Physicians

By: Vanessa Northington Gamble

Source:

 Black Women in America, Second Edition

Physicians

The 140-year history of black women physicians began during the Civil War, on 1 March 1864, when thirty-two-year-old Mrs. Rebecca Davis Lee (1831–1895), a former nurse, graduated from Boston's New England Female Medical College. Lee's pioneering accomplishment occurred seventeen years after the first black man, David John Peck, and fifteen years after the first white woman, Elizabeth Blackwell, had received their degrees. The minutes of the faculty meeting that voted to award Lee's “doctress of medicine” degree noted that she was “colored.” The need to identify her racially and the conferral of a gender-specific degree underscored the fact that she was just not a physician, let alone a woman physician, but a black woman physician. Such a distinction would also by made for those women who followed in Lee's professional footsteps. As was the case when Justina Ford, an 1899 graduate of Chicago's Hering Medical College and the first black woman licensed to practice in Colorado, applied for her medical license in 1902, the clerk was reluctant to accept the fee because he said that she had two strikes against her—she was a woman and she was black.

The history of black women physicians illuminates the difficulty of trying to advance in a prestigious profession when one has to face obstacles based on race and gender. Black women physicians were forced to battle not only sexism, including that of black men, but also racism, including that of white women. They also had to confront stereotypes about black women and about the contours of black women's work. Yet the history of black women physicians also reveals that despite these obstacles, black women physicians advanced in their profession and made significant contributions to medicine and the black community.

The Trailblazers

Rebecca Lee began her journey to become the first black woman physician on 8 February 1831 when she was born at an unknown location in Delaware to Matilda (Webber) and Absolum Davis. Not much is known about Lee's early life except that she was raised in Pennsylvania by an aunt. By 1852, she had moved to Charlestown, Massachusetts, where she worked as a nurse for various physicians. At some unknown point, she married a man surnamed Lee. In 1860, with letters of support from her physician-employers, Lee sought and gained admission to the New England Female Medical College.

Dr. Justina Ford, who graduated in 1899 from Hering Medical College in Chicago, was the first black woman licensed to practice medicine in Colorado.

Denver Public Library

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Lee's accomplishment was trailblazing. In 1860, of the 54,543 physicians in the United States, only 300 were women. Most physicians of the time did not attend medical school, but received their training through apprenticeships with practicing physicians. Most medical schools denied admission to African Americans and women. The first black medical school, Howard University, did not open until 1869. The historical record is silent on Lee's medical school experiences. However, it is clear that she encountered difficulties graduating. On 24 February 1864, Lee and her two white classmates came before the faculty for their final oral examinations. Each candidate had fulfilled the other requirements for graduation. At the conclusion of the oral exam, the faculty recommended degrees for all three students, but registered concerns about Lee's academic deficiencies. Despite these reservations, she shortly became the school's first and only black alumna.

After her graduation from medical school, Lee practiced in Boston, specializing in the care of women and children. For a time, she sought additional training in an unspecified location in the “British Dominion.” For a few months in 1866, she worked for the Freedmen's Bureau in Richmond, doing missionary work and providing medical care to recently emancipated slaves. At the end of her Freedmen's Bureau service, Lee returned to Boston where she married Arthur Crumpler, a native Virginian. By 1880, she had stopped actively practicing medicine. The 1880 census listed her occupation as keeping house and that of her husband as porter. However, Crumpler had not completely severed her ties to the world of medicine. In 1883, she published A Book of Medical Discourses, a manual to advise women on medical care for themselves and their children. On 9 March 1895, Rebecca Crumpler died at the age of sixty-four. In A Book of Medical Discourses, Crumpler discussed her motivation for entering medicine: “I [had] early conceived a liking for and sought every opportunity to be in a position to relieve the suffering of others.” Her comments underscore the fact that Crumpler was following the long tradition of black women who provided care as midwives, herbalists, and folk healers, while at the same time forging a new path for black women to provide care as physicians.

Three years after Crumpler received her medical degree, Philadelphian Rebecca Cole (1846–1922) became the second black woman physician when in 1867 she graduated from the Woman's Medical College of Pennsylvania. Afterward, Cole worked as a resident physician and a so-called sanitary visitor with Elizabeth Blackwell at the New York Infirmary for Women and Children. Her responsibilities consisted of visiting poor women in their homes and instructing them in the basics of hygiene.

