A Cautionary Tale

B. Dale Magee, MD - Curator

It is well-known that Elizabeth Blackwell was the first woman in the United States to earn an MD degree in 1849. Her roundabout path to formal medical education included spending a few years making contacts and gathering allies among recognized physicians as well as studying medical subjects informally. Having applied and been rejected by dozens of medical schools, including all in Philadelphia and New York City, she resolved to approach schools located in the country, where the weight of tradition may have been less. Her application to Geneva Medical College in 1847 came accompanied by a letter of recommendation from a Philadelphia physician. The faculty, not quite knowing how to respond, turned the decision over to the students stating that it was their decision and a single negative vote would result in rejection of Ms. Blackwell’s application. They voted her in more as a source of entertainment than a commitment to equality of the sexes.

Once enrolled, her sober presence and focus on study immediately quieted the normally boisterous classes. She finished first in her class and went on to blaze many more trails in medicine.

Three years after her application, in 1850, three prospective Black students; Daniel Laing Jr., Isaac Snowden, Martin Delany and a woman, Harriot Kezia Hunt; applied to Harvard Medical School. Ms. Hunt —who already had been practicing medicine without a degree, like about half of physicians at the time — had previously applied and been denied admission. The then-dean, Oliver Wendell Holmes, approved the admission of all four. When the students and faculty got word of this, they voted to protest the admissions — the actual votes were a little more nuanced, but the end result was the same. Mr. Holmes was able to advocate for two of the applicants, who were subsequently admitted to Dartmouth, but, in the end, he relented to the will of the students and faculty.

Mr. Holmes’ career was among the most distinguished in the country. His intelligence, critical thinking and advocacy resulted in uncovering the cause of child bed fever and drew attention to the ineffectiveness of homeopathy as well as traditional medical treatments. He was extensively educated in both the United States and Europe and brought a professor’s perspective to medicine. Beyond providing good care for his patients, he helped to change the face of medicine from one based on tradition to one focused more on science and results.

Medical school in the mid-19th century was not what we have come to expect today. There were no significant prerequisites; courses were lectures with little or no patient contact. Medical schools were completely dependent on income from student tuition and, thus, a protest could be ruinous. Examinations were oral in the case of Harvard, and others, since a significant percentage of the students were illiterate. Boisterous activity, sometimes leading to complaints by neighbors of the schools, was not unusual. A member of Ms. Blackwell’s class described the student body as one made up of the sons of farmers, tradesmen and mechanics. A common saying ... was, “a boy who proved unfit for anything else must become a doctor.”

In 2020, Harvard Medical School students circulated a petition protesting the name of the institution’s Oliver Wendell Holmes Society. The petition stated that “As dean of HMS in 1850, [Mr.] Holmes was challenged by students and faculty to revoke the acceptances of three Black students that had gained admission to HMS. Holmes responded by expelling the Black students and wrote, ‘This experiment that the intermixing of the white and Black races in their lecture rooms is distasteful to a large portion of the class and injurious to the interests of the school.’” Many other points are made in the petition, but no mention made of the fact that Mr. Holmes was responsible for admitting the three Black applicants, and a woman, in the first place. Over 650 signatures were obtained from faculty and students. The name of the Oliver Wendall Holmes Society has been changed.

The faculty of Geneva Medical College may have shown foresight in dodging a potential student revolt, but, by today’s standards, the students made the right decision for the wrong reasons. Mr. Holmes, condemned by students and faculty in 1850 for admitting Black students and a woman, now stands condemned by students and faculty for not succeeding in overcoming the ethos of the times. +

References:

Blackwell, Elizabeth. 1977. Pioneer Work in Opening the Medical Profession to Women. With New Introduction by Mary Roth Walsh. Schocken Books, New York.

Podolsky Scott, Bryan Charles. 2009. Oliver Wendall Holmes, Physician and Man of Letters. Science History Publications, Sagamore Beach.

Nolan, LaShyra. 2020. Renaming the Holmes Society At HMS/HSDM. Webpage Accessed 2021-2-10. [https://docs.google.com/forms/d/e/ 1FAIpQLSeGz-HFs9NGE1vQxGSuAbaJQh_LRap- 8jzkvNadrtL1PtrMX-A/viewform]