A WOMAN SURGEON THE LIFE AND WORK FOSALIE SLAUGHTER MORTON

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A WOMAN SURGEON

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WOMAN SURGEON

The Life and Work

of
ROSALIE SLAUGHTER MORTON

Frontispiece

FREDERICK A. STOKES COMPANY

NEW YORK MCMXXXVII

, 1937* BY^REDfiRICK A. STOKES COMPANY

Printed in the United States of America

To
THE DAUGHTERS OF AESCULAPIUS

EVERYWHERE

PREFACE

WOMEN doctors during the past fifty years have held a special
place in the field of medicine. They have helped to humanize
their profession as well as to administer their scientific knowl
edge. A woman physician sees life without its mask. To be
sure, all physicians do to a certain extent. But a woman gets
closer to the inner thought of other women in understanding
the many domestic and social factors in illness. She under
stands youth s vagaries and aspirations better, because her
mother heart has scientific facts to support intuition and
sympathy.

My life in medicine has been no more exceptional than that
of other women. We have all had to struggle as the first gen
eration following our pioneers, ignoring the stone-bruises of the
path and fixing our eyes on the guiding tree. When I was
starting the study of medicine, I was going into what had been
considered by the ruling forces up to that time as a man s pro
fession. That it should be exclusively his seemed ridiculous.
But in my town I was a minority of one who had to believe
deeply in the righteousness of minorities. And then came what
seems a miracle. The world speeded up its revolutions, bring
ing changes overnight that ordinarily would require a century.
It was thrilling to be part of the pattern turned by the kaleido
scope of evoluion from old to new forms. We women who are
now fifty are the first generation which has felt the click of
progress in the making. Every era has had its startling changes,
but ours most of all. Into the pattern of life of every one of us
have been woven high hopes and ideals, changing values, the
daring expansions of science, the amalgamation of world
endeavors.

In writing this book I have sought to give a picture of this
transition period between the pioneer women in medicine and
the college girls of today for whom everything is won and done.

vii

viii PREFACE

I have wanted to accent the number of splendid medical women
who are now practising, and something of the work they are
achieving, for many people still believe there are only twenty
or so in the United States; to give a picture of the World War
behind the trenches the quiet heroism and dramatic efficiency
of the hospitals. I have hoped also that I might do justice to
the noble character of the people of Serbia, with whom I have
had long association and who have often been misrepresented
to the world. And I have gathered these reminiscences together
because certain of my dear friends have thought that a record
of my adventures might provide interest for lovers of wide
horizons. Therefore, to Marian Craig Potter, Jean Aitken
Paddock, May Lewis, Emily Dunning Barringer and Olive
McKay I lovingly offer this book. Without their encourage
ment I would have considered the immediate demands on my
time as a physician sufficient service to the world.

As I have been writing these experiences, I have been sur
prised to find running through them certain qualities which I
realize represent me. Hitherto, my mind has been held too
closely to concrete endeavors for more than a hurried moment
of soliloquy. The accumulation of impressions suddenly be
comes an individual pattern of life. It is impossible to recall or
alter a line of it. However, there is compensation in the feeling
that, despite handicaps and trivialities, my life has been of some
service to the well-being of many people. This is more than
compensation. It is the highest reward.

* My varied life has harmonized the world for me. I have seen
that the trend of human aspiration is the same in Labrador and
Ceylon, in India and Indiana. In sailing forward toward a
constant sun like an airplane, I have struck many air pockets.
But my guiding star has been a shining faith, not abiding, nor
ferocious, but persistent, a faith that would direct my abilities
into a constructive sequence of events. Truth is subject to
adaptation and constant enrichment. It is advisable to be sure
of what is sincere, not merely stubborn. The summation of
life is satisfactory if inheritance, development and endeavor
have brought anything of value to the aid of others,
r As a physician, I have found my patients care little about

PREFACE ix

their age or their appearance, if in some way they may gain
health in order to serve humanity in the evolution of which we
are all a part. One of the joys of a doctor s life is to see the
human soul convincing itself that mentally and spiritually it
will not admit defeat. It is easy to persuade such brave patients
that they can make this moment the one of achievement as
their resolution insures success. No one dies while a purpose is
in the mind and heart. The storms through which a ship passes
are of less importance than the port it seeks to reach. All the
medical women of my generation have known this; together we
have reached many ports.

DECORATIONS FOR DISTINGUISHED
SERVICE

1916
Chevalier of the Order of St. Sava, Yugoslavia

Medal of Mercy, Yugoslavia
Kosovo Medal, Yugoslavia

1918

Serbian Red Cross, Yugoslavia
Cross of Charity, (also in 1919) , Yugoslavia

1919
Commander of the Order of St. Sava, Yugoslavia

1920

Medal of Veterans of Foreign Wars, United States
of America

1922
French Medaille d Honneur, (Nov. 22nd)

1923
Conspicuous Service Cross of the State of New York

1928
1 Palme Academique, (May 24th) , France

CONTENTS

CHAPTER PAGE

PREFACE vii

FOREWORD xiii

I. A MOMENTOUS DECISION i

II. ENTERING A NEW WORLD 20

III. LIFE AMONG THE UNDER-PRIVILEGED 27

IV. THE SENIOR YEAR 36

V. CHUMS IN SOUTH THIRD STREET 43

VI. STUDY IN GERMANY 50

VIL CHRISTMAS IN RUSSIA 71

VIII. NERVES AND PARIS 85

IX. IBSEN AT HOME 97

X. INDIA: THE BUBONIC PLAGUE 105

XI. HOMEWARD BOUND 121

XII. SETTING UP PRACTICE IN WASHINGTON 128

XIII. FIRST YEARS IN NEW YORK 146

XIV. PUBLIC HEALTH EDUCATION 165

XV. HAND TO THE PLOW 177

XVI. IN GRENFELL LAND *97

XVII. To THE WORLD WAR

XVIII. ON THE SALONICA FRONT

XIX. Jeevela Serbia 234

XX. Music IN WAR

xi

xii CONTENTS

CHAPTER PAGE

XXI. WITH THE FRENCH FLEET OF MERCY 261

XXII. FOUNDATION OF THE AMERICAN WOMEN S HOSPITALS 269

XXIII. VIRGINIA 294

XXIV. THE INTERNATIONAL SERBIAN EDUCATION COMMITTEE 305
XXV. EDUCATING A FAMILY OF SIXTY 316

XXVI. THEY RETURN TO THEIR NATIVE LAND 338

XXVII. NEW YORK AFTER THE WAR 346

XXVIII. SOUTH AFRICAN SUNLIGHT 356

XXIX. A SOCIAL LEAGUE OF NATIONS 367

XXX. FLORIDA ON THE EDGE OF THE TROPICS 380

FOREWORD

As I read this account of the life of a friend of many years,
vividly there comes before me a joyous young lady I met in her
teens at her first dance at the University of Virginia. Gay and
insouciant, though always considerate of other people, she had
also a serious side, which has aided her to develop into the
remarkable woman of medicine portrayed so well in her auto
biography. I doubt not that the medical ancestry which was
hers seventeen direct and fifty-two indirect collateral relatives
having devoted their lives to medicine was a weighty factor in
determining her career. It is well established that the micro
scopic genes in our chromosomes, which regulate not only our
bodily make-up, but our minds and souls, carry with them the
impulses and characteristics of remote generations. The irre
sistible impulse to go into medicine which this comely Virginia
girl felt was undoubtedly due to the inescapable effect of her
primordial cells.

Early impressed by the humanitarian side of medicine, dur
ing her vacations she devoted herself to work among the poor.
Her penetrating comments on the characters she met and the
patients she attended are full of pathos. When she graduated
in medicine she had already had an experience such as few doc
tors ever have, service in the slums with their teeming underfed
and disease-ridden population.

In Vienna she worked hard on pathology, that bedrock on
which scientific medicine is founded. Again, her genes from
surgical forebears influenced her, and the young woman turned
to surgery for her career.

In Berlin, and in Russia, at that time in the heyday of its
fascinating society, she made many interesting contacts. The
accounts of her conversations with Tolstoy are particularly fine.
In Paris she made a serious study of nervous diseases which led
to the publication of her first scientific paper, presented before
an International Congress in Washington. Her impressions of
great men in medicine, whom it was her privilege to know inti-

xiii

xiv FOREWORD

mately, are valuable documents. In Scandinavia she met men
of note. Her comments on the character of Ibsen are particu
larly important from the medical standpoint. In India, she
became a friend and student worker under the great bacteriolo
gist, Haffkine. She did not hesitate to go into the districts
where plague, cholera and other fearful diseases prevailed, in
the early period in the fight against these great pandemics. She
is one of the few who went unscathed through such dangerous
experiences. Her intimate contacts with both the lowly and
great of India are revealing. An insatiable thirst for knowl
edge led her to return to America by way of the Far East.
Reaching Manila, she began a long acquaintance with Dr. Rich
ard Strong, who with Dr. Victor Heiser, accomplished so much
in ridding the Philippines of deadly diseases.

Dr. Rosalie Slaughter Morton, as she had then become, re
turned to her homeland, and in Washington began to practise
her profession. The wide acquaintance of her distinguished
family soon gave her many friends in society, but eschewing its
fascination, she secured the privilege of operating at the George
Washington Hospital, and was also placed on the staff of a clinic
for women. My young friend, who has become one of the
most eminent surgeons in America, was the first woman to
undertake surgery in Washington. Her comments on a wom
an s adaptability to fine surgical technique is an unanswerable
argument for their natural gift of manual finesse, often difficult
for the clumsy hands of men to attain.

Busily engaged in major surgery, Dr. Morton yet found time
for much humanitarian work. Having entered with zest into
the many problems of public health, it is no wonder that so
constructive a person was widely called upon as a lecturer, and
attracted the attention of great sanitarians of all countries.

Verily a many-sided character, her wide experience makes
her life indeed the most colorful of any physician I know. It
has been a privilege to be a friend of this woman who felt the
call to desert a charming, easy social life in Virginia, to follow
in the footsteps of a long line of medical forebears.

HUGH HAMPTON YOUNG.

Johns Hopkins University

A WOMAN SURGEON

A WOMAN SURGEON

CHAPTER I
A MOMENTOUS DECISION

SINCE the day in 1620 when my father s ancestors came from
England to settle in Virginia, seventeen of their direct, and
fifty-two of their collateral descendants had followed in the
footsteps of JEsculapius. When this heritage, to the horror of
my parents, manifested itself in me, they acted like the minis
ter who, when calling on his congregation for volunteers to the
missionary field, seeing his own daughter rise, exclaimed, "Oh,
Anna, I didn t mean you!"

Of course, I could not expect their wholehearted approval.
In 1893 well-to-do families expected their daughters to marry
well and become model mothers. This attitude was no more
peculiar to Virginia than to Illinois. My entire upbringing and
education had been designed, as it was for all Southern girls, to
make me a capable wife not to imbue me with a desire for a
career.

As I recall those years, I am sure my choice caused my family
as much anxiety as does ardent youth of today. Four of my five
brothers and my sister disapproved, but I had an adorable Aunt
Sue who suggested to my mother that if she braved family dis
approval in leaving home at eighteen to marry in far-off Vir
ginia, I at least was not taking such a severing step.

My early education was in a school conducted by two
self-supporting ladies, Miss Sallie and Miss Mary Manson.
When I had reached the advanced, discreet age of twelve I went
to Edge Hill, a school established on a stately colonial estate of
the Randolphs in Albermarle County. This was directed by
Miss Caroline, a great-niece of Thomas Jefferson. Eventually,
under her sister, Miss Sarah Randolph, I went to a "finishing

A WOMAN SURGEON

school" in Baltimore. Many of the girls I met there became
life-long dear friends, among them Dora McGill Scott, of Rich
mond, Virginia. I had a wide circle of young friends with
whom I went boating, fox-hunting and attended dances.

But the spirit of my grandfather was apparently as vibrant in
me as in my doctor brothers. He, Dr. Robert Harrison
Slaughter (sixth generation from the John Slaughter who was
granted land on the James River in 1620) , had given his life
heroically in the pursuit of his profession. Graduated from the
University of Pennsylvania and from the University of Edin
burgh in Scotland, he had distinguished himself by his scientific
acumen, his energy, and his humanity. In 1832 when he was
forty-four years old the terrific epidemic of Asiatic cholera
swept over America from Europ.e, concentrating its virulence
in the seaport cities. New Orleans, particularly, had suffered
tragic death tolls.

Only a handful of men dared go to the devastated area when
the call came into the North for doctors and relief. But my
grandfather immediately volunteered his service, making the
journey from Virginia over the mountains and down the rivers,
to work in New Orleans for many months. At length, when
the epidemic was under control, he wearily boarded a river
steamer bound for home; his wife was expecting another baby
and he was anxious to return. As the steamboat plied up the
river, my grandfather felt weak and suffered severe headaches;
before the end of another day he had developed the violent
symptoms of cholera prostration, vicious diarrhea, vomiting,
cramps, cold sweats. Panic raged among the passengers. Their
fear of the dread Oriental disease became so hysterical that
they asked the captain to halt the vessel and put Dr. Slaughter
ashore at once, even though only swampland and desolate
woods lined the shores. It was better that he should die than
that all on board should perish and none of them reach their
homes.

In this crisis one of the passengers drew a pistol and, stepping
in front of my grandfather, faced the wild mob with a threat
that he would shoot the first man, captain or not, who laid
hands upon the dying man. Dr. Slaughter, he said, had con-

A MOMENTOUS DECISION

tracted his illness while voluntarily serving humanity. Could
they heartlessly leave him to die? The excitement, however,
solved the problem, for my grandfather died as a result of it.
At the steamer s next port of call, his volunteer friend saw to
it that the body was reverently buried, as befitted a valiant
doctor.

My mother, Mary Haines Harker, was a Quaker lady of
Mount Holly, New Jersey. She had the spirit of the English
Harcourts, who had been crusaders to the Holy Land, and later
pioneers to America for Quaker freedom. From her grace and
dignity I learned much of fortitude, perseverance, and faith,
which was lucky, for they had to be drawn upon heavily in my
election of an active life of service to mankind.

Through my childhood years the dearest friends of our
family were physicians and ministers. Two of my brothers had
gained medical degrees from the University of Virginia, and
followed graduate work in New York City by study in Europe.
With these brothers, when they returned to Lynchburg to prac
tice, I had moved in the atmosphere of surgical service; from
them I had learned much concerning the home care of the sick,
for they sometimes took me with them on their calls usually to
hold the horse, but sometimes to go inside. At home they let
me sterilize their instruments and even help with their office
cases. And for years I had doctored the sick animals of the
neighborhood pet rabbits, birds, dogs had passed through my
more or less healing hands. My brother Will had brought me
my first fracture case a cat with a broken leg. By instinct, or a
miracle, I set the leg. It soon healed, but the ungrateful feline
limped in my presence for months and ambled easily when out
of sight. Perhaps he had a human desire to be made much of or
a sense of the social value of an operation.

Looking back at myself in the unhurried social life of that
day, filled with home duties, parties, games and sewing hours,
I realize now that my apparent indifference to suitors for mar
riage stemmed from my determination to study medicine. I do
not remember that this decision, definitely reached when I was
sixteen, hinged upon any specific event, unless it was the night
I lay listening to my sister s agony as her fourth child was born,

A WOMAN SURGEON

and I vowed to alleviate such suffering and pain for women if I
possibly could. Certainly my decision sprang from no .careless
impulse. It was rather a deep desire to create something more
useful, of my mind and hands, than dexterity at tennis or a tea-
table.

Eleven years after the military operations of the Civil War
had ceased I was born. But I did not grow up with sectional
feeling, for every two years my mother paid a regular three
months visit to her Quaker home in New Jersey, taking with
her the youngest of her children. Thus I became a child of the
North as well as the South, and considered travel as natural as
"skipping rope. This periodical shuttling between Virginia and
New Jersey entailed as much preparation and inconvenience
as a modern voyage to the Antarctic. At school in Mount Holly
I was called "Johnny Reb" by the other children until my
Southern accent melted into their own. Back once more in
Lynchburg, I was "Yank" to my playmates.

Life in my mother s Quaker home was soft-spoken, austere,
and dignified. In that environment Mary Harker early ac
quired the courtesy, thoughtfulness, and gentle courage which
were so much a part of her character. On a holiday in Lynch
burg with a school chum, she met my father, John Flavel
Slaughter, who was immediately won by her beauty and gentle
nobility. When he came to her home to seek her hand, Mary s
father and mother were impressed by his good breeding and
faultless manners, his musical speaking voice and his gracious
courtesy in wearing Quaker gray. Fortified only with the faith
and the ardor of youth, Mary Harker left home at eighteen to
adapt herself to a life wholly foreign to that in which she had
grown up. In the more splendid society of Virginia she had to
exercise all her tact and ingenuity in winning over three gener
ations of Garlands and Slaughters.

My father was already the head of a family including his
widowed mother and three unmarried sisters. Ordinarily these
ladies of Garland Hill would have welcomed Jack s charming
young wife, but when he decided that his increasing law prac
tice would permit him to build a home of his own, his sisters
were naturally resentful that the social nucleus of the clan

A MOMENTOUS DECISION

should shift to the household of a Northern girl quite inexperi
enced in the artistries of a Southern hostess. Reared in the
shadow of the Quaker meeting-house, Mary Harker was now
required to raise her own children in the traditions of the
South. Negro servants had to be managed, entertainment for
unexpected guests provided at a moment s warning, family
gatherings of aunts, cousins, and other relatives gracefully ar-
ranged-sometimes to the number of twenty for a Sunday din
ner. But young Mrs. Slaughter triumphed. She won not only
a feather for her own cap, but also friendliness and affection
from the townspeople, and, above all, the appreciation of her,
husband.

Thus six years slipped by, each alternate year marked with
the birth of a baby boy. Shortly after the birth of the third son,
Lynchburg began to debate the question of the Preservation of
the Union. Intensity grew. There was talk of bloodshed, fire,
and death, as men polished and primed their guns. For the
first time, my mother realized how venturesome her "Jack" had
been in choosing a Yankee wife. If war came, her father and
brother would be on one side, her husband and home on the
other. It would sever the two allegiances of her heart. She
tried to quench her fear with Quaker calm and yearned to talk
again with her understanding father and feel the serene
presence of her mother.

At the announcement of the election of Abraham Lincoln
the town clock stopped, it was said, from indignation. "Shall
we secede?" was hurled back and forth in Virginia. My uncle,
Charles R. Slaughter, sat at the Richmond Convention in Feb
ruary of 1861 which drew up the ordinance of secession. Oddly
enough, it was his brother, my own father, who, as a member of
the "Committee of Nine" after the war, was one of those re
sponsible for Virginia s early return to the Union. He realized
from the first that civil war was a mistake. He sympathized
with my mother s viewpoint; he understood all that her torn
heart suffered; yet when Virginia began to mobilize, he volun
teered. He was placed in the reserve and only called out briefly
when the invading army of Sheridan and Hunter approached
Lynchburg in 1864.

A WOMAN SURGEON

When her second son, John, about six years old, developed
what was called "hip-joint disease" probably infantile paraly-
sis-my mother felt an even more urgent need to go North than
the desire to see her parents. She wished to take the boy to the
great Philadelphia physician, Dr. Agnew. To secure food and
sleeping accommodations in war time for her children and
servants, to arrange for relays of carriage horses, to cross ferries
under flags of truce, were unaccustomed experiences. The trip
was long and wearying, but it had its reward in the recovery of
the child, John.

To facilitate her return journey, Grandfather Harker and
Governor Newell of New Jersey secured a pass for her from
President Lincoln. He wrote on a visiting card, two months
before his assassination, the following, dated February 16, 1865:

Allow Mrs. Slaughter, children and servants, with
ordinary baggage to pass our lines and go South.

(Signed) A. LINCOLN.

From General Grant she secured another pass when she reached
City Point, Virginia. Railroads had been destroyed; there were
neither Pullmans nor locomotives. At one point her carriage
broke down and she was forced to resort to a flat freight-car
pulled by mules. Years later she delighted to tell how the mules
trotted amiably along the level stretches and willingly pulled
the car up hills, but stopped short and refused to go further
when they reached the summits. - Thereupon the drivers placed
planks for the mules to climb upon the car alongside of the
passengers and baggage, while all coasted together down the
slope. On reaching level road the mules resumed their task.

Young Mrs. Slaughter now found she must exercise her
housekeeping talents with even keener skilL Prices still kept
skyward. There was no express, telegraph, nor mail, and worst
of all, no currency, Confederate money having become about as
valuable as old lottery tickets. On March 24th, the local paper
suspended publication, merely printing an extra to announce
the news that General Lee had surrendered to General Grant
at Appomattox Court House on April 19, 1865. But the end of
the war did not herald the end of hard times. Just as trade was

A MOMENTOUS DECISION

beginning to recover from post-war chaos, just as carpetbag and
scalawag power was broken, and people could hope for civic
peace and prosperity, Lynchburg was all but destroyed by a
flood.

Through these long hardships the durability of Southern
character stood all tests. My parents, in common with their
neighbors, had borne much. And upon my father at the close
of the war lay heavy burdens, for he was the sole remaining
head of a household in seven Slaughter families. Emotional
turmoil and privation caused his two little girls born during
those war years to be very frail; they lived but a short time.
Their deaths, however, did not break my mother as did the acci
dental death of a son whose baby laughter had sustained her
through all her sorrow. Already, she had five growing children,
four boys and a girl, but her grief at the loss of this strong,
handsome boy was for a while inconsolable.

/It may have been this period of sadness which accounted for
my mother s happiness at my advent. To be welcomed gives a
child an affectionate disposition. I was a healthy, happy little
girl, full of bubbling energy, devoted to flowers, animals and
people, always busy and eager to be helpful. Temperamentally
active, I leaped, laughed, and imitated. I treasure many happy,
tender and amusing memories of my childhood.

Sensible training of a child in the home promotes its early
acquisition of a steering-gear for its own character. I was de
corously educated in all the social graces that suited the station
of my family and the period. But I was also permitted freedom
in play, taught discipline in thought, health, and morals, and
encouraged to grow as an individual.

From the paved courtyard at the rear of our house a path
bordered with cherry and plum trees wound to the servant s
quarters and the carriage house, both hidden by apricot and
apple trees. On one side of the courtyard spread a smooth lawn
where we played croquet, battledore and shuttlecock, or ran
barefoot in the early morning dew; on the other side began the
old-fashioned garden, shady and beautiful at every hour. There
blooming "Pride of China," "honey shuck/* and other towering
trees arched over shrubs and flowers of every variety.

A WOMAN SURGEON

My mother instructed me in garden botany, and won my
deepest interest when she pointed out the aconite, belladonna,
and other medicinal plants. It pleased me to know they were
useful as well as beautiful, but as my knowledge expanded
quickly on different fronts, I became confused by the similarity
between the names of flowers and illnesses. I was never sure
whether I meant petunia or pneumonia, plumbago or lumbago,
while fever-few seemed to me a silly name.^

Although house and garden were the respective domains of
"Wash," the butler, and "Presidenshy," the gardener, my
mother s executive hand guided all. Each morning she quietly
appointed the household tasks, exacting a perfection of per
formance that permitted no confusion or shortcoming. She
listened to the troubles of every Negro on the place, counseled
them wisely and administered to them in sickness as she had
done since she first became their mistress. With her children
she was a trusted, loving companion gay, witty, and sympa
thetic; she thoroughly understood our various personalities, en
couraging our enthusiasm and reason, correcting our faultiness
with clear explanation. She would hold me in her lap and, as
the chair rocked, correct my impetuosity and impress upon me
how a well-mannered girl should behave at a picnic. With
Quaker poise she held us strictly to our tasks: "Finish what you
begin, and then start the next thing." Tale-bearing on our
playmates or each other she forbade: "See good and describe
that. Remain quiet when you wish to criticize." With a
mother as wise and humane as she, I did not have to dash out
into the world to find out what was good or what was bad. I
knew before I left home the essential values in everyday living.

When I went to the day school of Miss, Mary and Miss Sallie
Manson, I found especial enjoyment in playing with the boys.
Whatever they did, I seconded as a matter of course. My
mother encouraged me in this, for while she must have worried
that I might never outgrow my "tomboy" stage, she cherished
none o the prevailing prudish ideas regarding "little ladies"
and "little gentlemen." She believed in the wholesome min
gling of boys and girls, the equality of their work and play. I do
remember, however, that she drew the line at my "skinning the

A MOMENTOUS DECISION

9

cat" when she found me head down, swinging on the gas pipes
in our basement, with three of my school fellows as appreciative
spectators.

Will, my youngest brother, and I signed an unwritten treaty
with my mother whereby we would escape punishment for mis
deeds if she learned of them first from our own lips. We were
both inordinately fond of climbing trees, especially of swinging
on the low branches over the roof of the carriage house and
jumping from there to the top of the high back fence. One
happy day we discovered the aerial possibilities of the steeple
of a church in course of erection. When I was nearing the
apex of the steeple, our pastor s wife passed by. She was hor
rified to see my starched skirts fluttering aloft like a cloud.
Hailing me, she beckoned earthward with angry gestures. I
waved blithely, inviting her to join me on the steeple. But,
alas! she turned on her heel in the direction of our house. I
knew that a spanking would be my portion if I did not reach
my mother before she did. Down I jumped, slipped, and slid,
leaving half my blue sash behind me fluttering on a nail. Rush
ing past my adversary in the street, I banged through our side
gate, raced up two flights of stairs and panted up to Mother,
assuring her that I had something important to tell. "Wait
until you get your breath, child," she said.

The door-bell rang. "No," I gasped. "I haven t time. I
want to tell you that I climbed all over the new church."

She went downstairs and I followed at a discreet distance.
After giving all the details of my escapade, the pastor s wife
exclaimed in amazement, "You are not going to spank her?"

"I cannot," my mother smiled. "She told me first."

My father, too, made companions of his children. His first
hour after coming home at night was devoted to us. In his
roomy chair by the library fire, with Will perched on one side
and me on the other, he would draw from us an accurate report
of all we had seen, said, and done that day. Just as though we
were witnesses in court, he accepted no vague generalizations.
This intelligent practice taught us to observe and record with
exactness. Then followed nursery games and a joyful romp.
At that hour, the long room seemed to me most beautiful, as

10 A WOMAN SURGEON

the firelight flickered on the walls, illuminating the old family
portraits and tinting the mellow bindings along the shelves.

As Will and I grew older, we considered ourselves too ma
ture for "children s hour." However, we were always in the
library at that time in the evening, for my grown brothers now
played whist with my father before dinner. Naturally, they
wanted to put me out when I marched around the table and
commented on their hands, but my father liked to have me
there* He played expertly despite distraction, while my
brothers were diverted by it. The only thing that could dis
turb him was the owl which haunted the silver poplar tree out
side the library window. Its mournful hoot disturbed his mind
and his luck was spotty. On "owl nights" the game usually
ended with my father throwing down his cards in exasperation,
crossing to the window, flinging it wide, and shouting into the
gloom: "Come in here if you are a gentleman, or, damn you, fly
away if you are not."

Will was my faithful ally most of the time. I often encoun
tered obstacles in asserting what I was pleased to consider my
rights, and at an early age suffered from the inequality of the
sexes. Well do I remember being scurried homeward from the
neighborhood fire house, whither Will and I always disap
peared at the first clang of the gong, to be tiresomely lectured
by an older brother on how little girls should deport them
selves. And this, while lucky Will remained behind to enjoy
the return of the lathered horses, the unharnessing, and the
detailed narrative of the firemen. Likewise, when we pitched
quoits in the back yard, the game would climax with Will s
lordly pronouncement, if I won, that "Quoits is not a game
for a girl."

Long before my decision to study medicine I developed re
sourcefulness in this two-fisted school of experience in a man s
world. One day our older brother John and our steadiest
prop in the hierarchy of adults took us to the circus. Will
pleaded for the privilege of buying the tickets, and having ex
changed three quarters for as many pieces of cardboard, we
proceeded to see the sideshows first. When the time came to
enter the big tent, Will could find only two tickets. A look of

A MOMENTOUS DECISION 11

dismay flitted across his chubby face, but quickly this melted
into beatific satisfaction as he held forth his two tickets to the
gateman and remarked in my direction, "Rose, it s too bad, but
I lost your ticket."

"No, you didn t/ I rejoined. "You lost yours/ and giving
him a hearty push, I walked in ahead of him.

"An emancipated woman/ I heard John murmur to the
ticket man, as he slipped him another quarter.

However, I do not remember acting in an emancipated man
ner when I went to Edge Hill to begin my formal education in
the art of becoming a Southern gentlewoman. But life among
the girls there, away from my home, made me aware of how my
world had altered. I had stepped out of childhood, in which I
had been the axis of my little universe, into a solar system of
which I was a very unimportant part. I, however, uncon
sciously learned the rudiments of organization, in our little
Greek letter society, debates, and in competitions in horseback
riding, skating, boat or tennis tournaments. I became a mem
ber, too, of a secret society, esoterically called "Theta Tau." I
forget the specific aspirations of that charmed circle, but I re
member our strong clan spirit and our momentous meetings in
the dead of night.

One of the high spots of life at Edge Hill was the occasional
"raid" by the students of Pantops, a neighboring boys school.
Periodically they sneaked from their own bounds and came
galloping over the extensive slopes of Edge Hill, yelling and
whooping an Indian complex, no doubt, or merely an irresisti
ble desire to show off. We were hurried to our rooms and
warned not to look out of the windows. If we happened to be
strolling about the grounds, we were assembled into a double
column and with sedate haste marched indoors, Miss Caroline
leading the procession, a fluttered teacher bringing up the rear.
No "lady" dared glance to right or left, or utter a sound. Alex
ander, the Negro factotum, was immediately dispatched to the
headmaster of Pantops. If the depredations, however, had
been more than usually serious, Miss Caroline herself mounted
horse and rode forth, like a general, to enter a formal protest.
While at Miss Randolph s school in Baltimore, I spent one

12 A WOMAN SURGEON

Christmas with my aged Quaker cousins, John and Lucy Kille.
They lived quietly in their three-story brownstone house in a
fashionable section of Philadelphia. Cousin Lucy went to the
meeting-house regularly. Cousin John, tall and spare, was over
eighty. One night when I was already in bed and Lucy sat
combing her sparse gray hair before the mirror, a scraping
sound came from under the bed. We both thought it a cat,
for there were many in the house. Lucy called, but there was
no response. She leaned down, and assuming a more command
ing tone, peered under the bed. She saw, not a cat, but the
heavy bulk of a man. Did she show surprise? Not that Quaker
ladyl In her usual quiet tone, she said, "Friend, I see thee;
thee had best come out!"

An upheaval tossed me to a sitting position as he rolled his
burly shoulder and inquired, "Do you mean me, ma am?"

"Yes, I mean thee."

He writhed out from under the bed. Dirty, disheveled, he
lay there an object of pity.

"Stand up, friend," Cousin Lucy commanded. Having
taken stock of his bulky neck and six feet of height, she con
tinued, "Thee is strong and powerful. It would be a pity for
John to shoot thee."

"Who s John?" barked the burglar.

"My brother," she said proudly. Her voice intimated that
John was the most stalwart of athletes. At the moment he was
dozing in the library below her bedroom. There was not a gun
in the house, and had there been, John probably could not have
hit a, barn door at ten paces. But Lucy had unfailing con
fidence in John s ability, tried or untried, in any field. She
placed her frail hand on the burglar s arm and cautioned, "Go
very quietly. Thee must make no noise. If John hears thee,
he will surely shoot thee."

As the man tiptoed across the room, the boards creaked be
neath his weight. Lucy anxiously repeated her injunction. As
they reached the top of two flights of stairs, she whispered,
"Lean on the banister and also on me. Thee must be very
quiet. John is in the library and we must pass the door."
Wide-eyed, I hung over the top rail as they descended and crept

A MOMENTOUS DECISION

past the library. Fortunately, the door was almost closed, and
the burglar caught only a glimpse of a man s foot. Lucy led
him across the front hall and closed the front door behind him
with a bang. The bolt shot into place, and Lucy sank into a
hall chair. I dashed down the stairs, thinking she might faint.
Not she. She felt just a little tired, she explained, and would
rest before starting upstairs.

The bang of the front door had awakened Cousin John.
Coming into the hall he irritably asked, "Lucy, what is thee
and that child doing downstairs at this hour?" It was nine
o clock.

"I have just let out a burglar, John."
"Why did thee not tell me?" he exclaimed.
"I thought perhaps thee might have a gun concealed some
where, and I knew that thee would surely shoot him."

"But thee should have called me," he persisted.

Softly she answered, "John, does thee forget that we have a

^new hall carpet? Thee would surely have spilled blood on it."

l Some of that Quaker fearlessness in the face of adversity

*^ strengthened my determination to go to college and study med-

|0icine, when my years at Miss Randolph s were ended. Slowly,

Q step by step, the strict mold for the women in my family was

^ being broken. My mother s mother had lived in conventional

sobriety, only tempering the severity of her Quaker gray dress

by wearing a Paisley shawl to the meeting-house. My mother

, had sewed roses into her Quaker bonnet after meeting my

ft father, and then she had moved to social Virginia. I was going

-**to take a third and more astounding step toward the self-

^Nexpression of women: I was going to become a physician and

00 surgeon.

ln my childhood doctors always seemed to me the highest type
of human beings. They of all people, I thought, must be thor
oughly good and constructive: their lives were dedicated to
helping human life and comfort. I idolized my two brothers
who were doctors, and the old physicians in Lynchburg whom
I knew won my devoted respect. Doctor Dulaney and Doctor
Latham and every other doctor were living forms of kindness;
it seemed to emanate from their eyes, their fingers and their

14 A WOMAN SURGEON

smiles. Knowing these men, I could not ever imagine that
there could exist medical men who would quibble over fees, or
chase ambulances, or go out to play golf after they had operated
on a patient. These old doctors, despite the lack of our modern
knowledge, brought profoundly healing self-sacrifice to their
work. From the first day that I thought seriously about study
ing medicine, I held the profession in the highest idealism. To
sign over one s life to the dedication of human needs: there
could be no finer life to live!

And so, inwardly ablaze with this desire, I met the opposi
tion of my family. At first, partly because I felt I would thus
prepare for bigger things, and partly because I thought my
parents would be less scandalized, I told my mother I would
like to become a nurse. She neither argued nor discouraged,
merely observing dispassionately that I ought first to ascertain
the requirements. She knew that no hospital would be likely
to accept a girl of sixteen.

I suspect that I appeared inadequate to a critical eye;
certainly, having to send my photograph handicapped my am
bition. I was not pampered nor frivolous, but all my photo
graphs, taken in party dress, made me look like a fragile
gardenia. Having been educated in Quaker honesty, I was too
scrupulous to detour the matter of my age. However, I penned
earnest notes, emphasizing my serious-mindedness and asking
for application blanks; these I duly filled in and sent, accom
panied by a letter from my pastor, to the superintendents of
schools of nursing far and wide. Whenever I eagerly tore open
a long envelope with a hospital address in the corner and then
remarked nonchalantly that it contained nothing of impor
tance, a quiet Quaker smile circled my mother s lips.

Unvanquished, I kept on trying, until I finally confessed to
my mother that I really did not want to make a life-work of
nursing. What relief showed in her eyes!

"That would be just to get started," I added. "I really in
tend to be a doctor, like the boys/*

Dismay blanched her face. Her placidity about my nursing
notion had not prepared me for the distressed voice and
anxious eyes with which she rejected my choice of a career.

A MOMENTOUS DECISION 15

First she urged serious objections all protective. I would
move in constant danger of contagion; I would be at the beck
and call of rude, uncouth people; I would walk alone on the
streets at night, exposed to every wild danger. . . . None of
these difficulties seemed insurmountable to me, I declared.
But she could not bear the thought of my serving all sorts of
people in clinics and hospitals; she did not wish the walls of my
sheltered life to tumble and admit struggle, knowledge, and
hardship. I realize now that she thought me too impression
able to come face to face with life and death.

To all her objections, I replied that I would need less cour
age to face those dangers, fancied or real, than Joan of Arc had
in becoming a soldier! Surely we both lost our sense of humor,
for my distraught mother exclaimed, "But my child, she was a
peasant! And she was burned at the stake!"

Then we had a heart-to-heart, will-to-will talk. All the
family, she warned, would oppose the idea. Most of all, my
father. Well, I would ask him. She suggested that I wait a
few days, since he was far from well. But I wished to have the
matter out.

He blinked at me, then scowled and tapped the arm of his
chair. He spoke kindly as my mother had; understanding now
how he felt, I honor him for his point of view; then it seemed
unreasonable.

