Saturday, November 7, 2009

Local Heroes in Medicine: Women Pioneers that Shaped Medicine in San Francisco

The following is an article from the September 2009 San Francisco Medicine publication:

Local Heroes in Medicine

Pioneers that Shaped Medicine in San Francisco
by Nancy Thomson, MD

“Women should not be expected to write or fight or build or compose scores. She does all by inspiring men to do all.” —Ralph Waldo Emerson (1802–1882)

In 1948, when I started college at Stanford University, my physician father discouraged me from preparing for medical school, saying that I would take a man’s place, then marry and never practice. Lois Scully, MD, a San Francisco internist, Stanford graduate, and 1979 president of the American Women’s Medical Association, ran into the same bias at about the same time when the
Stanford physician who interviewed her told her to go home, marry, and have five children.

In the early 19th century, Lucy Stone (1818–1893) wanted a good education, but the only college in the world that accepted women at that time was in Brazil. Luckily, Oberlin University was founded in 1835 in Ohio, the first U.S. college to accept both women and African-American students. Stone enrolled and graduated in 1847. However, when it came time to seek a profession, the only field open to women was teaching. In 1849 (the year Elizabeth Blackwell graduated from Geneva Medical College in New York), Lucy Stone wrote, “We believe that if the system of educating females for physicians be generally adopted, a great amount of suffering and death will be saved.”

In fact, the number of female medical school graduates rose steadily from 1849 to 1900. By 1900 in Boston, women represented 18 percent of practicing physicians. However, by 1903 women’s participation in medicine began to decline, as most of the women’s medical schools established in the previous 50 years were closed or merged with male dominated schools, which continued to reject women applicants. This situation generally prevailed until the 1970s, when the feminist movement and antibias legislation brought about an increase in women attending medical schools.

In 1970, female admissions to medical schools were at 9.2 percent; in 1980 they had risen to 27.9 percent, and they are at almost 50 percent today. The decline in economic potential for physicians (which was historically one of the foremost motivations for male medical students) is given comparatively little importance by female students, who cite longtime interest in medicine and science, the desire to help others, and dissatisfaction with other types of work among
their reasons for choosing medicine.

The following time line highlights women’s place in the medical history of San Francisco.

Historical Time Line

From the time of landing at Plymouth Rock, women as well as men practice medicine in New England, often after an apprenticeship with a practicing physician. However, when American medical schools are established, they follow the European pattern of barring women from
seeking medical degrees.

Elizabeth Pfeifer Stone, the first woman to practice medicine in California, settles in San Francisco. Probably German-born and -trained, she previously practiced in New York.

University of California acquires Toland Medical School in San Francisco, and since U.C. is already coeducational, Lucy Maria Field Wanzer, a thirty-three year-old teacher, is accepted as its first female medical student. However, the dean suggests to her fellow students that they “make it so uncomfortable for her that she cannot stay.”

Charlotte Blake Brown applies to the San Francisco Medical Society for admission. Some members of the membership committee feel strongly that females are mentally, physically, and morally unfit to study medicine, let alone practice the profession. On advice of mentors, Brown
withdraws her application.

Following the model of Elizabeth Blackwell’s New York Infirmary for Indigent Women, Pacific Dispensary for Women and Children is founded by three women, all educated on the East Coast: Charlotte Blake Brown, Martha Bucknall, and Sarah E. Browne. This outpatient clinic, initially located at 510 Taylor Street, is intended to provide opportunities for women physicians to obtain internship experience.

San Francisco Medical College of the Pacific accepts its first female student, Alice Boyle Higgins, who graduates in 1877.

Having been admitted to the California Medical Society along with four other women in 1876, Lucy Wanzer becomes the first female member of the San Francisco Medical Society.

Founders of Pacific Dispensary create the first nursing school west of the Rockies. Its one-year course becomes a two-year curriculum in 1882.

The Pacific Dispensary moves to a new two-story building at California and Maple Streets and becomes Children’s Hospital. Interns and residents can be either male or female, but there are no men allowed on the medical staff.

