_Formal opening of the College term--Professor Zakrzewska delivers
the Introductory Lecture--Father disapproves of her removal to
Boston--This increases the shock of news of his death. (Thirty years
of age: 1859.)_
The term of 1859-1860 of the college opened well. A goodly number of
students had registered, among them the fine women already mentioned
who assisted much in giving a high tone to our work, and I felt
greatly supported by their earnestness and zeal. [According to the
college announcement, this term opened on November 21, 1859, with the
“Introductory Lecture by Professor Zakrzewska.” A few extracts from
this formal address will help still further in developing the portrait
of the speaker.]
The study of medicine is so great and comprehensive a field that
within its horizon we find included the whole moral world. It
comprises mankind in all its conditions, in all its changes of
opinions and in all its modes of society. It has been subject to the
highest wisdom in existence, to the greatest folly and mysticism which
superstition could produce and, in our days, to the most profound
learning and scientific speculation. And though I am now addressing a
miscellaneous audience of which only a few are physicians or students
of medicine, every one is in some way connected with the profession,
be it only as a patient. Every one receives this liability as an
inheritance from nature and, therefore, ought to be interested in a
science which occupies itself with mankind.
The only motives that this profession permits to its votaries are
the clear and decided conviction of an inborn taste and talent
for the practice of medicine and an earnest desire for, and love
of, scientific investigations concerning the human being--its
construction, its condition of health and disease, and all its
relations with the surrounding world.
It is a positive fact, acknowledged among all nations and at all
times, that there is in the mass a growth of the human mind from
generation to generation similar to that in the different periods of
individual existence. And to these varying stages of mental growth
we must ascribe the different forms through which the practice of
medicine has passed.
Disease is as old as mankind. The first sore finger made the first
patient, and the first physician was the one who bound it up or who
inquired how it was doing. Pain awakens the instinct to relieve, one
following the other, and this must have existed from the creation of
mankind.
The practice of medicine dates back, therefore, to the morning of
life; the shadows of a hoary antiquity gather around its cradle. The
annals of history do not reach back of it, but only open the portals
of fable in whose shadowy domain it is supposed to dwell. Æsculapius
was the grandson of Zeus, whose father was Time himself.
Gradually we see it emerging from this hazy atmosphere in the form
of a mysterious science, assisted and appropriated by the mysticism
of the oracles and astrologers, until it found its devotees in the
priesthood who pursued the practice upon the body in connection with
their duties as priests for the soul.
It is only since medicine has ceased to stand isolated from the other
sciences that the erroneous belief that disease was produced by
supernatural agency has waned. Nothing has more retarded the progress
of medicine in becoming really scientific than its separation from
general learning; and nothing could favor empiricism and superstition
more than the promotion of this separation.
That this separation produced an apparently inextricable confusion
was very natural, just as it was natural that medical sects should
have been formed of which the one renounced this, the other that, and
the third something else--each individual sect being distinguished
by its one-sidedness. The only sect--if we may thus term the regular
physicians--which at no time could be accused of one-sidedness in
its proclamations was that based upon the principles of Hippocrates
and the Alexandrian School--these advising practical, experimenting
science, a course of reasoning which Lord Bacon in his works has
approved with such justice. And how necessary it was to follow this
recommendation continually and in every particular is best illustrated
by showing how one branch of medical practice could fall almost into
oblivion by neglect to pursue it as an _experimental_ science.
For instance, in the history of Obstetrics, we find that very little
was done to promote its elevation from the times of Hippocrates and
Celsus until within the last one hundred and twenty years, when
Pareus, Mauriceau, De la Motte, Deventer, and Justina Siegesmundin and
others began to investigate it and to raise it to its proper place as
a science.
Until this time, the obstetric art was so entirely neglected that
it was considered beneath the dignity of an honorable man. Low and
uneducated persons appropriated this practice to themselves, even in
cases of the greatest emergency. The degradation of this branch alone
proves the need of the introduction of new ideas formed by constant
observation in science at large; it also proves that we cannot abandon
speculations and experiments on the natural laws which pervade all
organizations; and that it is a matter of great necessity that every
student of medicine should be provided with ample opportunities for
so doing. And how successful and beneficent, although difficult, such
reforms are, I shall illustrate by speaking again of the resurrection
of obstetrical science.
New life had to be introduced into it before new light could be thrown
upon this field; and this new life was finally introduced when the
persons just named entered upon the study. They found that midwifery
as it was then practiced must be reorganized. Observations on nature
needed to be made and these were to be followed by scientific
analysis, and the results introduced into practice.