"I do not want my daughter to earn money/ he said firmly.
"It is not right that you should go into competition with those
who need to support themselves. A gentleman s daughter does
not work for money; your field of service is to keep on making
us happy, and later to marry a man of your own class. It is
essential that society s standards be maintained. You will bring
up your children with the highest ideals; your home will be a
center of culture, helpfulness, and happiness, as this one is; your
highest duty is to become a good wife and mother."

Tears of vexation filled my eyes. He took my trembling
hands in his, "I would feel that all my efforts as a lawyer,
banker, citizen and father were defeated if my daughter pre
pared herself to go to work. It is unthinkable that you should^
do so!"

ji6 A WOMAN SURGEON

I set my chin and urged, "Please understand; do try. It
isn t that I want money. I just want to be of .some real use in
this world. I am sure that a doctor can do a great deal of good.
I am now almost seventeen and that is quite old."

Ignoring this outburst my father continued quietly, "Archer
B came to see me yesterday. He would like to pay his
addresses to you. Your sister married when she was very young.
Give a thought to Archer; he is a fine man and will take good
care of you, my daughter."

We stood on opposite sides of a chasm. I realized that the
gap would widen. He would not comprehend my surging
desire to plunge forward, putting all that was best in me into
the swiftly progressing stream of science. How could he know
that my feet were seeking new paths? Our conversation drained
the blood from his head; he turned pale. Intuitively it struck
me that he had not long to live. Raising a flag of truce, then,
I temporarily abandoned the hope I still cherished, until I
might see his attitude weaken, or until it might never offend
him if I became that horror of the conservative, "a new
woman."

My brothers, too, held steel-like opinions upon the subject
of my studying medicine. There were four living at home-
only one approved of my project. And so, to allow the dust of
family battle to settle, I decided to visit my sister, Edith, who
had accepted my father s advice and was now the mistress of
her own home in Charlottesville.

She had married a dashing, brilliant lawyer, Richard
Thomas Walker Duke, Jr., of Albemarle County, who on a
trip to Europe had received much more attention than he de
served by a trick of punctuation when he signed the hotel
register, "Thomas, Duke of Albemarle." Their children
heightened my pride when they called me "Aunt Rose." I felt
old enough to have a mind of my ownl

Meanwhile, the cannon-fire did not cease at home. My
oldest brother, Charlie, wrote from Duluth, where he had
moved several years before, that if I graduated in medicine I
could come out and practise with him. Aunt Sue wrote that
inasmuch as my mother had married somewhat against her

A MOMENTOUS DECISION 17

family s wishes, she didn t see why I shouldn t choose a medical
education. My Quaker grandmother, she recalled, was on rec
ord as having said, "If women had studied medicine when I
was a girl I would have done so." This slim measure of support
gave me increased determination.

And then I had to hurry home to be at my father s side dur
ing his last illness.

Of course he thought that I would and should marry, and
that my husband would dutifully provide for me. Such was
paternal reasoning in his day. Consequently his will made no
provision for me. It was drawn in such a manner that after
providing for my mother, most of his money passed to his sons
and to his grandchildren. Since he had given my sister a
generous "marriage portion," some of my relatives urged that
I break what seemed an unjust will. But I was too proud.
And also glad, for it signalized freedom. I felt that now, sink
or swim, I would force my allowance to carry me through
college.

In his lifetime my father had provided for all my needs
and extravagances; in addition, to teach me something of fi
nance, he had given me several bonds that brought in an annual
income of $450 for spending money, to be spent judiciously and
accounted for strictly. This allowance must now suffice to
cover board, lodging, tuition, laboratory fees, books, clothes
and incidental expenses for the college year of eight months.
Vacations I would be at home; nevertheless, the venture would
require extremely careful management. Since my brothers dis
agreed about my studying medicine, they would not help me to
do so by setting aside the will. I felt no bitterness only release,
as though some destiny had ordered this circumstance.

A new, difficult world opened before me, a much wider hori
zon than any I had known, a life useful, demanding, and filled
with interest. Things would no longer revolve kindly around
me, as they had for so long. The day that my mother had first
taken me to stay at Edge Hill and I had been unhappy at having
to leave her now seemed a small memory compared to the
sharper adaptations I was going to face. I would hate to leave
my lovely home and my mother whom I adored, Lynchburg

A WOMAN SURGEON

and my friends, the sympathetic Negroes, particularly Mammy
Elvira. But I would make my mother proud of me when I
came back to practise in Virginia or was in an office with my
brother.

Lying in the hayloft, I pondered and planned. Going to
college would mean that I must relinquish Bonnie, my thor
oughbred horse on whom I had skimmed over roads and stubble
fields and fences on so many fox hunts. It would be difficult
enough to meet my expenses; certainly I could not support a
horse. Yet I could not bear to sell him. He might become
a common work-horse. Money from such a sale would be
hateful to me. And then I remembered a friend who admired
Bonnie extravagantly and who had often said, "Miss Rosalie,
if you ever want to sell that horse, give me a chance to buy
him."

My disdainful reply had been, Why not place a bid on my
left arm, or something else that s a part of me?"

But now things appeared in a somewhat different light. I
came to a decision which had serio-comic conclusions.

Bonnie s admirer, a man some ten years my senior, had
frequently accompanied me on rides. He had come to Vir
ginia from Philadelphia, commissioned to inspect and purchase
timber. Being of Quaker descent, and presenting a letter of
introduction to my family, he had greatly impressed my mother,
who encouraged our long early-morning rides through the
woods. After he had finished the business of inspecting the
trees, we would remove the saddles from our horses and while
they nibbled grass, have a picnic breakfast. He enjoyed hear
ing me read aloud Thomas Nelson Page s Negro dialect stories.
He loved Virginia in a romantic, poetic way, which pleased
me. I felt we were understanding friends.

I determined to give Bonnie to him, on condition that he
should never be sold. I telegraphed him that I was anxious
to see him; that I was willing to comply with an oft-repeated
request; that in the event he had not changed his mind, the
interview would have an important bearing on my going to
college. After dispatching this message, I told my mother
about it.

A MOMENTOUS DECISION 19

A smile flickered across her face as she said, "Very probably
he will misunderstand you, my dear. For three years he has
carried a ribbon from the dress you were wearing when he first
saw you, and six months ago asked whether I thought him too
old to marry you. I advised him to wait until you had made
up your mind about college."

Though he had hinted at this, I had never listened seriously,
I gazed at my mother wide-eyed, incredulous. I thought well
of giving him my horse; my heart was another matter.

The next morning brought a telegram in reply. He would
arrive by the first train. And he did, an engagement ring in
his pocket and effusive letters from his mother, to my mother
and to me, rejoicing, welcoming, and urging a speedy marriage.
All this I learned later, for I had fled in panic to the haymow,
relying on my mother s diplomacy to explain that a horse was
not a heart. And, Quaker gentleman that he was, he sadly
departed for home, taking Bonnie as the sole fulfilment of his
dreams.

Now my own dreams could be realized as well!

CHAPTER II

ENTERING A NEW WORLD

THE Women s Medical College of Pennsylvania, founded in
1850, remains to this day the only medical school exclusively for
women. 1 It was established by two physicians, members of the
Society of Friends, who stood their ground against outraged
public opinion. The institution was known for some time as
the Female Medical College of Pennsylvania- a shining half-way
mark on the road of social and educational revolutions in the
"women s century." At the time of its opening, Mary Lyon
and Emma Willard had just established two schools for the
higher education of women; Mount Holyoke Seminary was
then in its eleventh year and Oberlin, as a coeducational col
lege, was in its ninth; Geneva, New York, had granted its first
medical degree to a woman only the year before.

In those pioneer days the belligerent attitude of doctors-
and indeed of the public at large-toward the training of women
in medicine made life extremely difficult for the men who had
the courage to serve as professors in such progressive institu
tions. By the time of my matriculation at the college, succes
sive classes of graduates had returned members of the faculty
until two thirds of the professors were women. Many of these
women were outstanding in their fields: Anna E. Broomall, a
brilliant teacher whose methods were in advance of her time
and are now recognized as standard, was professor of obstetrics;
Hannah T. Croasdale, professor of gynecology, was a finished
operator, particularly in plastic surgery; Frances Emily White
was professor of physiology; Clara Marshall, dean of the college,
was also professor of materia medica and therapeutics.

Yet, in spite of all this progress of women in medicine, in
1893, the year of my college entrance, there were but 193
women on civilian hospital staffs. It was still the general opin
ion that women should lead the "sheltered life."

20

ENTERING A NEW WORLD

Each course of study was placed before us so interestingly,
with emphasis upon its inter-relation to other subjects, that I
moved from class to class with an awed reverence for the won
der world whose portals were opening to admit me. Modern
medicine, with its microscopic accuracy, allows no loose gen
eralizations. The histological study of each normal cell and its
nuclei, filaments and their combinations, blood corpuscles and
their variations, together with the differences and changes in
the healthy functioning and development of each tissue, formed
a logical sequence to the study of anatomy.

In pathology our professor, Dr. Lydia Rabinovitch, had just
come from her association with the great Koch in his discovery
of the micro-organism which causes tuberculosis. She drama
tized h^r subject excitingly, as we learned the life history of
each bacterium, baccilus, coccus, spirillum; the potentiality
of evil in each of those microscopic murderers; the warfare of
disease; and the climax the possibility of conquering it.

Nothing could be more illuminating than this nothing
could make all the forces of my life seem so integrated in serv
ice. I knew I had chosen well. Consequently it was something
of a mistake that I spent my first summer vacation at home.
Some of my friends declared that they hoped I was now satisfied
with my "experiment" and had come home to stay. My brothers
continued to urge me to give up my "foolish idea." Only two
were living at home; I had a confused sense of sadness and relief
when one went to Canada on a hunting trip and the other
somewhere else for a summer s fishing.

" Mammy" was comforting. She was disappointed that I had
indefinitely postponed marriage because she would have liked
to croon lullabies to more babies. But, as always, she was my
stoutest defender. Knowing that I liked an open fire, even in
the chilly summer mornings, she would kindle one on my bed
room hearth, muttering to herself, "Dat chile been livin God
knows how. She goin to warm her pink toes a while now.
When it s misty on de mountain, it s cool even if tis summer.
I gwine lay out her clothes fer her, too."

From my pillow I would watch her lumbering about the
room. She would come over to the bed and look down at me,

22 A WOMAN SURGEON

as mystified as the rest about my wanting to be a doctor. But
she wasn t critical. I would sit up and draw her to me and have
a good cry.

My mother accepted the idea with resignation, but she never
fully understood the strange urge which drove her daughter to
such an unconventional course of action. There was often a
look of sorrow in her eyes when cast in my direction. But her
pride of family was strong; she said that she would hate to see
me fail. Having made up my mind, I must succeed. At any
rate, she ruefully confessed, she had concluded that it was for
the best, since she had always feared that I might marry a
cripple of some kind, because I always sympathized deeply with
the handicapped. Now she believed that I would find my
"help to the helpless" strain satisfied in the practice of medicine
and would marry some man on whose strength I could lean.

Much of my vacation I spent sewing and mending, for while
my clothes had lasted well enough through the first winter at
college, they were now rather shabby. John grudgingly sug
gested, when he returned from Canada, that if I was going on
with that college foolishness, I needn t starve myself doing it,
nor dress like a fright. Rather than that, he would advance me
some money. Stubbornly, probably through hurt pride, I
refused.

"Well," he said, looking at me with strange, admiring eyes,
"a thorough-bred likes the hurdles!"

Later, when I had typhoid fever toward the middle of my
second college year, I again refused to accept assistance, al
though this illness caused unexpected expenses, serious inter
mission in classes, and enforced quiet in which to question the
wisdom of youth s headstrong pride, for,* had had several severe
"colds," a result of the deficiencies of my winter wardrobe. My
thin coat was not warm enough for Pennsylvania winters; to
remedy this, I wore a jacket of newspaper with a hole torn for
my head. When the heels of my overshoes wore through, I cut
them off, transforming the remnants into sandals. Fortunately
at the time I considered it a game to see how much I could do
without and embraced hardships with the ardor of a prophet in
the wilderness, saved money by walking whenever the wear on

ENTERING A NEW WORLD 23

shoe leather would not exceed carfare. Youth s passionate am
bitions! I walked myself back to healthA

Often I have been asked whether I would advise a girl with
no income to study medicine. If she is being educated for mis
sionary work, yes. If after proper scholastic education she can
borrow enough to see her through four years at medical college,
two years of hospital experience and one year of getting estab
lished, with the understanding that she will not be expected to
pay interest until she has been in practice for three years, nor
begin to repay capital for five years, yes. Otherwise, no. Had I
not had a small income and been impelled by a hereditary
urge, I could not have ignored the inevitable difficulties. Still I,,
wonder that I accomplished it on schedule time.

I was spurred on, too, by the thought that I was carrying the
torch passed from hand to hand through the decades from the first
American pioneer women physicians. Although the founding of
the Women s Medical College of Pennsylvania was considered
a pioneer movement in its day, and Dr. Elizabeth Blackwell,
when, in 1849, she gained her degree from Geneva Medi
cal College, was regarded as the first American "Doctoress"
as she was called by her contemporaries I learned that the
woman physician is more deeply rooted in American tradition.
Indeed, we have a record that the first person to be executed in
Massachusetts Bay Colony was one Margaret Jones, a female
physician accused of witchcraft. Surely this was a deplorable
beginning for the history of medical women in America! And
from the Connecticut blue laws, the following entry of March,
1638, tells somewhat of the state of affairs in another section
during Colonial times: "Jane Hawkins, the wife of Richard
Hawkins, has liberty till the beginning of the third month
called May, and the Magistrates (if she does not depart before)
to dispose of her, and in the meantime she is not to meddle in
surgery or phisick, drinks, plaisters, or oyles, nor to question
matters of religion except with the Elders for satisfaction."
What Jane had done to merit such punishment is not revealed;
mayhap, after the manner of her sex, she had asked some ques
tion that no man not even an Elder could answer!

24 A WOMAN SURGEON

The town records of Rehoboth, Massachusetts, mention the
arrival early in July, 1663, of Dr. Sam Fuller and his mother,
who began the practice of midwifery "to answer to the town s
necessity, which was great." In 1765, Marlboro, Vermont,
boasted a certain Mrs. Thomas Whitemore possessed of a
vigorous constitution and frequently traveling through the
woods on snow shoes from one part of the town to another by
night and by day, to relieve the distressed," while eight years
later in Torrington, Connecticut, there is frequent reference
to two women who were greatly honored for their skill as
accoucheuses. One of them, Mrs. Johnson, or "Granny" John
son, as she was called, "rode on horseback, keeping a horse for
the special purpose, and traveling night and day, far and near."

There was sturdy stuff in those early American physicians.
Over a century later, the same hardihood of spirit took a differ
ent expression when, female midwives having been effectively
suppressed by law, half a dozen women, unknown to each other
and widely separated, appeared almost simultaneously on the
scene and demanded the opportunity for education as full phy
sicians. Harriet K. Hunt, who was practising without a license
in Boston, applied for admission to attend lectures at Harvard
in 1847. She was refused but in 1850 made a second applica
tion, which she was asked to withdraw following a heated meet
ing of the students who resolved against the "amalgamation of
the sexes" and threatened to move to Yale if the "female stu
dent" were admitted. While Harriet Hunt was vainly battering
at the doors of Harvard, Elizabeth Blackwell, of English birth
but American education, was being refused entry at Philadel
phia and New York. But in the fall of 1847, the faculty of the
Geneva Medical School of western New York having put the
matter before the students, she was unanimously invited to be
come a member of the class. Through dignity and tact, she
overcame the prejudice of undergraduates and instructors; but
the public, scoffing at the idea of a "she doctor," regarded her
as "either mad or bad." She received her M.D. in 1849, the
first to be granted to a woman in modern times. She went
abroad for a year s study where she was permitted to practise in
all branches of medicine except, ironically enough, gynecology

ENTERING A NEW WORLD 25

and pediatrics, and returned to New York in 1850 to practise.
On encountering almost insuperable difficulties, she opened ia
dispensary of her own which, seven years later, became incor
porated into the New York Infirmary and College for Women
a hospital conducted entirely by women. In this venture she
was joined by her sister Emily, who graduated from Cleveland
after having been debarred from taking her second term at
Rush Medical College, and by Marie Zakzrewska, a young
Polish-German woman, who, through the kindness of Elizabeth
Blackwell, secured admission to the Medical School at Cleve
land and there obtained her degree after a long period of
ostracism and petitions.

Mary Putnam, later Dr. Mary Putnam Jacobi, was another
pioneer whom we all came to revere. Her father, George Pal
mer Putnam, the publisher, placed no obstacles in the path of
her "repulsive pursuit" and she was graduated from my college
in the class of 1864, the year in which a spirited controversy was
carried on in the New York Times, regarding insults offered
women medical students by male students while attending the
Bellevue Hospital clinics. Two years later she sailed for Paris
and laid deliberate siege to the Ecole de Medecine in which no
woman had yet set foot as a student. She finally circumvented
the faculty by appeal to the Minister of Public Instructions.
Her entrance through the side door, the first woman to gain
admission to the historic amphitheater, failed to precipitate the
predicted riot, but she had a stiff fight for the right to take ex-
. aminations leading to a degree. The victory of this American
* girl established a precedent which admitted a second woman,
Dr. Elizabeth Barrett of England, who matriculated shortly
thereafter. Pursuing her studies through the siege of Paris and
the disorders of the Commune, ]\|ary Putnam was graduated in
1871, receiving the highest mark granted by the faculty. Her
thesis won the second prize. Her own education secured, she
aspired to win opportunity for other women in medicine and,
returning to New York, she became professor to the new
Women s Medical College of the New York Infirmary, founded
by her friend, Elizabeth Blackwell. For sixteen years she lec
tured on materia medica and therapeutics, conducted a dis-

26 A WOMAN SURGEON

tinguished private practice and tirelessly labored against the
still virulent prejudices of the nineteenth century.

These were some of the medical women who blazed the trail
along which we were to make our way; each of us wanted to be
worthy of following in the footsteps of these pioneers; each of
us hoped that we, too, might be able to advance the position of
women in medicine in our own day.

CHAPTER III
LIFE AMONG THE UNDER-PRIVILEGED

DURING my second summer vacation on the recommendation of
one of my professors, I secured a position in the Massachusetts
State Hospital at Tewksbury. With high hopes of putting to
use my newly acquired knowledge I entered what was to be my
home for the next three months. The administration building
and the adjacent buildings for men, women, and the insane,
faced me with an institutional look, adequate but impersonal.
But I beamed back my anticipation.

On this, my initial job, I was to assist in the pharmacy, take
histories of the patients, record physical examinations, adminis
ter medicines in the long wards, and be on duty ten hours daily.

The first salary offered to me ruffled me with embarrassment.
I told the superintendent that I was sure my father would not
have liked me to take it; I was learning so much that it did not
seem fair to be paid for it.

"You have earned it; you must not upset our bookkeeping,"
he answered with a puzzled expression. "I never heard of any
body refusing money. How do you expect to get on in life?
Don t you intend to make a living?"

Unwillingly I accepted it. By the end of another month I
planned happily how to spend all these earnings.

Both doctors and nurses let me help them in numberless
ways. I felt many pulses, listened to many hearts. I was eager
to be near patients. As my professional interest quickly trans
lated itself into more personal terms, the patients soon appealed
to me not as "cases" but as human beings. Inevitably the gen
eral hospital attitude stood detached and impersonal. My
youthful zest in observing all that transpired, and in applying
what little I already knew, was outside the experience of most
of the patients. To them, I seemed as much of a rara avis as
they seemed curious birds of a feather to me.

2 g A WOMAN SURGEON

Most of them were paupers, pitiful discards in the game of
life. As I pieced out their stories I became aware of a side of
life previously beyond my ken. They had intricate problems to
unravel; they faced difficulties of a nature which I had never
suspected to exist. And they possessed magnificent courage. I
tried to make them my friends. Scientifically, as a student as
sistant, I could not do half as much for them as the doctors who
attended them. But they wanted understanding and sympathy
as much as healing. For the majority suffering was an old hat
which they wore stoically; they seldom spoke of pain but they
longed to pour out their life stories to some one who would
listen, to tell things they had never told before. Their hearts
bulged heavily and had to be unlocked. They did not babble
neuresthenically; their stories issued haltingly from lips unac
customed to expression, a word or a gesture spoke volumes.

Number 49, an opium addict, was a gentle old man, refined,
grateful for small services. Nothing seemed to him worth the
struggle of getting well. When he entered the hospital, he had
given a false name. Whenever I saw "alias" on the card at the
head of his bed, it hurt me, for I knew that he had hoped to
shelter his family. Why tear at his shred of pride? His hos
pital record told much of his history, but 49 elaborated it as
our acquaintance ripened into friendship. He had always been
frail. In middle age, drawn by passion rather than love, he had
married a buxom girl who was not his social or intellectual
equal. Years of heavy labor took their toll of him; he fell seri
ously ill. For hours at a time his healthy wife left him alone
and grudged whatever service she gave. The doctor prescribed
small doses of morphine to tide him over paroxysms of pain.
She increased the dose. After a month the narcotic habit had
become fixed. Having put his bank account in her name, she
sent him to this charity hospital. She had neither written nor
called on him.

Burbank, one of the hospital cooks, always clumsy and yet
wanting to do something above routine institutional cooking,
chatted with me while I made custard for Number 49. He in
quired my age. I wished to know why it interested him.

LIFE AMONG THE UNDER-PRIVILEGED 29

"Well, I want to put it with Number 49*8 age and the num
ber of the cook stove and play the lottery."

Poor 49 had lost in the lottery of life. I never learned what
luck Burbank had.

As I went my daily rounds of the women s wards, I became
haunted by the beautiful brown eyes of a patient about my own
age. Her eyes thanked me when I occasionally placed a bou
quet of field daisies at her bedside. Since her admission she had
maintained an almost unbroken silence. We all knew that she
must soon die, so we respected her obvious desire to be left
alone. Consequently I was startled when, as I was turning
down the lights one evening, she nodded toward her bedside
chair where no visitor had sat. I accepted her unspoken invita
tion. Her usually quiet fingers began to fold and refold the
sheet across her breast, her eyes hypnotizing mine with their
intensity. As I leaned over and placed my hand on her flutter
ing fingers, she whispered, pleadingly, "Will you please promise
me that I will be buried when I am gone?"

I thought that she must be delirious; to quiet her, I promised
quickly.

"My mother once told me that she would throw my body to
the dogs," she continued in an emotionless voice that was be
trayed by the very real terror in her eyes.

And then, as the silence of night deepened throughout the
ward, she told me her story the old, old story of country youth
betrayed by the persuasive lover. In her case he had been a
city cousin promising marriage as the price of silence. She had
tried in vain to find him in the city; ill, bewildered, she had
returned home to tell her widowed mother all that had hap
pened. Her horrified parent refused to believe in the guilt of
her nephew, but nevertheless summoned him to the farm. He
denied his paternity, suggested the overseer s son and asked his
aunt to be merciful toward her wayward, pretty daughter. Dis
illusioned, desperate, the child went to the city determined
never to see her mother or her lover again. She thought there
was but one path for her to follow. An unsympathetic hospital
experience at the time of the birth of her dead baby, disease,
night courts, the hospital again. . . . Determined to revenge

A WOMAN SURGEON

herself on society she deliberately tried to infect every one she
could. Learning that her mother was ill, she repented and
crept home, asking forgiveness. Her mother ordered her out
of her sight, as she would a leper. She wept, promised to re
form and begged a night s rest, saying that the doctor had told
her she had not a year to live. To this her mother replied that
if she outlived her she would throw her shameless body to the
dogs; it would defame Christian burial.

The girl s face, hair, and hands, upon the bedclothes, were
beautiful; underneath, her diseased body had wasted away.
She was twenty; I was twenty; I stroked her forehead and
wished that death had claimed that mother before she had
murdered this girl s soul and body. Within a week I asked for
an hour off to follow her body to a deep grave where she might
rest in peace.

The State allowed able-bodied patients to work during the
summer if they wished. One day after I had been in residence
at the hospital about a month, I was asked to go on a tour of
inspection of some of these "out patients." I was to examine
their physical condition while the State inspector, whom I ac
companied, was to make certain they were not being imposed
upon in any way. It was hog-killing time. One of our patients,
a husky, muscular, but fine-skinned man who from infancy had
been feeble-minded, had been "hired out" to a farmer. We
found him stripped to the waist, standing with three men by a
large table under the trees, cutting spare ribs. Blood spattered
his chest and arms. The inspector asked him whether there was
anything he would like to have.

"Yes," replied the hydrocephalic, "there is something, but/
he added gloomily, "I know you will not give it to me."

"You re earning money," the inspector encouraged. "If it is
not too expensive, you can ask for anything within reason and
tomorrow I will buy it for you with your own money."

Depression gave place to happy expectancy. "All right,"
was the reply. "Get me a long pair of white kid gloves."

Surprised by what seemed a flash of wit, I inquired, "What
will you do with them?"

Reminiscence stirred across his brain; the fine skin was

LIFE AMONG THE UNDER-PRIVILEGED 3 !

hereditary. "Keep them folded in white tissue paper," he
replied.

For some weeks I spent part of my time in the department
for the insane. There my youthful sympathies threatened daily
to snap. The supervisor of the insane division conducted me
into the women s ward. As we opened the door, loud guffaws
and hilarious laughter greeted us. Only after a moment did I
realize this was not directed at us. Several of the women were
dancing together locked arm in arm, two by two, over the
smoothly polished hard-wood floor, to the great merriment of
the rest of the inmates who stood about in a circle, clapping
their hands and shouting with glee. A mild and harmless
enough amusement, said the supervisor. As I discovered, it
was a daily occurrence. For three hours each afternoon all the
women in the ward polished the floor to a glassy smoothness;
then, for five minutes, they all enjoyed themselves, as I had
seen them. The pathos of that spirited entertainment, re
curring every day at the same hour, never failed to move me
gray-clad shadows moving in concert through a world of half-
light, which, for them, momentarily took on the glitter of a
golden ballroom.

I have often heard it said that the insane are incapable of
suffering pain. Perhaps, but certainly they suffer as keenly
from the effects of imagined pain. A mildly insane patient of
the men s department at Tewksbury was oblivious to real pain
but acutely aware of the fancied agonies caused by his teeth.
Every two weeks he would beg to have one out a perfectly
sound tooth. When he had set his mind on having it pulled, it
worried him incessantly; he appeared to suffer constantly.
Finally, thinking the pain of one extraction would cure his
mental quirk, the supervisor authorized me to extract a molar.
It had long roots. I was not expert. I pulled, hauled, rested,
and jerked again. He was well satisfied throughout the long
proceeding, and when it finally came drippingly out, he shook
hands with me effusively, insisting that he had had no pain. ^

I had been back on duty in the general hospital perhaps two
weeks when one day I heard it reported that a little boy was to
be brought in from a children s home, and would be put into

A WOMAN SURGEON

Medical Ward B. The vision of a five-year-old child in that
ward where twelve old alcoholics were paying for their dissipa
tions so revolted me that I shocked precedent with an appeal to
the chief physician to place the youngster in a room by himself.
My extraordinary request met refusal; private rooms were
needed for patients critically ill. But my fears withered, as I
learned that in every human wreck there stir decencies
which revive in the presence of a little child. Those bat
tered fragments of life became men again kind, thoughtful,
generous. No more quarreling, vulgar reminiscing, swearing,
or grouching. They either lay quiet or talked of their own
childhood. If one received an apple or an orange from a
visitor, he saved it for the "little shaver." With a collection of
pennies they asked me to buy him a picture-book and when he
knelt by his bed each night to say his prayers, a stillness, almost
reverent, descended upon Medical Ward B.

One night as this childish prayer in a piping voice filled
every corner of the ward, I noticed tears on the cheeks of a
rather young man in the bed at the far end of the line. His
face usually turned to the wall, but tonight all the aristocratic
modeling of his head lay revealed. I was struck by his beauty;
I wondered how he came to be here. That night before going
to my room I looked up his record. "Alias," of course, was
written across his name but from the meager record I patched
together his tragedy: "Bank clerk . . . took to drinking . . .
stole small amounts . . , falsified ledger . . . stole more . . .
careless of associates . . . infected . . . now suffering from
syphilitic ulcers of both legs."

And then, oddly enough, he was assigned to me for treat
ment. His voice and manners confirmed my first impression
that he was of good stock utterly degenerated. He often cried
while I cleaned and dressed those hideous ulcers, not so much
from pain as from humiliation, defeat, and horror of himself.
He did not know it, but he was a potent factor in the forming
of some of my basic conclusions on social drinking. As I
worked over him, there passed through my mind something
like "If it causeth my brother to offend" Year after year,
through observations in my practice, in social service, and in

LIFE AMONG THE UNDER-PRIVILEGED 33

other fields allied to medicine, this conviction has strengthened.
A strong constitution with which to combat exposure and
disease is essential; nothing so undermines the constitution as
does alcohol.

Three months amid life at its most pitiful might have been *
overwhelmingly depressing had I not developed simultaneously
a deep interest in the causes of the poverty and illness I ob
served. In this, my first opportunity to observe a large number
of the sick poor under uniform conditions, I recognized the
lack of caste of this section of American life. Heretofore, my
thoughts had been those of the class-conscious; the poor I had
lumped together in a group of generally inadequate individ
uals, of whom some possessed energy but no intelligence, and
the rest, intelligence but no energy. Now I saw that the lack
of either or both of these faculties did not account for the pres
ence of all the patients at Tewksbury. Each had arrived at this
charity hospital by a different route; each possessed a different
heredity; each had been acted upon by a different environment;
each faced a different solution. In short, each was an individ
ual. I began to study their dissimilar personalities. Psycho
analysis had not yet been refined to a sharp clinical instrument,
but as I look back, I realize that I wielded it in a tentative
fashion, as intimately I learned of human beings at their lowest,
even their worstand at their best. Hearing their histories, I
pieced together their problems, their defenses of mind and
action, trying to inject courage into those who might live, calm
ing those who might die.

^ " I learned, too, that death is not difficult. Rarely did I ob-
" serve, nor seldom since, what has been overdramatized in the
layman s mind as a "death-struggle." The chemical and elec
trical forces within the body are, at the approach of death, so
depleted that the actual passing is normally very quiet. Usually
the curtain of unconsciousness descends before the end. The
drama of the deathbed speech has little play on life s stage, for
death is merciful. _,

And in that Massachusetts summer I witnessed, too, the 1
awful truth behind the phrase, "visiting the iniquity of the
fathers upOD the children, and upon the children s children,

34 A WOMAN SURGEON

unto the third and to the fourth generation." I had learned
that syphilis was the only disease actually transmissible from
generation to generation, but I also recognized the degenerat
ing effects of other weaknesses which, through selfishness and
ignorance, father bequeathed to son. Alcoholism nerve-
poisoning, will-destroyingassumed second place in my calen
dar of social sins. I criticized the selfish carelessness of those
whose motto, "I do what I wish, and have what I want, when I
want it," eventuated in mental, physical, or economic penalties
not paid wholly by the offender. I came in contact with hun
dreds of such cases during those three months; by their very
number they could not be merely exceptional.

Out of observation of this chaos of broken lives there grew a
conviction that the potent uses of heredity and environment,
separately or as they modify each other, are something which
outrides what we too easily call destiny. The uses made of these
factors determines one person s success where another, under
similar circumstances, may fail. What is the explanation?

To reach an answer, I pondered on these individual failures.
Sympathy was touched, but the sense of responsibility awoke
with the hope of lessening the endless repetition of such defeat.
I wanted to classify those qualities which, absent in my patients,
might inversely assure success.

Courage, plenty of physical animal courage, was there. But
where was the courage of the will? And imagination to em
bellish and deepen that will? Here, the rational judgment that
should propel that will was either warped or perverted. The
lack, or the mere broken particles, of these three essential mind-
forces brought men to weakness and disintegration. Granted
these mental powers, what then were the forces of character
necessary to potentialize success? To me there are four prime
forces. First is honesty with oneself and others, in both the seen
and unseen hours of our lives. Then comes loyalty to the self
and others which assures the integrity of the individual. One
may be both honest and loyal, but only faith can direct and
carry forward that integrity. Spiritual courage, to xvhich fear is
unknown, can guide the faith into expanding fields of achieve
ment. ~"~"

LIFE AMONG THE UNDER-PRIVILEGED 35

Nevertheless, disregarding the few whom accident had de
featedalthough most of them overrated fate and underrated
their own responsibility in their destinies I came to the bed
side of a rare man or woman who seemed to possess these quali
ties in full measure. Here they were, trim and even-keeled, yet
shipwrecked alongside of rudderless derelicts. What was the
other more subtle force they lacked?

The quality, which is a prime requisite of success, is "health-
energy," a combination of endocrine balance and moral force.

Since before the dawn of history, through the mystic, pagan,
medieval, and modern contributions to the art of healing, there
have evolved certain laws of health which an individual cannot
break without paying dearly. The conservation of health-
energy is the foundation of all tribal law and is a principal
consideration in its individuals and society. But in the com
plexities of civilization we have forgotten that. And many have
forgotten, too if, indeed, they ever knew these elementary
laws of health. People eventually pay for their chosen aptitudes
either in ill health or in increased strength.

Reflecting on the suffering to which I had lived so close and
which I had, perhaps, to some extent alleviated suffering mostly
occasioned by ignorance I saw that a doctor s work must be to*
educate as well as to cure.

CHAPTER IV

THE SENIOR YEAR

AT LAST people stopped saying, "You will never graduate. You
will marry and give it up."

Before final examinations, each senior had to attend, deliver,
and give after-care to ten obstetrical cases. If we required as
sistance, we were free to call for it, thus safeguarding the pa
tient s interests. During this period of education we resided in
a house in the poorer section of Philadelphia, equipped by the
college as a pre-natal clinic, the first of its kind ever established.

Using this house as a base we probed our way through the
confusion of streets and blind alleys comprising this quarter of
the city. Unpainted two-storied flats leaned their drab forms
in unbroken, twisting double ranks, each house jostling its
neighbor and spilling its occupants over worn thresholds. Dur
ing the day, and especially at the supper hour, streets chattered
with the noise of many tongues. The very cobblestones seemed
vocal. Jew and Gentile shared the community water-faucet at
the curb; the good-natured Irish washerwomen bought their
soap from the pushcarts of Italians; the Pennsylvania Dutch and
Swedes added an air of solidity. From this polyglot population
we drew our patients.

My first case among them was a bony, raw Scotchwoman, old
enough to be my mother. Moreover, she had been a midwife
eighteen years! This was her tenth confinement. She sized me
up, eyed the ridiculous curls which rollicked over my head as a
result of the typhoid attack, and grunted that she knew more
in a minute than I could learn in a lifetime! "Indecent, it is,
for you to be callin yourself a doctor!" she stormed.

Disconcerting, but I must stay with my angered patient if I
hoped to attend other maternity cases. I stood my ground.

"How old is that daughter of yours, crying out there on the
steps?"

36

THE SENIOR YEAR

37

"Twenty-five."

"Has she any children?"

"Two."

"Well, if her age and experience will be of any use to you,
call her in."

Changing her tactics, the woman began a thorough quiz.
Evidently my answers satisfied her, for she barked out, "You ll
do."

The baby was a lusty, howling boy. I was glad when I might
leave inasmuch as the husband, half drunk, proposed to cele
brate the arrival of an addition to his family. When I returned
to see my patient the next morning, the baby lay dead suffo
cated by the intoxicated mother who had rolled over on it
during the night.

" Tis your own fault for not puttin the baby in another
bed," she began defiantly.

"What bed?" I returned, knowing there was none that did
not already overflow with children.

Her husband, sobered by the death of the infant, rebuked
her, "Don t scold the little doctor. She done a good job.
Tain t her fault the kid blinked. I ain t sorry. We got more."

Filing a death certificate seemed a poor way to begin a
career.

Determined not to have my age challenged again, and hav
ing saved one of the plaits cut off during my illness, I sewed the
hair into a neat "bun" in the back of a borrowed Quaker
bonnet. Thus fortified I could make an impressive entrance
into the sick-room, remove the bonnet in a dark corner, and
cover my curls completely with a sterile towel.

The next call, to my relief, was from a genial Irish soul. She
welcomed me warmly into her cozy flat. She was, however,
more concerned about a pain in her knee than her approaching
maternity.

"Sure, it s so throbbin , the pain is. Me knee is so crowded,
it is. It kin only be me heart has slipped down, for I ve a gone
feeling in me side. There, darlin , put yer hand on me knee
and tell me it s me heart."

As diplomacy appeared more important than a diagnosis of

A WOMAN SURGEON

rheumatism, I humored her by saying, "Do you know, my heart
was in my boots only yesterday! Maybe yours has stopped
half-way."

