishing to apologize for what he felt to be an intrusion.
In England there is at present only one woman legally qualified to practise medicine, and I understand that already her time is much more fully occupied, and her receipts much greater, than is usually the case with a medical man who has been practising for so short a period.
On the afternoon of Friday 18th November 1870, we walked to the Surgeon's Hall, where the anatomy examination was to be held. As soon as we reached the Surgeon's Hall we saw a dense mob filling up the road… The crowd was sufficient to stop all the traffic for an hour. We walked up to the gates, which remained open until we came within a yard of them, when they were slammed in our faces by a number of young men.
Mrs. Garrett Anderson has selected the very worst of all the alternatives suggested when she advises Englishwomen to go abroad for medical education… Mrs. Garrett Anderson's advice is premature in the extreme… Let me conclude that all women who wish to study medicine join the class already formed in Edinburgh, the great majority of whose members are thoroughly of one mind with me in this matter and who, having counted the cost, are like myself, thoroughly resolved to "fight it out on this line."
My sister joined the staff, which was heavily overworked, some eight thousand patients being seen yearly. But she soon discovered that all the more serious medical and surgical cases needing in-patient treatment had to be sent to the County Hospital. As there seemed no chance of a medical woman being put on the staff of that hospital, my mother, sister and others interested in the Dispensary felt that the only solution to the problem was to take a house adjoining and open there a small hospital of twelve beds for medical and surgical cases.
The opposition to this scheme was at first very strong. It seemed impossible to get money. Everything was wanting except the patients, and they were always there with their insistent demand to get a 'lady' to look at them because she would 'understand'. My mother became chairman of the committee… bringing all her organizing power, her clear sense, and unshakable faith, to the service of this building. In due course this little hospital grew to be one of the five general hospitals for women in Britain officered by women doctors.
In 1911 and my sister became the senior surgeon. Undoubtedly all the original work of establishing the hospital was due to my mother and also the breaking down of opposition and prejudice; the development of the hospital and its removal to Windlesham House came four years after her death and was due to my sister, who was recognised on all sides as the Founder of the New Sussex Hospital as it then came to be called.
The idea of women practising medicine in Great Britain distressed Queen Victoria. Indeed in 1881 the Queen's private physician announced that the royal patronage would be withdrawn from an international medical congress held in London if medical women were admitted, and so the women were shut out.
While women in Britain are prevented from studying for medical degrees… other European nations have taken a very different position. We have already seen the Italian Universities were in fact never closed to women, and that at Bologna no less than three women held Professors' chairs in the Medical faculty. We have several instances of degrees granted to women in the Middle Ages by the Universities of Bologna, Padua, Milan, Pavia and others… In Germany also such instances have occurred. At the University of Paris three women are now studying in its Medical School.
Three or four doctors in surrounding villages had seen Janet at my request and they each assured me that her cough was nothing serious. They said it was magnified in her own mind by the fact that her mother had died of consumption. They were wrong. Janet herself accepted the cough as more or less normal and thought I was being unduly fussy.
I insisted on her seeing a woman doctor, Dr. Louisa Martindale, a friend of Elizabeth Robins. The X-ray confirmed that she had tuberculosis. I was enraged by the delay in not catching the trouble at an earlier stage. I took her to Brompton Hospital. 'Too advanced for admission'. I boiled over with fury; after all, if I with only my eyes and no stethoscope had been able to diagnose all those months ago I could be a better doctor myself.
In a mood of complete despondency I grumbled to Elizabeth Robins. In my abysmal ignorance of what medical training involved, I told her that my observations and common sense had proved me right in diagnosis. 'Why couldn't I become qualified and be a doctor'. She turned and looked at me with flashing eyes and an expression I'd never seen in them before and burst out: 'Now that would be a worthwhile life. My father wanted me, urged me, to be a doctor,' and with passionate enthusiasm, 'It's the greatest profession in the world.'
I told my parents I wanted to study Medicine. They refused me to do this. Among other things it was "unsexing". They said they thought I had not the brains to pass the examinations, nor the physical stamina for the hard work involved in the seven years study.
One evening my mother came into my room to talk to me. 'If you are still thinking of being a doctor, you'd better give it up at once. The whole thing is not practical. For one thing you're too old. The profession is already overcrowded and hundreds of girls are going into it. Besides, you would have to live in London. You are too young to live in London'.
'Just now you said I was too old, and now I'm too young,' I remarked. I said that Dr. Louisa Martindale had told me the supply didn't meet the demand and all the woman doctors she knew were doing well. 'Women are so inaccurate, I don't believe her, said my mother. 'But as regards the living in London and training, I tell you at once, I couldn't afford it, so that's the end of it. I spend everything I have on making your father's remaining years happy.'
I was hating the whole conversation, but keeping very calm and cool, my mother continued 'Also it wants great physical strength and you aren't at all strong. You would be wasting the best years of your youth and happiness - you would lose all your friends… You would be mixing with girls of a lower class. The majority would be much beneath you. You couldn't possibly do anything socially, and you would ruin your chance of a woman's only real happiness - being a mother.'
'I feel sure you will regret it later. You would only be able to attend women… It would be a very dull life. Dorothy (Octavia's married sister) has a most interesting life. And she has the satisfaction of knowing that she is making one man perfectly happy', Then she went off into a lecture on the happiness to be obtained from a marriage for money.
We shook hands with Mrs Elizabeth Garrett Anderson, who was white-haired and gracious, and who said something tactful about William Wilberforce's great work for the slaves. Most of the girls were younger than I was and of varied types. Some of them by doing Medicine were following in a parent's footstep; some had a definite urge, like myself, to be of the use to the community. These were subdivided into those who wished to be medical missionaries and those who had worked in the Suffrage movement.
During the formative period of childhood and adolescence and and as a young woman one was treated quite differently, in a thousand different ways, from the way in which a boy would have been. One was more protected, less was expected of one in very many directions (although more, of course, in others). A girl in innumerable subtle indirect ways is taught to mistrust herself. Ambition is held up to her as a vice - to a boy it is held up as a virtue. She is taught docility, modesty and diffidence. Docility and diffidence are of uncommonly little use in the business or professional world. A girl, after all, is all the while being prepared for her own special profession; and the profession of a wife or of a daughter at home is best and most successfully carried out by those who are prepared to defer to the judgment of others before their own.