Wendy Moore, freelance writer and author, London,
The future is female— within a decade most UK doctors will be women—but then so was the past.
As herbalists, midwives, bonesetters, wives, and mothers, women have long provided the bulk of health care throughout the world. A plucky few were even allowed to scale the lofty heights to fame and, occasionally, fortune.
A female teacher, known only as Trotula, at the medical school of Salerno is believed to have written several important medical tracts in the 12th century, while the polymathic abbess Hildegard of Bingen was a renowned healer whose Book of Simple Medicine was a medieval page turner.
In the 18th century the services of the bonesetter Sarah Mapp were in such demand that she rode to her weekly clinics at a London coffee house in a luxurious coach and six. But far from being feted for her dexterity by male colleagues, "Crazy Sally" was denounced as an "ignorant, illiberal, drunken, female savage" by the surgeon Percival Pott. As Georgian women had no monopoly on ignorance, drunkenness, or savagery, it was plainly the female flaw in Mapp’s character to which Pott objected.
Certainly his Victorian successors had little doubt that feminine attributes were wholly incompatible with a career in medicine, by virtue of women’s inherent physical weakness, intellectual inferiority, and susceptibility to fits, hysteria, and—heaven forfend—menstruation. Only by a dogged negotiation of backdoor entrances and technical loopholes did the first female doctors—Elizabeth Blackwell in the United States and Elizabeth Garrett Anderson in Britain—finally manage to qualify. Even then (though Blackwell graduated top of her class) they were restricted to peripheral jobs treating predominantly women patients.
It took a world war to change attitudes—albeit grudgingly at first. When the Scottish doctor Elsie Inglis offered to run a hospital for British soldiers at the outbreak of the first world war, the War Office blustered: "My good lady, go home and sit still!" She promptly offered her services to the French government and founded women run units in France and Serbia.
Fellow suffragette doctors Louisa Garrett Anderson, daughter of Elizabeth, and Flora Murray also refused to sit still. Invited by the French Red Cross, they ran a highly efficient military hospital in a Parisian hotel from September 1914. Forced to admit the success of the venture, a chastened War Office belatedly asked the pair to run a British hospital in Wimereux, near Boulogne, and, the following year, in London.
Established in a former workhouse in Covent Garden, the 573 bed Endell Street Military Hospital was staffed and managed entirely by women. Admitting up to 80 casualties an hour and performing 20 operations a day, the hospital treated more than 26 000 casualties until it finally closed in December 1919.
The preceding year British women won the vote. The barricades of medicine would take somewhat longer to fall.
Cite this as: BMJ 2009;338:b2522
Sources: Roy Porter, The Greatest Benefit to Mankind (HarperCollins, 1997), pp 129, 356-8; Jennian F Geddes, ‘The Women’s Hospital Corps: forgotten surgeons of the first world war,’ J Med Biogr 2006;14:109-17.