In order to listen to her heart I untied my bonnet strings,
forgetfully, at the bedside instead of in a remote corner as I had
planned. When I bent over, stethescope in ears, the bonnet
and false hair rolled to the floor. I blushed. But appreciating
so much my understanding about her knee, my patient over
looked the catastrophe. At any rate my age went unquestioned.

The plump little girl who was born had a round, unmis
takably Irish face. In the days that followed, her mother and I
became great friends, and discussed all the happenings on the
block. Finally she admitted there might be a touch of "rheu-
matiz" mixed with the heart trouble, and soon she was on her
way to recovery.

The next patient was an "alley woman/ as convenience
called those who lived in any of the dark, forgotten little alleys
that punctured the flanks of houses half-way into the block and
ended at a blank wall. Here the swirling rush of noisy, vibrant
street life eddied into a shadowy backwater. Here, where the
sunshine filtered through for only an hour each day, huddled
those families who fought the hardest struggle for existence.

A pale slip of a woman answered my knock at the farthest
alley door. Her pinched lips indicated how little food had re
cently entered them, and her frail figure, pitiably distorted by
her condition, trembled under the faded dress. During my
examination I noticed bruises on her arms and shoulders.
Haltingly she murmured that her husband beat her on Satur
day nights when he came home drunk, if she complained that
his pay envelope, half emptied at the saloon, could not cover
the rent and clothe six children.

She looked at me with mournful eyes and said, "I hope the
baby ain t living. It s awful quiet. Maybe it s dead."

When the tiny bit of humanity was born, it weighed only
three and a half pounds. And soon it was- followed by a twin of
the same weight. When I told the mother, she cried out, "Lord,
take it back! I didn t want any, and now there are two. If I
couldn t take care of six, how can I of fcight?"

THE SENIOR YEAR 39

The second baby drew no breath. I began to resuscitate it.
"Please, doctor/* pleaded the mother, "let it stay dead. Don t
bring it to life to starve."

My heart ached, but my duty bade me work just as hard over
that infant as though it were heir to a throne. The collapsed
lungs gradually expanded, the spaces between the fragile ribs
filled out, and the rhythm of breathing began. I hurried with
the wrinkled, aged-looking babies to the Women s Hospital,
where they survived for ten days in an incubator.

One of my patients pains had become severe while scrub
bing the floor and she had gone to bed as she was, her clothes
wet and dirty, her shoes and stockings on. In one corner of the
dingy back room I found a cold stove; in another, a cracked
sink laden with unwashed dishes. Nothing was ready for the
baby and almost nothing for a doctor to improvise into useful
ness. I ran to the front door, dispatched one gaping neighbor
for tea-kettles filled with hot water, gave another ten cents with
which to buy fresh newspapers, and asked a third to bring an
old sheet, or a blanket, if she had one to spare.

After undressing and bathing the patient in a battered
bucket and wash basin, I slipped a gown on her, took off the
soiled bedclothes, covered the mattress with newspapers, four
layers thick, and placed the contents of my obstetrical bag
within reach; then she decided she must walk the floor. She
was a powerful Polish woman, with fury in her black eyes, an
Amazon not to be restrained. As she had no slippers, her feet
gathered dirt at every step. Finally I persuaded her to sit on
the edge of the bed and rest her feet in a bucket of warm water
while I scrubbed them. The infant was not easily delivered,
there being a shoulder impaction which necessitated external
and internal rotation.

"Do exactly as I tell you, or you and the baby will be lost."

Immediately she became docile and cooperative; at the end
of an hour the baby was born; we were both exhausted, but he
was a fine little chap. %

The miracle of reproduction, the magical capacities of two
microscopic cells, the endless possibilities for variation and
combination of the character traits and psychological inheri-

40 A WOMAN SURGEON

tances within the newly created being, were constant marvels
which never lessened their power to awe me. And always some
thing mystical hovered over the sweet warmth o the new-born
something which demanded love, even for the unwanted.

This practical obstetrical preparation for a degree con
cluded, I had the good fortune to be recommended to fill an
emergency in completing an unexpired interneship at the Phila
delphia City Hospital, but was warned that after working all
day in the wards I might be too tired in the evening to study for
my final examinations. However, not only would it give valu
able experience, but I could also save my room and board bill.
While the position carried no salary, it entailed no expenses.
There, working happily, actively, I had opportunity to learn
details of diagnosis and treatment and to become thoroughly
familiar with those cases which Dr. Henry, our professor of
internal medicine, and Dr. Stelwagon, professor of dermatology,
had previously chosen as most typical when conducting their
classes through the hospital wards for bedside instruction. One
of these I wrote up and submitted in a competition open to the
senior class, the full history of a case of pernicious anemia, sup
plemented with laboratory reports, charts, and record of treat
ment. It won the Alumnae Prize of twenty-five dollars, which
I joyfully squandered on clothes.

While I was interne in the hospital I had under my care a
patient who, of all the people I have ever met, was most positive
that the world owed her a living. One morning she was missing
from the ward and there were complaints that the bathroom, to
which convalescent patients went, had been occupied for three
hours. I found this slovenly young woman sitting on a chair
in the bathtub, her feet dangling in warm water, while she read
a popular magazine. She had no sense of responsibility or grat
itude for her position as a charity patient.

"No one cares anything about me," she said. "So why
should I care about anybody else? I believe in getting all I
can."

She had dragged in the chair from beside her bed and pro
posed to spend the rest of the day in comfort, monopolizing the
bathroom designed to accommodate twenty other people. She

THE SENIOR YEAR 41

had no conception o the deep satisfaction life gives to those
who prepare themselves for work and determine to do it well.

On graduation day, an hour before I was to receive the di
ploma to which I had so eagerly looked forward, which would
give me the degree of Doctor of Medicine and Surgery, I re
ceived a telegram while on ward duty:

"If you wish to see Mother alive, come home immediately."
The morning s brilliance vanished; but no train left for
Lynchburg for five hours. Meanwhile I received my diploma
with unfeeling hands; the good wishes of thirty classmates and
many friends fell on deaf ears. I sat, shaken, trembling, curious
as to why I had not been told of the seriousness of my mother s
illness, and whether I might reach her while she yet lived.

Months before, she had written to me saying that she was not
feeling well and that the doctor had ordered "a rest cure."
But she promised to be fully recovered by the time I finished
college. In reply to my frequent letters, I had received lengthy
notes from my sister which contained many affectionate mes
sages from my mother. Generous heart that she had, she
allowed only cheerful letters to reach me, and when she finally
knew she was slowly dying, she had kept the knowledge from
me because she wanted me to graduate.

When the train reached Lynchburg at three in the morning,
I was met by a stern brother. Why had I not answered a
special delivery letter and a telegram sent to my boarding
house? I explained that I had been living at the hospital, but
his manner still rebuked what he considered my indifference.
"Is she living?" I faltered. "May I see her?"
"Not tonight. It might be too much of a shock."
His sorrowful bitterness cut my heart. We rode home in
silence. Another brother met me there, likewise stern, his own
heart aching, his nerves torn.

"Why didn t you come a week ago?" he reproached,
Tears filled my eyes. I hoped I could make them believe
that nothing would have kept me from her side had I known
the truth.

/I did not leave her day or night, so anxious was I to make up
for all the hours I had been away. We spoke softly together,

42 A WOMAN SURGEON

of memories, of probabilities, of eternal things, sharing our
dreams once more. As I nibbled my meals in a corner of her
room, I wept silently. While she slept, I sat stunned by grief
and recollection. She assured me that my sister and brothers
might have been brusque because they were weary with the
long months of anxiety. She smiled feebly and spoke her plea
sure in my being prepared to take care of myself, now that she
had to die. She was happier, too, she whispered, that I had let
no obstacle deter me.

At the end of four weeks she was gone. My prayer was that
I might become worthy of such a mother.

CHAPTER V

CHUMS IN SOUTH THIRD STREET

RESCUED from profound grief and self-reproach by the oppor
tunity for immediate work, I will always be thankful for a
letter from Dean Clara Marshall asking me to become resident
physician of the Alumnae Hospital and Dispensary, which had
been founded a few years before to honor Dr. Amy Barton, our
professor of ophthalmology. The dispensary was run in con
junction with the maternity hospital already familiar through
under-graduate training in obstetrics.

Struggle, discouragement, and general privation served their
daily portion to the lives in South Third Street. Dramatic mo
ments of life in the slums would not be new; humor and pathos
would be.

On the street floor of the dispensary the large front receiving
room was bare except for the mantel and my desk in front of a
window. The "callers" waited on benches around the walls.
Two rooms on the upper floor, curtained into cubicles, func
tioned for various clinics. Here, daily, from nine till five, six
women physicians from the Women s Medical College came at
scheduled hours to give gratuitous help to the poor.

My mornings were devoted to registering new patients and
doing minor emergency work. By eight o clock several little
groups had already congregated on the steps outsideanxious
mothers with two or three children in tow, a youngster bring
ing in a sick or injured parent, brother, or sister, the faces of
them all dried and squeezed by poverty. Yet eyes dogged by
misery and bafflement never failed to offer a wan smile. Crowd
ing into the office, they sat patiently while I extracted splinters,
changed dressings, swabbed throats. Those with serious or
chronic conditions received cards, numbered to correspond
with the page in the big case-book where their histories were

43

44 A WOMAN SURGEON

recorded, and told when to come back for the special clinical
treatments upstairs.

My first "out" patient was the wife of an old man. He came
to see me regarding the possibility of removing cataracts from
his wife s eyes. She was too blind to come with him. Their
spotless house was in a dark alley. Examination showed the old
wife s eyes ready for removal of the cataracts. When it was
suggested that she go to the Women s Hospital for the oper
ation, she inquired anxiously, "Was there never an operation
that was a failure?"

Alas, all could not be successful, so I parried by inquiring
why she asked.

Her husband had not been well for two years. She didn t
know what the matter was. She could feel her way around the
house so that together they kept things tidy and comfortable.
She had rather never see clearly again than risk not being able
to take care of him now.

In the kitchen MacGregor, the old husband, was sitting
quietly in front of the stove. When the situation was explained,
he replied that his gradually failing health was caused by a
condition beyond cure.

"The operation on your wife is not dangerous/ I urged. "If
you will go to the hospital at the same time, you may he helped
and she will then be willing to have her sight restored."

"No," he replied gently. "I have known for a year that I
have a cancer and I do not want her to grieve over it. The
time is short. We will be happier here/

Whenever I was in their neighborhood I stopped to visit
them; on warm summer evenings we chatted over a dish of
ice-cream. He loved to talk of the years when he had supplied
game to a fashionable men s club and had even gone hunting
with the more democratic of its members. He had the charm
ing manners of one who had spent his life in association with
gentlemen. When he died I talked to Mrs. MacGregor again
about having the cataracts removed. She merely said, "Never
mind it doesn t matter now."

My first serious operative case was in Fish Head Alley. Mrs.
Saprouiski refused absolutely to go to the hospital. Would

CHUMS IN SOUTH THIRD STREET 45

rather die, she said. Resigned, I gave instructions for the two-
room, two-story house to be scrubbed from top to bottom, dress
ings to be baked in the oven; there must be plenty of boiling
water. The neighbors all assisted the twelve-year-old daughter.
On the morning of the great day, the house not only sparkled
with cleanliness but there were also twenty kettles of hot water
in the Saprouiski kitchen.

My former professor of gynecology, Dr. Hannah Croasdale,
was present. She arrived in her carriage, bringing with her an
anaesthetist and two nurses to help me. Excitement bubbled
through the alley. Nobody had ever had four doctors and two
nurses! The patient became a person of social importance.

Mr. Saprouiski accepted the statement that I would have to
put his wife on the kitchen table, that it would have to be
placed as near the window as possible, and that he must tell the
neighbors that no one should go upstairs in the house opposite.
He solemnly nodded, pulling anxiously at the ends of his long
moustache.

Midway through the operation we heard smothered, giggling
comments not ten feet away. Turning, I saw the entire female
population of the alley hanging out of a window opposite, in
layers, some kneeling, some on chairs, some higher on a bureau.
Mr. Saprouiski stood trembling outside the door. "What a
shame!" I stormed. The effect was magical. Heads, craning
necks, eyes, vanished and silence reigned during the rest of the
operation. Neighbors bowed apologetically as we walked out
to Dr. Croasdale s carriage and drove in state back to the dis
pensary.

During the subsequent calls at the Saprouiski house, I be
came well acquainted with the other denizens of Fish Head
Alley. On wash day the sociable atmosphere was at its warmest.
Sudsy water ran down the gutter; spicy gossip ran from the
tongues of Mrs. Louisa, Mrs. O Connor, Mrs. Petroske and
others who came in touch with uptown aristocracy through
their laundering activities. Their comments all bristled with
humor. Against the backdrop of linen flying in the wind, the
animated chatter rivaled a drawing-room.

When the last of the laundry had been stretched across the

46 A WOMAN SURGEON

alley, the tubs were overturned and soapy water sluiced down
the central gutter, carrying before it the day s accumulation of
rubbish. Then came the time for tea. We all sat on the door
steps, a tin cup in one hand, and if fortune smiled, a piece of
zwieback in the other, while the conversation turned upon the
affairs of the alley. When would Mrs. Brady s baby be born,
doctor? Oh, yes, they had forgotten that doctors don t answer
questions. Ah, well, anyway she would take her own sweet
time about it. ... And that brat of the Zaminsky s, when was
he getting out of the reform school? A bad one he was, indeed
but then Mrs. Zaminsky had spoiled him. A pity there
couldn t be more boys like that Abe Goldinsky. A fine boy
that any mother could be proud of. Wasn t he "taking the law"
at the University? My, my, and such a lot of books he buys,
and all out of the money he makes on the side, too. . . . And
how was Anna Strauss progressing on that new-fangled type
writing machine? All through with her lessons and working
already in a fine big office in Broad Street? Well, no doubt she
would be marrying the boss some day. A good-looker was Anna,
and she had brains, too, under all that blonde hair. . . .

Long after I had departed, they continued to discuss their
multifarious local interests.

More often than not the tea hour was interrupted by Mr.
Goldinsky who trundled up his pushcart piled high with oil
cloth bibs, bright colored calico and ribbons not too fresh from
their day in the sun and dust; he would toss a piece of canvas
over his wares and pause to drain a can of tea. He would
proudly relate Abe s latest progress at the University, and the
general praise and congratulation were unfailing. The hopes
of the alley, irrespective of race, color, or creed, centered upon
its Abes and Annas.

/ As I came to know and cherish the dwellers in alleys and side
streets of the so-called "slums," I began to feel that the word
was a misnomer. There are no actual "slums" in any American
city or town. In Europe where generation after generation may
be content to remain in the same squalor, with neither ambition
nor opportunity to pull themselves out, it may be justifiable to
use a word which denotes dirt and indifference. In the poorer

CHUMS IN SOUTH THIRD STREET

parts of our cities, inhabited largely by workers of foreign birth,
there is no hereditary moroseness, lack of initiative, or limited
outlook. A tonic quality invests those we call immigrants, but
who deserve to be called pioneers because only foreigners with
energy seek our shores. No work is drudgery, no sacrifice is
martyrdom, to parents whose initiative in abandoning their
old country sprang from the desire to assure their children s
progress.

Jimmy was a patient in whom I took an especial interest. He
was seven, and had come to me one afternoon with both hands
dangling from broken wrists. He had fallen off a pile of wood
while watching the boats on the Delaware. When I had re
duced the fractures and applied splints and bandages, I im
pressed upon him the importance of keeping off woodpiles, of
lying still in bed, and of keeping the bandages clean and in
place. To my horror he returned in three days without the
bandages.

Sternly I inquired why.

"I wanted you to put them on again/ he said a bit shame
facedly.

I learned that his mother was a whisky addict; she had been
deserted by her husband, who had first pawned the charity
clothes given to Jimmy and his sisters. Apparently the only
time the youngster had ever been called brave, or had been
given any sign of affection, was while having his wrists band
aged. When fully recovered he continued to spend most of
his time around the dispensary where I found work for him
to do, rolling bandages, washing bottles; occasionally we had a
cup of afternoon tea.

One day a six-foot lawyer came from New York to call on
me. He brought a large box of violets to help him argue the
error of my ways. Suddenly the doorbell rang. It was a holi
day and the dispensary was closed except to emergency or social
visitors. When I opened the door, Jimmy stood on the steps, a
broken-stemmed rose clutched in his fist. He handed it to me.

"Who s the little beggar?" asked the New Yorker,

"One of my best friends."

Jimmy sidled over to me and whispered, "What s he doing

48 A WOMAN SURGEON

here?" He eyed the violets, my caller eyed the rose. Both were
ill at ease.

"Where did you get the rose?"

"Well, I was going along the street and there was a parade
and some lady in a carriage had a lot of flowers and she dropped
it. I ran out quick and got it. The coachman of the carriage right
behind pulled his horses up short and said an awful cussword."

"Run along. I love this rose and I ll see you tomorrow."

He walked out slowly, darting a last glance of resentment
at my guest.

It was through Jimmy that I met Bill and Izzy. What a
triumvirate they made! Jimmy, shy but alert; Bill, forthright,
outspoken and keenly aware of the world of the street corner
where he had sold papers for the last three of his ten years;
black-eyed Izzy, wise beyond his age, and doted upon by his
Jewish mother. They wanted to discuss everything with "The
Doctor," and whenever I could spare an hour on Sunday after
noons we talked over their great store of news from the streets.
Bill was my source of information on the horrors of the week;
no headlined murder or scandal escaped his eye and he had a
zest for recounting all the details. He was always shocked that
I didn t keep up with the news until one day Jimmy, who kept
better account of my daily activities, reprovingly remarked,
"She ain t got time to read, what with Bridgie s sore eyes, and
old Mrs. Ratlinger fallin over and bustin her knee, and Mrs.
Doyle sprainin her hip and gettin all sprung inside, and Mrs.
Sorenson s milk leg."

Jimmy was right. I had, literally, no time for reading nor
for anything else outside the routine of dispensary duty and
the rounds of my out patients. When I succeeded in helping
one person in a hitherto unvisited alley, on the second call all
the helpless, chronic cases would be watching eagerly out of
their windows or crouching on the doorsteps in the hope that
I might also stop in to see them. For many there was little I
could do. As life became more bearable for some who had lost
hope, I acquired a local reputation. That I was interested in
trying to help them, and that they could see others improving,
made a strong psychological difference.

CHUMS IN SOUTH THIRD STREET 49

Often I was amused by their ways of describing their ailments *
and supposed afflictions. Some of the men struggled to express
themselves, for they regarded me as a sort of Sister of Charity
who would be embarrassed by their daily speech. I put several
at ease by telling them my father swore effectively, and that
sometimes I enjoyed a cuss-word. It lowered their ideal of me
but made us better friends.

Different nationalities explained their symptoms in widely
varying ways. The Jews were particularly dramatic. Either
they suffer more acutely or have less endurance in bearing pain.
The serious illness of a child, which would be accepted with a
degree of philosophical resignation by another race, would cause
Jewish mothers and fathers to wring their hands, beat their
breasts, run their fingers through their hair, and a character
istic gesture bend to the earth, their clasped hands between
their knees. The Irish had their extremes of expression, too,
t but they never failed to inject a bit of humor into the calendar
of symptoms. The Germans seldom showed their emotion and
were very precise in the matter of "telling just how it hap
pened. 5 * The majority of them had no conception of cause and
effect: that one condition leads to another and that pain is a
blessing in calling attention to something out of order.

They were all alike, however, in their friendliness. They"
depended on me, my medicine and a bit of kindness; paradox
ically, they wanted to protect, me. They worried that on my
night calls I might encounter a drunken rowdy, or be involved
as innocent bystander in neighborhood brawls. When they
learned that one morning at two A. M. I had been knocked
from my bicycle at an alley intersection by a man running from
pursuers with an unsheathed knife in his hand, they sent a
delegation to the local chief of police. He called on me and
suggested I come to headquarters at seven the next morning
"to get acquainted with the force."

When I was introduced to each of the "big boys," as they *
filed past, the chief directed that if ever I needed help, one of
them was to be on hand. I was presented with a police whistle
and told to blow it if in danger. I tested it and put it in my
pocket. But I have never had occasion to blow it.

CHAPTER VI

STUDY IN GERMANY

WITH six hundred dollars I started to Europe in the summer o
1899. It seemed a great deal of money, for it was more than I
had ever had in hand. But by this time I was accustomed to
economy. While resident physician of the Alumnae Hospital
and Dispensary I had saved about a year s income, which, added
to my next six months dividend, enabled me to go./ ;

And I had a specific purpose in going. Since my brother in
Duluth, who had invited me to come to practise medicine with
him, had died, I felt that in order to become a better trained
physician I should have post-graduate study in Europe. Both
my doctor brothers had done so, as well as my grandfather.

I was not bent upon specialization. I intended to go to
Berlin to study surgery, to Vienna to gain a knowledge of
internal diseases, and later to Paris to study nervous diseases.
It was important to be well rounded in order not to over
estimate any, and so lose sight of the inter-relation of all. My
prime ambition was to gain a thorough medical and surgical
knowledge of gynecology. Several friends, among them the
distinguished Dr. Prince Morrow, had suggested that I devote
myself to a single field, such as skin diseases, and Drs. Harvey
Gushing and Henry Christian urged surgery. But I believed,
and still believe, that overspecialization is a mistake. I would,
instead, make the most of my year abroad by widening my
horizons; in that way I could be of service to the women of
my country.

Equipped with a second-class steamer ticket, suitcase, two
pairs of shoes and the advice of Dr. Henry P. De Forest and
Dr. James Warbasse, I was on my way. They had wisely coun
seled me to go first to Gottingen for some months of language
study in order to be ready for the intensive work of the winter.

There had been little leisure during my college years. It

50

STUDY IN GERMANY K1

3 L

had been interesting to spend vacations industriously. Having
no financial margin, I felt that every hour and every effort must
be made to count. Dr. and Mrs. De Forest convinced me that
all I had taken for granted in America would be new to me in
Germany, and that I would not be wasting time if I went on
an occasional outing with the hausfrau and her daughters; con
versed with all who would tolerate my German; through direct
contact with the people get a perspective on German history,
art, architecture and music. Youth usually has no perspective.
It is so immediate in its impulses that it is prone to ignore
neighboring vistas which embellish a major purpose.

On this, my first crossing, I had such a delightful time that
I wondered why any one ever wished to travel first class.
Samuel T. Button, then head of Horace Mann School in
New York, his wife and their two daughters about my age
included me in their party. How we studied our Baedekers
and exchanged travel books! I did not expect to see Greece
or Rome, but the possibility of being near them sent me poring
over maps. It was overwhelming to learn how much there was
to see even in Holland and Belgium, and when I turned the
Baedeker to France, I wondered how I would ever be patient
enough to wait a year to go to Paris. But logic won out, as my
star led toward Berlin. I followed it as far as Gottingen, not
daring to linger more than a week en route.

Frau Haase and her two daughters had come to the station
with a heart-warming welcome. Walking beside them, I looked
forward to the time when my "two words of broken German"
would expand into sufficient fluency for me to tell them how
grateful I was.

Once installed in my tiny room, I set about learning the
language as if training a race horse. Mark Twain s description
that German cracked the jaw and split the ear-drums lost its
terror when my teacher, gray-haired and dainty Frau Professor
Hummel, read Schiller, Heine and Goethe; I not only learned
the texture and delicate rhythm of correct German, but I sensed
for the first time through the march and measure of words the
soul of the people s speech.

For two months all day and half the night I studied and

53 A WOMAN SURGEON

thought in German, pinned conjugations, declensions and lists
of words all over my walls. As soon as I wakened, I began to
memorize those upon which my eyes rested, repeating them all
through my bath; while brushing my hair, I went over again
and again the lists fastened to the mirror and, while dressing,
those on the wardrobe door. It was a game; soon my best
performance became an average and permitted no lagging.
Each day built an additional pier upon which to construct my
bridge of communication, but increasing auditory alertness at
meal conversations and on the street caused a curious fatigue
in my ears.

After two or three weeks I still spoke so amusingly it caused
me to be invited to dinner for the entertainment of the other
guests. Certain favorite words I popped into every conversation.
Etwas was one of these, until I found that it aroused speculation
as to just how much more I meant than I said. The widow
Haase was as tireless in correcting my pronunciation as was
Frau Professor Hummel. Anna and Lena, seventeen and nine
teen, whose round faces beamed across the snowy expanse of
table-cloth three times a day, likewise helped me polish off my
strange, foreign accent. My first sense of internationalism was
gained through adapting myself to their customs and points of
view.

Frau Haase s Geburtstag marked a red-letter day on the
calendar for our contented household. The walls threatened
to burst with excitement. Anna stitched until her eyes ached,
so anxious to finish embroidering the flowers on a new dress
for die Hebe Mutter that she would let no one take a stitch to
help her. Her mother appreciated this dedication of effort, but
observed wryly that there were sufficient stems already. How
ever, thorough Anna, stitched diligently until she proudly
pressed the completed gift the night before the celebration
with a charcoal-filled flat iron which had required a two-hour
heating.

Lena, not to be surpassed in devotion, ran to the nearest
store to fetch an armful of books that Hebe Mutter might make
a choice. To celebrate the day she had also baked a large rich
cake for the Kaftee Klatsch. Thirty-nine candles sent up their

STUDY IN GERMANY __^ 53

trails of smoke as it was carried out to the garden behind the
house, now ornamented with yellow, silver and red balls on
sticks. Neighbors crowded in, bringing presents of home-grown
flowers, fruit and good ,wishes, while the rich aroma of coffee
pervaded the atmosphere. The Frau read from the book of her
choice; a neighbor recited a poem written for the occasion; all
agreed admiringly that Anna had not one stem too many.

The next day being Sunday, the celebration continued with
an afternoon Ausflug. Our party was augmented by an elderly
mathematician whom I had come to dislike because of his habit
of helping himself to all the food on a dish while he talked
rapidly and loudly to conceal the extent of his scoop. He had
the equally annoying practice of domineering his son into a
state of nervous irritability. This professor assured me he could
read "Eggleesh" and had indeed translated a book, but alas, he
could not speak it for he had never met any one who pro
nounced it well enough for him to understand! Nevertheless,
two fresh-cheeked lads, the sons of a neighbor, were going along
as well, and they would relieve his arrogance.

Lena had mashed a fresh coffee cake into a box; our knap
sacks brimmed with sandwiches, apples, nuts and other entice
ments. Carrying a camera, bottles of water, books and other
impediments, we rushed through the gate just in time to catch
the slow train which was to carry us to the village where we
could start the climb to a schone Aussicht.

The fresh country air, washed by a week s steady rain, sent
our spirits soaring. We began an energetic ascent, but spike-
soled shoes, walking sticks and the things in our laden arms
soon reminded us that we were earthbound creatures. Finally
we reached ancient iron gates which once had barred the nar
row road to a crumbling castle on the mountain top. We
skirted its ruined outer walls and found the remains of a stately
portal surmounted by a coat-of-arms. From the mushroom-
carpeted parapet I could see the busy housewives grouped about
the village well far below and children dancing in a grassy
square much, no doubt, as retainers made merry there in the
days of now forgotten barons.

A horde of boisterous students drove up to the inn in the

54 A WOMAN SURGEON

valley and hilariously greeted the fat proprietor, who bounced
out into the sunshine, resplendent in a vast white apron. One
of the boys looked up and with youth s greeting to youth,
impulsively, I waved my handkerchief. They all waved their
caps and started to swarm up the mountainside. I fled back to
the terrace, where I joined my friends in a leisurely lunch and
a gay Tyrolean song. All went amiably until the Herr Professor
mounted a broken column and stentoriously declaimed a pas
sage from Homer.

During my two months in Gottingen I worked absorbedly
five or six days each week and for recreation took week-end
trips in third-class coaches. One day I set out for Heidelberg.
My companions of the road were little people from little towns.
At lunch-time a comfortable, red-cheeked Gretchen offered me
a piece of liver pudding, a thick slice of bread and a bite from
a cheese wrapped in a cloth. My return of hospitality took the
form of a boiled egg and a tomato. Two dusty workmen oppo
site vied with each other in asking me friendly questions about
America until a public porter entered. He was carrying a box
which at once diverted their attention for it contained bottles
filled with what appeared to be very pale, thin beer. Triumph
antly he announced that he was taking these special bottles to
a Herr in Heidelberg. No, it was not Rhine wine, something
better. Did he know what it was? No? Well, might they look
at it? Might they feel the Herfs bottles?

At length the workmen persuaded the porter to let them
taste the contents. They opened a bottle and smacked their
lips over the light, sweet liquid. "Prosit" they toasted each
other. "Erlauben" they toasted the rest of us. Soon the quickly
vanishing champagne had the workmen and the porter maudlin.
They told funny stories and then cried over them. The porter
wanted to kiss the Gretchen. I protested in English.

One of the workmen, swaying toward me, shouted, "Pretty,
is she not?" and sidled closer. I had been told the cord over
head rang a bell to be used only in case of danger. I jumped
upon the seat and gave a vigorous tug. The brakes screamed,
cars bumped together, and the train stopped with a jolt that

STUDY IN GERMANY 55

sent us all to the floor. The conductor appeared, angry and
anxious. Who had pulled the cord? Why?

I blushingly confessed.

"Ach," he cried disapprovingly. But denunciation was pre
vented by the porter who, waving an arm and winking, handed
the conductor a bottle.

At Darmstatt my liver-pudding hostess got off and I moved
into a second-class compartment, reserviert fiir Frauen } and
watched soldiers climb into neighboring coaches. Military
maneuvers were just over. Two women who shared the com
partment with me talked about the army. Both had sons who
were young officers. I learned that every male citizen had to
serve two years in the infantry or three in the cavalry or navy,
whatever his civilian occupation might be. The ladies agreed
that it was an honor to marry a German officer. Oh yes, the
lucky girl must be of excellent family, must possess a dowry of
at least 65,000 marks then about $ 16,000. But officers as poten
tial husbands did not appeal to me. I had observed them
socially and on the streets. Frequently I had seen them jostle
old men and women off the sidewalks. At dinners they ap
praised openly and offensively the marriage value of the ladies
present.

As we neared Heidelberg one of the ladies offered to draw
a diagram of the town to help me make the steep and crooked
climb to the old castle. After she had covered every available
scrap of paper with minute directions, she generously decided
to accompany me in person. Otherwise, she maintained, I
would never see Heidelberg properly. Who but a German
would be so kind!

The student duel, I learned, was not a matter of animosity,
but rather a test of endurance. In student circles he who did
not have a scar across his cheek was considered a weakling. As
the fight progressed, the duelist had to manage to receive a
Schlager that cut from ear tip to chin. If the resulting wound
was not deep enough to require bandaging, he frequently ap
plied an irritant to make it worse. As a doctor I was revolted
by the vanity recorded in the livid scars marking these youthful
faces.

56 A WOMAN SURGEON

Another week-end took me to Hildesheim in search of a
famous rose that had survived the blasts of a thousand winters
to blossom forth in a thousand springtime resurrections. I
found it clinging to the choir of an old cathedral. Under it
sat two sweet-faced nuns from the ancient hospital near by.
When they learned that I was a doctor, they told me about St.
Hildegarde, "The Sybil of the Rhine/ who lived in Germany
in the twelfth century and founded the Abbey of St. Rupert.
They spoke with pride of the two medical books she had
written, one of which had been issued in 1533 under the title,
Phisica St. Hildegardis; the other, recovered from a library in
Copenhagen, was a manuscript called Hildegardis Curae et
Causae which treated in five books the general divisions of
created things, the human body and its diseases, and the causes,
symptoms and treatment of illnesses. The gentle sisters enjoyed
my enthusiasm for their great abbess, and when I asked if she
might become my patron saint, they graciously agreed.

But would I not like to see their own hospital? Of course.
With these soft-voiced guides I was soon passing through the
lofty Gothic entrance of the hospital, founded by the good
Bishop Barnard in 1005. It had a modern addition, but it was
not directed by a modern mind. A dusty stove was in the oper
ating room, and vines grew through the tiny windows which,
in any case, would have given little enough light and ventila
tion. In the gable of the attic spread a long ward where
patients were lying with their heads under the eaves, and I
could scarce stand erect under the peak of the roof. All the
beds were occupied. One of my companions explained that,
lacking this shelter, the poor men would be without care. I
expressed my admiration for the ingenuity and patience of the
nurses who could work under such cramped and difficult con
ditions.

"So nursing has been done here for almost nine hundred
years. How is it done in your America?"

Sometimes I had regretted our American lack of tradition,
but at that moment I realized that it was to escape such tradi
tion that our forefathers had come across the sea to make a
fresh start, free of hampering precedent.^ .

STUDY IN GERMANY 57

Describing our operating rooms with marble walls and floors,
the faucets that turn off and on by foot or knee pressure, so
that the hands of doctors and nurses remain surgically clean,
caused them to look at me through round eyes of wonder. One
commented that, not having kings, we built palaces for those
who suffer!

On othe^r brief journeys I went to Frankfort-on-the-Main,
where I was disappointed in the overstuffed furnishings of
Goethe s home, and to Mainz. At the latter I made a pilgrim
age to the tomb of the first Minnesinger, Heinrich von Meissen,
the fourteenth-century priest whom churchly education had not
blinded to the spiritual beauties of womanhood, and whose
judicious praise of women had won him the name of Frauenlob.

As 1 gazed at the Cathedral in Cologne, I stood near a party
who had recently traveled in Spain. The father, looking up at
the exquisite towers, drew a deep breath and said to his wife,
"This is the most beautiful building in the world."

Whereupon their son exclaimed, "That is what you said
about the cathedral in Burgos."

"Ssh," warned the mother. "That is the most perfect, but
we Germans must never admit it!"

In Cologne, at the little-known church of St. Gereon, built
in the ninth century to honor a Christian martyr, I stood in the
decagonal nave with its ten niches and recalled the similar
temple to Minerva Medica at Rome, pleased with the blending
of mythology and Christianity through a goddess of medicine.

October was coming and I had to leave for Berlin. I was
eager to renew my medical studies, and women were not ad
mitted to the medical department of Gottingen s Georg- August
University. In 1754, by a special decree of Frederick the Great,
the University of Halle had granted a medical degree to Frau
Dorothea Erxleben-said to be the first in the history of any
German university and later Giessen granted degrees as doctor
of obstetrics in 1816 to Frau von Seibold, who officiated at the
birth of Queen Victoria, and also to Frau von Heidenrich, the
daughter of Frau von Seibold. But since their time few women
had received degrees, and those by some elaborate, red-sealed
dispensation. Not until 1900 were women generally registered

5 8 A WOMAN SURGEON

to receive medical degrees in Germany. It had been a long
battering at the gates for this independence o women, and some
of my professors in Berlin were kind enough to say that I helped
to open them. But I was only one of many who disarmed the
prejudice and opposition which Hitler is reestablishing.

I chanced to arrive in Berlin in the midst of a parade. People
had stood for hours to see the Kaiser pass. My friend hurried
me from the station out to join the crowds. Powerful, robot-
like soldiers, goose-stepping as though their legs had springs,
marched fiercely by, and at their head, the Kaiser! His tall
helmet heightened his stature; his military cape hid his dim
inutive arm.

My friend, ignoring the strict rules regarding lese majeste,
remarked, "Here comes Billie with his moustache upside-
down!"

Immediately a hand was laid on her shoulder and an un
friendly voice warned, "Be careful, you may be arrested!/

The captains and the kings depart! My concern \^as not
with parades, but living quarters and study. Once settled in
a quiet pension, I presented myself before the professors under
whom I wished to study. Of several major subjects the most
important to me was surgery, and I arranged to follow the work
of Landau, Martin and Olshausen. I called on them, presented
my credentials and received cards on which were written the
hours and days of their operative clinics. I managed to see each
of these distinguished surgeons operate twice a week. Besides
this, I took a course in microscopic diagnosis under Pick, whose
laboratory was in Landau s hospital. In this laboratory was
first used a method now general, which has its dramatic side.
It was Landau s custom, in the case of all growths of doubtful
nature, to send during an operation a specimen of tissue for
examination and diagnosis to the laboratory. The specimen
was quickly frozen, cut into microscopic sections, stained and
examined under the microscope. The diagnosis, which would
determine the extent to which the operation should go, was
rushed back to Dr. Landau in time to be of immediate service
and to prevent the necessity for secondary operations. Every
thing had to move quickly about Landau, whose keenly intelli-

STUDY IN GERMANY 59

gent and expressive face seemed to light up from within as the
operation progressed. His interest in his work was such that
he never seemed to feel fatigue.

