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  ‘The first thing women must learn is to dress like ladies and behave like gentlemen.’

  Elizabeth Garrett Anderson

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  Elizabeth Garrett Anderson

  1836–1917

  As far as medicine goes, I’ve chosen Elizabeth Garrett Anderson as the first woman to qualify as a medical doctor in Britain because she did so as a woman, went on to specialise in women and children, and worked hard for the greater emancipation of women throughout her long life.

  She was not, though, strictly the first. James Miranda Stuart Barry, who is thought to have entered this world in 1789 and lived until 1865, was actually born Margaret Anne Bulkley and qualified more than fifty years before Garrett Anderson. Bulkley chose to disguise herself as a man in order to gain acceptance to the medical school in Edinburgh. She lived the rest of her life as a man, working as a military surgeon, serving in India and in Cape Town, South Africa, where there is a museum dedicated to her/his achievements, one of which was the first Caesarean carried out in Africa where both the mother and child survived.

  Barry died in England from dysentery and the woman who cared for him and dealt with the body reported to the authorities, after the funeral, that she had examined his anatomy and that she had discovered Inspector General Dr James Barry to be, in fact, female, and the stretch marks on his stomach indicated that he had, at some time, given birth to a child. The subterfuge came to light in an exchange of letters between George Graham of the General Register Office and Major D. R. McKinnon, the doctor who had issued the death certificate on which Barry was identified as male.

  McKinnon in his letter said that it was none of his business whether Dr Barry was a male or a female. He said he could only positively swear that the identity of the body was that of a person with whom he had been acquainted as Inspector General of Hospitals for a period of years. She certainly deserves an acknowledgement here.

  Elizabeth Garrett was born in Whitechapel in London and was the second of the nine children of Newson Garrett and his wife, Louisa. The family became well-to-do as the children grew up. Garrett was a self-made man who started out as a pawnbroker and developed a business as a grain merchant and maltster, operating out of Aldeburgh in Suffolk, which is where Elizabeth spent most of her childhood.

  She was educated by her mother, then by a governess at home before attending, for five years from 1849, a boarding school for ladies at Blackheath in Kent run by the aunts of the poet Robert Browning. It was during this period that she met Emily Davies, who would later found Girton College, the first Cambridge college for women. The two of them became active members of the Langham Place circle and agreed on the careers they would pursue as part of their determined campaign to forward the advancement of women’s rights and professional opportunities. Garrett would open the medical profession to women and Davies planned to open the doors of British universities.

  The Langham Place Ladies were a group of middle-class, highly educated women who were associated with the Society for Promoting the Employment of Women and the English Woman’s Journal. I think of them often when I arrive for work at Broadcasting House, around the corner from Langham Place. They were the foundation of the growing Victorian women’s movement. As a result of her activities with the ‘ladies’ Garrett met Dr Elizabeth Blackwell, an Englishwoman who had been raised in the United States where she had, despite endless barriers placed in her way, managed to study medicine and obtain a degree.

  Blackwell had come to London to have her name entered on the General Medical Council’s newly established register. There was a temporary provision for doctors who qualified overseas to be registered after the Medical Act of 1858 and Blackwell was then, for a short time, the only woman on the list. During her visit she promoted the cause of women who wanted to enter the medical profession. Garrett was inspired.

  Her father took some persuading that this was a suitable plan for a daughter of his. Mr Garrett had been a supporter of the education of his girls, but he was also a man deeply steeped in Victorian values. A respectable daughter with a good marriage was the aim of every responsible father, and the thought of his girl being involved in work that would have involved blood, guts and the more intimate parts of the human anatomy must have horrified him.

  With Blackwell’s support, Elizabeth managed to win him round to the extent that he agreed to give her his full support with both connections and finance. She was then able to begin her attempts to overcome the difficulties of prejudice against women she knew she would face. The profession was entirely dominated by men who, like her father, would have found the idea of a woman wielding a scalpel or discussing personal matters with a sick patient utterly unacceptable.

  She made formal applications to several London teaching hospitals and to Edinburgh and St Andrews. She was turned down as a student by all of them, although Middlesex Hospital offered her a trial period from 1860 to 1861. She was to work as a nurse, but be given access to the operating theatre and classes on materia medica (medicine), Latin and Greek with the hospital’s apothecary.

  Eventually she was allowed into the dissecting room, but this seems to have proved too much for her shocked male colleagues. In 1861 they presented a memo to the hospital’s medical school authorities making clear their determination that a woman should not be allowed admittance as a fellow student. They argued that the work they were expected to do with patients, cadavers and in the laboratory was simply not suitable for feminine sensibilities. Elizabeth was also an attractive young woman, modestly dressed in the style of the day with her hair neatly tied up in a bun, but her erstwhile colleagues were not happy with the distraction that the female of the species presented. What’s more likely is that they were jealous of her academic and practical abilities.