After completing her training, Cole forged a career that foreshadowed those of black women who followed in her professional footsteps—she combined medicine, public health, and activism. During her fifty-year career, she worked for a variety of medical and social agencies that provided services to poor African Americans. She provided care at the Home for Aged and Infirmed Colored People and the Woman's Directory, a social welfare agency that she co-founded in 1873 to provide medical and legal aid to poor women. Cole also spoke out against racial discrimination and segregation. She wrote letters to Philadelphia newspapers, protesting the establishment of racially separate women's committees to celebrate the nation's centennial. Cole also emerged as a vocal critic ofmedical and social theories that attributed the poor health status of African Americans to immoral lifestyles and inherent susceptibilities. She instead called attention to social and economic conditions such as racism, poor health care, and poverty. In addition to her public health work, Cole maintained a private practice in Philadelphia where she died in 1922.

The third black woman physician, Susan Smith McKinney Steward (1847–1918), was born Susan Maria Smith in 1847 in Brooklyn to a successful pig farmer and his wife. She taught school in Washington, DC, for two years before she entered New York Medical College for Women, a homeopathic institution. (Homeopathy was a popular and accepted medical practice then). Smith graduated as the valedictorian of the 1870 class. At a time when postgraduate training was not rare for the average practitioner, she went on to complete such training.

Eventually, Steward established a successful medical career. In 1881, she helped establish Brooklyn's Woman's and Children's Hospital and served on its staff and that of other institutions such as the Brooklyn Home for Aged Colored People. Steward also maintained a prosperous private practice that catered to both black and white patients.

Steward was involved in political and community activities. She served as the organist and choir director at her church. She helped found the Woman's Loyal Union, a black women's club, and the Equal Suffrage League of Brooklyn. She served as a member of the U.S. delegation to the 1911 World Congress of Races, convened in London to refute theories of racial inferiority.

Steward married twice. After her second marriage, she closed her New York offices. She later practiced on army posts in Montana and Nebraska and worked as the resident physician at Wilberforce University where she died on 7 March 1918.

Following in the Steps of the Pioneers

According to the Census Bureau, in 1890, 104,805 physicians practiced in the United States, including 115 black women and 909 black men. By 1920, the number of physicians nationwide had grown to 144,977, and the number of black male physicians had increased to 3,495, but the number of black females had declined to 65. The decline was due in large part to a growing resistance to women practicing medicine (the number of white female physicians had also declined).

Many of the black women physicians who practiced in the late nineteenth and early twentieth centuries came from elite, prosperous families who supported their professional aspirations. In addition, many of these women combined their medical careers with work in a wide variety of civic, charitable, and religious organizations.

Sarah Loguen Fraser (1850–1933) was the daughter of Jermain Loguen, a bishop in the African Methodist Episcopal Zion Church and a wealthy landowner in Syracuse. Bishop Loguen, a former slave, and his wife, Caroline, ran one of the most active stations of the Underground Railroad. Their daughter Sarah entered Syracuse Medical College in 1873 and graduated three years later. She then interned at the Woman's Hospital in Philadelphia and Boston's New England Hospital for Women. In 1880, she became the first African American woman with a medical degree to practice in Washington. In the ceremony that opened her office, Frederick Douglass, her sister's father-in-law, hung her office shingle.

Caroline Still Wiley Anderson (1848–1919) also hailed from a prosperous and politically active family. Her parents, William and Letitia Still, founded the Underground Railroad in her native Philadelphia. In 1868, Anderson graduated from Oberlin College, the only black woman in a class of forty-four. The following year, she married Edward Wiley, a former slave. After his untimely death, Anderson moved to Washington, DC, with her young daughter, where she taught music, drawing, and elocution at Howard University. In 1875, she began her medical studies at the Howard University Medical Department. She completed one year before she transferred to the Woman's Medical College of Philadelphia, from which she graduated in 1878. She was one of two black women in her graduating class of seventeen; the other was Georgiana E. Patterson Young (1845–1887) of New York.

Sarah Loguen Fraser, one of the earliest black women doctors in the United States, with her graduating class at Syracuse Medical College, 1876. She was the only Negro member in the class of eleven men and four women.