August Martin, by contrast, seemed the sort of man that
Falstaff might have been had he preferred human service to
hilarity. He was tall, bulky, powerful, with a general air of
good humor. His clothes, carelessly worn and not infrequently
bearing a spot or two, seemed to hamper him; for on changing
into his operating apron, he invariably gave a sigh of relief, as
though at last he had found his right element. His pudgy
hands were slow but accurate, and he called attention to the
interesting features of his work in a matter-of-fact, off-hand way.
He had written a standard textbook on surgery, and was editor
and publisher of Geburtshelfe und Gynakalogie, a leading
magazine on obstetrics and the diseases of women.

He was assisted by a giantess of a nurse. When she wished
to empty a basin, she simply threw its contents on the floor.
Every one wore rubber boots and stepped with care. In fact,
the whole proceeding was extremely wet. Above the tables
were glass irrigators filled with various disinfectants, which
were kept playing constantly on the area of operation. After
it was all over, the floor was flooded and washed with a hose.

Robert von Olshausen, world-famous gynecologist and a
prolific writer on his subject, was faultless in appearance and
manner. Graying, curly hair added to his look of distinction.
He was a silent man and did not welcome students, especially
women perhaps because of subconscious jealousy of them as
potential rivals in his specialty. His work was skilful to the
point of delicacy; he held and used his instruments with the
precision of an artist. We might gain what we could from
observation; he never said a word. But in his deftness of tech
nique I found a standard.

On Sundays I sought out the American colony, which was
large and hospitable. Our ambassador and his wife were popu
lar, but Dr. Dickie, the pastor of the American Church, had a
special genius for making newcomers welcome, and there we
rested, laughed and even compared notes on cases.

Graduates of European universities were inclined to feel

60 A WOMAN SURGEON

that their preliminary training had been more thorough than
ours, because their M.D. degrees required six years to our four.
However, the hospital work we covered as internes paralleled
similar requirements they had to meet in their junior and
senior years. The work I had had at the Massachusetts General
Hospital, interneship at the Philadelphia City Hospital and
experience as resident physician of the Alumnae Hospital and
Dispensary in Philadelphia, had given me with my four years
diploma a little better training than most of the European
graduates. So I refused to be abashed. And the American
boys encouraged me to stand up for myself because it might
help German women. They had an exaggerated idea of the
oppression of the Hausfmu> which was really similar to the
position of women in other countries at that time.

Probably I would not have come to know Germany so well
had not many of my professors and their wives been very
hospitable. Among my friends were Professor and Mrs. Paul
Ehrlich. Professor Ehrlich had already achieved important
results in his experiments on stains, which would bring to
microscopic view certain bacteria then known for only a few
years as the causes of disease. He was now director of the newly
opened Institut fur Experimentelle Therapie at Frankfort-on-
the-Main. His was the sharp ascetic look of a typical research
worker. He had already instituted the long series of trial-and-
error experiments to find a therapia sterilisans against syphilis.
Patiently he was making effort after effort, but it was not until
1909 that he made the six hundred and sixth test and produced
salvarsan. However, he did not halt. On his nine hundred
and fourteenth test three years later, he produced neo-salvarsan,
which was superior, having a less deleterious effect on the eyes
and the nervous system. On his twelve hundred and sixth trial
in 1914, one year before his death, he produced "1206," com
posed of salvarsan and sodium, and nothing better has since
been evolved. His effective work in the science of infectious
diseases paralleled that of Pasteur and Koch, and heralded much
that is being accomplished throughout Europe, in Japan and
in America today.

The friendship of Professor and Mrs. Ewald was a delight.

STUDY IN GERMANY 61

He was a visiting physician at the Kaiserin Augusta Hospital in
Berlin, and only the year before had been honored with the
distinction of being appointed medical Privy Counselor. In
internal medicine his opinion was authoritative. The Gemut-
lichkeit of these German professors and their families gave me
a sense of heart and hearth hospitality which has lasted through
the years, and made them international friends as well as teach
ers. This friendship helped me to bridge the transition from
a Virginia girl to a cosmopolitan. I am grateful that my first
year away from home was spent in Germany in association
with men and women who expressed an aristocracy of intellect.
To be in their presence was to learn how simple and unpreten
tious are the really great. They knew the worth of their work,
otherwise they would not have dedicated themselves to it. But
they also knew that elsewhere other men and women were as
earnestly searching the manifestations of truth and that, what
ever their work, wherever they lived, all were world comrades.

In order to accomplish all I had set my heart upon, I was
busy from seven in the morning until five or six in the after
noon, with an hour s intermission for a light lunch and a short
stroll in one of the many pretty parks where trees, grass and
flowers took my mind off sickness and all the many forms of
suffering allied with it. Refreshed, I would think of what I
would one day be able to do to lessen pain and save life. No
one could stand the shock of learning how much pain has op
pressed all classes since the beginning of the world, if he did
not treasure the hope of relieving some of it.

As the courses on my program in Berlin neared completion
that winter, I turned toward Vienna, where my two doctor
brothers had each studied after their graduation from the Uni
versity of Virginia Medical School.

On my way to Vienna, I stopped for a day or two in Munich,
Dresden and Prague. No one could pass those places by. In
the old Pinakotek and in the new I observed among other
things much that was pathological in art and began a collection
of pictures to which I still add. It was Herbert Spencer who
said, "To one who has studied anatomy nothing is more gro
tesque than the majority of old paintings which are prized as

62 A WOMAN SURGEON

national treasures." I do not go as far in condemnation as that,
but many of them are ridiculous; for instance, St. George, the
vigorous warrior who slew the dragon, is depicted with puny
muscles, Gabriel has a goiter, and so it goes. On the other
hand, the many paintings of doctors attending patients are very
interesting, in showing the clinical methods, customs, interiors
of sick rooms, etc. of that day.

To be in the city of Mozart, Haydn and Beethoven, to walk
in the Ring-strasse, to hear the softly spoken German, to live
in the most cosmopolitan place for education in the world, was
privilege indeed. Here students from South America debated
with those from St. Petersburg. It was here I met young Major
Fukuda of Japan, who some years later aided me to see the
hospitals in his own country.

On a bulletin board at the entrance to the great Kaiserlich
und Koniglich Algemein Krankenhaus were posted charts of
professors and their classes. Classes of ten studied for two
months with the various professors; but the list of a hundred .
possible instructors was a checkerboard maze. Anxious to get
into direct contact with the doctors, I presented my only letter
of introduction, one which my cousin, Dr. Prince Morrow, had
given me to Dr. Caposi, the great skin specialist.

Caposi, a small, round-headed man, hedged and hemmed
when he read the letter. It would be difficult to have a young
woman in his classes. There was angry agitation in his manner
as I urged my extraordinary request. Ach Himmel, a Frdulein
in his classes! It would embarrass him so much; it would em
barrass me so much. Impossible! I acknowledged the difficulty
of the situation, for him and for me, but pointed out that in
asmuch as the men would eventually treat women patients, it
was quite as suitable for me to attend his classes as for them.
Yes, yes, logically I was correct, but nevertheless he felt con
fident that I would regret my insistence. He was weakening,
so I pressed my point. He then warned that I would have to
expect a certain amount of impudence on the part of the men ri
students. Quaker blood mounted to my disdainful brow as I
assured him that in such a case they would not exist for me,
that I would ignore them completely.

STUDY IN GERMANY 63

Finally a curt "All right, young woman, you can try it."

For a time he thoughtfully arranged the lectures to discuss
and demonstrate cases of skin disease manifestations which
would not embarrass me. Nevertheless, whenever I entered
the class room, the students made a number of audible personal
comments. If I asked questions, they shuffled their feet, and
if they felt in a particularly merry mood, they made a kissing
sound. I tried not to give any evidence of resentment, and I
learned afterwards that my apparent indifference hurt their
feelings immeasurably.

One day, after my presence no longer occasioned a demon
stration, I had a shock. A naked syphilitic man was brought
before the class. He was probably as startled to see a young
woman as I was to see him. No doubt that made him assume
an air of bravado, or perhaps he was naturally common, for his
attitude, his statements, everything about him seared my sense
of propriety. The professor, in an effort to appear at ease,
made some wholly unnecessary remarks. That awful hour
realized my father s worst fears for a lady, his daughter, study
ing medicine.

Next day I called at the professor s office before class and
surrendered. "You win," I said, "I am not coming to your class
again. I never expect to treat diseases of men, and you put an
unnecessary accent on the venereal side of syphilis yesterday;
I bore it because women and children are also often its victims."
Instead of taking exception to the impertinence in my protest,
he looked immensely relieved and said, "If you wish to make
my private hospital rounds with me, I will give you special
instruction." I was elated, for I would gain far more than if
I continued in the class.

Gratefully I remember the tact of one of the American
students on that trying occasion. In order to ignore the strut
ting of the naked man, I absorbed myself in reading past record
ings in my notebook. This feeble method of escape caused my
countryman to realize my feelings. As soon as the class was
dismissed, he proposed that we go to see some Dutch portraits of
which he had previously spoken. Nothing could have soothed

64 A WOMAN SURGEON

my soul more completely than those dignified worthies fully
dressed from neck ruffs to buckled shoes.

Through following Caposi and other classes under a sub-
professor, a "privat decent/ I soon became a tiny part of the
general fabric of hospital life. I lived near the famous Alge-
mein Krankenhaus, where the medical work of all Austria was
concentrated. This general hospital of 70,000 patients was a
veritable city of the sick. In the many wards and among the
miles of beds I studied both medical and surgical cases.

But in class I grew impatient when seven of us were held
back by the stupidity of three students. I decided to gain
further individual instruction, if possible. The secretary of
the Anglo-American Medical Association of Vienna told me
which professors were considered the best lecturers. Then
taking courage or audacity into my hands, I approached several
of these and asked whether I might find some special work to
do in the hospital.

One of these professors asked me irrelevant questions with
fatherly kindness. He wished to know why I was in mourning,
why I had chosen to study in Vienna, how many members were
in my family, how much money I had for my studies per year.
I answered definitely, briefly, and hastened to explain that I
did not want to be paid anything; I wanted education in return
for hospital service.

He gave me an opportunity to assist the regular internes in
the physical examinations of incoming patients and in writing
their histories. The internes were delighted with the arrange
ment, as it lessened their hours of work. He also gave me per
mission to be present in the dissecting room at all autopsies and
assist in writing the pathology reports; soon he invited me to
make the rounds with him every morning and night. Here was
privilege indeed! I not only became thoroughly familiar with
his technique and took notes on all I saw, heard and did, but
also made a study of the results of education in German uni
versities as exemplified in the work of the internes.

After a few weeks, when I had become used to my duties,
this generous, thoughtful man permitted me to be present at
all of the operations which I wished to attend, and to stand

STUDY IN GERMANY 65

where I could observe every detail. Also he secured opportu
nity for me to observe the work o Obersteiner, Kraft-Ebbing,
Nothnagle, Kovacs, and autopsies under the great Polish doctor,
Kalisko. Since most students had only group work in Vienna,
I was more than lucky to have these opportunities which were
equal to private instruction.

The systematic hospitalization of the sick poor furnished a
wealth of clinical material. Through Saturday afternoon out
ings I had become familiar with colloquial German, which
made it easier for me to take case histories and learn much of
the life of the humble and unfortunate.

Vienna attracted more students than Berlin, because its
charity hospital was then the largest in the world, and con
sequently there was endless opportunity for specialized educa
tion in each malady. For example, a large number of persons
with various diseases of the liver would be placed in a long
ward side by side. The history, examination and deduction
made on one or two cases in the average hospital could be
made here separately and deducted collectively on forty cases
or more.

Similarly, the inevitable death of many persons, who before
entering the hospital had advanced beyond the hope of cure,
provided for post-mortem examinations with abundance of
parallel pathological material. The specimens were arranged
for study with a view to demonstrate the progress of the disease;
also to point out the typical and the complicating conditions as
they could be observed with clearness only after death. Diag
nosis in lung, heart, kidney, tumor, brain and all other con
ditions was equally clear. I spent many hours daily in this
field, for diagnosis is the basis of the practice of medicine and
surgery.

By observation, explanation and demonstration of tissues
one learns volumes in an hour. What illustrations, textbooks
and lectures could not teach in a year, a professor of pathology
could make perfectly clear in the Algemein Krankenhaus in
Vienna in a week. Each course averaged three weeks. I stayed
five months in order to take many and work in addition.

After familiarizing myself with the operative technique of

66 ^ A WOMAN SURGEON

three great surgeons, Bilroth, Albert and Gusserow, I decided
to follow only one. This surgical and medical shopping gave
me a chance to determine where I could get the most with a
limited amount of time and money. I arranged my other work
in order to take the course under the distinguished Professor
Gusserow, from whom I learned much that was valuable,
especially the importance of doing accurate surgical work
quickly in order to lessen "shock."

One day, however, my sense of humor pushed ahead of dis
cretion. It was Professor Gusserow s debonair desire, instead
of making himself comfortable in the customary loose, white
operating gown, to retain the formality of his linen collar. He
was fat and had a very thick neck, which climbed redly over
the constricting band. Not expecting to be observed, I made
a comic sketch of him. A curious fellow student snatched it;
alas, it slipped and fluttered all around the room to the floor!
I knew his two assistants could pay no attention, but a nurse
without sterilized hands might pick it up. Woe to me if she
did; I would probably be requested not to attend this operative
clinic again. She leaned over; I was very anxious. She picked
it up heaven help me! Well-trained as she was, she handed it
to me without turning it over; I was saved. It had fallen face
down. Quickly I tore it up and put the pieces into my note
book.

The only thing which disturbed me in Vienna was the un
necessary exposure of patients in the amphitheater when ill
nesses or operations were being demonstrated before the classes.,
Never was I more horrified than when I saw a poor woman ill
all the suffering of childbirth, lying entirely stripped on a
revolving table, while students for an hour and a half noted
her writhing agony.

At that time every courtesy was shown to the wealthy, none
to the poor. One day I actually saw a young surgeon bear not
only his arm s weight but, through it, that of his body as well
down on the chest of a child while determining, in consultation
with his assistant, how extensive an operation to perform and
what the next step should be!

it seemed only a matter of course for a patient to lie or stand

STUDY IN GERMANY

67

naked before a class, whereas in our country the self-respect of
individuals demands that only that portion of the patient be
undraped which is necessary to demonstrate the malady. Great
consideration is customarily shown to charity patients in Amer
ica; because people are poor does not excuse inhuman treat
ment. In our clinics it is not considered just to keep a patient
under ether for a longer time than the operation demands, or
to cut longer incisions, merely to teach more about the case./

At the home of one of the professors I met Dr. Richard
Hitschmann, a young assistant of the great ophthalmologist,
Fuchs. He suggested that I, on a business basis, should help
him translate into English some of his professor s writings. Of
course, I welcomed such an opportunity. Dr. Hitschmann was
also very helpful in another way. He planned for me my Satur
day afternoons, my play half-day, and often with another friend
he accompanied us sightseeing.

Such is the wealth of museum material, marvelously arranged
and accessible to the most cursory observer s mind, that if all
the treasures accumulated elsewhere were destroyed, in Vienna
one could still gain a complete education through the objects
of every age, people and art assembled there. Dr. Hitschmann
declared I was the sort of person all collectors dreamed might
come to see the results of their often unappreciated labors. As
a matter of fact, I adore museums. I am grateful first to the
people everywhere who have preserved relics of the past or the
strange treasures from far places. Then I am grateful to those
who have the foresight and inspiration to arrange and describe
them with sympathetic verve. Take a guide book and your
next vacation in Vienna. You will agree with me at the end
of a day, and be my friend by the end of a week.

Vienna socially was gay. The people were more affable to
foreigners than were the Germans. Always dressing very simply,
I nevertheless admire decorative people and things. The high,
intricately patterned tortoise-shell combs, elegant fans, many
jewels and elaborate gowns interested me as I looked far down
from the upper gallery at concert audiences costumed as if for
presentation at court. Now times and things are sadly changed,
but then the love of drama and music was life itself to the Vien-

68 A WOMAN SURGEON

nese, with play and opera houses always filled. Speaking voices
were musical, manners neither blunt nor suave, but the perfect
medium which results from genuinely kindly feeling. Rude
ness did not exist in military, social or scholastic circles. The
soldiers seemed to me far more human than those in Germany;
that was why they were commanded by Germany in the World
War, because the Austrian training had not made them suffici
ently brutal and cruel for that fierce, demented conflict.

Perfect Austrian types were Count von Pirquet and his wife.
Slender, gracious, he held his head like a prince. He was a
specialist in tuberculosis, the inventor of the test which bears
his name. She had sparkling, expressive eyes, was a perfect
hostess and was especially fond of America in which, to my
delight, she liked Virginia the best of all. En rapport with the
world s art, music and literature, the Von Pirquets epitomized
in their beautiful home the elegance of the Austrian Empire
at its best.

As typical of America were two other friends of mine, Mr.
and Mrs. Samuel Clemens, then resident in Vienna. Mark
Twain was the idol of American- Viennese society. He, to my
joy, did not think it ridiculous for me to give up a social life
in America and then admire its perfection in Vienna. He
realized I must give it up, at least for some years, in order to
become a physician.

The thing which drew your heart to Samuel Langhorne
Clemens was the deep human understanding underlying his
wit, the sympathy which softened his raillery. His great, shaggy
head gave a feeling of vitality. His kind, keen eyes saw the
good in everything, even in ragamuffins, all wound whimsically
around natural cussedness. He liked venturesomeness and con
sidered my graduate study in Vienna a mental expedition into
uncertain territory. He encouraged my telling him stories of
the surprises I encountered in the hospital and the constant
adjustments I found necessary. He looked clear through my
thoughts, and when he placed one of my hands on his left palm
and gave it a pat with his strong, sensitive right hand, I felt
that nothing could ever be very much amiss within the radius

STUDY IN GERMANY 69

of his smile, and that he had long since dismissed the problems
I was meeting % .

Of course, I have been asked if I did not have love affairs in
those student days, and it probably sounds very dull for me to
confess that I did not; but it would have seemed to the boys,
as much as to me, silly and a waste of time; our futures were
still far ahead of us. We had the glow of courage in declaring
we were going to become fine doctors, great writers, singers,
pianists, whatever our ambition indicated. We were there to
make good and knew that our opportunities were not to be
taken lightly. Our ideals and our determination to achieve
them were our motivation. Not one of us had any thought of
marrying for years; that would have defeated all our scholarly
ambitions. We had learned that accomplishment in one line
requires elimination in others. Young men usually do not
concern themselves with ideas about establishing a family until
they have established themselves in their professions, unless
they are cursed by riches or eroticism, which none of my young
colleagues was.

We were a jolly but serious-minded lot of youngsters; -I was
twenty-three, the others a few years older. We fully intended
to marry some day, but we could see no value in unimportant
love affairs. Experimenting with life had not come into vogue.
We avidly pursued learning nine hours a day, five and one-half
days in the week. Sunday afternoons we, with other foreign
students, especially some from Budapest, and from Geneva,
went auf das Land. With forest-cut staff in hand and rucksacks
on our backs, no one was allowed to talk medicine or anything
connected with it. We had our Baedekers along to look up
points of interest. We walked, laughed, climbed, rowed or
swam as athletic and healthy a crowd as you could wish to see.

My happiest Ausflug was at Easter time on the Danube River.
As we drifted along through sunset and moonlight, snatches of
song wafted to us. The thought of the Lorelei seemed to bring
alive my mother s voice crooning, as she often did, in lullaby
fashion after she had put a sleepy little girl to bed, or while she
brushed her long, lovely hair; another favorite was "Never,

70 A WOMAN SURGEON

love, oh, never can I forget that night in June upon the Danube
River."

One night in the week, usually Wednesday, we went to the
top gallery to hear Lilli Lehmann sing her marvelous lieder,
or we took our coffee Kuchen to a folk garten where for a few
pfennigs we purchased coffee or milk, and sat around shining
tables in the open air for an hour or more, listening to concerts
of folk music.

Good middle-class families brought their suppers in baskets,
buying only beverages, and greeted neighboring families with
whom they exchanged delicacies, while strains of Strauss made
the air sing and dance. Music in Vienna was melodious educa
tion. It rested us, lifted us out of and beyond ourselves and
increased our power of appreciation until we grew, without
realizing it, musical. Occasionally we would all join in some
refrain from one of the current operas led by a full-throated
baritone, or in lighter vein, chorus joyfully:

"Du, dUj liegst mir im Herzen"

Those were healthy, happy days!

CHAPTER VII

CHRISTMAS IN RUSSIA

As CHRISTMAS approached while I was in Berlin, one of the
most gemutlich of my professors, Paul Ehrlich, suggested that
I spend those holidays in Russia. With German generosity he
arranged for friends of his to meet me in St. Petersburg.

The Nevsky Prospektl A wide boulevard skirting the Neva
River, thick with wind-swept ice. The avenues, fir trees fes
tooned with electric lights that would glitter by night like a
necklace of diamonds on the bosom of the river. The three
spirited horses drawing our troika paced along under high
arched collars, colorful with bright-painted flowers and tuneful
with bells. Soft fur robes draped the back and sides of our
sleigh and of the sleighs passing to and fro on the Prospekt.
Men and women in fur coats and caps, cheeks rosy, eyes spark
ling, voices lifting on the crystal air ... Russian aristocracy
enjoying the tonic of the crisp morning from the warm comfort
of their robes and coats. Bright-eyed, laughing children were
out for their morning airings, attended by nursemaids from
whose caps floated long streamers of varicolored ribbons. Scarfs
slashed the sunlight. Joy rose in both color and voice. All
bore themselves with an air rich, well-groomed, vigorous.
Russia seemed an enchanted land. Only later did I discover
that the poor were forbidden the Nevsky Prospekt, as well as
the fashionable Voznesensky Prospekt. Their presence would
have been distressing to the wealthy.

Here was no industrious Germany, but pulsating life, jubi
lant, infectious, soaring. My host, a doctor from the university,
with his daughter, remarked upon the lightness of my coat, but
I insisted that it would suffocate me to be any warmer. The
blood raced in the sparkling cold.

Reaching the hospital, our destination, I found it perfectly
appointed, equipped with laboratory devices more modern than

72 A WOMAN SURGEON

any I had yet seen, such as the introduction of a glass window be
tween the microscopist and his slide, preventing the breath from
contaminating the air. Space below the window admitted the
arms of the worker. Every member of the hospital staff re
sponded to new ideas and their practical application. At the
university, on the contrary, I found an unkempt, hollow-eyed
lot of young people, milling restlessly about. Political agitation
was endless among them. As a protest against some recent
government action, they were brewing a strike. In retaliation
the university would probably be closed. This had happened
before. It would happen again.

My new friends took me to the opera to hear Alexander
Borodin s Prince Igor. The composer, a professor of organic
chemistry at the Military Academy, had been among the first
to demand that women be given the right to receive medical
degrees. This was achieved in 1878. Since that time, Borodin,
a man of vast energy, had organized the Medical School for
Women.

After the opera we went to a strange sort of fairy land.
Following a drive of several miles amid an Arctic whiteness, we
arrived at a garden of palms in the suburbs. A lavish tropical
paradise palm trees, orchids, warmth, perfume was separated
from the vast cold outside by panes of glass. We had exchanged
the exquisite delicacy of the opera ballet for an equal, but far
different beauty. We lingered an hour in this luxurious garden
fantasy. As we dashed back to the hotel, the outer horses
galloping, the center one trotting, the crystal stars low in the
sky seemed polished to a special holiday brightness. Gay voices
carried far in the darkness, merriment was heightened by the
quickening of blood by still, dry cold. Tucked into rugs, I
admired the dashing officers who whisked past our troika,
wrapped in their faultless, sable-lined, pale-gray overcoats.
Handsome, careless, debonair men where are they now?

The following day I saw the reverse side of the fabric which
clothed St. Petersburg in so much beauty. Wandering late in
the afternoon off the broad boulevards, I came into a section
that exhaled the miasma of decay. Gaunt wooden buildings,
with small closed windows, were held upright by arcades of

CHRISTMAS IN RUSSIA

rusty iron that threatened to tumble into ruins. Visible in this
silent place were only a few tattered beggars, clutching their
scant rags about them against the biting cold, their begging
arms stretched in mute appeal. At a corner I addressed a
policeman in colloquial German, inquiring the name of this
dismal street into which I had strayed.

"Stoliarny Peroulsk?" Was this the famous "S Street" where *
Dostoievski had set many of the scenes of Crime and Punish
ment? Yes, Dostoievski s house stood on the corner, now a
show place. In response to my inquiries, the policeman con
stituted himself my guide and guard. He helped me up a few
broken steps and through a dark passageway into an inner
court. In one corner lay a pile of wet twigs blanketed with
sooty snow; in another was a rickety cart, its upraised shafts
leaned against the molding wall like skeleton arms in suppli
cation. We stood as if in a deep well of darkness, the gloom
punctuated feebly by the pale glow of a few dirty windows.
There on the fifth floor, high in the gray wall, hung the dark
window of Dostoievski s room. From it he had looked down on
the bustling life of the courtyard now so silent.

As we retraced our steps to the street, my companion
expressed admiration for the courage to venture alone into such
a section of the city. I asked what there was to fear. He
pointed ahead to a four-story house, occupying the entire block.

"The whole building is inhabited by thieves."

"Do take me there." He hesitated; I slipped a ruble into
his palm. Soon we pushed open the unlatched street door.
Again we entered a dingy passageway giving upon a large inner
courtyard. Along its four sides rose galleries, tier above tier,
with many small doors. These were entrances into barrack-
like rooms where many poor men slept. We mounted the stair
from the court to the first gallery and opened a door. The
murky windows in the far end admitted little light and less
air. Rows of cots, slat beds and pallets lined the walls, a narrow
aisle between them. Disheveled, discouraged men sat or lay
on the makeshift beds. A few ambled around.

"Your life wouldn t be worth much if you were alone here

74 A WOMAN SURGEON

and they thought you had as much as three kopecks in your
pocket," my guide explained.

I believed him. Half the desolation of the world seemed
crowded within those moisture-streaked walls. Men observed
us furtively, murmuring speculations to each other about our
visit. We walked the length of the room. Stretched on some
of the piles of rags lay men asleep, their faces broad and empty
as the steppes. A slouchy woman, with a greasy nest of black
hair and mournful eyes, sat patching the semblance of a smock.
As her lean, mottled fingers clumsily sewed, she glanced fre
quently around the room. She rented the entire room and in
turn let space to lodgers. Wearily raising her tired eyes to us,
she asked the officer if he "wanted" any one. The officer
explained that he was merely obliging an American lady who
wanted to look around. She shrugged, and with the vestige of
a bitter smile, indicated I might look as much as I pleased. A
mere glance sufficed to take in the sodden misery. My guide
pointed out several notorious characters, and said the place had
advantages for the police. It simplified the location of
criminals when they were "wanted/ for while they kept out of
sight for a time after committing a crime, eventually they
returned to the accustomed hang-out. How pitiful at times is
the homing instinct!

I asked if I might talk to a few of the men, explaining that
I had practised medicine in the poorest section of an American
city and knew other unfortunates like these. A young fellow
with eyes dim from discouragement, hearing * me speak,
volunteered that he had been in America where his brother
lived. Why had he ever returned to Russia? His mother, he
said, craved the sight of him. She lived in a famine-stricken
district covering twenty provinces and a population of thirty
million people. Yes, she had received her scant government
ration of flour, but it was very cold, and she had no fuel. She
had eaten the flour raw as thousands of other peasants were
forced to do. The middlemen, the youth said, stole large
quantities of the flour or mixed it with chaff and sand. Many
families had lost out entirely in the distribution. Straw roofs
had been pulled off to make fuel or for food for the cattle;

CHRISTMAS IN RUSSIA

75

animals, children and adults huddled together to keep warm.
When I exclaimed at this, he, and those around us who under
stood the mixed English and German we were speaking, assured
me that no word of the famine was allowed to get into the
newspapers. Nor did this end the tale. Smallpox, black typhus
and tuberculosis had added to the suffering of starvation. The
youth had brought to his mother all his and his brother s
savings from America, but the money, he added ruefully, went
only a little way. His mother and most of her neighbors had
died, ^A man named Tolstoi, he said, ran about one hundred
and fifty kitchens which fed twenty thousand people each day,
but thirty million more were hungry.

Several of the men spoke briefly. They were hard-visaged
from suffering, hopeless in their gestures. One, with a more
intelligent face, summed up the situation: "There is no human *
feeling for us here." I recalled that one of the students at the
university that morning had remarked, as if it were a truth,
generally accepted by her group, "Revolution must precede
evolution here."

One of the men, who spoke as if he had been a student of
History, remarked sadly, "Since the day of Peter the Great i
generations of innocent people have been sent to die and starve
in Siberia, sent on foot and in chains, often over frozen roads,
because they dared to think of a better Russia. They were
condemned to continual servitude in the salt mines because
they had a different political vision from that of their rulers.
They went, and they died, rather than renounce their prin
ciples. Children, born of these mothers in exile, grew up
vindictive. Witnessing the suffering of cruelly treated grand
parents, they grew bitter and they had no opportunity to alter
it. Resentment grows because all our sufferings seem futile.
We have no voice. A revolution is coming which has been on
its way three hundred years. It will be terrible in its victories,
and in its mistakes, but out of it will come the resurrection of
those who have died in Siberia and of us, who are starving,
freezing and hushed."

Here was Red Russia in the making, her garments dyed in

76 | A WOMAN SURGEON

blood. Fires of hate or revenge were being laid and readied
for igniting./

Silent and depressed, I descended the rickety stair. My
guide escorted me to the vicinity of my hotel where I saw a
chart showing the location of charities supported by the royal
family and certain of the nobles. This appeased me somewhat.
But remembering the squalor I had just witnessed, it seemed to
me that the charity administered throughout the whole empire
would have been insufficient for even St. Petersburg alone. I
thought of the Neva "River and of the sparkling Nevsky
Prospekt; such was the social system of Imperial Russia a
beautiful crust of glistening ice supported by a turgid torrent
underneath. And heedless wealth sped gracefully back and
forth over it. Yet little did I dream how soon the flood would
swell its hidden power in a change of wind and season to smash
the glittering crust of ice.

An official call on our charg< d affaires, Mr. Breckenridge,
and his wife, led to my meeting the rector of the Anglo-Ameri
can church in St. Petersburg, a most agreeable man, who told
me that he often lent books to the Czar who, on reading them,
would send a little note saying, "My wife and I have enjoyed
this," or "I read this aloud to my family." Czar Nicholas, he
confided, was a devoted husband, a fine father and a gracious
friend.

The rector, hearing of my plan to leave shortly for Moscow,
asked me if I would like to take some books to Tolstoi his own
books which were contraband in Russia. They had been
printed in England and smuggled back into the country. The
rector warned me that, if police discovered the books, I should
have a difficult time. But I would have risked it, even if it
cost me a trip to Siberia.

I was not to know the names of the books, or anything about
them. I was merely to carry a parcel to a friend in Moscow.
The police would probably not be overzealous in examining
my Baggage, and an insignificant paper parcel would hardly
elicit much curiosity. My passport and papers showed that I
had no political interest in visiting Russia, and the rector

CHRISTMAS IN RUSSIA

encouraged me with the comment that I was naturally dis
arming and could make a smile go a long way.

As I boarded the train, I exulted with the thrill of carrying
to Tolstoi his own forbidden books. When the inspectors
entered, I shared in the general apprehension, but my qualms
were quite unnecessary. In Moscow, however, before I could
be assigned a room at the hotel, my luggage would have to be
inspected and my passports collected for registration at police
headquarters. Happily, no one noticed the precious books.

The courtesy of colleagues in Moscow once more gave me
the opportunity of observing the work in hospitals and follow
ing laboratory technique; through luncheons and dinners I
became acquainted with the social life of the city. The per-
fumed drawing-rooms furnished with French furniture and
oriental rugs beamed in soft light, while the dining-rooms with
their silver- and crystal-adorned buffets were always brilliantly
illuminated. At mealtimes the buffet was heaped with a pro
fusion of dainty sandwiches, delicate cuts of meat, salads in
amazing molds, fruits and ices. On my first evening in high
Russian society, I noticed that the guests seemed to be sampling
everything. I decided this was positively the most elaborate
buffet supper ever given. To my surprise, I learned that this
feast merely began the dinner of twelve courses, each of which,
for the sake of courtesy, I must at least taste. Mortified that I
had mistaken the hors d oeuvres for the repast, I remembered
the house I had seen a few days before where a thousand men
were starving. ,

One evening, shortly after my arrival in Moscow, I found
myself seated at dinner next to a friend of Tolstoi s daughter.
I told her about the books and my concern in delivering them.
I had been afraid to send them by a messenger from the hotel,
and asked if she would kindly suggest that a trusted servant
from Tolstoi s household be sent for them. With what rapture
the next morning I received a note from Leo Tolstoi asking me
to bring the books myself at five o clock that day!

For hours I walked on air. I have never been able to recall
what I did in the intervening time, but a five minutes before
the hour I was at the door of his large city house in the suburb,

78 A WOMAN SURGEON

Khamovniki. A gentleman, muffled in fur, entered just before
me and went upstairs, while the doorman assisted me out of
my coat in the lower hall. I was directed to follow. Passing
through a small room, so bare that I recall only a piano, I was
ushered into a long reception room. The hardwood floor,
scrubbed to immaculateness and sanded to a dull glow, lay bare
of rugs. There were no pictures. The absence of all ornament
produced an air of austere simplicity. Neither luxury nor
extravagance had a place in this household. Evidently, since
Tolstoi found such things absurd, the members of the family
had perforce adapted themselves to his ideas with what grace
I was not certain, for I had read that the family resented his
conversion to the life of a peasant. In 1880 he had renounced
the income from his books, and in 1897, his property.

The door swung open. I had heard that Tolstoi went
unkempt, but his long gray hair was smoothly brushed except
for one refractory lock. A high forehead, heavy brows, deep-
set gray eyes of a curious luminosity like the far-focused gaze of
an astronomer. The strength of the jaw showed even under
the long grizzled beard. His clear skin was fine-textured, his
hands shapely and strong. He obviously wore the leather-
belted blue blouse for comfort, as well as for a symbol of
brotherhood. Slender and of medium height, his heroic head
dominated the rest of his body. At seventy he carried himself
with an ease, and walked with an elasticity, which reminded me
that he had been a soldier, though he bore the slight droop of a
man who spent many hours daily at a desk. His appearance
recalled to my mind an exquisite Chinese ivory figure of a
philosopher each line eloquently carved to an expression of
sagacious reserve, yet the figure as a whole leaning forward as
though eager not to be cut off from the world of men y

Tolstoi, in a richly modulated voice, thanked me in perfect
English for bringing the books, which he handled lovingly. I
was so interested in watching the author that I forgot to ask
the titles. Probably they were Confession and What Shall We
Do Then? since those had been circulated only in mimeograph
form in Russia.

After inquiring how the books came to be entrusted to me,

CHRISTMAS IN RUSSIA

he began questioning me about myself: What was I doing in
Europe? Why had I studied medicine? What would I do
with it? What did my family think of it? How old was I?
In what part of America was I born? He added, partly as if in
explanation, partly in apology, "We may never meet again, you
know. Does it seem crude to you that I should be so personal?
I like to save time; directness leads to sincere acquaintance/

The noble simplicity of his mind increased my admiration.
Dared I hope for mental comradeship with this man? To him
I was merely a type to be analyzed and catalogued in the
laboratory of literature. He had to know my aspirations in
order to estimate the values in my life; my social and educa
tional background in order to understand my outlook. He
said he had never met such a young woman physician (I
was twenty-three) and that he had fancied Virginians very
conservative.

At the end of an hour he asked me to call upon him again
the next day. He explained that the gentleman who had come
in just ahead of me was his doctor, that by now he had had his
tea and must not be kept waiting any longer. "My cold is
slight but my family insist on its being attended to," he
explained.

The following afternoon we began our conversation exactly
where we had left off. After a few moments he suggested, with
a twinkle, that I might like to ask him some questions. Em
boldened by his friendliness, I summoned the courage to tell
him that he seemed to me inconsistent. Each of his books, I
argued, delineated an interesting philosophy but each seemed
at variance with the rest. In the maze of analyses I became too
confused to obtain a rounded picture of the real Tolstoi. In
each book was shown part of his splendid soul, but his
combined written work formed a confused autobiography. He
said that hypersensitiveness and a tendency to overanalysis had
made him a pessimistic youth, delaying his decisions. He
believed he had later partly outgrown these characteristics. I
amended that perhaps his versatility bewildered readers like
myself when confronted with the facets of a personality too
intellectual and many-mooded for facile comprehension. A

8o A WOMAN SURGEON

puzzled frown crossed his face. He leaned forward and sug
gested I make my statement more clear.

With the confidence of one being indulged I plunged on,
realizing my presumption, but anxious to dispel the perplexity
his critics had thrust upon my mind. Tolstoi seemed so deeply
sincere; I was confident he could explain.