  The hospital excluded her from any further study there. But this was a woman who was described in her youth as being of indomitable will, unprepared to suffer fools gladly. She threatened legal action and the Society of Apothecaries, responsible for issuing medical licences, acknowledged that they could not prevent her from taking their examinations as long as she completed the required courses of study. This she had to do as a private student of teachers from recognised medical schools and after serving an apprenticeship under a licensed apothecary.

  Happily, her wealthy, determined and by now encouraging father financed her and, in 1865, she obtained the licence of the Society of Apothecaries, which entitled her to have her name on the medical register. Only three of the seven applicants who took the exam passed it and Elizabeth gained the top marks. No wonder those young men were jealous and resentful. Soon after, the Society decided that no more women would be allowed to register, so Elizabeth was the first woman qualified in Britain to achieve such official status and the last until the Medical Act of 1876 allowed the British medical authorities to license all qualified applicants, regardless of gender.

  In order to become a fully qualified doctor she had to leave the country and study at the University of Paris, and her low-status qualification as an apothecary was now raised to the level of MD. She was the first woman to achieve the degree, and in 1873 she was admitted to membership of the British Medical Association. In 1878 pressure was put on her to resign her membership as the BMA had voted against the admission of any more women. She refused and was the only female member for the next nineteen years, just one of several cases where Garrett would be the first woman to enter an all-male medical institution which would then block any further applications by women.

  Now she was fully qualified to work as a doctor, Garrett set up her own practice in Upper Berkeley Street in London, just around the corner from fashionable Harley Street and only a few minutes’ walk from Langham Place where the ‘ladies’ had congregated. She also set up the St Mary’s Dispensary for Women and Children in Marylebone and, for this project, being well-connected among London’s wealthy proved a great help. Charitable funds were found for the dispensary itself, as well as money to pay the fees for women who could not afford their own treatment.

  Elizabeth had, for obvious reasons, a keen interest in education and in 1870 she stood as a candidate for the London School Board, the first time women had been allowed to stand. Robert Browning was an active supporter, as were a number of husbands of her more wealthy and influential patients. She won the highest number of votes in the whole of the capital.

  James George Skelton Anderson was chairman of her election campaign. He worked for the Orient Steamship Line and was a son of a clergyman. The two married in 1871 and she went on to have three children, first a son, Alan, and two daughters, Margaret and Louisa. Margaret died of meningitis in 1875. All her children had the name Garrett Anderson, the name by which Elizabeth was known after her marriage. It was a rare move in the period for a married woman to insist that her own family name should continue down her line. Her younger sister, Millicent Garrett, a leading suffragist, did the same thing, becoming Millicent Garrett Fawcett – more of her in the next chapter.

  Elizabeth carried on working hard after marriage and motherhood, becoming a model for the mother who also wants to have a career, although she did resign an honorary post at the East London Hospital for Children, which she’d held since 1870, and she quit the school board. I guess even with the funds to pay for adequate childcare it wasn’t absolutely possible to have it all! She once said, ‘A doctor leads two lives, the professional and the private, and the boundaries between the two are never traversed.’

  Her creation of the first hospital dedicated to the health of women with only female medical staff to care for them occurred in 1871, the same year as her wedding. The New Hospital for Women began as just ten beds above the dispensary, and the doctors she appointed were unregistered as they had medical degrees obtained abroad.
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  It was around this time that Elizabeth began to enter into the political arena on behalf of the burgeoning feminist movement. In 1874 Henry Maudsley (now known for his hospital in south London and his work in mental health) wrote an article on ‘Sex and Mind in Education’ in which he argued that education for women caused overexertion, and thus reduced their reproductive capacity, sometimes causing ‘nervous and even mental disorders’. Elizabeth countered his argument by saying the real danger to women’s mental health was not their education, but boredom. She said fresh air and exercise were infinitely preferable to sitting by the fire reading a novel.

  It was in the same year, 1874, that she became a joint founder of the London School of Medicine for Women together with another medical pioneer, Sophia Jex-Blake. Elizabeth became a lecturer in the only medical school available to women and was Dean of the school from 1883 to 1902. She gave her students access to patients in the hospital, set them an example of female professionalism and always told them that ‘the first thing women must learn is to dress like ladies and behave like gentlemen’. The school was later renamed the Royal Free Hospital of Medicine and prepared students for London University’s medical degree, which was open to women from 1878.

  In 1872 the New Hospital for Women moved to larger premises and then, in 1874, to a purpose-built facility on Euston Road. In 1918, the year after her death, it was named the Elizabeth Garrett Anderson and Obstetric Hospital and continued to employ only women doctors until it was absorbed into University College Hospital in the 1980s. It had been under threat of complete closure since the 1960s, but, when closure was announced by Camden Health Authority, the building was occupied in protest by the staff. The campaign to keep the hospital open continued until 1979. There is still an Elizabeth Garrett Anderson wing at UCH’s new building, serving maternity and neonatal cases since 2008, but both male and female medical staff are employed.

  By 1880 Garrett Anderson had set up a successful private practice alongside her work for poorer women and, in insisting that she would have only women caring for other women, she was able to conform to some degree to those Victorian standards of modesty that had threatened to block her advancement earlier in her career. Mind you, even today there are lots of women who would prefer to deal with a doctor of their own sex, particularly if their medical problems are obstetric or gynaecological. I remember a great sense of disappointment among my acquaintances – all in the midst of our childbearing years – when the principle she had established of women treating women was lost.