Citizens of San Francisco raise money to build the Little Jim Building for pediatrics at Children’s Hospital.

One year after X-rays are discovered, Elizabeth Fleischman-Aschheim, an engineer, opens the first X-ray laboratory in California, at 611 Sutter Street.

William Randolph Hearst leads the campaign for the Eye and Ear Pavilion at Children’s Hospital.

Dr. Charlotte Blake Brown dies at age fifty-eight. Her daughter, Adelaide Brown, MD (1868–1933), carries on her mother’s work at Children’s Hospital but also serves on the Stanford faculty at Lane Hospital. She fights locally and nationally for clean milk, sanitary garbage disposal, maternal and child welfare, visiting nurse services, and clinics offering cardiac care and birth control.

The San Francisco earthquake forces the demolition of the 1887 Children’s Hospital building.

A new, four-story brick Children’s Hospital building opens at California and Cherry Streets.

The Contagious Disease Pavilion opens at Children’s Hospital, with money donated by William Randolph Hearst, to care for diphtheria, scarlet fever, measles, TB, and, later, polio.

Children’s Hospital affiliates with the University of California for the teaching of medical students.

The American Medical Association admits its first female member.

Henries Hagar Duggan, MD, becomes a pioneering medical anesthesiologist. She works at various hospitals but settles at Children’s for twenty-five years, retiring after the end of World War II.

UCSF pediatricians Mary Olney and Ellen Simpson found summer camps for children with diabetes.

Marian Yueh Mei Li arrives in San Francisco, having completed medical school in Shanghai. She eventually opens a private practice and becomes the first Chinese female ophthalmologist to practice in Chinatown.

Pediatrician Hulda Thelander establishes the Child Development Center at Children’s Hospital for children with cerebral palsy, developmental delays, and congenital defects.

Internist Roberta Fenlon, MD, becomes the first female president of the San Francisco Medical Society.

Dr. Roberta Fenlon becomes the first female president of the California Medical Association.

Linda Hawes Clever, MD, MPH, founds (and chairs) the Department of Occupational Health at California Pacific Medical Center. She is also the first female editor of the Western Journal of
Medicine and is the founder of RENEW, an organization to help fight professional exhaustion and dissatisfaction.

Children’s Hospital acquires St. Joseph’s Hospital.

Marshall Hale Hospital, formerly Hahnemann Homeopathic Hospital, merges with Children’s Hospital.

Children’s Hospital and Pacific-Presbyterian Medical Center merge to create California Pacific Medical Center (CPMC). CPMC joins the Sutter Health chain.

Judith M. Mates, MD (ob-gyn), becomes the second female president of the San Francisco Medical Society.

Toni J. Brayer, MD (internist), becomes third female president of SFMS and, in 1990, the first female chief of staff at California Pacific Medical Center.

Rita Melkonian, MD, FACOG (obgyn), becomes the fourth female president of the San Francisco Medical Society, with E. Ann Myers, MD (endocrinology), as the president-elect.

In closing, it’s interesting to note that in 1868, while debating the admission of women, the American Medical Association recorded this statement by Dr. Alfred Stille, prominent teacher of pathology:

“Another disease has become epidemic. The woman question in relation to medicine is only one of the forms in which the pestis mulieribus vexes the world. In other shapes it attacks the bar, wriggles in the jury box, and clearly means to mount upon the bench; it strives thus far in vain to serve at the altar and thunder from the pulpit; it raves at political meetings, harangues in the lecture room, infects the masses with its poison, and even pierces the triple brass that surrounds the politician.”

If only Dr. Stille could see us today. We’ve sure come a long way.

Nancy Thomson, MD, was a practicing anesthesiologist at Children’s Hospital from 1963 to 1985. In 1988 she received her master’s in public health from the University of California at Berkeley. From 1991 to 2000 she worked as the infectious disease officer and staff physician at San Quentin State Prison. Dr. Thomson currently serves on the editorial board for San Francisco Medicine and is the magazine’s obituarist.