"There are people who maintain that you are an affected
individual, clinging to pose; still others believe that in going to
extremes of personal discomfort you are trying to punish your
self for the inherited luxury and extravagance in which you
lived during your early life." I flushed at my own daring, but
his expression was so benign that I added, "It is said that you
resent any attitude of mind except that held by yourself, that
you impose an unconventional habit of life upon your family.
Others consider you a sincere, but self-deluded and impractical
reformer. However, more of your readers, and these I believe
understand you most truly, see the reasonableness of your
evolution, from the moral handicaps of wealth in your youth,
toward unselfishness; we believe that you yearn for under
standing from those nearest you, but having partly failed in
this, you seek to say something to all those whose minds are in
tune with yours, wherever they may be."

Instead of rebuffing my monstrous boldness, he seemed glad
that I had given free expression to criticisms which had hurt
him with their half-truths.

* "I did not write with conviction until I was over forty," 1 he
explained. "Many of the opinions of my critics have been
based on my early writings. I was a pampered child, an
indulged student and a gay young officer. Although I did not
steadily see the beauty of earnestness, I had, from time to time,
been impressed by the seriousness of life. These impressions
deepened through the influence of an eighteen-year-old girl,
the daughter of a physician. In 1862, when I was thirty-four,
she became my wife. Her devout, lovely soul gave me much
happiness for many years. In 1877 I had reached the convic
tion that religion as taught in the Orthodox Church expressed
neither the teachings of Christ nor my own faith. I discarded

1 War and Peace was published when he was forty-two.

CHRISTMAS IN RUSSIA 81

the forms of the Church and resolved to search for simple
elemental truths."

Something prompted me to tell Tolstoi of my visit to the
"den of thieves" and how they seemed to have been spiritually
robbed.

"Yes," he sighed, "there is vast unrest here. I see it on
every side, but my former friends, the aristocrats, will not *
recognize its menace. I am trying in the books they condemn
to bring them to a realization of their responsibility to the poor.
In this climate there is no middle class, living in quiet comfort.
During our long and severe winters our peasants live in such
desolate country districts that the majority of them do not have
enough money for sufficient fuel, food and clothing to enable
them to ward off starvation, disease and desperation. If my
own class would only listen to me, we could in one year make
changes which, as it is now, I fear will require a century of
bungling half -methods."

His eyes glowed with sad, prophetic fire. "My contact with
the suffering of the peasants in the famine of 1875 made me feel
I had no moral right to comfort, and when I took the census in
the worst section of Moscow seventeen years later, I was over
whelmed by the duty people in my position owed to the poor
and outcast. I have since tried to reconcile my life and con
science, but my family s point of view has at times been at
variance with my own. I am like a man who has walked down
a road, and has turned to walk the other way; everything which
was on my right I now find on my left: and humanity is every
thing. Many dismiss me as extreme, but such is the cross of
the reformer. With the realization of greater values in life,
I have lost all interest in superficialities. As my views changed
I felt obliged to put on paper the ideas which clamored for
expression. I wrote with renewed vigor, new purpose. But I
feel I wrote too quickly. One must live long to understand
life. By the time a book was written, proof-read and printed,
I had outgrown it. I would have recalled it if possible, but
since I could not, I eagerly wrote another rushing it along to
modify some of the former thoughts and to accentuate others.
Inconsistencies really express growth of both mind and soul.

8s A WOMAN SURGEON

After one book is printed, I feel that to be true to myself I
must write another and yet another. And to present a finer,
more fruitful philosophy, I must strip my mind of the past to
be able to move forward."

He nodded toward the adjoining room. "You see that the
room in which I work is bare. I do not wish, indeed, I cannot
tolerate, distracting objects about me. My mind is dragged
back. I am easily diverted. I have had to train myself to con
centrate. I now compel my mind to a single channel and
absorb myself in a thought until it is expressed. I never feel,
however, that I think conclusively; each thought is sincere, but
it is only a step."

He arose with me and walked to the door. "I have enjoyed
talking to you as a comrade," he said. "We have crossed the
thresholds of each other s minds and found hospitality."

I returned to my hotel feeling ennobled and stout-hearted.
Never again need I waste time in patter, for people worth
knowing could be reached directly. After a few days, I received
a message from my new friend asking me to call again. With
a word or two of greeting, he began our third conversation by
an inquiry as to whether I did not think it would have been
better to have given to the poor the money I had spent in
coming to Europe. He added, "Were you seasick?"

Smilingly, I asked him if his attitude arose from moral
courage or from fear of the sea. He blushed, but held to his
contention that it is wrong to spend money in travel, for the
cost of the journey might relieve much suffering among the
poor. Furthermore, one could always read books of travel.
I countered by asking him who would write such books if no
one traveled. Here he told me that only his disapproval of
travel had prevented him from visiting America.

He sighed and said, "I am no longer young and I have much
to do. I am interested in knowing people as they really are,
and have enjoyed what you and I have in common; our differ
ences have been stimulating. I believe that my best friends are
in America. They understand my writings. There you are
free; you have a chance to try all plans for social betterment.
Why do you not thoroughly test the Henry George plan of

CHRISTMAS IN RUSSIA 83

single tax? It seems good to me. I wish it might be put into
effect in Russia. Here we can only work for a future we shall
never see."

Again he sighed. I urged him to visit America, telling him
we needed a prophet to show us the immensity of our
opportunities.

A regretful shadow darkened his brief smile. "Yes, my
books are welcomed in America. There they are read more
sensitively. But they are written for Russia. One must experi
ence democracy to comprehend it. I am writing a book now"
(It was Resurrection.} "for which I shall probably be excom
municated. In it I attack both Church and State, but it cannot
be helped I must do it." He held out his hand impulsively.
"When you read it," he said, "do not criticize me; help me."

I was deeply touched. This appeal showed unhealed
wounds from misunderstanding from which he would continue
to suffer for his vision of the truth.

"How can my opinion matter?" I asked. "I am no literary
critic and as yet know little of life."

He regarded me earnestly and impersonally. "I must feel
that somewhere people reading my books see their spirit, not
their errors. I write to an audience, serious-minded and also
imaginative, not to those who seek in literature an escape from
reality. You Americans help me to bear the avalanche of
opposition close at hand. The soul takes courage and strength
from the thought that somewhere there are friends who want
to understand."

At the door, as I stood ready to leave, he held out both his
hands. "We shall probably never meet again. You are going
far. I wish you happiness; I am afraid you will suffer much.
But know that underneath the stress, the trouble and suffering,
you will be happy, for you mean to work. You have dedicated
your life to service. Work brings happinesswork means
happiness."

I had seen Red Russia in the making and I had met a
"mediator who might have averted many a catastrophe, had
those in power listened to his plans for moderate transforma
tion. Few Russians, however, are listeners. I They must

A WOMAN SURGEON

experience, experiment, dramatize every idea, and at long last,
conclude. The mind of Leo Tolstoi was a bridge upon which
the nation might have crossed from chaos to calm, without
fording the disastrous waters.

The social laboratory in Russia o today has among several
misconceptions of progress much of value and much of dyna
mite, which only Russians with their dramatic intensity and
their belief in fatalities would dare to carry out. In those
far-gone days of my student life I foresaw in the restless eyes of
youth, in the drawing-rooms of the aristocracy, in my after
noons with Leo Tolstoi, much that has since come to pass. To
be a comprehending physician one must also be a student of
sociology. That long-ago Christmas vacation started questions
in my mind which are not yet fully answered. But new Russia,
the Russia Tolstoi helped to create, has for its watchword
Work.

CHAPTER VIII
NERVES AND PARIS

WHEN I came to Paris from Vienna, I began to lay the founda
tion for a thorough study of nervous diseases, neurasthenias
and reflex conditions, especially as they complicated medical
and surgical procedure.

The relation of circulatory disturbances, respiratory mal
function, colon distribution and other constitutional conditions
to gynecology interested me intensely. I had a theory that with
good food and housing conditions, secured through knowledge
of personal and community hygiene, and adequate salaries for
workers to apply their knowledge, many vague feminine ill
nesses would disappear and others assert themselves more
definitely. As a champion of women I knew that biological
differences between the sexes, which had received scant
attention in the classification of diseases, should be considered
from a variety of angles. Years later, taking this as a starting
point, I worked the problem out on the basis of occupation,
location, hours and kind of work, as modified by heredity, by
age and by salary, from scrub-women to circus bare-back eques
trians, from clerks to executives. After a thorough study of
the ramifications and perplexities of the inter-relation of
mental, social and economic conditions to individual health, I
concluded that all things considered, the health, energy and
endurance of women equal those of men. This was sum
marized in several scientific papers. 1

1 Effect of Industrial Strain on the Health of Working Women, read before
the Section on Hygiene and Occupation of the International Congress on
Hygiene and Demography, Washington, D. C., Sept. 26, 1912; published in
American Journal of Obstetrics, Dec., 1912.

Constitutional States in Relation to Gynecological Conditions, read before
the New York Academy of Medicine, Section on Gynecology and Obstetrics,
May 25, 1914; published in the New York Medical Journal, August, 1914.

Industrial Diseases of Women as a Factor of Eugenics, read before the ggth
annual meeting of the Alumnae Association of the Women s Medical College of
Pennsylvania, June, 1914; published in Proceedings of the Alumnae Association
of the Women s Medical College of Pennsylvania.

85

86 A WOMAN SURGEON

Even in my slight experience I had noted that diagnosis
made by men often indicated that they either did not, or could
not, fully understand the diseases classified as those of women.
Their analyses lacked clarity through insufficient differenti
ation from male disorders. They found it temptingly easy to
dismiss a nervous woman as exaggerating her symptoms, as
fussy, self-centered, or unreasonable; when actually this type of
patient had usually suffered for years with an inflammatory or
congestive condition, misplaced organs, laceration or tumors, to
which she had accustomed herself, although the condition grew
progressively harmful. She had neglected to seek relief because
of modesty, poverty, the mistaken idea that it is normal for
women to have pain and endure it, or the pressure of daily
duties, causing a visit to doctor or clinic to be postponed for
years, until her nervous system collapsed with exhaustion. On
the other hand, had the patient been a sick man, his wife would
have insisted upon his having care at once. Economic necessity
would also compel the bread-winner to keep well. Women
suffer from acute and accumulated fatigue without attention
being -jpaid to it either by themselves, or by any one else, until
its toxemia has given them headache, depression, insomnia,
irritability, symptoms of acidosis, and strung up a chain of other
pathologies.

The electro-chemical changes and other disarrangements in
the system under these conditions are now generally recognized,
but in my student days I was regarded as overloyal to my sex.
However, both men and women listened, with what degree of
toleration I cannot say, when I announced one day that I did
not believe that any one in perfect health was ever cross. Much
that we now know about endocrines, anemia, autointoxication,
ptomaine, malnutrition and other causes of health deficiency,
has since proved my theory correct.

Still, too often people who are able to get about and who
declare, "I have never been strong. It is natural for me to be
pale," may seek no relief until the causes have advanced into a
stage of complications. Adequate remedy demands thorough
diagnosis. I determined to absorb all available information on
the medical and surgical complications which may cause women

NERVES AND PARIS ______^_ 8 7

as well as men to be "complaining" and to be dismissed with
the blanket diagnosis, "a nervous condition." I was not going
to confuse crankiness" and chronic illness in my practice. In
a word, I wished to be fair to those who would come to me for
treatment, and not demonstrate my own ignorance by waving
them aside as "willfully difficult, not to be humored." Happily,
since then, discovery after discovery has catalogued the subtle
relations of each cell of the body into a veritable dictionary.

In Paris I walked the wards in company with other young
doctors, following celebrated specialists as they made their daily
round of the Hotel Dieu, Hotel des Invalides, Val de Grace, the
Charit, and the Salpetriere. I profited by this bedside instruc
tion, observing the methods of nursing and the type of French
women who became nurses. In Catholic countries Sisters of
Charity have for centuries given devoted and skilful care to
the sick; but their cloth habits, long skirts, sleeves and wide
wimples are not the best sick-room costumes. Otherwise, their
excellent training and consecration to their work give them
high efficiency. Other French women then employed in
hospital service looked slovenly. Their work was menial but
they ought at least to have been tidy.

After a few days of medical and surgical observation, I
decided to follow a series of cases at the Broca Hospital. Dr.
Pozzi, the chief surgeon, was a slender, precise, well-groomed
French gentleman. He operated deftly and quickly, allowed
no conversation in the room, but usually kept his class waiting.
There was often a delay of from ten to fifty minutes before he
entered the room. Generally he had been delayed by the insist
ently curious relatives of some distinguished patient.

His hospital walls were the first to deviate from the dull
monotones of gray, brown or white. Here there were mural
decorations, done by artist patients in thanksgiving for release
from suffering. The pictures expressed the emotional needs
which patients had felt while awaiting operation or passing
through convalescence. To experience peace, one had painted
a meadow on the walls of the long hallway down which families
of the patients approached their loved ones.

Another artist, wishing to express to the feeble the obedience

88 A WOMAN SURGEON

of the forces of nature to a divine law, had painted at the end
of the ward where he had lain a mural of waves dashing against
stone cliffs. The strength of line and color, the rhythm of end
less tides, relaxed taut nerves. Another mural of an oak-tree
in a spring wind stimulated despairing patients to renew their
fight, as it symbolized the renewal of health beyond the struggle
of the tissueswhich we call suffering. To the doctors and
nurses in Broca Hospital, to those of us who only passed
through, those walls gave happiness. They lifted fatigue and
worry from the mind, refilling it with the quiet, refreshing
knowledge of the harmony of nature.

Radiant Professor Doyen was another of the French doctors
whom no one could forget. Imitating movements, students
watched his fingers and wrists while operating as I once saw
Eva LeGalliene watch those of the great Duse. Those who
were jealous said Doyen was theatrical. But his surgical assist
ants and nurses caught the verve of his personality, and
operations moved like clockwork. Each case was not only out
lined before the patient was brought in, but, between opera
tions, we were shown motion pictures of those he had performed
to relieve a similar pathological condition. This method was
not then in general use, nor is it even now, hospital organiza
tion being such that case follows case too quickly to admit of
adjournment to another room for cinema pictures. Routine is
so systematized that the immediate pre-operative preparation
and post-operative dressing of patients is done in adjoining
rooms; the surgeons and their assistants only have time to
resterilize their hands, put on fresh sterile gowns, gloves and
face masks before beginning the succeeding operation.
t Surgery in Paris differed from that of Germany in the
artistry of its technique. There was greater nicety of detail;
smaller instruments were used. Consideration was shown for
the mental reactions of the patients and of their families. On
the other hand, in Germany, there had been greater prompt
ness, more teaching while operating, more consulting after an
operation began, longer exposure of patients, and, for the poor,
an utter disregard of emotional reactions. Teutonic state hos
pitals were health factories..-

NERVES AND PARIS 89

Charcot had been dead for years, but there still was much
talk of hypnotism in relation to psycopathies and neurasthenias.
Some considered it a side-show charlatanism; others thought it
of profound value. I determined to decide for myself, even
though I never expected to use it. For a woman doctor to
practise hypnotism would be adding dynamite to the prejudices
which in any event I must expect. However, the effect of
mental control on circulation and many other conditions,
made it worth while for me to learn the uses and limitations of
hypnosis, as part of my preparation as a diagnostician and, I
hoped, an authority on the relation of physiological and patho
logical processes throughout the body to my chosen specialty,
gynecology. If, with the natural combativeness of human
beings submerged by hypnotism, beneficial results could be
obtained, I believed that by winning the cooperation of the
patient when fully conscious the same benefits might be
secured. On inquiry I learned that Dr. Eugene Berillon, a
specialist in nervous diseases, held a clinic in connection with
his consultation office, where he employed the therapeutic use
of hypnotism in connection with medical care. There was an
unpretentious quietness about his work even at its most
dramatic which gave me confidence in his scientific judgment.

Dr. Berillon was still a young man, sincere, executive. An
assistant took the histories of the patients. These were read to
the doctor as he observed the patient s expression, the reaction
to a recital of biography, the manifest symptoms, posture, com
plexion, mannerisms, height, weight. The majority of patients
were either chronic medical or post-operative cases. Berillon
made a careful physical examination of each one, asked a few
questions and prescribed necessary medications for health
deficiencies. Many were anemic; most were discouraged; all
had idees fixes about themselves and their ailments. Ill persons
of all ages develop health delusions which, fed by opposition
and self-pity, grow into convictions. Under hypnotism stubborn
obsessions can be broken down and obliterated, but the treat
ment of temperamental and memory-formed neuroses must
rely on the conscious application of the more modern psycho
analysis.

go A WOMAN SURGEON

Dr. Berillon conducted me to a large room on the floor above
his office where many people sat in comfortable attitudes of
sleep. The room was partially darkened, but well ventilated,
the atmosphere restful, not uncanny. He permitted me to
assist him in treating the cases.

One was a lad about seven years old whose mother had
brought him to the clinic because he persisted in setting fire
to fences and outhouses, even to things in his home. He
relished the ingenuity required to plan the fire, but found his
ripest joy in watching the brilliant red patterns of the flames.
He lacked any sense of responsibility or any consciousness of
penalty, for he did not try to elude detection. A typical case
of pyromania.

Most of the patients were men. They included a retired -
preacher who had developed a form of hysteria known as crowd
fright; a street-car conductor who, following a small accident,
was unable to drive the car with confidence and suffered from
indecision regarding other acts he had previously performed
with confidence; a business man who could no longer go to
his office through fear of crossing the street; another unable to
lift his arm; an insomniac art student, who hoped to gain a
scholarship for advanced work in Rome.

The man who could not lift his arm was pallid and lean.
He explained that his right arm had been caught and broken in
a machine. It had had immediate expert care but while the
plaster cast was still on, some one had suggested that the flesh
might be withered and that he might not be able to use his
muscles again. The idea preyed on his mind. Being a day
laborer, he had to use his arm for his family s livelihood. He
stated that when the cast was removed he found the arm smaller,
weaker and whiter than the left one. He tried but could not
lift it. He had lost confidence in the surgeon who had assured
him it would be all right. Since the removal of the cast his
general health had been progressively declining.

Dr. Berillon examined his arm, tried the muscle and nerve
reactions and other reflexes. Finding them normal, he pinched
and rubbed the arm, and increase of circulation was apparent,
then told the man to try to squeeze his hand. The trial gesture

NERVES AND PARIS gi

failed. He then asked the patient to try to lift his arm. This
effort, too, was unsuccessful.

My colleague asked graciously what I would suggest.
Electricity, massage, graduated active and passive movements
for the spine and arm, increased nutrition, a daily walk and
bath, a combined general and digestive tonic. To this the
chief of the clinic agreed, but he added that the patient, a man
of limited intelligence, would still retain his delusion and his
arm would remain useless. Even if he saw and felt himself
improving, for the sake of his ego he would combat the idea
and cling to helplessness. Of course, he persisted that he
wanted to regain the size and strength of his arm, but he agreed
reluctantly to follow the medical directions given him. He
, preferred to be cured by this magic of hypnosis, as others had
been.

Next day, he was one of the first to arrive. As soon as he
looked around the treatment room, he yawned. Evidently, the
atmosphere made him feel sleepy. Dr. Berillon requested him
to gaze at the pencil which he swayed rhythmically before his
eyes. The sense of sight is the most easily fatigued. Soon his
lids dropped. He was gently urged to open them. He tried
again to follow the movement of the pencil but his eyelids
fluttered shut.

"You will go to sleep/" said the doctor soothingly, "but not
deeply. You will hear what I say to you and you will reply.
You have come to me to be helped, you must work with me.
You realize that the mind has control over the body/ 7

"Yes."

"You were told your arm might be withered, so you thought
about it all the time."

"Yes."

"You really have the same healthy bones, muscles and nerves
in this arm as in the other, but they have been bound up and
not used for so long they are weak. They will grow strong
again."

"No," said the man.

Without allowing an argumentative inflection to come into
his voice, the doctor continued, "You will see, and be very

A WOMAN SURGEON

happy. Now in five minutes you will be fully awake, have no
headache and feel rested."

For a week the patient subconsciously combated the idea of
recovery. Gradually he accepted it. A nurse raised his arm,
placed it in all positions and under hypnotism had him do so
himself. When he was awake, his attention was called to the
improvement in color and tissue tone, but still he insisted that
he could not lift it. While asleep, he was trained to raise it
slowly and eventually to rest his hand on his head. At the end
of a month he emerged from the induced sleep with his arm
in this position and found to his delight that he could lower
and lift it without assistance. He shouted that a miracle had
been performed. Clinging to the joy of flattering his ego, he
could not comprehend the patience and skill which had
removed an obsession and implanted faith and accomplishment.

Gradually Dr. Berillon turned more and more patients over
to me. Children I found easiest to put to sleep. They sat in
low chairs against the walls and looked at an arrangement of
small mirrors revolved by clockwork. The "tick tick" of the
bright objects moving in a fixed orbit tired their ears and eyes
simultaneously. When little heads toppled to one side, I would
gently place them so that they were supported by the wall. In
this half-conscious state, too sleepy to be obstinate, they heard
my soft persuasions. In such a drowsy state it was easier to
agree than not. The child who liked to set things on fire had
to learn that red was a bloody, horrid color, instead of the most
beautiful. He had to realize that he was silly instead of clever
to waste playtime on fires and be made to wince at the descrip
tion of an imaginary burn on his leg. When there had been
sufficient mental suggestion for one day, the children would be
told that they would awaken in five minutes feeling fine. Their
bright eyes would pop open in just five minutes and they would
walk out, fresh and chipper as sparrows, subconsciously grow
ing cooperative and amenable until they left behind them
whatever mental obliquity had filled their mothers with despair.

The artist was willful. He refused to accept the idea of
dictation. He declared that he must sleep or else he could no
longer have a steady hand or see to paint. He admitted over-

NERVES AND PARIS

anxiety to sleep increased his insomnia and that he defeated
himself by thinking of all the misfortunes it might cause. But
he distrusted ability to help him. When he felt himself drift
ing off, he would pull his mind back to ask a question: Would
he have a headache? Would he ever wake up? I advised him
to take an hour s walk in the park and return to the clinic the
following day. He must have time to think over his questions
and decide whether to believe my answers. As a parting blow
to his vanity, I called out that I didn t care a fig whether he
slept or not. The benefits were all his. With a shrug he
departed.

The next day he arrived compliant, but still unable to over
come subconscious stubbornness born of arrogance, combative
ideas regarding male superiority and fear that hypnotism would
give me an influence over him or permanently weaken his will.
I explained that it was impossible to make a hypnotized person
do anything foreign to his nature, implant an idea to be carried
out at some future time, or any of the imaginative absurdities
in literature. Finally convinced, he said like a docile child that
he was ready, but on the verge of success the tiger in him arose.
I determined not to let his willfulness defeat the artist in him.
I wanted to help him gain that scholarship. A battle began
my will to do him good against his will to let no mind influence
him. Eventually he closed his eyes and relaxed in a dreamless
sleep. I was as exhausted as if I had been in a hand-to-hand
physical struggle. He slept for an hour and awoke with rap
turous surprise. He came each day for a week and accepted
the suggestion that he should go to bed early and work only
two hours each morning. He found that the absolute quiet of
the nervous system in hypnotic sleep acted as a tonic and
reestablished the habit of relaxation and rest, eventually rein
stating natural sleep. His temper, tone of voice, color, gait,
digestion, and his capacity for sleep improved rapidly. He won
his scholarship.

A knowledge of legal medicine is an important part of a
doctor s training, whether to determine the causes of death
complicating a murder, suicide, accident and other unnatural
deaths, or as part of the armamentarium of an expert witness

94 A WOMAN SURGEON

in court. Paris affords convenient and dramatic study of the
first group of cases, since bodies are usually found in the Seine.
With a river winding through city and suburbs, the despondent
need make little effort to leave the society which they have
found unkind. Suicidal intent is deterred by a visit to a peace
ful countryside. On the other hand a tumultuous waterfall or
a sheer cliff satisfy the pathological desire for endless falling.

In my student days the gloomy morgue, a one-story building
lighted mainly through the roof, was situated on the lie de la
Cit, the oldest part of Paris. Its somber mysteries attracted
many, who were not seeking their dead, to walk through the
wide passage before the glass partition which separated the
living from the dead. Back of the partition always four stark
bodies to be identified lay on four tables. A continuous line
filed past daily in at the south door and out at the north: piti
ful old people searching for a long-absent daughter or son;
disillusioned wives, with half a hope that they were widows
rather than deserted. Their peering faces were marked by
strain and tears, except some who found relief in the certain
knowledge of death for a loved weakling rather than that he
or she had been deported to a penal colony. Tragedy lay
exposed on both sides of the glass partition. Some Parisians
came from morbid curiosity, leading children by the hand.
Others strolled through indifferently on their way to deliver a
package. One such received a shock when he saw his sister s
body; he had thought her safely married in America.

At the side of the building was the door through which the
doctors, taking a course in legal medicine, entered a large
classroom. They hung their hats above a row of glass jars
containing specimens, set on a long shelf for convenient teach
ing reference. The seats in the amphitheater surrounded a
marble table on which were placed, one after another, the
bodies we were to view. An unidentified man had been taken
from the Seine. The question was whether he had thrown
himself in or had been thrown in, whether he was murdered
first, had fallen through losing consciousness from heart failure,
epilepsy or a cerebral hemorrhage, had had a convulsion or
slipped accidentally; whether he was partly dead when his body

NERVES AND PARIS 95

entered the water, or stunned by striking his head on a stone
when he deliberately plunged in. All these and many other
points had to be decided by a thorough study of bruises, cuts
and the amount of water in the lungs, the condition of the
clothing, as well as by an examination of the organs, blood
vessels and other tissues of the body.

Every variety of social and medical problem was there to be
solved. Having the details of the case, we were to make specific
requests for further information, give opinions, reconstruct
the probabilities. Sometimes I became emotional regarding a
corpse, but I was careful not to betray myself. One day the
body of a woman with beautiful arms and hands lay on the
marble-topped table. I soliloquized on the delicacy of her skin,
the graceful lines of her arms, the perishableness of flowers and
of beauty in general. Through the haze of my abstraction the
professor s voice had become almost inaudible. Suddenly I
heard him announce, "This woman was killed by a blow on the
head, delivered by a man now at the point of death in the
hospital; she crushed his skull!"

One day, as I entered the class, I found a large crowd of
people gathered around the door. They were whispering,
nodding and shaking their heads. They told me that a young
girl, either English or American, had committed suicide in a
church. They were excitedly curious to see the body of some
one who had desecrated a sanctuary. Was I going in? Was I a
relative? No. This girl had been lonely, friendless, hopeless
or perhaps too stubborn to communicate with her people when
in distress. I began to speculate on the many causes which
might have determined her to end her life, and decided that,
despite the impulses, she had shown her faith in God by offer
ing her soul to Him in His house.

After the hour s class had ended and I was leaving the
morgue, people in the crowd edged their way to speak to me,
and asked me again if I were a relative. I said, "No," but then
I thought, "It is true I am racially a kinswoman." And the
poor girl would not be given a funeral service, for the suicide
forfeits civil rights. I went to the great church of Notre Dame
close by and asked the priest if I could arrange for a service in

96 A WOMAN SURGEON

one of the chapels. He also inquired whether I was related to
the girl. When I told him that I had never seen her until
she was dead, the questioning expression in his eyes led me to
say, "Holy Father, youth understands youth. It was the chance
of birth that I am not the girl in the coffin. She must have a
family somewhere. If you do not mind, I would like to repre
sent them."

"Bien" he answered tenderly.

While I studied in Paris, besides the holding of scientific
assemblies like the International Congress of Tuberculosis, the
World Exposition of 1900 brought the ends of the earth together
in a brotherhood of arts and artisans. France stands always in
my mind as a country with worldly intellect and an interna
tional soul.

One morning, shortly before leaving for England, I was
sitting in a cafe in the little Rue Leopold Robert watching
"madame" behind her high desk accepting her customers
statements of how many croissants and cups of chocolate they
had enjoyed for breakfast. Of course, from her dais she sur
veyed the room and registered this information before the
breakfaster presented himself to pay her. "Madame" is the
business manager of all the small industries of France. Ac
curate, industrious, she is the basis of national finance.

As I sipped my chocolate, a girl passed selling cigarettes.
Following came a child, who suggested that her parrot should
choose from the envelopes in a little rack the one containing my
fortune. The ingenious wording of such printed clairvoyance
cannot fail to suit ninety per cent of those who invest five
centimes. Mine read, "You will cross the water and have great
interest in a tall gentleman" it suited. The four months and a
half which I had scheduled for study in Paris were drawing to a
close. I would soon cross the Channel and go at once to the
laboratory of Dr. Victor Horsley, who was more than six feet
tall.

CHAPTER IX
IBSEN AT HOME

SOMEWHERE a strain of Viking blood had slipped into the Saxon
veins of my mother s family. I wanted to see the land of these
stalwart forebears, and during the summer of 1900 I went to
Norway. I had been burning midnight oil Anglicizing a Ger
man medical book and tutoring with the hope of seeing the
midnight sun. But my elation in sailing for Christiania was
doubled by the presence in my bag of a letter of introduction to
Ibsen from a Norwegian friend in Philadelphia.

My fellow students envied my good fortune. Ibsen appealed
strongly to the youth of that day when they saw that he, like
Browning, believed the race must be periodically reformed.
They berated those who condemned him as a disturber of
sacred rites and a revolutionist destroying the serenity of the
home. We youngsters thought he would help us to express a
truer religion and to create better homes through equal fair
ness to both men and women. Having no patience with stereo
typed characters, we admitted only that they might have served
some purpose in the past, while in our advanced day they ob
structed new ideas. Ibsen s literary challenge seemed to be our
opportunity. Molding minds through the theater, he was edu
cating the public to make room for free self-expression. How
valiant and idealistic was youth at the turn of the century!

Some of my professors considered Ibsen a prophet. In Berlin
and Vienna I had heard physicians laud Ghosts and The Wild
Duck. The majority of them felt kinship with Ibsen s ap
proach, attack and treatment; to them he seemed to resemble
a doctor in his diagnosis and remedies; his analyses of sick indi
viduals followed both scientific and humane principles.
Through the interwoven revelation of character students could
observe the dramatic actuality of difficult cases, for which medi
cine and psychoanalysis have since documented names and his-

97

98 A WOMAN SURGEON

tories. My colleagues, likewise, appreciated Ibsen s explicit
candor, for they recognized that he was helping to break down
the prejudices and superstitions which they themselves con
stantly faced and tactfully had to combat.

In Christiania I heard that the great playwright was irascible
and resented the intrusion of strangers. I sought specific advice
from a friend.

/ "My dear/ she replied, "you will continue to enjoy his writ-
fags more if you do not meet him. "/

* Baffled, I urged her to inform-rne of his well-known habits,
and learned that he rose, at seven, took an hour and a half to
dress, ate a light breakfastnot more than a morsel of bread and
a small cup of coffee. Punctually at nine, he went to his desk
and wrote steadily for four hours resting himself by an occa
sional stroll around the rooms adjoining his study while smok
ing a short pipe, which he put aside as soon as he resumed
work. At the stroke of one he would go for a short walk before
his midday meal, which he usually took alone./

The next day at noon I went to the Grand Hotel and frankly
told the clerk why I had come. He indicated Ibsen s favorite
seat near the window. I took a chair near by, occupying myself
with a book. At a dinner the evening before, I had been told
that he was so punctual and regular in his habits that the town
clock and all watches might be set at one, or at eight in the
evening, by his crossing the threshold of this hotel. Just before
the hour, I saw him coming down Carl Johans Gade. As soon
as he seated himself, the waiter brought him a bottle of brandy
and one of sparkling water. Slowly, meditatively, he sipped his
glass and smoked his pipe, as if weighing the hereditary values
of a character he was evolving. The glitter of his gold spec^
tacles kept me from seeing the most expressive and revealing
feature of his face, but I knew that from time to time his eyes
observed every one who passed, and from behind the shelter of
his newspaper he saw all the life in the lobby cafe.

He did not appear as grim and austere as legend had painted
him. What was it about him that seemed so oddly familiar and
lessened the austerity? Suddenly I "knew. The shape of his
head, his walk down the lobby-they resembled my father s. As

IBSEN AT HOME 99

tender memories of sternness flooded over me, all my appre
hension departed. I knew I would feel at home with Ibsen,
even though he appeared joyless. His mind could not all be
the color of his somber broadcloth.

Soon after Ibsen returned to his home, a large house on
Drammensvej opposite the Royal Gardens, I rang his doorbell
and left my note of introduction with my card, on which I
wrote that I would, if agreeable to him, give myself the pleasure
of calling the following afternoon at two. I begged that he
would not take the trouble to reply unless he would find my call
an intrusion.

The next day I was ushered into the home of Henrik Ibsen.

According to European etiquette, I took a seat near the door
in a parlor. The chairs were arranged in the formal manner
usual on the Continent and the pictures on the walls were by
second-rate Italian artists. I was disappointed to find the room
so uninteresting; I had expected to see the walls half-lined with
books. Only a Bible lay on the table.

Then Ibsen appeared, looking directly at me with a genial,
half-amused expression. Again he reminded me of my father.
His direct eyes demanded such directness that I felt comfort
able.

"You are the young lady I saw in the caf drinking a glass of
milk and looking at me while you were pretending to read a
book." Then he inquired why I had selected two o clock as the
hour to call.

I hesitated to tell him the reason. But as I looked across at
him, sitting now with elbows on the table, I decided that the
truth might amuse him. "Since you have a walk and a rest
after one o clock, I thought I might be safest in approaching
you at two. And I must say since you are so hospitable that
your townspeople do you a great injustice/ He lifted his
shaggy eyebrows. "Just fancy/ I recklessly continued, "I was
told that you have a terrible temper. My father had one. His
amiable hour was six o clock. I m glad yours is at two/ He
laughed and the ice broke.

We discussed in German why I was in Christiania and my
plans to be a doctor, but soon we were conversing about his

loo A WOMAN SURGEON

plays. I managed to get in how much I appreciated, as I sup
posed all women did, the fact that each of his plays struck a
different and decided note for women s independence of
thought and action. Saying this, I glanced at his wife, who
continued to find furniture and books to adjust in the adjoining
room during my entire visit. As he had made no effort to intro
duce me to her, I surmised that she hovered near in order to
assist him in case he wished to bring the interview to a speedy
close.

1 I ventured to ask how and where he found his material. He
replied that his characters were not Scandinavian, unless he
chose to put them in that setting, since he wished to express uni
versal truths. "I always go/ he said, "to Germany, France or
some other country in Europe where I can make the detached
acquaintance of people who I think will fit into a drama, culti
vate their acquaintance, bring out as many phases as possible of
their personalities, and then concentrate on the most vital of
these." He protested that he did not invent characters, but in
his literary building accentuated the characteristics which
most clearly revealed the ideas he could silhouette. This pur
pose fulfilled, he would return home and shut himself up until
he had written what was in his mind. He confessed that he
could not bear to hear the doorbell ring or have callers, because
they broke the sequence of his thought. He wished to live
mentally in each country where he had been, in each situation
he had evolved, until the play was finished. Interruptions he
considered the great misfortune of a literary life^

He exclaimed, "The painter, the architect and the engineer
seldom have to endure popularity; and Shakespeare was a lucky
fellow, because he died before his plays became well known!"
I suspected this attitude to be something of a pose, since public
adulation would compensate for the severe criticism he had
received in earlier years. He confided that he had been much
annoyed by an Ibsen banquet and ball given in his honor.
"The worst of it was/ he went on, "all the women in town pre
pared to represent my characters in dress and manners.
Throughout the evening they were to act as if they had just
stepped out of my books. Two ladies came to see me regarding

IBSEN AT HOME

a controversy; both wished to represent Nora, and there was a
difference of opinion as to how she should dress and act. It
had been agreed that the lady who found herself mistaken
either would not attend the ball or would represent some minor
character.

"One of my callers was quiet, the other gave me a voluble
opinion of my conception of Nora. Partly because I was irri
tated, and could not bear to have one of my characters repre
sented by her, I gave my decision, Tour adversary is right/
Whereupon the lady struck the table flatly with her palm, Mr.
Ibsen, you may think that now, but when you wrote the part I
am sure you thought what I thinkr "

He said that he read few books. His dramas hinged upon
questions of the day, and consequently he found the ways of
people as reported in newspapers more stimulating. Journal
istic highlights isolated the essential pain or dilemma of im
mediate situations more conveniently than an elaborate thesis
in the form of a novel or scientific discourse. Once he started
composition, an introspective, retrospective mood engulfed him
in which he moved freely toward the creation of his imagined
and notated drama. A book or conversation during this time
rather infuriated than diverted him.