Austin/Thompson Collection, by permission of Moorland-Spingarn Research Center

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Anderson also did her internship at the New England Hospital for Women. Initially, she had been denied a position because of her race. In 1879, she returned to Philadelphia, and the following year she married the Reverend Matthew Anderson, a prominent Presbyterian minister and educator. She practiced medicine for more than thirty years, and much of her medical work was centered at the clinic that she operated at her husband's church, the Berean Presbyterian Church. In 1889, she helped her husband establish the Berean Manual Training and Industrial School, a facility that helped to train African Americans. She served as the school's assistant principal for thirty-two years. Anderson also helped found the Philadelphia YWCA for black women and the Berean Women's Christian Temperance Union.

Ionia Rollin Whipper (1872–1953), a 1903 graduate of the Medical Department at Howard University, was the daughter of William J. and Frances A. Rollin Whipper. Her father was a prominent Republican politician, lawyer, and municipal judge in South Carolina. Her mother was an author. During the 1920s, the Children's Bureau, a federal child welfare agency, hired her to assist its efforts to reduce infant and maternal mortality in the South. Her responsibilities included training midwives, registering births, and conducting child health classes. In 1931, she organized the Lend-A-Hand Club, a campaign to establish a home for black unwed mothers in Washington, DC. At the time, any existing homes did not accept black women. In 1941, the Ionia R. Whipper Home for Unwed Mothers opened, and Whipper maintained the facility until her death in 1953.

Not all these early black women physicians came from privileged backgrounds. For example, Eliza Anna Grier (1864–1902) was born into slavery. It took her seven years to work and study her way through Fisk University, from which she graduated in 1891. In December 1890, she wrote to the Woman's Medical College of Pennsylvania about admission to its program. She stated that she was without the funds to pursue medical studies and that she desired to be a physician to work for the benefit of her race. Grier later noted that she had decided to become a physician “when [she] saw colored women doing all the work in cases of accouchement and all the fee going to some white doctor who merely looked on.” She wondered why she herself should not receive the fee.

Grier matriculated at the Woman's Medical College in 1893 and graduated four years later. This “coal Black negress,” as the North American Medical Review called her in 1898, went on to become the first black woman licensed to practice in Georgia. She set up practices in Atlanta and later in Greenville, South Carolina. She did not prosper financially because she worked mostly among the very poor and in neglected districts. Grier's professional career was short-lived. She died in 1902, only five years after her medical school graduation.

Education and Careers of Later Black Women Physicians

Racial and sexual discrimination limited educational opportunities for black women, and until the late twentieth century most received their medical degrees from either black or women's medical schools. It was not until the advent of affirmative action programs in the 1970s that black women entered coed majority medical schools in significant numbers.

In 1900, there were ten black medical schools. By 1923, only two remained—Howard University in Washington, DC, and Meharry Medical College in Nashville, Tennessee. These two schools were essential for the development of black women as physicians. Of the sixty-five black women who practiced in 1920, more than two-thirds had graduated from these two schools. The Howard University Medical Department opened in 1869 and graduated its first woman, Mary Sparkman, three years later. Sparkman was white. It graduated its first black woman, Eunice Shadd, a former teacher, in 1877. Most of the early black women physicians received their medical education at Meharry, founded in 1876. By 1920, thirty-nine had graduated. The first black women, Annie D. Gregg and Georgia Washington Patton, received their degrees in 1891. After her graduation, Patton, who had been born a slave, became the first black woman physician licensed in Tennessee and worked as a medical missionary for two years in Liberia.

At the turn of the twentieth century, most black women who attended a women's medical college attended the Woman's Medical College of Pennsylvania. By 1900, the school had graduated ten African American women, including Verina Morton-Jones (1888), Lucy Hughes Brown (1894), and Lulu Cecilia Fleming (1895). In smaller numbers black women received their degrees from other women's medical colleges. Emma Reynolds, a former nurse, graduated from Northwestern University Woman's Medical School in 1895. Earlier, her exclusion from Chicago nursing schools prompted the 1891 establishment of Provident Hospital, the first black hospital. In 1915, Isabella Vandervall graduated from another women's medical college, the New York Medical College for Women.

Verina Morton-Jones was the first woman to practice medicine in Mississippi. She began her practice there in 1888.