A new era for the studious was opened, and many young and brilliant
minds now found their attention directed towards this branch of
learning which before they had considered as a subject beneath their
dignity. Very soon after the first attempt for improvement, an ardent
enthusiasm was created in the subject, since in it a field for new
investigations, and consequently for new honors, became apparent
to the eyes of the ambitious or the learned. In a very short time,
the practice of obstetrics was regulated in such a manner that not
only had the horror towards the persons engaged in it entirely
disappeared, but the terrible operations often practiced had also
become lessened to an insignificant number, these latter belonging to
the class of unavoidables.
Every country produced authorities. England boasted her John Burns and
Hunter, while France raised up her Baudeloque, her Madame Lachapelle,
Madame Boivin and many others. But no country gave to the profession
such thoroughly scientific investigators as did Germany, and of these
a _woman_ took the lead. Justina Siegesmundin was the pioneer of
this great reform, and her work, written upon the subject in 1741,
came upon Europe like a thunderbolt. In every country, minds which had
been preoccupied with a thousand other things, forgetting the most
important, were awakened to an activity which would but a short time
before have been deemed impossible. In Germany, therefore, the subject
of obstetrics is still considered as of momentous importance, the
foundation almost of all other practice ... and the statistics prove
that in this branch of practice less loss of life occurs there than
in any other country, though its proportion of difficult cases is the
greatest of any.
Reformations similar to this will be constantly demanded in all the
different branches of medical science.... Every day brings results of
new researches which are throwing fresh light upon subjects not yet
understood.
And this is the position which a physician must assume to-day, and
for which those who are entering upon this field of study should
fit themselves. To be an honorable acquisition to the profession, a
consoler to those who require assistance in overcoming disease, a
public instructor in the art of preserving health, a reformer from
the artificial to the natural--these are the aspirations which must
animate every one who dares attempt to step forward to the platform of
the benefactors of mankind.
This is the aim which the beginner must have in her mind, and if she
falls short of attaining it, she must be able to say that it was
neither through indolence nor indifference, but through absolute
powerlessness. If you doubt this to be the position which the student
should take, then look around and ask yourself what you want of your
physician.
If you are educated, you want your physician to be still more so; if
you possess perception of conditions and circumstances, you demand
this of your physician still more. You want of him that he shall not
only perceive and penetrate into the secret relations and conditions
of the body physically and psychically, but that he shall also explain
to you those phenomena which are incomprehensible to you in spite of
your great perceptive faculties.
You further demand of your physician that he shall know everything
belonging to medical science. If you understand physiology well,
you demand that your physician shall explain in a moment every fact
that is dark to you, while a lifetime may not be sufficient to prove
a hypothesis. If you are at home in chemistry, you will certainly
be greatly surprised if your physician makes a mistake in some
combinations, and you will be ready to say that he is stupid. If you
have great skill in nursing, you will expect your physician to teach
you how to improve; if you are kind and agreeable and amiable, you
demand the same qualities in him; if you are irritable, fretful and
capricious so that you have been designated by your neighborhood as
a fury, you want at least that your physician should comprehend your
subtle nature. And in addition to all this, your physician must be
sociable, entertaining, wise in every word, overflowing with great
thoughts, and uttering new truths whenever you invite him to your
table.
All this is really demanded of the physician, but how far it may be
justifiable, I leave it to the thinking ones to decide. But of this
we may be sure--the physician of the present day occupies a higher
station than ever before and greater qualifications for the study of
medicine are increasingly demanded.
I mentioned in the beginning that the motives for the study of
medicine must be the right ones; now I have to add that these alone
will not suffice to make a good physician such as we want to-day.
These motives must be accompanied by certain qualifications. The
latter are twofold, and may be divided into those belonging to the
intellect, and those belonging to our personal and affectional nature.
It is of infinite importance that the intellect should have been
previously developed by a course of study which shall train the
student in logic and reasoning and familiarize him with natural as
well as with moral and mental philosophy. Observation and experiment
are the two great auxiliaries to medical study. Those who possess
the first as a natural gift and who have judgment enough to apply it
whenever they have an opportunity will take the lead, but those in
whom both must be developed will always limp behind unless they study
most industriously and perseveringly.
Foremost among the second group of qualifications stands the matter of
age. The student ought to be mature enough to think and to reason, but
not advanced beyond the time when the mind is naturally predisposed
to acquiring knowledge. Physical health and prepossessing appearance
are of the next importance; while cultivated manners and agreeable
behavior, as well as talent in adapting himself or herself to all
conditions, all circumstances and all persons, are by no means the
last to be considered.
In addition there are some qualifications yet to be mentioned
which form a part of our affectional nature and without which
no practitioner can succeed. Of these, the most essential is
sympathy--not sentimentalizing sympathy, but the sympathy which never
betrays weakness or timidity and which is firm and persevering,
controlling every action that it may not become rashness. Modesty
and reticence, sobriety and unselfishness are other virtues much
desired in the practitioner. And I add here a word of warning against
temptations into which physicians are constantly led because I know
how often pecuniary gain or social position can be obtained by being
untrue to one’s best self. I have also had occasion to see the
consequences in those who have yielded to the temptation to abandon
their principles.