Naturally we spoke of medicine. "I am a student, too,"
Ibsen said. "I reconstruct the heredity and childhood of each
of my characters. I write out a forework giving each person a
reasonable background, constructing family situations as influ
enced by heredity and environment, until the resulting indi
viduals are clear and convincing in my own mind. I write and
rewrite with such care that it irritates me to see my plays acted
on surface values alone. They are dramas of the mind/ /

He confided that his first responsible job had been that of a
drug clerk. In the apothecary s shop he discovered the impor
tance of compounding exactly proportioned drugs. He knew
the infinitesimal amount of strychnia which acts as a tonic; also
how more acts as a poison. In his plays he frequently refers to
drugs, as "with arsenic in it, Hedda, and digitalis, too, and
strychnine and the best beetle-killer." From those early, im
pressionable years came his accurate knowledge of diseases and

102 A WOMAN SURGEON

their symptoms, both obvious and subtle. Doctors appear in
several of his plays.

But even more valuable to a playwright was his observation
of all types of people coming into the drug shop, wanting medi
cine for a sick child, to overcome a drunken debauch, a tonic
for an ill mother, perhaps a supposed cure for venereal disease.
The appearance and the manner of each customer provided the
psychological background for every prescription filled. This
early experience affected his outlook profoundly, and later his
literary manner was decidedly clinical.

I told him that I had seen The Lady from the Sea acted in
Germany earlier in the year, and considered it the best of his
plays.

"How odd!" he exclaimed. "Most Americans prefer The
Doll s House or Hedda Gabler. But I suppose it is because you
are a doctor that the play has a psychological interest for you."
Like two congenial doctors analyzing a patient, we talked of
that study of neurasthenia. Ibsen questioned why I thought he
had constructed the play well. Obviously the unity of the
drama lay in his thorough projection of the psychological fac
tors back of Ellida s crucial decision; also the interpretation of
life which presented instincts pulling in one direction, responsi
bilities in another. Eventually the plot balanced these warring
forces; and I appreciated Ellida s renewal of health and mental
poise through the acceptance of responsibility, thereby estab
lishing an ideal for the individual and for society. Throughout
the early struggle I had wondered whether Ellida would turn
to her doctor-husband or to the returned sailor-lover, and at
the end found deep satisfaction in her triumph of judgment in
the rejection of a fantastic infatuation for real values. When
her husband tells her that she must make her own choice, she is
free; neither man dan compel her. And instinctively she chooses
the one who is just. As she turns to him, it is like seeing the
birth of a soul. Now, for the first time, there came a marriage
of mind and spirit with ier husband. Accepting the challenge
of becoming a mother to his two half-grown daughters, she takes
her place among the responsibilities and fulfilments of a devel-

IBSEN AT HOME 103

oped social world, instead of reverting madly, blindly, to the
primitive.

Ibsen smiled. His natural formality had succumbed to his
deeper natural kindness. Removing his glasses, he polished
them while he talked. As if by habit, he seemed to weigh his
words carefully. Like Tolstoi, he asked me many personal
questions, and I was impressed by the similarity as well as by
the differences in the two men. At length Ibsen took me into
his writing-room and showed me the little figures with which
he acted out his dramas, while writing them.

At the door he kissed my hand, expressing the hope that we
would meet again. I spoiled the moment by urging that he let
me put on my glove in order to keep the kiss as a souvenir. I
told him I would put the glove in a treasure trunk for my
grandchildren. I have it still.

As the years have passed and Ibsen s thunderbolts become
commonplace, I have come to the conclusion that many of the
scientific types which Ibsen wove into his plays were abnormal
especially in their lack of endocrine balance. Tempestuous
Hedda, with her (Edipus complex, was an example of supra
renal instability overbearing, antagonistic and belligerent to
every one around her. Characteristically her solution lay in
flight. The determined young woman who pushed the master-
builder to his death was thyroid-driven. Little Eyolf s mother
was oversexed. Four of the characters in The Wild Duck would
have made interesting neurasthenic patients for the psycho
analyst. Rosmer had a suicidal mania, while the egocentricity
of many other characters kept them wavering on the borderline.

Ibsen knew which reform doses would prove tonic, and thus
he was like a doctor at the bedside of society. By opening many
social and political abscesses he cured them. He knew that
candid, vivified education of society might help to cure diseases
-mental and physical-which ignorance alone perpetuates. His
treatment of hereditary syphilis in Ghosts broached a vital
social problem which only information and common sense can
solve. Indeed, if every inhabitant of this terrestrial globe were
intelligently informed and cooperative, all disease could be

1Q4 A WOMAN SURGEON

obliterated from the earth and we might begin to inhabit a
Kingdom of Heaven.

Ibsen so filled my mind with the present and the future that
I left Norway still hazy regarding the genealogy of my Matson
kin. I decided that, before taking up medical research in Lon
don, I should at least attend to my English ancestors. I found
an Elizabethan manor house and a family chapel between
Burton-on-the-Water and Stow-in-the-Wold in Gloucestershire.
In the Cathedral Library were many records of the Slaughters,
Harcourts, Garlands and Ridgeways. Satisfied of my family s
integrity, I proceeded to my study of gynecological surgery and
medicine under Sir Arbuthnot Lane, Morris, the anatomist,
and other London specialists, with additional obstetrical work
in Dublin.

CHAPTER X
INDIA: THE BUBONIC PLAGUE

How little we know what destiny has in store for us! When I
went to England to work in the laboratory of the celebrated
brain surgeon, Sir Victor Horsley, I expected only to gain a
clearer conception of the relation of brain functions to nervous
diseases. I never dreamed that such a step would lead me to
remote and mystical India and a study of bubonic plague.

But before that strange adventure, I had a foretaste of Asia
in assisting the great doctor in his experiments on monkeys, ob
serving how pressure upon various parts of the brain caused the
monkey to move a finger, thumb, arm, foot or some other part
of its body. For example, we found that when pressure was
applied to a certain area of the brain, the monkey yawned.
Mine was the task of observing whether in yawning, the jaw
deviated any, right or left, before closing.

Anti-vivisectionists may ask: "What of it?" The answer is
this: Years later, I was called in consultation on the case of a
young teacher who lay in Bellevue hospital with a fractured
skull. It was a somewhat strange case, involving a decision as to
just what area of the brain needed to be relieved of the pressure
caused by the fracture. It so happened that the patient s only
symptom was yawning, repeated yawning with a deviation of
the jaw. As I stood there surrounded by other doctors, sud
denly there came before my mind s eye a wizened little old face,
chattering and scolding, yawning, with a window in its skull,
far from its Asiatic jungle.

When my work with Sir Victor was drawing to a close, and I
was preparing to terminate my three years of post-graduate
work, he asked me to take up a permanent position in his
laboratory. But I was not sufficiently interested in research
work, to give up active practice and returning.

105

10 g A WOMAN SURGEON

"Well then/* he said, "have you ever thought of returning to
America by way of India?"

The proposal sounded fantastic. But I soon discovered it
was no idle suggestion. Bubonic plague was raging in India.
Dr. Walderman Haffkine, C.I.E., in the British Government
Laboratory at Bombay, had just discovered a prophylactic
against the three forms of plague, which arrested the spread of
the disease. To an American this should be of interest, since
the relations of the United States with Cuba and the Philippine
Islands had greatly increased its public-health responsibilities
as commerce with semitropical lands had conspicuously intro
duced the rat to the world s attention.

"Well?"

Dr. Horsley inclined his head. "No American doctors are
writing on plague work in India a commission for observation
cannot afford an extended time there to work through an epi
demic and observe Haffkine s new technique of control, and
perhaps cure. Of course, Dr. Slaughter, in the years ahead of
you, no matter how industriously you apply yourself, you will
be lost among the high achievements of men doctors unless you
contribute something special to the field of medicine. With a
woman s instinct for detail, you may call attention to unnoticed
relationships between systemic conditions and special ailments,
thereby aiding diagnosis. Probably with a woman s deft fingers
you may contribute something to surgical technique; perhaps
invent an instrument or two. But those are theoretical possi
bilities and are of less value to you and to medicine than this
immediate intensive study in India of a scourge that lies on the
threshold of America."

Grateful for his perspicuous vision, I assured him I would
not neglect the opportunity.

With a gray-haired lady, Mrs. Devin, I sailed from Trieste.
She was going to India to write articles for the Chicago Record-
Herald on the religions of India as they were exemplified in
daily living, and was willing to travel in the economical style I
could afford. As we neared Bombay English officials and their
wives, returning from furlough, gave us their views of India.
What Colonel "A" told us in the morning Major "B" denied in

INDIA: THE BUBONIC PLAGUE 107

the afternoon. We were bewildered. But after we had spent
six months in India, journeying from Amritzar to Madras, from
Bombay to Darjeeling, meeting Parsees, Mohammedans, Bud
dhists, Hindus, doctors, philosophers, merchants, poets, lawyers,
artists, teachers; English, German, Dutch and American mis
sionaries; Maharajas, Guiquars and other local rulers; we real
ized that there were at least a hundred different Indias.

In a former palace in the suburbs of Bombay was the British
Government Laboratory. Here Dr. Haffkine, a veritable wiz
ard, directed the preparation of his serum. I spent many hours
in observing the details of the process, which is today still in use
for preventive inoculation. Long battalions of bottles whose
contents were being readied, not only for India, but for ship
ment to San Francisco, Hongkong and many other cities, looked
prosaic, but they held a fluid more potent than that in Alad
din s lamp. Research scientists from six countries worked side
by side with a common purpose.

After my first day in Haffkine s laboratory I mused on the
ghastly chronicle of bubonic plague; of how Rufus of Ephesus
wrote of its devastation in Libya, Egypt and Syria three hun
dred years before the birth of Christ. Livy records that a mil
lion people died of it in one visitation, 200 B. CL The Bible
records that in the attacking Assyrian army, a hundred four
score and five thousand died of plague.

In the reign of Justinian it passed from Egypt by boats to
Constantinople, Spain and Marseilles. Soon it spread through
out Europe, where for fifty years off and on it took its deadly
toll. In the fourteenth century, by caravan routes, it swept
from China to Turkey, then to Italy, Germany, Russia and
Sweden. Its course was recorded by the writings of physicians,
who described its symptoms and the demise of high and low,
rich and poor: in China 13,000,000 died of it and through India
and the fatalistic East, 24,000,000 people perished in agony. In
London death stalked from palace to hovel. In Italy half the
population was swept into the grave. A moderate calculation
of those who perished from the "Black Death" in Europe at that
time is 25,000,000 human beings. Africa and the islands of the
sea, indeed the whole of the known world, suffered the scourge.

lo8 A WOMAN SURGEON

Ships without crews, with all on board dead, drifted hither and
thither in the Mediterranean, the Black and the North Seas,
cursing with contagion the shores on which wind and tide drove
them. On shore mothers forsook their children; the world
sickened with fear and consciousness of sin. One of the most
cruel effects of the plague was a fearful persecution of Jews, on
the theory that the pestilence was due to their having poisoned
the public wells. In Mainz alone 12,000 were murdered. In
Hungary and Germany a strange brotherhood, "The Flagel
lants/* banded together by a common dread. To expiate their
sins its members lacerated their bodies with triple leather
thongs tipped with points of iron, until streams of blood flowed
down their backs. The vulgar found their only escape in de
bauchery of mind and body. During the eighteenth and nine
teenth centuries the plague had raged throughout the world;
an epidemic in 1894 became pandemic for it swept the globe.
During this time it ravaged India continually.

I thought of all the destruction the plague had caused and
how, from before the days of recorded history until that very
moment, ignorance the cost of which can never be calculated,
the misery of which will never be measured had come to an
end in the acetate science of our day.

A young Japanese physician, Kitasato, guided by Koch, had
discovered the bacillus pestis, the cause of the plague a small
rod, short and thick, with rounded ends, which gathers enor
mous armies of its clan into the lymphatic glands (Buboes
those in the groin are called) , into the spleen and, after death,
into the blood. The deadly microbes, transported by a flea on
the rat, may enter the body through mere inhalation, through
the digestive tract, through even a slight scratch of the skin. An
other Japanese scientist, Yersin, elaborated a serum cure, and
Haffkine s prophylactic completed the victory by a prevention
of festering bubonic death, suffocating pneumonic plague and
the further spread of this scourge of humanity.

Plague is the most fatal of epidemic diseases, its mortality
varying from 70 to go per cent; it slashes its destructive way
through the body with rapid virulence, bringing death by the
second or third day. Clinically there are three recognized

INDIA: THE BUBONIC PLAGUE 109

forms: bubonic, pneumonic and septicemic. The pneumonic
form is almost invariably fatal, while the ferocity of a septicemic
attack barely allows a prostrated man time to bid his wife fare
well. The bubonic form usually begins with extreme prostra
tion, headache, vertigo, nausea, fever, deafness, expectoration of
bloody mucous and a granular tongue covered with velvety
yellow fur. Then the lymphatic glands, in which the pestis
concentrates bombardment, enlarge in the neck, in the groin
or the armpit, swelling to a purple pus-filled melon which rup
tures into abscesses. The pain caused by these suppurating
buboes demands morphine, but the patient dies from hemor
rhage, peritonitis, hyperprexia or heart failure in syncope.
Many a mother has lifted up the arm of her convulsive baby
and seeing the black swelling of subcutaneous hemorrhage or
abscess, has known her child was doomed.

In Bombay it was my privilege to study from day to day the
condition of patients to whom the prophylactic was given, as
compared to those in the same families who were unwilling to
receive it; for with the indifference of heedless centuries many
refused the salvation at hand. For three months I witnessed
miracles of medicine which in the face o stubborn, at
times insuperable, opposition, the British Government daily
performed.

Whije Mrs. Devin was visiting temples and schools, I was
accompanying Major Bannerman as he supervised the work of
his assistants throughout Bombay and its environs. The city
was divided into districts, each of which had an office in the
middle of the street in order to be easily accessible for case re
porting. We went to homes where plague cases had been
reported and to the isolation camps to which the natives were
removed. Major Bannerman told me that if I refrained from
touching the patients and washed ray shoes with a solution of
carbolic acid before I entered my hotel, I would be in no danger
and run no risk of transmitting the disease..

Profound resentment burned in the faces of the Hindus.
Had not England promised their true rulers, the native princes,
not to interfere with religious beliefs and practices? The Hin
dus had known nothing of municipal control of contagious

A WOMAN SURGEON

no

diseases, nor had Britain anticipated that health measures
would conflict with religion. But now the separation of families
and the touch of a "Christian dog -even when the dog was a
doctor-taking the pulse of a Brahmin, was defiling religious
dogma. The Government endeavored to explain that the re
moval of members of a family who had bubonic or pneumonic
plague from those not infected would protect them, their
friends and neighbors.

The Hindus stubbornly refused to accept that to stamp out
an epidemic is social justice." In order to avoid separation
from each other, they resorted to many deceptions. When we
visited the homes of the plague-stricken, we often found among
the seated figures one or more dead bodies propped up in atti
tudes of domestic handiwork. In a group of women, Moham
medans conventionally veiled, a corpse might be in the attitude
of grinding corn; another might appear to be eating. In an
other hovel the corpse of a mother held a living baby in her
dead arms. It was also the custom, as an act of affection, for a
relative usually a mother or father to receive the sputum of
a stricken person in the bare hands. In reply to our inquiries
the relatives would reply, "All is well." When night came, the
dead would be laid in the street, or if the survivors could afford
it, the body would be carried to the burning ghat, where the
carriers often fell dead beside the pyre. The mourners returned
to their homes, scattering infection broadcast. No wonder the
plague was spreading.

% Every one familiar with India s countless sacred wells, cow
temples, and tanks, sheltered from the sun, fetid with decaying
floral gifts thrown into the water by devotees, will at once recog
nize that they are a perennial source of the baccillus pestis.
The decaying vegetable matter, the slime and the continual
pollution of the water become a sort of concentration point for
the spread of disease. Only the accumulated immunity of
the Hindus keeps them from dying in droves merely from bath
ing in the refuse-laden waters of the Ganges. Generations of
men, women and children, habitually eating with dirty hands
food cooked in dirty utensils, must develop immunity or per
ish. To bathe in the sacred river is a great accomplishment

INDIA: THE BUBONIC PLAGUE 111

since it frees the body from six thousand reincarnations. No
record is kept of the numbers who doubtless do become toxic
after swallowing the putrid water. To the Hindu that would
not matter; for to go on a pilgrimage to Benares is to acquire
merit; to die there or on the return, a mark of God s favor.
When I stood looking at the corpses soaking in the water near
the burning ghat, only a few feet from the bathers, a Hindu
said to me, "This river is to us as the Jordan is to the Chris
tians. A pure stream cleansing all who drink it."

By laboratory experiment the bacilli of plague have been
found to live longest in water contaminated with organic mat
ter and in moist cool earth. In the dark huts of the poor the
floors were of earth, moistened to appease the household gods.
Saliva and excrement caused plague germs to mingle with the
dust upon which many families slept. No shoes were worn, so
even slight abrasions on the feet admitted bacilli. Likewise,
through uncleanliness in cooking and handling food, they en
tered the body. These germ-filled people had no knowledge of
how the disease traveled, nor of its death toll during the last
two hundred and fifty years throughout their country. In one
year 1,400,000 had been stricken with plague in Bombay alone.

But whether Hindu or Mohammedan, they all blamed the
English for the illness. Had they not built the railroads? Did
not the disease come on the train? Furthermore, it added in
sult to injury not to permit them the burial of their own dead
according to ceremonial traditions of caressing and fondling the
corpses and arranging them comfortably.

Major Bannerman and his assistants remained patient, even
courteous, before the difficulty of bridging ten thousand years
by sanitation. Natives, stricken or developing symptoms, were
at once removed to hospitals, isolated and possibly cured. The
families had to be placed in segregation camps. There they
were well fed and waited on by servants of their own caste.
Their huts had to be burned to prevent the spread of pestilence.
Yet every step of hygienic procedure desecrated standards sacred
to the Hindus. Native fathers cursed with uncomprehending
fury when they returned at night to find their families removed
to an isolation camp and their homes in ashes. | I watched the

112 A WOMAN SURGEON

dramatic human reactions on one side, the methodical, even
stolid, scientific progress on the other. x

Nor did the plague respect caste./ One day Major Banner-
man and I went to a palace. After the blinding sun the cool
high rooms were as refreshing as an oasis. We ascended a wide
marble stair and crossed a broad veranda to the room where the
feverish princess lay. The walls and the latticed windows were
hung with embroidered draperies in a heavy, luxuriant room.
Looking at the exotic, beautiful creature on the pillows, I could
understand how Englishmen in India were fascinated by Hindu
women. Her finely chiseled face was wan; she tossed drowsily
on her silk-draped couch. She wore handsome bracelets and
anklets; at the border of her dark hair a gold fillet held in place
a beautiful jewel. She had had fever for three days. Her
slender hand against her chest tried vainly to suppress her
cough. The glands in her neck were swelling into the solidity
of oranges.

It was useless to suggest to her anxious, aristocratic husband
that she be taken to a hospital. The only possible plan would
be segregation in the room where she lay and removal of all the
beauty that surrounded her, because the bacillus remains viable
on silk at ordinary temperature for eighteen days. She must
lie on and be covered with sterile linen sheets, disinfectants
must be used freely. The prophylactic must at once be injected
into her arms. She closed her eyes in acquiescence. Her hus
band bowed his head.

As we left the room, we saw an exquisite little figure ap
proaching along the veranda, a child perhaps two years old, the
daughter of this young princess. She wore no clothes. Her
nurse, in flowing sari, walked beside her. The child chattered
and laughed, but seeing us she became as terrified as if we had
been horned and hoofed. She had never seen white people
before.

When told that she must not enter her mother s room to be
loved and kissed, she did not scream or utter a sound, as a Euro
pean child might have done. We had come and blocked her
way, but racially she had inherited the ability to isolate herself
from what offended. With complete composure she withdrew

INDIA: THE BUBONIC PLAGUE 113

within herself, not even looking at us. I was on the point of
speaking quietly to her, but before words left my lips I realized
how intolerable my voice would be to hear. I would try a
caress. I reached my hand toward her shoulder. Ever so
slightly she drew aside. My hand dropped. Here was East
meeting West. In spite of England s good intentions, India
would ever draw herself to herself

I marveled daily that Great Britain had accomplished as
much as she had in India; also, that the Hindus, in spite of
rejecting and opposing much, accepted as well as they did the
great changes with which they were fundamentally, tempera
mentally, traditionally and climatically out of sympathy. They
have shown much more growth and courage than has been
accredited to them.

It was modern magic to learn that Haffkine s prophylactic
acted in less than twenty-four hours, thereby preventing the
development of plague even after a person had been infected,
since its actions are more rapid than those of the bacillus. Im
munization was secured, I learned, by injecting the people with
5cc. doses of the prophylactic every three months until the epi
demic was over. By this means such an epidemic as previously
had raged wholesale for years could be checked in a few days.

But despite England s persistent efforts to exterminate the
plague, little appeared to be accomplished. This was primarily
because the work being done covered a comparatively small
area of India. Secondly, if every case of plague in a single town
were cured and the villagers persuaded to adopt hygienic con
ditions of living, by next year, their fright having passed, they
would grow lax. Many trained in hygiene would have left on
business or pilgrimages, others would have come from neighbor
ing towns bringing with them unclean personal customs.
Third, natives who had light cases of the plague and had fled
to other towns would return, bringing in their systems atten
uated bacilli, which under favoring conditions regain their
virulence. Likewise, Hindus returning from pilgrimages
through thousands of villages, and Mohammedans returning
from Mecca, Egypt and other corners of the Orient, where they
had been in contact with plague sufferers, would carry infection

114 ^________ A WOMAN SURGEON

in their bodies or on the dark folds of their garments. The
bacilli may live in clothing for ninety-seven days. These would
precipitate a new epidemic as soon as winter caused the people
to live again in close quarters. As a consequence the work of
the Government has to be done over each year.

The description of one house in Bombay will, perhaps, show
the difficulty under which the Government sometimes worked
and how, although the prophylactic is efficacious, Yersin serum
is curative, and the plague officers are faithful and watchful, the
results are discouraging.

We passed through a dark hall into a small court which,
though cleaned under police inspection the day before, now
contained old rags, human excreta and decayed vegetables.
From this court we entered another long passage, climbed a
flight of rickety steps and reached a short, totally black halL
Opening from it was a room about six by nine feet with no
window. We passed through this into a similar room. The
house was a veritable honeycomb of dark, foul chambers,
lighted only by earthen lamps in niches of the wall, giving out
from their rag wicks more smoke and smell than light. In one
such room a woman was cooking, in another a man lay dying,
in another a rigid outline under a heap of dirty rags indicated
a corpse. The authorities removed the dead Hindu, disinfected
the room and placed a small circle with a line through it on the
house door to show that a death by plague had occurred there.
The date of the person s death was chalked above the central
line and below it the date of disinfection. In the course of the
night, the owner of the house removed all traces of this warn
ing, because its presence depreciated the value of his property.
He promptly rented the room the next day to a pious Hindu
who purified the place o its Christian contamination by cover
ing the floor thoroughly with cow urine and dung two very
holy substances. Before his death the plague victim, whose
corpse was removed, had circulated freely among his neighbors.
But to disinfect the whole house would cause a riot among the
hundred and fifty other inmates.

When Dr. Haffkine first introduced his prophylactic, the
supersensitive consciences of the Hindus shook with alarm be-

INDIA: THE BUBONIC PLAGUE 115

cause of the animal basis of the culture medium. Pork and
beef being abhorrent to the natives, serum was obtained from
goats flesh, until this nettled the religious scruples of other
sects. To quiet the pandemonium that ensued, Mr. Gibson in
the laboratory at Parel prepared a medium out of wheat from
which the starch had been washed. Even so, small progress
would have been made if many influential natives had not
asked to be treated by English methods and urged all their em
ployees to submit to inoculation. The example of Sir Aga
Sultan Kahn and various Parsee leaders led to an acceptance of
the prophylactic as originally prepared.

"Why, then," I persisted in inquiring, "is there still an in
crease in the plague death statistics?" The answers were ra
tional. With the growing confidence in the authorities, cases
are no longer concealed, but are, each year, more fully and gen
erally reported; therefore, although more cases do not exist,
more appear on the statistic sheets. In addition, many cases of
ambulant, septicemic, pneumonic and intestinal plague for
merly not recognized as such were excluded from the statistics.
In some sections the natives, seeing the good results of inocula
tion, went from absolute distrust of it to the opposite extreme
of unreasonable faith; when their expectations were not
realized, they quickly called attention to the fact.

Another cause of the increase, as shown by statistics, is the
growing cooperation between native and English doctors. As
a result, they now report, instead of concealing as they did
formerly, cases of plague coming under their notice. The
Government recognizes that the native doctors have consider
able skill in dealing with the disease. When given a trial they
succeed in curing a fair percentage of cases. One of them has
been placed in charge of a hospital in Bombay. The result of
this innovation has been the growth of a much more friendly
feeling on the part of the natives.

The missionaries were of incalculable benefit in arresting the
plague. One of the most active, Dr. Bertha Caldwell, a college
mate of mine who thoroughly understood the people among
whom she worked in Allahabad, had through her skilful medi
cal work gained their confidence and, therefore, easily per-

Il6 A WOMAN SURGEON

suaded individuals to be inoculated who had positively refused
it at the hands o the plague officials. They would not believe
that wearing shoes and being cleanly prevented the Europeans
from catching the plague. They believed, on the contrary, that
it was either a curse brought upon them by the God of the
Christians, or some scheme of the English to weaken and de
stroy them as a race. So persuaded were they of the truth of
this latter assumption that it was often impossible for the plague
officials to enter a house in Allahabad at that time unless all the
adult inmates in it were dead and only children, unable to de
fend themselves, remained. These would be taken to segrega
tion camps, the house unroofed, the straw burned, the floor dug
up and disinfectants liberally used.

The plague spread like wild-fire, once it was ignited; the
chief difficulty lay in effective policing. Men of the "domes"
caste, those who bury the dead, perished in such numbers that
not enough survived to dig graves for the Mohammedans;
neither was there enough wood to build funeral pyres on which
to burn the Hindu dead. The streets were deserted but for an
occasional passerby who was likely at any moment to drop as he
walked. Shops were empty.

In the last epidemic at Allahabad, where 28,000 died in a
short time, the authorities were compelled to fasten long lines
of corpses together, the ankle of one cadaver tied to the wrist of
another, and drag them by mules to the river where they were
cast to the crocodiles. This method, of course, involved danger
in spreading the infection, as bits of contaminated flesh clung
to stones by the roadside, but it was preferable to leaving the
unburied bodies in the streets and houses. Curiously enough,
the grim undertakers to which these hapless victims of the
plague were thus consigned suffered in no way from devouring
the disease-infected bodies which swarmed with plague bacilli.
Examination of the stomach of a crocodile, soon after it was
known to have eaten one of the corpses, showed that the bacilli
liad been destroyed. The same fact was observed in the stom-
aclis of the vultures which quickly devoured the bodies of
Parsees exposed to the elements in the open-topped "towers of

INDIA: THE BUBONIC PLAGUE 117

silence/ Here may be found a substance of service to
humanity.

An interesting test was carried on at Undhera, a village six
miles from Baroda. Dr. Haffkine, accompanied by Major
Bannerman and a number of prominent men of that district,
including local physicians, conducted a house-to-house canvass
calling out the inmates from a census paper. As each house
hold collected in the street, half the number was inoculated,
half left untreated, efforts being made to divide them equally as
to age, sex and conditions of health. In a family where there
were two children, one sickly, the other strong, only the sickly
one would be inoculated, the procedure being reversed on the
next similar occasion.

Six weeks later the inhabitants of this village again were
called from their homes. Among the 512 inoculated, there had
been only three deaths. Among the 437 uninoculated, twenty-
seven had developed plague of which twenty-six died. In two
huts which stood side by side, all the uninoculated had died.
Only the inoculated were able to come out and answer to their
names.

The Hindu s sincere belief in the transmigration of souls did
not help to make the physician s work any easier. Those of low
estate who did not break caste looked forward to having their
souls pass after death into a higher estate; to them death was
welcomed as the door to a more comfortable existence. If, on
the other hand, all the rules and traditions of caste had not been
kept inviolate, the soul would pass at once into an animal.
Many of the sick had a cow brought to the bedside, their last
strength being expended in grasping the beast s tail in order to
enable the sdul to enter the venerated animal. Without this
precaution the soul might enter the body of a rat or even a flea.
In that case the long series of upward migrations to Nirvana
would have to begin all over again.

/A. Yogi explained, "Life can be comprehended only in part
in each incarnation. No one can obtain complete understand
ing, for truth is too extensive to be grasped in one lifetime, and
it is only when we have lived many times and acquired as
sembled knowledge that we can teach those who wish to learn."

A WOMAN SURGEON

He went on to deny that his people worshiped animals, to say
rather that they saw the godlike attributes in all creatures: "His
strength in the bull; His helpfulness in the cow, whose milk
nourishes; His sagacity in the elephant, which can direct other
elephants/ Naturally, dying men would desire to have their
souls pass into one of the most virtuous of God s creations./

These religious delusions worked against the British doctors
in three vital ways. First, if a Christian touched a Hindu, as
was necessary in testing the pulse and the percussion of the
chest, a grave religious risk was run. Fortunately the use of the
stethoscope saved the situation. Also, medicine prepared or
administered by a Christian, or by one of lower Hindu caste,
was unthinkable, making it necessary for native technicians to
prepare both the prophylactic and the curative sera. Other
native doctors, under British guidance, had to give the hypo
dermics, the medicinal and the therapeutic treatments.

> . Lastly, no animal, even if plague infested, could be killed.
Si^ch was tantamount to murder of a friend or relative. Con
sequently, dogs, rats and other plague-transmitters ran ram
pant, although it had been known for ages that before an out-
break of the disease among human beings, "the visitation was
preceded by an epizootic among rats, which losing their
timidity, staggered with bleary eyes from their hiding places
and fell dead."

y/To the black-abscessed, choking inhabitants of India, Eng
land s expenditure of time, energy and large sums of money to
create and maintain cleanliness, willingly devoted to the saving
of lowly lives, was incomprehensible madness. It was also, they
thought, at variance with Christian theology. Did Westerners
not say that Heaven is happier than earth, worth losing one s
life to attain? x

* The faults of the Anglo-Saxon, as India sees them, result
from excessive energy idealism and action, which are an ex
pression of hyper-thyroidism. A metabolism test made on a
thousand average Hindus to determine the rate of functioning
of the thyroid and other hormone-producing glands, would
undoubtedly show a minus endocrine balance, while a similar
test on a thousand average Englishmen would be normal or

INDIA: THE BUBONIC PLAGUE 119

plus. The vegetarian diet and frequently resulting anemia of
India and the low blood pressure advantageous in perpetual
warm weather, widen the breach of misunderstanding; for diet,
climate and glandular imbalance play significant roles in history
and politics. Nordics admire ambition and courage, take zest
in achievement and adventure, demand directness, efficiency
and a rational solution to problems. They are stimulated by
opposition and plan for the future. They believe that God has
given man talents to be used to the utmost in a dedication to
His service and to that of humanity; that health, morality and
individual advancement are duties. Christianity itself is ener
getic: "By their works, ye shall know them." All the virtues
which Nordics admire and desire exhibit high thyroid poten
tiality just as their faults and vices are energetic.

Hindus, on the contrary, do not wish to be disturbed by
practicality as they seek the essence of spiritual life in the r$-
moval of themselves and their minds from the real world. They
measure success in life by the degree to which they can separate
the spiritual from the material axiomatically; they believe that
man conquers only as he withdraws from life, and true attain
ment exists in abstract contemplation of the mysteries of trans
cendentalism. Lacking any concept of responsibility, they
make no effort to alter conditions which induce poverty,
famine, illness.

When I visited Annie Besant in Benares and heard her extol
the glory of this negative religion, I asked her how it worked
out in the lives of the people, what charities it supported sys
tematically, where I might find asylums for the old, crippled,
deaf, dumb, blind and insane. She slowly pressed the folds of
her sheetlike garment as she sat tailor-wise and smiled
tolerantly.

"We do not believe in that form of charity," she said. "The
Hindu benevolence is the most humane of all. It is more dig
nified to give directly to the needy, for the alms a rich man be
stows on a beggar ennoble both himself and the beggar."

I had seen thousands of Hindu beggars struggling to live on
this "personal charity" and I had not been impressed by their
dignity nor any subtle veiling of noble character. In Puri by

120 A WOMAN SURGEON

the road over which the great god Jurganath rides each year in
his mighty car on his trip from his winter to his summer temple,
I had seen a little Hindu lad lying under a huge stone that
covered him from breast to thighs. He appeared in momentary
danger of being crushed to death. Sitting unconcernedly near
his lamentations was a group of chatting natives. Annoyed by
their cruel indifference, I hastily pushed the stone off the child
and demanded why he was being punished thus. The only
reply was a smile. The boy sat up and stopped crying. We
went on to the summer temple. On our return we heard the
same cries and found the boy under the rock again, holding out
his hand for alms. On many other roads the way is entirely
lined by lepers and professional beggars of all sorts. The rich
man passing by haughtily throws them a few pennies.

Mrs. Besant called my attention to the existence of a small
native hospital and a few "rest homes" in Benares, as examples
of the generous, unquestioning charity of the Hindu. At these
shelters any wayfarer might stop at will and rest. Later I went
to see them and found them mere roofs supported by posts. A
traveler might lie on the ground or infrequently on a shelf,
which served also as a seat. There were no walls, nor the least
suggestion of comfort and protection.

But to Annie Besant the Hindu religion was a glorious white
contentment, in which she praised the deep piety and high
civilization of its devotees. She does not see that the disgust
ingly filthy floors of the cow temples make them more like the
Stygian stables than places of worship. She does not see the
lewd rites and carvings in the temple by the sacred Ganges. To
her, as to all religious India, these are associated with purity,
beauty and self-denial. To the British doctors, to me, to all
Anglo-Saxons, they remain inexcusable and distasteful. Even
the emergencies of bubonic plague could only faintly har
monize our discrepancies.

CHAPTER XI

HOMEWARD BOUND

THE six months of work in India raced along, as I wavered
constantly between fascination and horror. As a physician I
was interested in the Mohammedan howling and dancing der
vishes, as they swayed and moaned in ecstasy, especially in one
who stood upon the body of a little child, ostensibly to cast out
disease. Fakirs along the roadside, with their grotesque physi
cal disfigurations and self-imposed tortures, amazed me with
their demonstrations of human endurance when they recovered
from being buried alive. And the plight of the child-wives and >
of the widows pulled at my heart, as I wished that I might do
something to alleviate their hardships.

But I was charmed by the various refinements of home life
among the high-caste Parsees, Hindus, Mohammedans and
Buddhists. Sometimes we found discontent. Since Mrs. Devin
and I were neither English nor missionaries, both men and
women spoke to us freely. Women would sometimes confide
to us that they envied our freedom. The Myzani of Hyder
abad, a reigning Indian princess, confessed that oriental splen
dor palled upon. her. Her palace abounded in her most recent
diversion mechanical toys of gold; but they no longer amused
her. As we bade her adieu, she thanked us for lessening her
mental loneliness and presented us with characteristic gifts-
such as fantastic pith necklaces, specimens of betel-nut and
bouquets made of spices. The women of India nearest our
own were the Parsees. They were well educated, often dis
tinguished, and held dignified positions in their families. Par-
sees maintain justice, courtesy, health standards, and care for
their dependents; among the millions of beggars spreading
pestilence through India no Parsee can be found.

Among my strange memories of that strange land, none
comes back to me more vividly than the sight of marauding

121

122 A WOMAN SURGEON

monkeys wandering through the deserted courts of Fatepur
Sikri, the City of Victory of the Mogul Kings, who had designed
like Titans and embellished like artists, only to have this glory
shaken to the ground by animals. We found the monkeys side
by side, their tails wrapped around each other, as they used
their combined strength with destructive delight in shaking
balconies till they fell from the palace walls. Forsaking this
waste of departed wealth, we were surrounded again by the
age-old sorrow of India starvation arising from stupidity. As
the scraggy-armed, ragged women and their tottering, naked
children begged for bread, I looked at their pitiful heads, pain
fully bloated, distended abdomens, feeble, sticklike legs, and
thought of the gold and silver accouterments of the Prince s
elephants, of the jewels and magnificent robes of rajahs, of their
spiced elaborate foods, their wealth and indulgences, while rats,
moles and other pests were allowed to destroy agriculture, and
lazy natives neither planted nor garnered. I wondered how
Annie Besant could close her eyes to the selfishness and indiffer
ence of the Hindu code and fail to see that it is only the excep
tional men and women among them who have been able to
grasp and apply the Anglo-Saxon belief of noblesse oblige.