  In addition to her clinical work, Garrett Anderson also became a surgeon – unusual for a woman even today – much to the horror of the management board of the hospital, who refused to allow major surgery to be performed on the premises. She went ahead and successfully removed a patient’s diseased ovary – a very dangerous operation at the time. She wrote a short medical textbook, The Student’s Pocket Index, in 1878, sharing the experience that she felt needed to be passed on to other young women entering the profession. She also contributed numerous articles on cases to the British Medical Journal and wrote for newspapers on medical matters and the women’s cause.

  In 1902, after a phenomenally successful career, Elizabeth and her husband moved back to the Garrett family home in Aldeburgh after the death of her mother. Her husband died five years later after suffering a stroke. She was pretty much retired from her medical work – she had resigned as senior physician at the New Hospital in 1892, only remaining as a consultant, but she did stand as mayor of Aldeburgh in 1908 and was elected. Thus she achieved another first – no other woman had ever succeeded in becoming a mayor in Britain.

  Her two-year stint as mayor gave her an opportunity to pursue her interests in housing and sanitation, knowing that one of the most vital ways of improving the health of the population was to ensure that there was a substantial roof over the head of every family and that cleanliness would help keep infection and disease at bay. She was also a prime mover in the women’s suffrage movement. She had begun her campaigning for women to have the vote in 1866 when she and Emily Davies gathered more than 1,500 signatures on a petition asking that female heads of households should have the right to vote. She joined the first British Women’s Suffrage Committee and became a member, in 1889, of the Central Committee of the National Society for Women’s Suffrage.

  After her husband’s death, Elizabeth became even more active. She shocked some of Aldeburgh’s town councillors by becoming, in 1908, a supporter of Emmeline Pankhurst’s Women’s Social and Political Union (WSPU), the more radical wing of the campaign, although in 1912 she stepped back from women who believed active revolution was the best way forward and publicly rejected the militant tactics of the suffragettes. She now leaned towards the suffragists’ approach, led by her sister, Millicent Garrett Fawcett, believing that lobbying powerful men might be more effective. It was, in reality, an approach more suited to her character, which had always employed research, information and reasoned argument, rather than breaking windows or tying oneself to the railings of Parliament. Her daughter Louisa, on the other hand, who also became a doctor, joined the militant suffragettes and was imprisoned in 1912 for her activities.

  Dr Elizabeth Garrett Anderson died in 1917 after a long illness and was consequently denied the opportunity of ever marking a ballot paper with a cross. The Great War was coming to a close and the following year, 1918, would see the Representation of the People Act in which limited suffrage was won for women of property over the age of thirty. It would take another ten years for universal suffrage to be achieved for all men and women over the age of twenty-one in the Equal Franchise Act of 1928.

  Elizabeth is buried in the churchyard of St Peter and St Paul’s Church in Aldeburgh, and I just wish I could tell her that now fifty-eight per cent of all doctors in training are female. They have a great deal for which to thank her.

  ‘I cannot say I became a suffragist. I always was one, from the time I was old enough to think at all about the principles of Representative Government.’

  Millicent Garrett Fawcett

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  Millicent Garrett Fawcett

  1847–1929

  I’ve often wondered whether, had I been around before women won the vote, I would have been a militant suffragette or a suffragist, relying on my capacity for reasoned argument and lobbying those powerful men in Parliament whose support would be necessary to get the law changed. Although I’ve been the President of the Fawcett Society – now the only organisation in Britain to work consistently for equality between men and women – since 2003, I suspect I may have been so angry and anxious for a speedy fulfilment of the demand for No Taxation without Representation that I may well have smashed a window or two, burned a post box and chained myself to the railings.

  That was not Millicent Fawcett’s way. Like her sister Elizabeth she spent her childhood in Aldeburgh in Suffolk, where she had been born. The Garretts were a close and loving family where the children were encouraged to learn, get plenty of physical exercise, read and sit around the dinner table for conversation and discussion. Their father, Newson, had been a Conservative politically, but he became a convert to Liberalism and the family was fervently interested in political debate.

  Like her older sister, Milly attended the school in Blackheath, Kent from eleven, leaving at fifteen with a passion for literature, the arts and further education. Through Elizabeth and Louisa, the older sister who died young at the age of only thirty-two, she got to know the Langham Place Ladies and learned about the embryonic women’s movement and its supporters.

  She heard John Stuart Mill speak and was present when Garrett Anderson and Emily Davies organised the 1866 petition for women’s suffrage. It called for ‘the representation of all householders, without distinction of sex, who possess such property or rental qualifications as your honourable House may determine’. The two older women would not allow her to sign it. At the age of only nineteen they considered her too young, but they made no objection to her expending a huge amount of energy persuading others to sign it. There were 1,499 signatures on the petition when it was presented to Parliament by Mill. It failed.