No greater misery can perhaps be imagined than contempt for one’s
self; no greater punishment can be endured than the consciousness
of having acted meanly and despicably. A man who when alone in
his chamber is forced to blush for himself carries hell within
him--the loss of a clear conscience is the source of much despair.
Conscientiousness, so important for every man of whatever station
in life, is still more important in a physician. To be scrupulously
honest, to satisfy his own conscience even at the cost of material
profit, is absolutely essential for him.
It is human life--that most divine element in creation and
irreplaceable when once lost, for which the practitioner is
responsible; and no regrets, no penitence, no despair will be
accepted by those who mourn or will reconcile them to their
bereavement. The loss of a beloved wife and mother perhaps brings
another life to the grave, or it may fix the unhappy fate of a dozen
human beings of whom she was the guardian angel, and who now are left
alone.
Pause and think for a moment, and try to appreciate the weight of
misery which in lonely hours such a picture reveals to the mind of one
who in a critical moment was made responsible for life and death, and
who must confess that such victims fell a sacrifice to the ambition
which prevented him from owning his inability for the work intrusted
to his hands.
I must leave the subject here and allow you to decide if I have
pictured clearly enough what we want in a physician of to-day. If I
have succeeded, you will certainly join with me in giving voice to
your convictions that not only the very best method for instruction
should be provided, but that every facility should be offered to
the student to make him or her acquainted with the past history of
medicine. Only those who are familiar with all that occurred before
they stepped on the platform as public instructors or practitioners
will thoroughly comprehend their duty. Great deeds stimulate to
greater ones, and so much has already been done in the profession that
in order to understand his or her own position the newcomer needs to
have knowledge not only of to-day and yesterday but of all times.
[The foregoing definition of the medical profession paints a picture
far removed from that of Dr. Johnson, as quoted in one place by the
speaker--“The profession of physic is a melancholy attendance on
misery, a mean submission to peevishness and a continued interruption
of pleasure.”]
The men professors, of whom there were four, and the other woman
professor (teaching physiology) were in apparent harmony with my
plans. These were to devote my teaching--which was threefold, namely,
obstetrics, diseases of women and diseases of children--to only one of
these subjects at a time instead of giving two lessons a week on each.
This seemed to work very well; but as it left only four weeks for
treating the diseases of children, while obstetrical teaching ran
through the winter, the students of less intelligence began to be
dissatisfied and my college troubles had already begun before the
winter session had ended.
Meanwhile, I was not happy in my relations with my father, whose
letters disapproved of my having left New York, where he felt that
I was under the supervision of the Drs. Blackwell with whom all
responsibilities for the hospital enterprise rested. He now became
really distressing to me because his conviction was that whether I
succeeded or not I was disgracing the family, and German womanhood
in general, by accepting a position which caused my name to come
prominently before the public.
I finally felt that I must write a strong and decided letter to him,
requesting him either to stop writing to me altogether or else to
preserve silence as to his judgment of me and my actions. This letter
arrived in Berlin at a time when he was ill in bed and he died a few
days later.
I received the news of his death in November from his wife, he having
married again. But I never knew whether he read my letter or not. The
shock was very great and it upset my nerves, not only as the loss of
so near a relative naturally would but also from the fact that I had
written a letter which I had for several years hesitated to write, not
wishing to place myself in a hostile position to a father who, after
all, had been kind and had done the best he knew how to do for his
children.
This news also added another care and responsibility, as my father left
two younger sisters unprovided for. Being a salaried civil officer in
the government, he had no opportunity to accumulate money, and both
these sisters were above the age when government pensions are allowed
to children. Although my sisters who were married and lived in New
York and Washington gladly joined in this financial care yet their own
family interests could not be sacrificed.
Thus ended the year 1859, and Christmas time was a rather _triste_
one, especially as that cheerful festival was not then celebrated in
New England, and schools and colleges continued in session as usual.
In looking back upon it, it seems to me that that year was one of
the most delightful as well as the most tragic, and one of the most
peaceful yet most conflicting, in emotion, in judgment and in making
decisions.
Often have I meditated how differently would we act if we clearly saw
events a little before they occurred. And how utterly tales of fiction
fail when they describe how rightly instinctive wisdom decides at
a moment when emotions and intelligence oppose each other, always
leading the hero to do the right thing. The calm reasoning of the
author knows what aim he has in view and what will be the end. In real
life it is quite a different affair, and no one can judge the result
when in a condition of conflict between heart and head.