At Lahore, where English officers condemned Kipling as "an
upstart and a bounder," we learned that the temple contained
several well-authenticated personal effects of Mohammed, the
Praised. When a grumpy priest refused to admit us into the
well-guarded chamber of these holies, we were nettled. But
on the theory that a grumbling disposition is a symptom of ill
health, I took pains to sympathize with our guide and expressed
the regret that we were demanding attention when he obviously
was suffering from an acute headache. This softened his irri
tability, and we exchanged reciprocal courtesies. Observing his
puffy eyelids, his pallid skin and his irritable nerves, I asked
him a few questions, and diagnosing his ailment as nephritis,
gave him medical advice which he warmly accepted; an offered
prescription acted as a talisman. Instantly we were ushered
into the upper chamber, where the prophet s slippers, turban
and other articles of dress, as well as objects belonging to his
favorite wife, were treasured. Most sacred of all was the revered

HOMEWARD BOUND 123

red hair from Mohammed s beard, which in the course of time
would become the bridge on which the faithful would cross to
Paradise.

At Christmas, we were in Darjeeling where we looked up
to yet higher mountains and snowy Mt. Everest. Down the
slopes came a train of men and women from Tibet on their
way to market. We conversed with them through many signs
and plentiful laughter, finally accompanying the turquoise-
decorated women down to the market-place. When we our
selves came down the mountain, we boarded a toylike train that
puffed and clanged through the thick jungle vegetation. Aloft
on the engine s stack was a torch. Its flame and sparks through
the dancing shadows, swaying trees and vines, the fireflies and
smoke, and the sinuous rumble of the open cars gave me the
sense of riding on a dragon.

Before leaving India I saw the splendid medical and surgical
work being accomplished by American missionaries. Dr. Van
Allen in his hospital at Madura was so appreciated by the
natives that the hospital had gained the support of all the
people living in that province. One of my college mates, Dr.
Ida Scudder, was engaged in constructive scientific and educa
tional work in Vellore; and at Allahabad I found my former
professor, Dr. Anna Fullerton, who had inspired me to become
a surgeon, directing a hospital and teaching.

Finally reaching Calcutta, where we visited Lady Curzon, I
received a letter from Dr. Annie Young who had graduated
four years before from the Women s Medical College of Penn
sylvania. She was now a missionary in northern Ceylon. She
wrote that she longed to hear the sound of an American voice
and that she had much of scientific interest to show me if I
would come to Jaffna.

Mrs. Devin decided to remain in India during my stay in
Ceylon, where I spent six weeks. From the moment I landed
in Colombo, the New York of the Orient, and took the queer
little steamer to the Islands at the northern tip of Ceylon, until
I returned from Jaffna in a bullock cart through the jungle,
every hour jostled with new experience and interest. 1

1 Buried. City of Ceylon, published in Scribner s Magazine, January, 1907.

A WOMAN SURGEON

Annie Young s hospital was at Inuvil, where she was asso
ciated with Dr. Isabel Carr. Dr. T. B. Scott s hospital was at
Manepay, a few miles away. He and Mrs. Scott asked me if I
would enable them to have a much needed rest. They had just
lost a child, and Mrs. Scott, worn by nursing and grief, longed
for quiet; Dr. Scott, also exhausted, needed time to write his
annual report. Almost immediately, then, I found myself in
charge of the native patients.

- How quickly my appreciation of missionaries and their work
increased! My patients obstinately preferred the floor to a bed,
and would sleep under instead of on one. With a sick person
came his whole family, who camped in the hospital yard in
order to provide food and give service to their loved ones. If
they had not been allowed to camp there, they would not have
brought the patient for surgical or medical relief. This cus
tom entailed training impromptu family nurses and dieticians.
Likewise, I learned that it required five servants to do the work
of one, since, without knowing it, these people had unionized
themselves centuries ago, when they decided that only one kind
of work could be done by a single class. Consequently, the
ward was cluttered with helpers. Even so, I had to perform
the most menial tasks for myself, wondering at the same time
how much I forfeited the respect of my patients by promoting
sanitation.

One family brought their young daughter for treatment,
explaining that she was subject to fits and * possessed of a devil/
Whenever they wanted her to work in the fields, she would
have a convulsion resembling epilepsy, then would lie wooden
and speechless as though in a trance. She had no other symp
toms of any disease, and though I pitied her natural desire for
freedom from hard work and the responsibilities of being a
wife to an old man she did not love, I suspected the authenticity
of her ailment. As I passed her bed, after the first attack in the
hospital I observed her feet protruding and gave one of them a
sliarp pinch. She made no visible sign of reaction, but the next
day her feet were carefully covered. I took her pulse, which
was normal, and gave her wrist a quick twist. This slight pain
did not gain any response, but at the next visit, she lay on her

HOMEWARD BOUND 12 g

hands. Quietly I brought a pitcher of cold water and emptied
it on her head. This brought an immediate reflex, for she sat
up with a shocked start. Caught in her subterfuge, she insisted
that she had been cured by a miracle. "A miracle, a miracle!"
she shouted as she left the hospital to return to her dull, labo
rious life.

The bath women protested against my ignorantly getting
into a tub of water, for it was the proper thing to dip it out in
a basket and shower it over myself.

/One day when I was passing along -the road, a man fell from
a coconut tree. As he lay unconscious, a number of men gath
ered around to watch me examine his body to ascertain whether
his arms, legs or skull might be fractured. I asked one to help
me lift him, another to fetch a cup of water. All stood stolidly
staring. I exclaimed, "Have you no mercy?"

They calmly replied, "He is only a tree climber. We cannot
touch him."

"Why?"

With a shrug one of the onlookers clarified. "We must not
lose caste; as you are only a Christian, it does not matter,"
Explaining further, "For you, a dog-of-a-Christian "

He got no further, the hauteur of my manner checked him./
Soon a trifle abashed, these men strolled away, their curiosity
satisfied, as the man had opened his eyes and stirred sufficiently
to prove that he had not been killed.

The variegated fireflies in a cloud around my lamp wore
gayer and prettier dresses each night. Absorbed one evening
in reading, I did not notice a rustle in the waste-paper basket
until a large black snake somewhat laboriously pulled himself
out of it and kindly caught a rat which was scurrying from one
open door to another.

My volunteer relief work had endless fascinating angles,
including tarantulas, scorpions and a fierce fight between a
snake and a crow. I was sorry when it ended. At Anaradja-
pura I was called to visit two sick women. As reward I received
from the husband of one of them a set of little silver elephant
shirt studs, and from the priest husband of the other a leaf from

126 A WOMAN SURGEON

the sacred Bo tree which had been overlaid with gold leafan
offering from a pilgrim jeweler.

Mrs. Devin and I met in Kandy. After exploring the botan
ical gardens and resolving some day to have a banyan tree, we
visited the temple of Buddha s Tooth, spent hours in its library
and wondered why comparatively few people write of Ceylon,
which in its way has as many challenges and more satisfactions
than India.

It had been such a long time since I had seen a population
of Americans. In Manila my heart swelled with nostalgia. The
lads on customs duty were average youths, but to me they
seemed remarkable. The officers and their wives driving, din
ing, walking, conversing in American idioms, charmed my eyes
and ears. I was positive, too, that the United States Laboratory
in Manila under Dr. Richard Strong was better equipped than
any I had ever seen. I was eager to return to real America. I
had been away so long and learned so much in these years of
preparation. Dr. Strong invited me to work with him in the
study of typhus and malaria, but again I refused research work.
Mrs* Devin and I pushed on to China.

./There I developed violent contempt for aggressive war. We
arrived just after the Boxer Rebellion. In the white marble
temple of the Emperor s winter palace, we saw the floor littered
and piled high with rare Chinese books on which German
soldiers had walked rough shod. Thousands of them, bound
in silk woven with the Emperor s imperial dragon straining
toward the symbol of perfection, a white pearl, lay scattered,
heel-marked, soiled and shredded./"

Angrily I demanded who was in command. A well-groomed
young German officer came forward, clicked his heels, saluted
and held out his hand. I did not acknowledge his salutation.
Instead, indignant and red-faced, I asked, "How could you, a
German, permit this destruction?"

Taken aback by my challenge and by my speaking in Ger
man, he stammered confusedly, then slowly twirled his mous
tache with a nonchalant air. "If the hoch wohlgeborne gnadige
Fraulein would rescue literature, she is welcome to help her
self/ I tossed my head. "We have orders to clean up the

HOMEWARD BOUND

127

place/ he added. "Tomorrow this place will be swept out and
the contents burned."

On translating his remarks to Mrs. Devin, she checked my
protest and urged me to tell him that, with the intention of
returning them to the Chinese, we would accept the least muti
lated books.

With an assumption of triumph, the officer commanded one
of his men to fetch a few volumes and to bring a roll of draw
ings from behind the altar. The priests had hidden them there
after cutting them from the frames, praying that holy mercy
might protect the treasures from being utterly destroyed. And
it did. The officer laughingly handed me the roll, declaring
that they were so hideous it was fortunate they had been rolled
up; otherwise they would have given his men Katzenjammer.
He opened the outer one. I observed that it was a Chinese
cartoon. I had no idea what it or the rest signified, but I knew
that an extraordinary effort would not have been made to save
them unless they were of great value.

Later when I called at the Chinese legation in Washington
and showed the books and the scrolls to the minister, his face
filled with sadness. Holding a volume with the delicacy of one
who loves beautiful things, he sighed regretfully that he could
not accept our offer to return the treasures. It would distress
the priests to receive what was equivalent to one leaf of the
Encyclopaedia Britannica. The mutilated drawings could never
be placed in the temple again. Since other treasures had been
burned, I would merely reopen an old wound. The minister
presented the books and drawings to me; they were one of the
very few sets of the Lohans, or wise men.

Saddened by this evidence of imperialist barbarism, Mrs.
Devin and I sailed on toward America, stopping in Korea to
see the beginning of Dr. Rosetta Hall s work, and in Japan,
where, seeking shelter from the rain, I found Bishop Williams
sitting on the floor of his tiny house translating the Bible.

CHAPTER XII

SETTING UP PRACTICE IN WASHINGTON

ALTHOUGH I would not have shortened my years in Europe and
Asia by a single hour, I almost hailed the postal clerk in San
Francisco as a kinsman when he extended his arm through the
window and smiled, "May I welcome you? We have been
expecting you. Mail has been accumulating for months."
Many friends were in San Francisco: Miss Mary and Miss Sallie
Manson, who had guided my first scholastic efforts, and many
others from Lynchburg, who had migrated across the continent.
There was inward content in finding myself really at home
again. Mr. and Mrs. Langhorne urged me to settle in San
Francisco and take up practice, promising to help me get
launched. As anxious as I might be to pitch my tent in the
very first place in the United States, I hesitated about a decision
and went off prospecting for the most suitable location to begin
my life work. After surveying Southern California, St. Louis,
Chicago, New York, I chose Washington. Members of the old
Virginia families the "cliff dwellers" said, "You belong to us."
I could not deny it; nor did I want to. After seeing twenty-six
foreign countries, I longed to be thoroughly American.

My preference may have arisen from that heart-warming
vibration that comes to us, as though rising above a great silence,
when suddenly we hear again the voices of our own people.
Analyzed, this seems to me to stem from the fact that, if our
lives when we are children move in normal surroundings, every
one speaks to us gently. Kindness surrounds us and sorrows are
withheld from us. In every voice there is solicitude, protection,
tenderness. Therefore, from whatever part of the earth we
come, our mother tongue carries intangible meanings that stir
our faith, loyalty and happiest memories. After seeing the
suppressions and heartaches in Asiatic countries where millions
had bowed souls, I felt anew the buoyancy of spirit in America,

128

SETTING UP PRACTICE IN WASHINGTON 129

the square straight shoulders of working men and women who
had shaken off the shackles of old civilizations to build a free
one in America. Even the whistling boy who delivered the
milk seemed to me a Galahad.

And so at last I began to practise medicine and surgery.
Office furnishings I chose with joyful exactitude. The brass
plate with my name and M.D. after it fastened on the door,
filled me with satisfaction and a little awe, while vowing to
myself to justify the long heritage of my profession with con
centration of service. At once I made gynecology my specialty.
As anticipated, the study of nervous diseases became valuable
in differential diagnosis; in potentializing my education for
comprehensive work, it gave me a psychological insight as welL

The day after I passed the District of Columbia medical
examinations, Dr. A. R. Shands, whose wife I had met in Vir
ginia, called and invited me to go to a meeting of the Medical
Society of the District of Columbia. It was the first I had
attended. I was impressed by the dignity and erudition of the
members who read papers and also by the heartening fact that
several women members were present. Feeling profound
humility, I wondered if this experienced body would find me
an acceptable colleague.

The kindness of Dr. and Mrs. Shands was the most impor
tant factor in my starting practice in Washington. Most young
physicians have a doctor father, uncle or brother concerned
with their becoming established or perhaps some one who
previously has been assisted by a member of their family and
who returns the courtesy. I, however, had no one, for while
two of my brothers had been practising physicians when I grad
uated, both had gone west. One was located in Superior, Wis
consin, while the other, who had been a surgeon in Duluth,
Minnesota, had died. Through Dr. Shands I was accorded the
privilege of operating at the George Washington Hospital,
Then I was invited by the medical women, who had established
the igth Street Clinic for poor women and children, to join
them as a member of the clinical staff,

American professors who had asked me to inform them when
and where I began practice wrote to their friends in Washing-

igo A WOMAN SURGEON

ton; and some of those under whom I had studied abroad did
likewise. Colleagues of my own age were equally helpful. This
thoughtfulness heightened my belief that the world is a very
kindly place and my desire to justify that kindness.

Mrs. Devin came to Washington to make her home with me.
She was an ebullient conversationalist. Whenever I began to
utter a positive statement, she would interrupt, "Before you say
it, let me disagree with you! But pray do not let that divert
you." I had to battle with her for self-expression. But rather
than allow the conversation to shrivel, I was willing, for the
zest of discussion, to show more consideration than I sometimes
felt. If we had met for the first time in Washington, I doubt
if we should have become friends; but having shared experi
ences of travel, our divergent minds enjoyed familiar humor.
We laughed a great deal, our maid-of-all-work remarked that
we acted all the time as if we were at a party. It is not an
inadvisable pattern for any home.

Many friends were in Washington, among them Senator
Daniel and Senator Martin from the Old Dominion. Governor
Swanson of Virginia and his wife were old family friends. One
of the pleasantest of our associations was with Ambassador and
Madame Jusserand. I met this ideal Frenchman and his Amer
ican wife at the home of my sister Edith and her husband,
Judge R. T. W. Duke, Jr., in Charlottesville at a meeting of
the Alliance Frangaise. A wreath was to be placed on the tomb
of Thomas Jefferson. My thoughts raced back to the Misses
Randolph and Edge Hill! On another occasion at Monticello
I met the British ambassador and his wife, who seemed to take
an interest in my stories of the lives of the women of India.
Through new friends among the embassies, I learned more
about the countries I had lived in.

Two of my dearest friends were Secretary and Mrs. George
B. Cortelyou. She had attended St. Mary s Hall in New Jersey
as had my mother in an earlier day. Mrs. Cortelyou knew many
people in Mount Holly; we felt as if we were old friends, and
at her hospitable home I met official Washington. Among the
popular bachelors was James McReynolds, now a Justice of the
Supreme Court.. Our first meeting was gaily informal. He

SETTING UP PRACTICE IN WASHINGTON 131

recognized me by my likeness to my cousin Coleman, one of his
boyhood friends. Coming across the room with his engaging
smile, he said, "This must be Dr. Rosalie Slaughter; I shall
write to Coleman that I recognized you by your eyes."

To have all these contacts and to feel socially at home in
Washington was of inestimable advantage to me as a young
and a woman physician. I was able to make my expenses the
first year. Mrs. Devin and I were "at home" every second and
fourth Thursday, thereby concentrating our social interests
sufficiently for her to spend much time in writing and for me
to establish a practice.

Surgical work was a great satisfaction. I think surgery is
much easier, more instinctive for women; we have a lengthy
heritage of sewing, embroidering and knitting behind us, in
dividually learned at an early age. For most men, clumsily
manipulating a large needle, surgery is a sweating, nervous
task. My concentration and calmness during an operation,
on which my colleagues sometimes commented, was due to my
mother s training. To quiet an overly active child, she en
couraged me to embroider and sew. She taught me to use
needles deftly, handle scissors carefully and put everything to
gether neatly. One day she remarked to a friend that sewing
calmed a woman s nerves. My recalling this showed that it
made a psychological impression; perhaps it played a part in
preventing my feeling excited when operating; certainly swift
and accurate ease in the handling of instruments should have
come to me more easily than it could be expected to come to
a man whose youthful muscular adjustments were usually based
on hurling and catching baseballs. This enabled me to use
smaller instruments effectively and handle tissues more lightly.
Appendectomies seemed no more difficult than swabbing a
throat.

Like most women s my hands are pliable and can slip easily
into a narrow aperture; this requires only small incisions, for
given accurate knowledge of anatomy and a sensitive tactile
sense, it is easy inside the abdomen speedily to determine any
dislocation, pathological growth or abnormal swelling. Small
incisions result in less shock, shorten the operation and the

A WOMAN SURGEON

convalescence. Dr. Robert Morris years later told me he, too,
believed in small incisions, while Dr. John Deever is represent
ative of many men, claiming that large incisions are necessary
in order to see what one is doing.

Since the child of generations of musicians feels at home at
the piano and enjoys learning how to use its inheritance, it is
natural that I should possess an innate surgical sense. Fortu
nately, my education was in the methods of the "Fourth Era
of Surgery/ as Dr. Morris calls the modern surgical, bacteria-
conscious years in his book, Fifty Years a Surgeon. No chances
were taken; caution, accuracy, constant consideration of all
items, insured correct procedure.

One day while riding horseback with Dr. Hugh Young, who
was just beginning to become famous, we were talking about
the blessings American women have as compared with those in
most other lands, especially India, and he quizzed me a bit
about my study of the Haffkine prophylactic in plague pre
vention. A week later, I received an invitation from the Johns
Hopkins Medical Society to read before that august assembly
on May 20, 1903, a paper on that subject. I was tempted to
frame that letter.

From notes I had taken I carefully prepared statistical tables
of technical interest, ranging from seven days consecutive ob
servation of a group of average cases to reports covering six
months data on the number of attacks of plague and its treat
ment among picked soldiers, such as the Sepoys in their canton
ments, comparing results among well-fed and -housed men with
cases among undernourished women and children in crowded,
unsanitary villages.

Anxious to make it as complete a picture of plague control
in India as possible, I labored over the paper, for interest in
this was new in America and my colleagues wished especially to
know whether the Haffkine prophylactic inoculation increased
the liability to other diseases; tabulated evidence proved that it
did not and gave additional information in treatment and other
items of importance to physicians in meeting their responsibil
ities in the war beginning here on the plague.

Naturally I was anxious as to how it was received, and was

SETTING UP PRACTICE IN WASHINGTON 133

greatly relieved when Hugh generously told me that the mem
bers of the society who had come to the meeting, expecting to
scoff and to suggest that no more women be invited to present
papers, had found their time profitably spent.

The paper was printed in the November issue, 1903, of the
Johns Hopkins Hospital Bulletin, where it attracted the atten
tion of Dr. Walter Wyman, Surgeon-General of the United
States Public Health and Marine Hospital Service. He called
and told me that he wished to send copies of the paper to each
of the American medical men on duty in quarantine ports
throughout the world; there were not enough copies for this
purpose, so he had the paper reprinted and distributed. This
interest on his part led to my being chosen by the Medical
Society of the District of Columbia as their delegate to the
Pan-American Medical Congress which was held in Panama and
to the meeting of the American Public Health Association in
Havana which followed it in January, 1905, chiefly because
tropical diseases would be discussed at both places, and the
plague was of especial interest, owing to the fact that cases were
coming into San Francisco and other western ports. Dr. Hors-
ley s foresight caused me to bless him for having prophetically
encouraged my study in India.

Our boat sailed from Baltimore. Though its regular business
was fruit transportation, it had lately been smartened with
white paint. Many distinguished physicians were on board:
Dr. A. E. MacDonald, of New York; Dr. W. B. Chase, of Bos
ton; Dr. Seneca Egbert, Dean of the Medical-Chirurgical Col
lege of Philadelphia; Dr. Joseph McFarland, of Philadelphia;
Dr. W. Sohier Bryant, of New York; Dr. D. A. Shirres, Professor
of Neurology in McGill University, Montreal, Canada. Here
was Dora Keen, who was to become a famous mountain climber,
accompanying her father, Dr. William W. Keen, a leading sur
geon of Philadelphia. Amelia Tileston, later to become a war
heroine, was with friends from Boston.

We elected a committee to take charge of our expedition.
One of them suggested an inspection of the life-boats. The
ship s employees were not interested. We insisted. When the
oars were tested, one after the other snapped. There was no

134 A WOMAN SURGEON

drinking water in the life-boats. Such biscuits as were found
in the tins were moldy. When the boats were lowered into the
water, each of them leaked in several places. The next day a
fire drill was suggested. The crew had not the least idea what
to do. When the whistle sounded, they stared stupidly while
the passengers put on their life-preservers. A stoker said he
could see no sense in putting on life-preservers for a fire drill.
The hose was attached to the deck pump; on the second stroke
it burst. In a few minutes the pump broke. Some one hum
med the jumbly jingle:

"They went to sea in a sieve, they did;

In a sieve they went to sea:
In spite of all their friends could say,
On a winter s morn, on a stormy day.

In a sieve they went to sea.
And when the sieve turned round and round,
Every one cried, You ll all be drowned. "

Radio messages and accusing letters were sent to the company
guilty of sending such a boat out of harbor.

Though we climbed into our bunks every night expecting
to sink in our sleep, a calm sea brought us to Panama three days
late. To divert our apprehension, scientific sessions were held
each afternoon during the voyage. The papers presented and
discussed were later made an official part of the Congress.

A special train met our party at Colon. Surgeon-General
Wyman had written to the medical officers in the Canal Zone
to be attentive to me with becoming grace. I was, therefore,
handsomely escorted. Later, when we had become friends, the
officers confessed that they had supposed I would be the same
age as the general and groaningly had tried to push the bore-
some duty off upon each other. Of course, they must obey their
chief but obedience would be such a burden. When buoy
antly I descended the gangplank, they were relieved and even
jostled one another in order to win their commander s approval.

We met Colonel William Gorgas, a master in medical science
engaged in preventing the pestilential yellow, typhoid and ma
laria fevers from destroying the workmen on the Panama Canal,

SETTING UP PRACTICE IN WASHINGTON 135

as they had mowed down the French laborers seventeen years
before. His medical triumph had made the construction possi
ble. He accompanied us on our visit to the construction work
at Culebra Cut. We saw how landslides poured earth into the
divide which powerful cranes, like the hands of God, lifted out
again. We paid our profound respects to General Goethals and
his associate engineers.

To be off our steamship was such a relief that many of the
passengers expressed their joy with extraordinary intensity. Al
though our time was all too short to see the architectural and
tropical charms of Colon, old Panama and other places, several
of the white-haired solons set out to capture snails, lizards and
toads, giving a flimsy biological excuse. Others botanized plants
they could have found at home but had not sought for forty
years. After our voyage in a sieve everything attached to earth
was precious.

The Pan-American Medical Congress justified its name. For
a day and a half we enjoyed the papers presented by Dr. Jose
Ramos, of Mexico; Dr. Keen, of Philadelphia; Dr. Martinez, of
Cuba; Dr. Azurdia, of Guatemala; Dr. Biffi, of Peru; Dr. Ca-
dova, of Honduras; and Dr. Echeverria, of Costa Rica. Presi
dent Amador, who had been a physician, received us at the
Palacio. In compliment to him the little republic had set aside
$12,000 to entertain us royally. Balls, banquets, sightseeing
trips and other diversions were prepared on an elaborate scale.

We spent interesting hours at the well-equipped hospital
of Ancon, in the suburbs of Panama City. Several cases of
convalescent yellow fever were protected by mosquito netting
fastened to a framework that formed a sort of room at one end
of the ward. We also saw cases of profound tropical anemia
and one of Peruvian warts as well as routine cases in the hos
pital, which was under the superintendence of Major La Garde,
of the Army. The smaller hospitals at Nuraflores, Culebra,
Gorgona, Bahio and Colon were also under the charge of highly
competent medical officers, the isthmus was being guarded
against imported as well as local disease.

As there was no other ship available on which we could reach
Havana in time for the Congress there, we regretfully sailed on

i 3 6 A WOMAN SURGEON

the "Sieve/ as we had dubbed our craft. After five slow days
at sea, we reached Havana on January 12, to find that the ship
which had preceded ours from Colon had anchored in Havana
with three cases of yellow fever on board. Anxiety lest we be
quarantined was dispelled on learning that we would be allowed
freedom on shore provided we reported daily to have our tem
peratures taken. Even this inconvenience became unnecessary
when the health officers knocked on our doors just before break
fast each morning.

The health officer s launch was interesting. The stern had
been wired off around a cot. In this improvised room, yellow
fever and malaria cases were carried from the ships to the quar
antine hospital. Dr. Finlay, Dr. Juan Guiteras and other physi
cians had so ably carried on the work inaugurated in Cuba by
the Americans that, since the city was freed of yellow fever in
1901, not a single case had originated in Havana. Almost every
month, however, a case or two was brought from some infected
port. By receiving the patients in the mosquito-proof room,
transferring them to a similarly protected ambulance and keep
ing them in a screened room in the city, no Havana mosquito
could bite them; therefore, the Stegomyia fasciata and the An
opheles had no chance to transmit, respectively, yellow fever
and malaria.

I was invited to take part in the discussion of papers on
plague. Dr. Rupert Blue reported the work he had accom
plished in San Francisco in 1903-4. He had followed up his
discovery that rat fleas spread plague by speedy extermination
of rodents in ships, wharfs, warehouses, stores, barns and houses.
His work completed the trilogy of research experiment begun
by Yersin and Haffkine.

When we visited Morro Castle and Cavany Fortress, the
dungeons were alive with recent history. From the battlements
we could see the wrecked Maine. We heard many stories of
Spanish cruelty and saw the marks of innumerable bullets on
the walls where Spaniards had shot down their Cuban captives.
That night we attended the ball given by President and Mad
ame Palma, the first large social affair since the war.

At Las Animas Hospital Dr. Guiteras took us into the

SETTING UP PRACTICE IN WASHINGTON 137

rooms where imported yellow fever patients had recently died;
they were already reoccupied, the rooms having been disinfected
by burning pyrethrum in the proportion of one pound per 1000
cubic feet for two hours. A new building was being erected,
with double windows and doors protected by netting, eighteen
wires to the inch. Before its occupation, pyrethrum would be
burned in it; mosquitoes not killed by the fumes would be
paralyzed, fall to the floor, be gathered up and burned.

In the laboratory were many "fomites," among them old
sleeves, around the mouths of jars containing yellow fever
mosquitoes, stiffened with perspiration and dirt from the arms
of stricken patients. There was still some question as to
whether Madame Stegomyia was the sole transmitter. The
doctors and laboratory assistants had been in constant contact
with these soiled rags for years but had not developed a single
case of yellow fever. Further proofs that fomites play no part
in the transmission were that for twenty-one years no baggage
from Cuba or Vera Cruz had been kept out of New York; nor
for twenty-eight years had Spain protected herself against bag
gage from infected ports; yet from this exposure no cases of
infection had occurred. Havana and Vera Cruz were in con
stant communication, and with no attempt to sterilize baggage
Havana had escaped infection. Many other experiments proved
that disinfection to control epidemics before attention had been
called to the vital role of mosquitoes had incidentally killed
them also.

Yellow fever has never occurred where stegomyia do not
thrive. Under the magnifying glass they present well-marked
characteristicsa white, harplike mark between the shoulders,
black and white crossbars on the legs. They become infective
the twelfth day after biting a yellow fever patient, and may
continue to bite and infect every three days up to the end of
their lives, a period of 150 days.

When sailing day came, only two of the doctors would make
the return journey on the "Sieve." Mrs. Devin decided to join
the others in a suit against the company, and also in their
demand for return tickets on a safer boat. I could not afford
to risk having to buy another ticket, nor to assume a portion

i 8 8

A WOMAN SURGEON

of the legal expenses. Fortunately for me, a young teacher, an
American girl, who had taken passage for the trip from Havana
to Baltimore, could not delay her voyage. We decided to share
a stateroom, although many were vacant. We were comforted
to find that a young doctor, obliged to return to the hospital
in which he was an interne, was sailing with us.

Shortly before the boat left the harbor, a wind and rain storm
beat up a furious sea. We went on board hopeful that Provi
dence would join us on the deck, reassuring ourselves that the
storm would pass. On the contrary, we had scarcely cleared
Havana when the fury increased, becoming so severe that for
two days the captain could make no sextant calculations. The
ship rocked wherever the wind and waves carried it, tossed
hither and thither on any latitude and longitude. No one
could sleep, food could not be prepared, nor did any one want
it. By the third day the decks and the crow s nest were hidden
in deep snow, cabin windows, railings, ladders, spars, ropes and
ventilators sheathed thick with ice. The stokers, cook and
stewards went to the captain, trembling with fright, and begged
to be allowed into the lounge. They did not want to die down
in the hold, drowned like rats in a trap. Every one on board
waited for death either with courage or terror. When, ex
hausted and nerve-torn, we finally reached Baltimore, the ship
looked like a floating iceberg. And she carried a cargo of tropi
cal fruits! We had just reason to be thankful for our safe
arrival, for on her very next voyage she, the same captain and
all on board were lost.

Shortly after my return I reported on the two conventions
to the District of Columbia Medical Society. This increased
my comradeship with my colleagues and led to a busier private
practice. Occasionally I was called into consultation. Perhaps
I would have become absorbed in my profession to the exclu
sion of other interests if Mrs. Devin had not kept me in touch
with literature. She read aloud well and recounted every-day
experiences delightfully. Often when tired, I would throw

t myself across the bed in her room and she would rest me simply

)by changing my thought.

Other friends also gave the rest of diversion, among them

SETTING UP PRACTICE IN WASHINGTON 139

Edward Everett Hale, then the blind chaplain of the Senate.
One Sunday I was dining with his family especially to see a
portrait his daughter had recently finished. Mrs. Hale had just
had a birthday. She read aloud the poem her distinguished
husband had written for the occasion. In it he stated that in
their early married life he had felt reasonably sure of her un
divided affection, but that he was now greatly worried because
a number of young men had, successively and successfully, as
serted claims to her affection. They had, in fact, absorbed her
interest too much for his peace of mind. The interlopers, the
poem finally confessed, were their grandsons.

The sermon Dr. Hale had preached that Sunday had given
my spirit strength. When I listened to the comforting words
illuminated by his sure faith, I seemed to see the radiance of
Heaven shine in his face as if between us and eternity there
was a veil at the edge of which he stood, equally near to us and
to Paradise, its light reflected from him to us. Gently he said
later, "My child, there is no veil." A compensation of maturity,
I now know, is that the veil grows ever thinner.

At various times in Washington opinion arose against the
employment of so many women in the government offices, de
spite the fact that most of them were the widows or daughters
of men to whom the nation owed a debt of gratitude those
who had been killed in war or had died while engaged in the
other forms of poorly paid service to our country. Should not
men as providers for families have the preference in positions?
The question led to a check-up which proved that most of the
women employed were either educating younger members of
their families, helping brothers through college, providing for
aged or invalided relatives, or were widows supporting their
children, whereas most of the men were bachelors. The major
ity of employed women had necessary household activities in
addition to their regular work from nine to four. This extra
expenditure of energy was always a factor when they became
ill. I was interested not only in the application of medical and
surgical knowledge for these, but in the importance of consider
ing the general wear and tear of life on my patients in relation
to their special ailments. The pressure of economic and emo-

i4p A WOMAN SURGEON

tional strains had to be reckoned with in combating the toxemia
of fatigue.

The veil must have been thin for my cousin, Dr. Robert
Slaughter, who also had his office in Washington. He was a
modest, self-sacrificing man, devoted entirely to his patients.
Even when suffering severely from malaria, he went to see pau
per patients in the rough-roaded country. More than once I
saw him with great beads of fever perspiration on his brow, his
lips thin and blue, climb into his carriage and, after making
sure that the blanket was there for the horse, drive off through
deep and falling snow, the wind whirring around his muffled
ears, his sole concern that he reach his patients without delay.
To me he was the ideal physician.

1 Permanent goodness, a constant spirit of kindly solicitude
and Christian lovingness for one s neighbors are prime requi
sites for a doctor, who must never utter a word of fatigue or
shirking, no matter into what hardships the paths lead. It is
necessary instantaneously and automatically to adjust to all
types of patients, with understanding as to how knowledge can
restore the health of a patient. No one remains really sick in
mind or body, even if constitutionally ill, after the visit of a
good doctor. The presence of a trained person, using knowl
edge with authority and sympathy, removes the burden of worry
from a sick mind. A doctor s greatest joy rests in what can be
done to help a patient, and deepest sorrow rests in awareness
that nothing more can be done.x

One day, my laundress sent her daughter to say she felt "too
weak and porely" to come to work and would I please step
around to doctor her. Her shining black face was surrounded
by something which I thought survived only in early American
museums, a white ruffled nightcap with strings neatly tied
under her ample double chin. After an examination, I advised
that she notify the insurance company, to which she paid twenty-
five cents a week, as she had pneumonia and would be in bed
for some time. She could not believe that she would not "be
well next Wednesday," the next or the next.
"Why," I urged, "is that day so important?"

SETTING UP PRACTICE IN WASHINGTON 141

"The best in the week, when I meets my friends. I wouldn t
on no account work that day/"

More perplexed, I recalled that on a certain Wednesday
afternoon she had refused to clean up after an office operation
planned ahead for that day.

"What do you save it for?" I queried.

Pridefully she responded, "It s my day at the dump!"

All the years I had pitied poor people picking over ashes in
city dumps mocked my misplaced sympathy, for obviously it
was their well-guarded social opportunity, when they might,
and often did, find treasure and lived in a world of recreation
and romance.

Sallie, our colored maid-of-all-work, developed an original
philanthropic plan. She told her friends to recite their symp
toms to her and she would learn from me how to remedy them.
She described to me her non-existent serious pains and aches,
and then asked me how to get rid of the misery. In this way
she feigned cancer one day, pleurisy the next and typhoid fever
the day following. Dissatisfied with this vicarious practice, I
promised Sallie, if she would stop talking symptoms to me when
I wanted to talk waffles to her, I would freely treat the person
in whom she was most interested. I cured her aged mother s
pneumonia and we had much better waffles.^

Having a Negro servant pleased me, for I had been accus
tomed to them as a child. It was fun to initiate Sallie into the
mysteries of new recipes. She paid not the slightest attention
to what the cook book said, but observed closely the amounts
which I showed her, never failing to remember the correct
pinch of a seasoning. As she developed pride in her work and
was becoming a comfort, the benefits of my training were lost
to us. One afternoon she dolefully announced, "I mought jes
as well say goodby, Miss Rose, cause I m gwine when my
month s up. Yas m, I gwine ter git married," she added re
signedly.

"Whom are you going to marry?"

"Dat colored gent man dat comes ter see me home nights.
You done seed him settin in de kitchen, ain t you, honey?"

"Yes, but I thought he was your father."

142 A WOMAN SURGEON

"Yas m, he do look purty old, and when he s co tin he don t
say nothin , jes sits round, but he s co tin jes de same. Dat
don worry me none, but dat nigger look like he done forgot
all bout kissin . Sometimes I look at him and I says to myself,
Name o sense, Sallie, what you want ter marry dat old man
fur, he s a regular graveyard deserter, and he ain t wuth a
second-hand muffin. Den agin, Miss Rose, it s different, deed
tis, cause he acts so expensive, I jes bound to take him."

Bewildered, I asked what he did. As a smile lit her hitherto
depressed expression, her now ecstatic voice replied, "He s a
swell giver, t other day he give me a gold tooth."

One day after office hours were over and the "walk in" sign
had been removed from the door, the bell rang. As the maid
was out, I opened it. A tall, dark-haired, handsome man of
about thirty greeted me cordially; not remembering having
met him, I suggested that he had made a mistake. With dash
ing impudence and a disarming smile, he insisted such was not
the case, that on the contrary we had been acquainted for five
years. Triumphantly he produced a note which I had written
to him expressing regret in missing a call, which he had made
on my sister and me the day after I had met him.

This letter brought back to my mind a dance near the Uni
versity of Virginia which I had attended with a crowd of young
people. This engaging caller told me that he had sat back of
me in the four-seated surrey; I had worn a light veil over my
rebellious and easily wind-tossed hair. He had whispered to
the lady he was accompanying that he was going to marry me.
She warned, "Many youths have had that idea but Rosalie is
not interested. Her heart is set on becoming a doctor. She
has been studying medicine for three years, and neither heaven
nor earth will change her purpose." This admonition evidently
had not disturbed the man of quick decisions, for after five
years here he was with his mind tenaciously clinging to the
same determination. "I am going to make an impression upon
you this time, which you will not forget," he announced.