Moorland-Spingarn Research Center, Howard University

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By the late nineteenth century, a few black women had gained admission to coed majority institutions. In 1885, Sophia Bethena Jones (1857–1932) became the first black woman to earn a medical degree at the University of Michigan. In 1920, Dorothy B. Ferebee (1898–1980) entered Tufts Medical School where she was one of five women and the only African American in a class of 137. She was named a member of the woman's honor society, elected class historian, and graduated at the top of her class.

Frequently, extended periods of time existed between the admission of black male and black female medical students to coed majority schools. Harvard Medical School, for example, graduated its first black man in 1869 and its first black woman, Mildred Jefferson, in 1951. The University of Pennsylvania graduated its first black man in 1882 and its first black woman, Arlene Bennett, in 1964. The gap between these graduation dates highlights the historical distinctions between the career paths of African American male physicians and African American female physicians.

At the end of World War II, medical education remained rigorously segregated. One-third of accredited medical schools—twenty-six out of seventy-eight—barred African American students. In 1948, 84 percent of black medical students attended either Howard or Meharry. On 10 September 1948, Edith Irby Jones took a major step at chiseling away segregation in medical education when she entered the University of Arkansas School of Medicine and became the first black person admitted to a southern medical school. Jones, the daughter of sharecroppers, entered the school without incident. In 1948, educational officials at the University of Arkansas, eager to avoid possible lawsuits, had decided to admit black students to programs for which alternatives for black students did not exist. They acknowledged that the establishment of a racially separate medical school was financially untenable. Jones gained admission because she ranked twenty-eighth out of 230 applicants on the medical school's aptitude test. (The school admitted the top ninety applicants.) Jones was allowed to attend classes on a nonsegregated basis, but she had to use a separate restroom and dining area. Jones did well in medical school and in 1952 became the first black intern at University Hospital in Little Rock and in 1959 the first black internal medicine resident at Houston's Baylor Hospital. Afterward, the University of Arkansas continued to accept black students, including Joycelyn Elders, who in 1993 became the first black woman surgeon general of the United States. Elders credited Jones as her inspiration to become a physician.

Racism and sexism limited not only the educational options available to black women but also their postgraduate and career opportunities. In contrast to white women, who began to graduate from Howard at the turn of the twentieth century, many black women did not actually practice medicine. Instead, they used their medical degrees to progress in the segregated Washington school system because the degree was one of their few advanced training options. For example, Lucy Moten (1851–1933), an 1897 graduate, became a school principal, and Mary Louise Brown, an 1898 graduate, taught school.

At times, black women were the first women of any race to practice medicine in a given area. In 1888, Verina Morton-Jones (1865–1943) became the first woman to practice medicine in Mississippi. Sarah G. Boyd Jones (1865–1905), an 1893 graduate of the Howard University Medical Department, was the first woman to pass the Virginia medical board examinations. When Halle Tanner Dillon Johnson (1864–1901) in 1891 became the first woman to pass the strenuous ten-day Alabama medical board examination, even the New York Times heralded her accomplishment. After her 1891 graduation from the Woman's Medical College of Pennsylvania, Johnson went to work at Tuskegee Institute as the school's first resident physician. At the time, working as a resident physician at a black college was one of the few career options open to black women doctors.

Until the mid-twentieth century, most black women physicians had general practices because of their limited opportunities to obtain specialty training. After World War II, however, a greater number entered the more prestigious and financially rewarding medical specialties. In 1946, Helen O. Dickens (1909–2001), the daughter of a former slave and a 1934 graduate of the University of Illinois School of Medicine, received her certification from the American Board of Obstetrics and Gynecology. Four years later, she became the first black woman admitted to the American College of Surgeons. The American Board of Surgery certified its first black woman, Hughenna L. Gauntlett, in 1968; the American Board of Neurological Surgery certified its first, Dr. Alexa Canady, in 1984; and the American Board of Thoracic Surgery, Dr. Rosalyn Sterling Scott, in 1986.

Finding a Place in Medicine: Maneuvering Racial and Sexual Obstacles

After 1920, hospitals became increasingly important to physicians' careers. In contrast to their nineteenth-century counterparts, twentieth-century black women physicians had to secure access to hospitals. Hospitals had become essential for medical education, medical practice, and medical specialization. Several states had even passed laws requiring the completion of an internship as a prerequisite for medical licensure.

