During 2020 we celebrated the suffragists who worked to gain votes for women. They won that right in 1920 when the 19^th Amendment was passed. But during the same years that the suffragists were fighting for women’s right to vote, many women paid little attention to voting but pursued other paths to empower women. When we consider how women’s lives have changed over the past century, we can see that women’s right to participate in business and professions may have been just as important as winning the right to vote.

One example of women’s changing role is the number of women doctors in the United States. In 2019, according to the Kaiser Family Foundation, one-third of practicing physicians were women. And in that same year, the Washington Post reported that the majority of medical students were women. We take these figures for granted now, but the battle to allow women to practice medicine was long and difficult.

Elizabeth Blackwell, the first American woman to become a medical doctor, made great strides for women, but never bothered to support women’s right to vote. This year has seen the publication of a new biography of Elizabeth Blackwell and her sister Emily, both of whom were pioneer doctors. Janice Nimura’s recent biography The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine (Norton 2021) gives a vivid picture of how difficult it was for women to be accepted in the medical profession.

Through the years, centuries even, men have found it hard to accept women into the schools and professions. Elizabeth Blackwell was accepted as a student at Geneva Medical College in New York mainly because the medical students were allowed to vote on whether or not she should be admitted. Faculty members refused to make that decision, but many students thought it would be a good joke to have a female student in their classes. No one apparently expected Elizabeth to become a real doctor. That idea was outlandish.

After completing medical school and earning high grades in her classes, Elizabeth Blackwell was unable to find a hospital that would allow her to observe patients and to learn from practicing doctors. She had to travel to Europe—to both England and France—to find hospitals that gave her the chance to observe patients and practice her skills.

Elizabeth Blackwell demonstrated an almost superhuman persistence and strength in seeking entry to the field. Early in her life she decided that women should be treated by female doctors who could understand their symptoms and establish more useful doctor-patient relations than men could. She did not, however, seem to believe that many other women could follow her path. Her relations with women did not demonstrate great understanding or sympathy. Although she found a number of male mentors in her tireless pursuit of medical training, she was critical of the women she encountered. When she met the wives of doctors with whom she worked, she complained about their dress and manners. “Women so dressed out,” she declared, “don’t look like rational beings and cannot be expected to be treated as such.”

The Blackwells were a large family and they worked together well. Elizabeth encouraged her younger sister, Emily, to become a doctor even though she recognized how hard a path that was. After several attempts to be accepted at an American medical school, Emily was finally able to earn her degree. Like Elizabeth, she had to go to Europe to find the practical experience to complete her skills. Along the way, both Blackwell sisters encouraged other women to follow their path.

Ever so slowly, women gradually entered the medical field. More of them became nurses than doctors, but nonetheless, generations of women discovered they could support themselves and sometimes their families by entering medicine. This movement into economic freedom was probably as important in most women’s lives as the movement to gain votes. Nimura’s book about the Blackwell sisters shows us both the importance and the difficulty of their pioneer work. It is well worth reading.