Women Pioneers in San Francisco Medicine

Nancy G. 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. She was prepared to go. 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."

Stone married Elizabeth Blackwell's brother in 1855 but insisted on keeping her maiden name. They both became activists in the antislavery and women's rights movements.

Beginning with Elizabeth Blackwell, the number of female medical school graduates rose steadily from 1849 to 1900, so that by 1900 in Boston, for example, 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. The 1912 Flexner Report that tightened requirements for medical education probably contributed to the closures. 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 9.2 percent; in 1980 they had risen to 27.9 percent and have continued to increase to almost 50 percent today. The decline in economic potential (which was historically one of the foremost motivations for male medical students) for physicians in today's health care industry, is given 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.

I present the following time line to highlight women's place in medical history, specifically in San Francisco. And because San Francisco is the site of two of the medical schools, UCSF and Stanford (until 1959), these hospital facilities are featured. Historically, San Francisco was the medical center for Northern California and in some specialties for the entire state, but as time passed and excellent hospitals, medical centers and medical schools opened throughout California, patient care was redistributed. Of the 26 San Francisco hospitals open in 1960, only 14 still survived in 1990. For more information, see Paul Scholten's article on this subject.

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.

1849
America's first female doctor, Elizabeth Blackwell (whose sister Emily also became a physician), graduates first in her class from Geneva Medical College in New York. The college has to bend the rules to grant her a medical degree.

1850
World's first chartered medical school for women opens: the Women's Medical College of Pennsylvania, founded in Philadelphia with six male professors.

1858
Dr. Elias Cooper organizes the West's first medical school with a charter from the University of the Pacific. The school is located above his office on Mission Street. In six years, 28 men complete the 18-week course. On Dr. Cooper's death from a brain tumor at age 40 in 1862, his nephew Levi Cooper Lane attempts to take over as leader, but the school flounders and he and his colleagues join the faculty of Toland, now UCSF.

1863
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.

1864
Rebecca Lee, the first African-American woman doctor, graduates from the New England Female Medical College of Boston.
    
1870
University of Michigan becomes the first state medical school to fully accept women. However, women still have problems getting clinical experience as hospitals, ambulances and dissection rooms are not considered proper places for the "gentler sex."
    
1870
Dr. Lane and colleagues leave Toland to found their own school, again under the auspices of the University of the Pacific, at Sacramento and Webster Streets. (Medical College of the Pacific became Cooper Medical College in 1882 and in 1908, the Stanford University School of Medicine.)

1873
University of California acquires Toland Medical School in San Francisco, and since UC is already coeducational, Lucy Maria Field Wanzer, a 33-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."

1874
Charlotte Blake Brown applies to the San Francisco Medical Society for admission. Some members of the membership committee feel strongly that the female of the species is mentally, physically, and morally unfit to study medicine, let alone practice the profession, so on advice of mentors, Brown withdraws her application.

1875
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 beneath the office of Dr. Bucknell at 510 Taylor Street, is intended to provide opportunities for women physicians to obtain internship experience.
   
1876
San Francisco Medical College of the Pacific accepts its first female student, Alice Boyle Higgins, who graduates in 1877 and goes to Women's Medical College of Pennsylvania from 1881 to 1882 for postgraduate training before returning to practice in Orange County. Dr. Higgins wanted to be a physician since childhood but was married at 16 to a pharmacist. She was the mother of three children before she began her medical training at age 40.

1877
Having been admitted to the California Medical Society (which bent its rule about joint county society membership) along with four other women in 1876, Lucy Wanzer becomes the first female member of the San Francisco Medical Society.

1880
Founders of Pacific Dispensary create the first nursing school west of the Rockies. Its one-year course becomes a two-year curriculum in 1882.

1887
The Pacific Dispensary, after several relcoations in the Mission District, moves to a new two-story building at California and Maple Streets and becomes Children's Hospital. Besides 25 private rooms and an open ward, it includes a cow barn, a chicken yard and a laundry. Total cost with furniture and equipment is $26,000. In 1890, a Contagious Cottage opens, and in 1892, the Alexander Maternity Cottage opens. Interns and residents can be either male or female but there are no men allowed on the medical staff.

1889
Susan LaFlesche Picotte, daughter of an Omaha tribal chieftain, is the first Native American graduate of Women's Medical College of Pennsylvania.

1895
X-rays are discovered. In 1896, Elizabeth Fleischman-Aschheim, an engineer, encouraged by her brother-in-law Michael J. H. Woolf, MD, opens the first X-ray laboratory in California at 611 Sutter Street. X-rays were invaluable in helping surgeons to locate bullets and shrapnel in soldiers returning from the Spanish-American War. (Tragically, in January 1905, X-ray burns on her right arm required Fleischman-Aschheim to have her arm amputated. She died later that year at the age of 46.)