These changes in medical practice threatened the future of black physicians and placed an additional burden on black women's advancement in the profession. African American physicians seeking internships and residencies were expected to pursue them at black hospitals, which usually had inferior programs. Black hospitals, however, preferred to admit black men for their few existing slots. In addition, the small number of women's hospitals did not always welcome black women.

The opportunities, therefore, for black women to obtain hospital appointments and specialty training were severely limited. Isabella Vandervall was rejected for an internship by four hospitals, including the one affilia-ted with her medical school, not because she was unqualified—she had graduated first in her class—but because of her race. She was able to practice only because she had obtained a license before the laws on compulsory internship went into effect. In 1923, Lillian Atkins Moore, a senior medical student at the Woman's Medical College of Pennsylvania, applied for an internship at the college's hospital. She, too, was rejected because she was black. The hospital's medical director admitted that race had been the deciding factor in the hospital's action and offered to get her an appointment at one of the “colored” hospitals. Moore finally secured a position at Douglass Hospital, a black hospital in Philadelphia.

A few black women were able to gain admission to programs at government hospitals. Dorothy Ferebee, after several rejections from white hospitals, secured an internship at Freedmen's Hospital in Washington, DC. In 1926, May Chinn (1896–1980) became the first black woman intern at Harlem Hospital. This was not the first time that Chinn had been a pioneer. She was also the first black woman to graduate from Bellevue Hospital Medical College, later New York University School of Medicine. Chinn also found that racial discrimination prohibited black physicians from appointments to private hospitals. Margaret Lawrence also completed her internship at Harlem Hospital. She had not been allowed to work at New York's Babies' Hospital, ostensibly because housing could not be provided for a black woman in the nurses' dormitory where female interns were housed. This was not the first time that Lawrence encountered racial barriers. She was denied admission to Cornell Medical School because a black man who had been admitted twenty-five years earlier had failed to graduate after contracting tuberculosis. Lawrence eventually gained admission to Columbia Medical School. In 1946, she was to become the first black trainee at the Columbia Psychoanalytic Clinic.

Racism was not the only obstacle in the professional paths of twentieth-century black women physicians, who were also forced to battle sexism. When Chinn opened her practice in Harlem, she encountered resistance from her black male colleagues. When Margaret Lawrence taught at Meharry Medical College in the 1940s, she was the only woman on the faculty and encountered blatant sexism. She was excluded from intellectual camaraderie, overburdened with responsibilities, and poorly paid in comparison with her male colleagues. Dorothy Ferebee, who spent most of her professional life at male-dominated Howard University, contended that sexism, rather than racism, had been her greatest professional challenge.

Black Women Physicians as Activists and Leaders

Many African American women physicians engaged in social uplift activities and often crafted careers that combined medicine and social with political activism. Their efforts helped improve the health and lives of black Americans.

At a time when racial segregation severely restricted the options available to black patients, black women physicians established facilities to tend to the sick. Matilda Evans (1872–1935), the first black woman to practice in South Carolina, established three hospitals in Columbia between 1898 and 1916. In 1920, Georgia Dwelle (1884–1977) established Dwelle Infirmary—the first obstetrical hospital for black women in Atlanta and Georgia's first venereal disease clinic for African Americans. Virginia Alexander (1899–1949), a 1925 graduate of Woman's Medical College of Pennsylvania, established the Aspiranto Health Home in 1931 to provide health care for the poor women and children of North Philadelphia. She also conducted research to document the poor health status of African Americans and used her membership in the predominantly white Society of Friends (Quakers) to push for the elimination of inequities in health care.

Dorothy Ferebee conducted much of her medical and social activism through black women's organizations. From 1940 to 1951, she served as the national president of Alpha Kappa Alpha (AKA), a black sorority, and steered the organization to increase its lobbying efforts in health, child welfare, racial discrimination, and economic security. For seven summers between 1935 and 1942, she led the AKA Mississippi Health Project, a program to bring health care to poor African American communities in Mississippi. In 1949, she succeeded Mary McLeod Bethune as the second president of the National Council of Negro Women and served in that position until 1953. Ferebee was not the first black physician to achieve prominence in a black women's organization. The Chicago physician Mary Fitzbutler Waring served as president of the National Association of Colored Women from 1933 until 1937.