1895
Citizens of San Francisco raise money to build the Little Jim Building for pediatrics at Children's Hospital.

1896
William Randolph Hearst leads the campaign for the Eye and Ear Pavilion at Children's Hospital.

1904
Dr. Charlotte Blake Brown (whose name is part of Brown and Toland Medical Group) dies at age 58. 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 hard in San Francisco and the nation for clean milk, sanitary garbage disposal, maternal and child welfare, visiting nurse services, and clinics offering cardiac care and birth control.

1906
The San Francisco earthquake forces the demolition of the 1887 Children's Hospital building. A new, four-story brick building opens at California and Cherry Streets in 1911.

1908
Cooper College becomes Stanford University School of Medicine.

1910
The Flexner Report establishes standards for medical education.

1912
Following bubonic plague in 1900 and 1907 and typhoid fever in 1903, the Contagious Disease Pavilion opens at Children's Hospital with money donated by William Randolph Hearst to care for diphtheria, scarlet fever, measles and "miscellaneous" infectious diseases, which include TB and, later, polio. (During the great influenza epidemic of 1918-1919, Children's Hospital was closed to all but flu patients.)

1915
Children's Hospital affiliates with the University of California for the teaching of medical students.

1915
The American Medical Association admits the first female member.

1916
Henries Hagar Duggan, MD (UC, 1903), becomes the pioneer medical anesthesiologist. She works at various hospitals before Children's, but practices there 25 years, retiring after the end of World War II.

1921
The first "iron lung" west of the Mississippi arrives at Children's Hospital.

1938
UCSF pediatricians Mary Olney and Ellen Simpson found summer camps for children with diabetes.

1941
Irwin Memorial Blood Bank, the nation's first community blood bank, opens its doors using the ballroom/basement of the old Irwin Mansion at Washington and Laguna Streets. (Irwin Mansions also housed the SFMS at that time.)

1942
The armed services admits the first female physicians to its Medical Corps.

1944
Bernice Hemphill, a licensed bio-analyist who worked at Pearl Harbor on December 7, 1941, joins the blood bank as its managing director, then serves as CEO until 1981. She is elected president of the American Association of Blood Banks in 1975 and is the first nonphysician and woman to hold that position.
      
1946
Marian Yueh Mei Li, born in Canton China, arrives in San Francisco. (She completed medical school in Shanghai.) After more training at French and Green's Eye Hospitals, she opens a private practice. She is the first Chinese female ophthalmologist to practice in Chinatown.

1952
Pediatrician Hulda Thelander establishes the Child Development Center at Children's Hospital for children with cerebral palsy, developmental delays and congenital defects.
      
1955
Children's Hospital admits its first adult male patients.

1959
Stanford University moves its medical school to Palo Alto. Most of its physicians remain in San Francisco.

1960
Presbyterian Church accepts the former Stanford facility as a gift from Stanford. The intern residence is demolished to erect the new hospital at Presbyterian Medical Center, which becomes Pacific Presbyterian Medical Center in 1967.

1960
Internist Roberta Fenlon, MD, becomes the first female president of the San Francisco Medical Society.

1971
Dr. Roberta Fenlon becomes the first female president of the California Medical Association.
 
1977
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 in the 1990s. In 2000, she begins RENEW, an organization to help fight professional exhaustion and dissatisfaction.

1980
Children's Hospital acquires St. Josep's Hospital.

1988
Marshall Hale Hospital, formerly Hahnemann Homeopathic Hospital, merges with Children's Hospital.

1991
Children's Hospital and Pacific-Presbyterian Medical Center merge to create California Pacific Medical Center (CPMC). Ralph K. Davies Hospital was acquired in 1999. CPMC joins the Sutter Health chain.

1995
Judith M. Mates, MD (ob-gyn), becomes the second female president of the San Francisco Medical Society.

1996
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.

2003
Rita Melkonian, MD, FACOG, (ob-gyn), 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, founded in 1846, 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 muleribus 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.

Dr. Thomson 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. A former secretary on the SFMS Board of Directors and delegate to the CMA, Dr. Thomson remains actively involved in SFMS on the editorial board and as the obituarian. Dr. Thomson welcomes readers' input to make this time line more complete.

Resources

1. Women in White, Their Role as Doctors Through the Ages by Geoffrey Marks and William K. Beatty. Charles Scribner and Sons, 1972.
2. Building Bridges Across Time—A History of California Pacific Medical Center, 1994.
3. "Women's Admissions" by Constance Chen in Stanford Medicine, fall 2000.
4. History of the San Francisco Medical Society, Vol I 1850-1900, J. Marion Ried and Mary E. Mathes. Published by SFMS, 1958.
5. Various issues of San Francisco Medicine (journal of the San Francisco Medical Society), especially Paul Scholten's writings as the historian.
6. "Women in Medicine" by Joe LaDou, MD, in UCSF's Alumni-Faculty Assn. Bulletin 27:1 Winter 1980 7. Various Internet sources