The activism of black women physicians included work in political parties and political organizations. Philadelphian Ethel Allen (1929–1981) described herself as a “BFR—a Black female Republican, an entity as rare as a Black elephant, and just as smart.” In addition to her medical practice, Allen, who graduated from the Philadelphia College of Osteopathic Medicine in 1963, pursued a political career. In 1975, she was elected to an at-large seat on the Philadelphia City Council, and Esquire named her one of the nation's outstanding politicians. Donna Christian-Christensen, a family physician, likewise found prominence in the political arena. In 1996, with her election as the U.S. Delegate from the Virgin Islands, she became the first woman physician to become a member of Congress. After 1998, she chaired the Congressional Black Caucus's Health Braintrust and took an active role in minority health issues. In the 1970s, Mildred Jefferson emerged as a prominent leader of the pro-life movement. In 1975, she began a three-year tenure as the president of the National Right to Life Committee.

Dr. Edith Irby Jones, photographed in 1977. In 1948, she became the first African American admitted to a southern medical school, the University of Arkansas School of Medicine; in 1952, she became its first African American graduate.

Arkansas History Commission

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By the late twentieth century, black women began to assume leadership roles within the medical profession. In 1985, Edith Irby Jones was elected the first woman president of the National Medical Association. By 2004, six additional women—Vivian Pinn, Alma George, Yvonnecris Veal, Javette Orgain, Lucille Perez, and L. Natalie Carroll—held the position. In 1991, Pinn, was appointed the first permanent director of the National Institutes of Health Office of Women's Health Research. Roselyn Payne Epps in 1990 became the first black physician to be president of the American Medical Women's Association. Two years later, she was elected the first black woman president of the Medical Society of the District of Columbia. In 1995, Regina Benjamin became the first African American woman named to the Board of Trustees of the American Medical Association, and in 2002, she was elected the first African American and first woman president of the State Medical Society of Alabama. In 1993, Barbara Ross-Lee, upon her appointment as dean of the Ohio University College of Osteopathic Medicine, became the first black woman to head an American medical school. In 2002, PonJola Coney became the first black woman physician to head an allopathic medical school when she was named senior vice president for health affairs and dean of Meharry Medical School. That same year, Risa Lavizzo-Mourey became the first woman and first African American to be president and chief executive officer of the Robert Wood Johnson Foundation, the nation's largest health-care philanthropy.

Medicine as Black Women's Work

In their pursuit of medical careers, black women physicians have had to challenge stereotypical notions about black women and their work. May Chinn recalled that a black woman patient wept when she approached because “she felt she had been denied the privilege of having a white doctor wait on her.” While Margaret Lawrence was in medical school, white women often stopped her on the street to offer her day work as a maid. In 1980, Jackson, Mississippi, police arrested Gloria Frelix for false pretense and possession of a controlled substance after she picked up a prescription for a patient. Although she had identified herself as a physician she was arrested because, in the words of one white police officer, “She didn't look like no doctor.” Vanessa Northington Gamble and Cheryl Rucker wrote about how when they attended medical school in the 1970s and the 1990s, respectively, they were misidentified as maids and cooks.

Despite obstacles based on their race and gender, the number of black women in medicine increased steadily throughout the twentieth century. In 1920, there were sixty-five black women physicians. By 1930, the number had grown to ninety-two. Fifty years later, in 1980, they numbered three thousand. Ten years later, as a result of affirmative action, the total had more than doubled to over seven thousand. The 2000 Census reported that there were 12,500 black women physicians working in the United States—1.8 percent of all physicians. Significantly, after 1985 the number of black women entering medical school outpaced the number of black men doing so.

Black women physicians have made significant con-tributions to medicine and their communities. These women founded hospitals, established civic organizations, practiced medicine among the underserved, and broke down barriers in a profession that has been and continues to be white and, although the demographics are changing, male-dominated. And by so doing, they have challenged racist and sexist presumptions about the abilities of black women.

See also Jemison, Mae Carol; Jones, Verina Harris Morton; Petioni, Muriel Marjorie; Steward, Susan McKinney; and Wright, Jane Cooke.

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