The siege began. A variety of books with marked passages
and gay notes filled my mail-box and rapidly deepened our
acquaintance. These he suggested would be the nucleus of our

SETTING UP PRACTICE IN WASHINGTON 143

future library. He sent huge boxes of the loveliest flowers,
which I knew he could not afford; when I remonstrated that
they were a great extravagance, he smilingly retorted that he
liked the prospect of marrying a thrifty girl.

Until now I had not given a serious thought to marriage.
Of course I had, as all girls have, a number of beaux, but I had
managed to keep them on the safe side of friendliness. Flir
tations did not appeal to me. My idea of an engagement was
that it could only be entered into with the absolute intention
of being speedily followed by a marriage which should last until
death; even now I cannot understand how a girl with any grain
of self-respect can allow familiarities which must cheapen her
in her own eyes. Some people are more sensitive in their elec
tric reaction to personal contact than others. In this I am
supersensitive. Electric energy is easily exhausted or stimulated
according to the mental impetus which repels or attracts. I had
liked boys because they were good pals. I was fond of sports,
had a lively imagination, was fairly quick at repartee and ob
jective in my interests. I relished the comradeship of young
men mainly because of their possibilities for achievement. A
lad without ambition would have bored me intolerably; my
friends were going to be great engineers, inventors, lawyers,
judges, governors. When I talked to them about what they
were going to accomplish, their pleasure in my expectations
found a ready conversational by-play of more interest than
adolescent love-making. Gradually there developed the idea
of preparing myself for similar achievement. From the moment
I entered college, my mind had been so preoccupied with the
acquisition of knowledge that I had seldom given thought to
marriage. If destiny had not placed a very determined young
man in a surrey, if I had not chanced to sit where my profile
caught his fancy, romance would not have come knocking at
the door that afternoon.

Several of the ablest medical women in Washington were
happily married. Dr. Sophie Nordoff-Jung had an international
reputation, as did her husband. Dr. Anita Newcomb McGee,
Dr. Isabelle Haslup Lamb and many others had successfully
solved the marriage problem; in each case harmonious comrade-

144 A WOMAN SURGEON

ship was evident. Dr. D. S. Lamb, one of, the leading men in
the Medical Society, practised with his equally capable wife.

George B. Morton, Jr., had studied medicine for two years
and had then preferred law. Already he was a practising attor
ney in New York. The summer I had met him, he was taking
special work at the University of Virginia. His ideas were
modern for igpjj; he saw no conceivable reason why I should
not continue my own work and keep house as well since, as a
matter of fact, I was doing both already. If I decided to marry
him, I must, of course, give up the position I had made some
progress in establishing and move to New York where I knew
practically no one. It would mean beginning all over again.
I debated, took another look at him and decided that the
compensations would be well worth it.

However, I was constitutionally opposed to women being
required to say "obey" in the marriage service. We agreed
between us that it should be omitted, but the minister thought
differently. I explained that the contract would be between
God, my husband, and me. Not content with a civil marriage,
I wished to have the sanction of the church; nevertheless, I
could not tell a lie; if my husband and I ever differed on a
moral issue, he would not be held responsible for my delin
quency. If I should steal or kill, I would be sent to jail; if I
committed even mild offenses against moral and economic
codes, I would have to take the consequences; obedience to my
husband would be a shabby, impossible defense. Believing
that he had a high, fine character, otherwise I would not have
considered marrying him, I would coincide with his wishes and
was willing to subordinate my preferences to his as a matter of
simple justice since, as my husband, he would be legally liable
for my bills, even though we had agreed to share our expenses
equally as soon as I began practice in New York. Earnestly I
upheld my belief.

The minister was somewhat confused. He saw the ideal of
married life only as it had been lived around him. I saw several
ideals of marriage and was not afraid to attempt the most dif
ficult. He said he would take it up with the Bishop. Reporting
everything to my fiance, I urged that if he was afraid to marry

SETTING UP PRACTICE IN WASHINGTON 145

such a headstrong lass, we should shake hands and feel no em
barrassment in returning the wedding-presents our families and
friends had sent. We would be good friends but nothing more.
He, God bless him, said that he liked the idea of a new adjust
ment to life, that we were part of a new era and had to meet a
different set of circumstances from those met by our pioneer
and intermediate ancestors. We would go valiantly forward
with our eyes on our ideals.

I had fought for independence in going to college, but I
wanted to be married in Lynchburg according to the traditions
of my family. As the carriage stopped before St. Paul s Epis
copal Church, on the grounds formerly occupied by the home
of my childhood, I thought of my mother, wishing I might have
her blessing. My brother opened the carriage door. There
stood a determined minister.

"I have heard from the Bishop. You must say obey. "

I would not allow myself to be disturbed; I had told him
how I felt. With a tightened feeling in my heart and misty
eyes, I walked into the vestibule of the church, hoping no one
would speak to me. The few minutes before the strains of the
wedding-march came through the door, I thought of the years
I had been away from home, the tenderness of the old friends
who had decorated the church, who were now gathered for the
wedding, the relatives who had come a distance, and my faith
in the man I was to meet at the altar. The beauty of the flow
ers, the candles aglow, the sanctity of the altar I was approach
ing, combined to give me a very solemn, humble feeling.

When the minister instructed us to repeat after him the
fateful words, I said with all the fervor of my soul, "I will love,
honor, cherish" there was a perceptible pause "but not obey."
A flicker went across my husband s face. The minister looked
nonplused. He could not dispatch me from the high altar.
After another pause he went on with the ceremony. I was not
sure whether I had been married or not, but I decided to act
as if I were v I snuggled happily against a pounding heart on
the way to my brother s home. The wedding-reception was in
a silver candelabra settingquite appropriate for a Virginia
maiden s adieu to her girlhood environment.

CHAPTER XIII

FIRST YEARS IN NEW YORK

IF MY husband had not been an excellent oarsman, we would
probably have been drowned on the way to our honeymoon
visit to his Maryland home. His family lived on a tributary of
the Potomac River. The wind was high, the rowboat small.
My trunk of wedding finery teetered and toppled from side to
side as the boat rocked. Water splashed over us. When my
husband assured me that he had the boat well under control,
smiling confidently, full of pride, I watched the rhythm of his
strong chest, back and arms as he. battled the heavy waves for
an hour. The family expressed their relief at our arrival in
characteristic manner: Mother with a prayer of thanksgiving,
Father with a slap on the back, big brother with an ejaculation
about our being a pair of idiots, and little brother with a hearty
"Gee, what muscles!"

So many members of my own family had passed on that I
rejoiced in these new relatives. My mother-in-law was an ex
cellent housekeeper, bustling, resourceful. My father-in-law
was a typical southern gentleman farmer, quietly humorous,
fond of a book by the fire. There were a pretty sister, two
younger brothers, a grandmother who had been an Athena in
her day, and graceful Aunt Nellie. I grew increasingly fond of
them and saw them whenever my former patients in Washing
ton called me from New York for consultation or to perform
an operation.

Meanwhile we had found a sunny apartment near Riverside
Drive, selected because of its wide hall, where we could make
a frieze of our Lohans, and a room which I could use for an
office. This would be closed at five o clock, my husband would
return home at five-thirty. For a time at least the delight of
home-making put medicine in a decidedly second place. Like
every human wren building a nest, my mind was filled with

146

FIRST YEARS IN NEW YORK 147

ruffled curtains, pictures, new furniture and kitchen utensils.
The creation of a home atmosphere and a center for family life
seemed more important than passing a new medical examina
tion in New York State. If we should have children, I would,
in justice to them, lay my work aside for a few years.

Every man, good or bad, has always a little boy mixed in
with his grown-up self. That is why a wife is a bit of a mother
to her man. When he is tired, cross or discouraged, she knows
just what to do. Her tenderness is a tremendous asset to them
both. . When he is feeling pretty proud of himself, she pats him
on the back; when he is depressed, she convinces him that he is
a success no matter what his board of directors or senior part
ner may think. While every woman discovers the small boy in
the man she loves, few men discover the little girl in the woman.
That is where I was fortunate. My handsome husband often
would say, with his dark eyes twinkling perhaps after I had
made a speech at a banquet, "My dear, other people may think
you clever, but I know you are just a dear little girl.* Which
was eminently satisfactory.

The boy and girl in us enjoyed animal stories and tales of
adventure, while in more sober fields of literature our tastes
likewise ran similarly. We cared little for fiction; our own
romance was better. We preferred history, biography, books of
travel or archaeology. But we were more athletic than most
bookish young people. However, after canoeing on the hazard
ous Potomac in courtship days, a row on Central Park lakes
made us feel like tin ducks in a china dish; and tennis on city
courts was all very well for people so unlucky as to have been
born in New York. Indoor tennis was dusty, breathless. We
gave up trying to be country athletes in a city, and substituted
horseback riding and long walks whenever we could glimpse
from a street-car trees and a winding road.

It was not long before our apartment became a family center.
Mr. Morton s family and my own nieces and nephews from
Virginia thought it an admirable time to see both us and New
York. Our visitors kept us from becoming too self-absorbed,
and I saw the metropolis with freshened eyes, as I began to
realize that the skyward architecture represented man s growth

148

A WOMAN SURGEON

in knowledge of the best use o space, light, ventilation and
securityexpressed in forms of utility and beauty.

My husband must have known my mind better than I did,
for he soon suggested that I take the New York State Board
examinations in order to be able to begin practice. He knew
that when the first excitement of a new home had worn off, I
would become restless, and like many husbands of today be
lieved that a wife is a better companion if her mind is active.
So we reviewed together, as he renewed his knowledge of medi
cine and I sharpened mine. When the time came for the ex
aminations, he was more excited than I. Each day on the way
to his office he escorted me to the class, just to bring me luck, he
said, and wore a blue tie to prove it. He even claimed to be
perfectly willing to put blue ink behind his ears if that would
help me. These tactics were of undoubted value. I received
my certificate to practise in the State of New York.

Of course it took time to become established, but luckily
several members of President Theodore Roosevelt s cabinet, at
the end of his term in office, moved to New York. I continued
to care for the families of those who had been my patients in
Washington. Several Southern girls who held positions in book
stores, others who were at the Three Arts Club studying art
and music, had heard from my nieces in Virginia that I was
starting practice, so placed their health in my care. My hus
band s office associates consulted me; the elevator and delivery
boys, as well as the cook s family. Therefore I did not have
weeks or months of waiting.

As it chanced, my husband was my first New York patient.
When we had cozy Sunday suppers, as we often did, the maid,
having left everything in readiness, departed before the guests
arrived. We enjoyed using our new linen, glass and china. Jt
was fun later to clear up everything ourselves.

. One evening after Mr. Morton had escorted an elderly guest
home while I washed the dishes, he was standing on a chair plac
ing a cut glass bowl on a high shelf. Crash! the heavy bowl
shattered. A piece cut deep into his leg and stayed there. Blood
spattered. First aid plus was at hand. A tourniquet soon con
trolled the hemorrhage. The table, lately so festive, became

FIRST YEARS IN NEW YORK 149

useful to give easy surgical access to the wound. A local anaes
theticthe glass out, the tissues guarded against infection, six
stitches, dressing and bandage, completed the evening.

The human side of practice deeply interested my husband;
as a lawyer he also saw much of the seamy side of life. It was
often his duty to help selfish people gain selfish ends. While
this aspect was relieved by occasional generosity, there were no
such constant fine levels of selflessness as a doctor sees daily.

A city position which I held for several years was that of ex
aminer of applicants for city employment. It gave me for four
hours a week an admirable opportunity to study human nature.
Men and women applied for every type of work scrub women,
policemen, playground directors, doctors for municipal hospi
tals and many other groups, diverse in age, mental development
and background; all had an equal chance. Those with defec
tive vision, speech, stiff joints or other obvious physical defects
were, of course, soon eliminated. Eventually those in the upper
educational ranks reached the Civil Service Examinations. All
this was an education to me as well. I had thought that health
was more or less a personal matter. I learned that a worker is,
in effect, a piece of municipal machinery, guaranteed to ac
complish a certain amount of work in a given time. Good
health then is a public duty and necessarily a public responsi
bility. The applicants for the position of teachers of physical
training were a fine energetic group. Applicants for night
watchman or for scrub woman were a motley crew, among them
a pitiful number of incompetents; some were hard-muscled,
heavy-faced human automatons. Although the history of each
case was limited to previous disabilities, we could tell a vast deal
about physical conditions from the way in which applicants
were dressed, walked, talked, held their heads, answered ques
tions, their voice and manner, the color of their skins and hair,
use of cosmetics, the directness of their glance, their manner
and depth of breathing, their habitual pose when standing or
sitting.

Women were examined one day, men another. Routine
heart, lung and eye tests were easily and accurately made. Ef
ficient methods instituted by Dr. Henry P. de Forest tested by

150 A WOMAN SURGEON

a single act the condition of neck, back, shoulders, elbows,
fingers, hips, knees, ankles and toes that of lifting a dumbbell
from the floor to the greatest height possible, with fully ex
tended right arm, then left, while standing on tiptoe. Comic
were the antics of some, supreme the ease of others. This test
required less than a minute per person and eliminated all who
had rheumatism, joint disabilities, or were otherwise muscle- or
ligament-bound. The appealing nature of widows with chil
dren to support inclined me, when the margin was narrow, to
be governed by need rather than by physical fitness, until it was
impressed upon me that my duty to the city, in its effort to
secure efficiency, granted me no discretionary powers, especially
because the expense of disability pensions and possible lawsuits
must be avoided. Out of five thousand the best two hundred
and fifty had to be chosen for each specific occupation. Cour
ageously many who failed returned in better health to reapply
the following year.

New York policemen are examined yearly and must remain
in perfect health, to retain their positions or to apply for pro
motion. Accuracy of ear, eye, strong muscles, general endur
ance, strength of wind and limb, are essential. They are as fine
specimens of humanity as those in any army of picked men
anywhere, at any time, in the world s history. When they
apply to enter the service they are put through varied gym
nastics to determine whether they may become applicants for
"the force."

One day when Dr. de Forest, Dr. James P. Warbasse and I
were busy listening to heartbeats, taking blood pressure tests,
counting pulse rates, and at other silent activities, we were dis
turbed by a great commotion outside the door. I went to the
door to ascertain the trouble. There stood a hot and bothered
young man, hair, shirt and tie all awry. A champion swimmer,
who was slightly deaf as are many swimmers, supervised the
athletic tests. He explained that this man had hurdled a
barricade several times successfully, had carried a bucket of
water to the top of a ladder without spilling it, had jumped,
run and wrestled with considerable skill, but for no reason at
all had stopped in the middle of the tests, refusing to complete

FIRST YEARS IN NEW YORK

them. The swimmer was angry that the young man should
give up so late in the police tests.

The exasperated applicant blurted out, "I came here to get
a marriage license; if all this is necessary I m through!" We
hastened to explain that the marriage license bureau was on the
next floor. A much relieved young man was escorted with
apologies to its demure domain. -

One night I was called in consultation on an operative case
by Dr. Fielding Lewis Taylor, to the New York Hospital at the
theater hour when traffic was dense and clogged. I instructed
the taxi driver to make all possible hasteeven if he had to
cross the streets against a red traffic light. He looked at me
reproachfully, "Well, who ll answer for it in court? * I ex
plained that in an emergency a doctor has the right of way.

It was not long before an officer strode up to the cab with a
"You are under arrest" expression on his face, and the taxi
driver sank lower in his seat. He had little faith in my card.
But as soon as I had explained the nature of my business the
officer wrote something under my name, and handing it to the
driver told him to show that to any other policeman who
stopped us. A miraculous change came over my driver. His
eyes acquired an imperious expression, his lips curled and his
chest swelled as he drove past a dozen cars and sped from Fifty-
ninth to Eleventh Street in mad haste.

The consultation completed, the husband of my patient
accompanied me to the waiting taxi; his appreciative words
were overheard by the driver, who, as soon as we were under
way, was quick to grasp an opportunity. He was now con
vinced that I was an outstanding surgical authority. He sug
gested genially that if I wasn t in a hurry any more, would I
mind if he drove me around Central Park while he consulted
me about his own health, that of his wife and their two chil
dren? He added that he wouldn t charge me anything extra
for the time. I wrote my clinic hours on my card for his wife,
and gave him another for the hours when his children could
have attention at the dispensary of the Physicians and Surgeons
Hospital in Fifty-ninth Street. He declined one for himself,
"I couldn t support them if I had to spend half a day twice a

i 5 g A WOMAN SURGEON

week at a clinic waiting my turn in order to get well/ I was
obviously his only chance of gaining the information he needed,
so I rode around long enough to hear a detailed, confused
history, give him two prescriptions and a good deal of dietetic
advice which he needed and which I hope he followed.

During my first years in New York I was a member of the
medical staff of the Teacher s Retirement System of the city.
This occupied an office evening once a month, house and hos
pital visits to extreme cases. The position held many angles.
If a superintendent wished prejudically to have a teacher re
moved, a health excuse might be trumped up, appear impersonal
and be difficult to combat. A teacher wishing a vacation might
claim disability which did not exist, or one which existed only
in the schoolroom, as in the case of a woman who had sinovitis
from the effects of chalk dust but during the summer was in
lusty health, conducting a girls camp.

According to law, a percentage of each salary is deducted
from the pay-roll each month and put aside toward a retire
ment fund; if after thirty-five years the teacher wishes to retire,
this accumulated amount, plus the interest thereon, becomes
available. In case of permanent illness or death, the propor
tionate amount due is paid to teachers or to their heirs. In
case of death we were required to give a full account of the
cause. The law has three benefits; primarily, the interests of
students to insure for them adequate instruction; second, pro
tection to the tax payers of the city, insuring the best educa
tional use of their money; and third, justice to the teachers in
providing against imposition, old age and permanent disability.
Late one evening Dr. de Forest and I were notified that we
were to go to see a patient in the suburbs of Brooklyn, a teacher
who had been confined to her bed for- some weeks with paralysis
of the legs. She was reported to be sinking rapidly, not
expected to live through the night. It had been snowing
heavily for some hours. We had difficulty in finding the loca
tion of the house and were thoroughly chilled by the time we
reached a small two-story frame building in a remote district
of the city. It stood at a twisty angle far back from the road,
well apart from its neighbors.

FIRST YEARS IN NEW YORK 153

The only light issued from a dirty upper-story window; its
murkiness did nothing to illuminate the pathless space between
the road and the house; there was no fence with a gate to
indicate the way to the entrance. With the aid of electric
torches, we at last found a door at the back of the uninviting
building. Dr. de Forest pounded and knocked; but the only
response was a dog s ferocious bark. He pounded harder and
presently the clumsy clapping of slippered feet sounded on
stairs and a querulous, half-frightened voice demanded what
we wanted. After explanations the door was cautiously opened,
and we followed a woman in a torn skirt and a shabby unravel
ing jacket up a narrow stairway. We were met at the top by
an older woman, probably her mother. Scraggly gray hair
hung over her wrinkled face. She unfolded her faded shawl
to extend her arm and point a scrawny, shaking finger toward a
room at the end of the hall.

We found, lying on a bed, a sweet-faced, frail woman, who to
our astonishment was covered only by a sheet which threatened
to blow off the bed at any minute from the force of the icy
wind coming through the half-opened window. With a wist
ful smile she looked wonderingly at us and inquired to what
she owed the honor of our visit. She was genuinely, helplessly
surprised.

The slattern in the slipshod slippers beckoned me to come
out into the hall, leaving my colleague to examine the patient.
The woman said she was a sister of the patient and then in a
whisper, "Do you have to tell her you re going to report her
sickness to the retirement board? She don t want to be re
tired. She thinks she s goin to get well. Can t you just slip
in your opinion before she dies to make it all right for us to
get the money?"

At that moment there were sounds of a struggle behind a
closed door at the other end of the hall. As the door swung
part-way open, I caught a glimpse of a large angry dog fighting
to get out. A man jerked him back by a large chain which
clanked heavily. The door was kicked shut. I heard the dog
growl and whine as if he had been kicked.

"He s a fierce one," muttered the old crone who was stand-

154 A WOMAN SURGEON

ing near by. "A neighbor s dog we re takin care of im for
the night/ she added nervously.

My suspicions were thoroughly aroused. I was sure that
there was a sinister reason for the dog s presence in the house.
Why was not such a huge, fierce animal kept in the basement?
I stepped into the slovenly kitchen to get a glass of water and
there I found much to confirm my apprehension that the
patient would never recover if the family could prevent it.
Although they told me that they expected to remain in the
house indefinitely, it was plain that everything was in readiness
for a hasty move. Clothes-baskets and boxes packed with china
and kitchen utensils stood near the door. The untidy room
had little appearance of being used.

A thousand questions raced through my mind. By what
freak of heredity was this teacher born into a family of parasites
a thousand years removed from her in the progress of evolu
tion? Had they deliberately chosen this remote house when she
became ill so that neighbors could not hear her cries? Why
hadn t they sent for a physician sooner? There was no evidence
of any food in the house such as an invalid should have. I
wished we might take the patient away with us, but unfortu
nately we had no authority for such an act of mercy.

Dr. de Forest was waiting for me to examine the patient
also; she was blue with the cold; when I asked the mother for
blankets, she shook her head, shrugged her bent shoulders and
said it was too much trouble to wash them. "I m worn out as
it is, washing messy sheets every day. Every day and half the
night for weeks and weeks. She is going to die anyhow. The
sooner the better. We need the money it takes to keep her."
The sister approached and with a shifty glance whispered,
"How soon can we get the money? We want to be sure of it."
Keeping my voice even, I asked, "Who is responsible for the
care of the patient?" There was a noticeable pause before each
accused the other of having entire responsibility.

"Don t be too hard on me," sniffled the old woman. "I m
wore out takin care of her. What with her bowels movin all
the time even when we don t feed her, seems like she won t
never die."

FIRST YEARS IN NEW YORK 155

From the car I brought in several robes which we bundled
around the sick woman and told her that she must get some
sleep.

"Oh, I can t/ she trembled. "I m afraid something dreadful
might happen to me if I lost consciousness/

I assured her that she could sleep comfortably that night
without fear. She gave me a comprehending, grateful smile.
As we left, the mother and sister asked how long it would be
before our report was acted upon. They could not carry out
their intentions until this was done, so I answered, "Several
days/

Back in the car I remarked, "They can t use that dog
tonight/

"Sentimental, nervous or second sight?" inquired my com
panion.

I could not tell, but I suggested that whatever money was
due the patient be applied at once to her care with a private
nurse in a sanitarium. That very night we wrote two letters
which brought this about. Every comfort was given to the poor
woman during the remaining two weeks of her life.

Often a doctor is called upon to run great risks in carrying
out professional duty, but it is taken as a matter of course; yet
often those unheeded perils swing back with a knife-edged
boomerang. One of my patients, a woman physican from a
western city, was suddenly overwhelmed by a danger from the
past of which she was wholly unconscious. Intellectually
ambitious, when she moved to New York, she had taken a Ph.D.
at Columbia in addition to the State medical examinations.
But exhaustion crippled her. It was August, and I advised her
to go out of town to some cool place where her most active
moments could be spent lying in the grass, listening to the wind
in the trees.

I was so insistent that she left my office for the railroad
station. To hasten her going, I promised to pack and send her
suitcase. When she arrived at the depot, her mind swung like
a pendulum between going and not going, as a tired mind
usually does, and she called me on the phone to thrash over
the same arguments. A few minutes after she hung up the

Ig 6 A WOMAN SURGEON

receiver, a strange voice called, "Could you give me the name
and address o the lady who just spoke to you? She fainted as
she came out of the phone booth. I got your number from the
operator."

Immediately I hastened to Grand Central and took my
colleague to a hospital. She was unable to answer any ques
tions. When given a pencil and paper and asked to write her
address, she could not coordinate either her mind or her
muscles. She seemed to be in a swooning daze although, aside
from the pallor of overstudy, she had looked as healthy as an
Amazon.

As a matter of routine a blood test was made for syphilis
and to my surprise it was strongly positive. Treatment began
immediately, but it was two years before she was able to take up
the normal course of life. She did not want to have anything
more to do with the practice of medicine: the mere thought of
illness had become repugnant to her.

When I asked if she knew how she had become infected,
she replied, "At first the diagnosis floored me. I wasn t able to
think of any possible way I could have contacted the disease,
until I remembered that in taking care of a charity case, the
thumb of my rubber glove broke in one small spot during the
delivery of a child born dead due to syphilis. My thumb was
slightly sore afterwards, but it healed quickly and I thought
nothing of it. Three months later I now recall that I had the
usual secondary symptoms of slight sore throat, skin eruption
and falling hair, but did not attribute them to infection. Sud
denly the tertiary nerve degeneration swooped down upon me,
and I fainted at the station without any warning."

No wonder all modern doctors emphasize that since there
are many innocent sources of infection even in drinking cups
and glasses, toilets and other public utilities every human
being should have a complete physical examination with a
standardization of their health at least once every two years.
The adjustment of life through accurate knowledge of it, is the
most essential thing in the physical world. Venereal diseases
have been associated with so much shock and shame and fear of
social penalties that their early recognition and treatment have

FIRST YEARS IN NEW YORK

157

often been masked. Many a woman, thinking her husband a
soul of generosity and affection, has undergone a major
abdominal operation as vicarious payment for that husband s
youthful ignorance and folly. Many a man, like Schopenhauer,
has had his whole philosophy warped into bitterness and his
whole life deformed, because of venereal infection. The rami
fications of these diseases into economic and social burdens,
their relation to crime, idiocy and hospital maintenance for
mentally deficient victims, adds to the wasteful cost of igno
rance. Physicians, since the day of ^Esculapius, have made it a
duty to protect family relations and conceal knowledge that
would cause disruption and heartache. All doctors are re
quired to take an oath before they receive their diplomas that
they will not disclose such information.

But something had to be done especially when doctors
realized that it was only reasonable to prevent degeneration.
The only solution was sensible factual education of men and
women. My merciful, far-visioned cousin, Dr. Prince Morrow,
had the courage to become a crusader in the prevention of
those age-old destroyers of health and happiness. As a skin
specialist in New York he had seen many tragic results to men
and women through their ignorance of syphilis and gonorrhea,
caused by the sins of the fathers (and sometimes of the
mothers) , crippling not only themselves but their children to
the third and fourth generation. He, together with Dr. Stephen
Smith, Dr. William M. Polk, Dr. E. L. Keyes and others,
founded the American Society of Sanitary and Moral Prophy
laxis, pioneer movement for social education. It branched into
many states, emphasizing lectures and conferences in colleges,
settlements, neighborhood associations among industrial and
other social groups of men and women. Out of this discreet and
tactful handling of venereal diseases eventually grew the wide
spread work now existent under state and national health
boards, the floods of literature and lectures on the subject, the
responsible movements in army, navy and civic bodies.

Dr. Morrow asked me to represent the Society of Sanitary
and Moral Prophylaxis of which I was a member at the meet
ing of the National Women s Suffrage Association in Buffalo in

158

A WOMAN SURGEON

October, 1908, and at the meeting of the International Council
of Women in Toronto in June, 1909. He had been invited to
speak himself, for women, hearing of his work, were anxious
to have the facts placed clearly before them. But his many
duties in New York could not release him and, in casting about
for a suitable substitute, he thought it might be even more
appropriate to have the address made by a woman who was a
physician, married and possessed of sufficient tact not to wound
sensibilities.

I hesitated in accepting. The subject, so long tabooed,
presented frightening difficulties. Much study of statistics-
many of them inadequate would be necessary. I must prepare
to make helpful suggestions regarding social, educational and
preventive medicine, as well as discuss venereal diseases not
only on a medical basis, but also in relation to character build
ing. I would have to propose mental and physical activities
that would protect youth from moral hazards, impart knowl
edge of the importance of developing wholesome energy out
lets, elaborate the causes of sex delinquency, report existing
measures against prostitution and conclude with a summary of
practicable means of protecting the social and physical health
of the family and community. I faltered, he looked disap
pointed, with a deep breath I resolutely promised to justify his
choosing me as the first woman delegate to represent his organ
ization.

To prepare my paper I secured copies of authentic records
from all countries in which they were published, some of which
were usually accessible only to Boards of Health. A prolonged
study of statistics, compared, condensed or underscored as
would seem best to a lay audience, followed. The Inter
national Council of Women would be composed of thoughtful
women from all over the world, who, although experts in
education, social work, moral reform, health and physical train
ing, would be shocked by some of the facts assembled. Mr.
Morton checked over with me the horrifying details, as we
segregated bugaboo from scientific facts. Through it all stood
the ghastly figure of ignorance, around which indifference,
economic greed and weakness added to the evil picture. Dread-

FIRST YEARS IN NEW YORK 159

ing the presence of newspaper representatives, I deliberately
chose a conservative title for the address: "A Higher Standard
of Morality" even though I knew the Canadian press was less
sensational than our own in its search for headlines. As my
husband put me on the train he patted my arm and said,
"Goodbye, brave lady." It was just the encouragement I
needed.

As I was younger than most of the women at the conference,
and felt shy, even presumptuous, in presenting my carefully
prepared paper. But it was well received. Only a few years
ago I met a lady who was present. She assured me that she
would never forget the earnestness of my voice, the pallor of my
face when I began speaking, or the quaker-gray dress I wore.
I had wished to be as self-effacing as possible.

Miss Kate Gordon of New Orleans, National President of
the American Women s Suffrage Association, wrote to Dr. Mor
row and to me after my address before those law-minded
women, stressing how much political equality would improve
many of the aspects of this many-sided problem. At that meet
ing I had been happy to follow the leadership of Dr. Anna
Shaw, Carrie Chapman Catt and Anna Garland Spencer in
emphasizing the importance of mothers having legal rights to
protect their children.

All doctors are sick at some time or other. But I was as
vexed and angry when I contracted diphtheria from a patient,
as if I had turned traitor to health. Many people suffer this
sense of shame when they first become ill. I was pushed into
bed with the greatest difficulty. There were, however, some
compensations. I had a good nurse and my attentive husband
came home earlier from the office to joke and spin tales at my
bedside. But convalescence was slow and Mr. Morton sug
gested I take a short trip to Bermuda. It was time for a vaca
tion anyway; in adapting my mother s pattern of a holiday in
alternate years, I had decided to plan vacation travel every
three years.

In Bermuda I found President Woodrow Wilson, Mr. H. H.
Rogers and Mark Twain, my old friend of Vienna days. The
social life of teas and balls had its own leisurely charm until

i6o A WOMAN SURGEON

one day Dr. Tucker, a tall, square-shouldered, square-jawed
British chap, expressed his antagonism toward the local com
petition of American physicians by a sweeping remark to
the effect that education in the United States was very in
ferior to that in England. He had never been in America and
based his judgment on the status of two American doctors
living in Bermuda; both were ill and past middle age, havino*
retired some years before. They were reputed to have had
distinction as diagnosticians and practitioners. If they were
samples well!

He had graduated twenty years later than those men, and
I five years later than he. I was willing to prove that he was
wrong. He accepted my challenge with alacrity. What should
the test be?

"Give me the stiffest examination you can," I said with
patriotic bravado, "and I defy you to flunk me."

He was vastly pleased and rubbed his hands for the fray. In
one week to the day Dr. Wilkinson, Health Officer of the port,
friendly and not a whit interested in private practices; Dr.
Trott, somewhat older, small, rotund and neutral toward the
contest, privately thinking me absurdly extravagant to pay
$30.00 for the examination fee; and the self-satisfied, boasting
Dr. Tucker, sat on one side of a long table I on the other.

The mental gymnastics began. The questions in anatomy
were diagrammatic. Fortunately I have a photographic
memory, so I reveled in making sketches of the shoulder joint,
the diaphragm, the folds of the peritoneum and the angles of the
neck. ^ It was easier than describing all the details of their con
struction. The drawings were examined by the three and
approved-grudgingly by my antagonist. He then, with a
shrug, pushed sheets of paper toward me. The seventeen sub-
jects,^ usually tested by ten questions on each, had only five
questions each. Failure to answer one correctly would count
double. Time was an element, since one day only could be
spared from their busy lives. With the hope that no one would
need them while this ordeal was on, my pencil raced over the
papers.

The men were amused, bored, annoyed according to their

FIRST YEARS IN NEW YORK 161

dispositions. All were hot. They mutually agreed if I would
write answers to the first three questionnaires the rest of the
examination could be verbal. Then those sinners divided the
remaining sheets and hurled the questions at me without any
sequence. It is easier to answer in continuity than to adjust
and readjust the mind to chemistry, pathology, children s
diseases, histology, obstetrics, and so on throughout the list. It
developed into a game. No one was bored now. Each man
paid no attention to any answer except to the question he asked.
I kept a bridge score the only use I have ever had for one.

The competition was amusing. I had no intention of ever
practising in Bermuda, and yet here I was qualifying to do so,
much to the discomfiture of the Island s established physicians.
Dr. Tucker and Dr. Trott intended to give me a hopelesss, ir-
radicable inferiority complex, but, as I think America is England
plus, I merrily ran this mental Marathon for no other motive
than patriotism. Financially the outcome, whether success or
failure, meant nothing. The $30.00 fee was very little to pay
for the chance to prove that the American standard medical
schools give training equal to those in England, or for that
matter anywhere in Europe. My inquisitors were puzzled. To
me the excitement was as stimulating as a game of tennis. I
had to be all over the court at once.

"What are those marks?" queried genial Dr. Wilkinson.

"The score," I said.

He liked sport. "Ninety-five up and five to play!" cheered
he. "There really should only have been seventy! Well, we
will call time on one hundred."

The last five questions were typical of the diversity of the
preceding ninety-five. A medico-legal question was followed by
"draw fever charts of typhoid, typhus and two forms of mala
ria." Next a blood test formula the questioner holding a book
on laboratory technique open before him. Then, "Give the
etiology, symptoms and prognosis of dementia prsecox." The
final inquiry "the treatment of bronchitis" was such a come
down I might have known there was a catch in it. Any mother,
nurse or neighbor knows how to treat bronchitis. I wanted to

A WOMAN SURGEON

be generous. I told Dr. Tucker more than any doctor in the
world would find it necessary to do.

"Wrong!" he triumphed.

"What do you want her to say?" asked the surprised Dr.
Trott.

"She has not mentioned the main drug used in this simple
ailment," was the taunting reply.

I reeled off five or six. Still wrong. "You win, dear col
league, let us make the score 99," and added irritably, "I will
be satisfied to lose the other point for the sake of the education
I shall gain."

"What is it?" demanded Trott and Wilkinson in one breath.

"Antimony," said Tucker with finality.

Stubbornly I maintained, "Antimony alone is never given;
in old text-books antimony et potassii tartras is mentioned."
His glare showed me that I had scored.

The next day a most inconspicuous three lines appeared in
the local paper stating that I had passed the British Colonial
Examinations qualifying me to practise medicine and surgery
in Bermuda. That night Dr. Trott solemnly invited me to
confer with him on the spacious porch of the Princess Hotel.
He was friendly enough to tell me that there never had been,
nor would be, an opportunity for any but British doctors in
Bermuda. To emphasize this he confided that Dr. Tucker held
controlling stock in the Hamilton and he in the Princess Hotel,
and that any employee would be instantly dismissed who called,
or encouraged, the attendance of any outside doctor for a tour
ist in either of these well-filled hostelries. Just to tease him I
suggested that women residents in Bermuda might, if one were
available, prefer a woman physician. "In that case," he re
torted, "you could never leave the island, for if you did, and
any of us were called to see one of your patients, we would not
go. We would, instead, advise him or her to send for you."

My ideal of the long revered asset of my forefathers, "British
fairness," received a shock. Dr. Trott meant to be kind and
offset future disappointment. He could not believe that the
length and breadth of our land would hold me, when I might
establish myself in Bermuda. To quiet his mind forever I told

FIRST YEARS IN NEW YORK 163

him that I liked my husband passing well, that it was good taste
and our actual preference to live in the same city, and that as
he was an established lawyer in New York, that city would no
doubt prove a sufficient field for my practice.

Did these worthies grant me a certificate? No! When I
asked for it, they explained that since I was leaving on the
morrow it would be mailed to me. With the patience of indif
ference I waited a year. Then I wrote requesting it, asking
whether it would be accepted in any other part of the British
Empire. This important question has never been answered.
I was, however, informed that as the announcement of my hav
ing passed the examination had been published, I needed noth
ing further to establish the fact. I regretted that I had not kept
a copy of so valuable a newspaper. But in a round-about way
I eventually secured a certificate.

In 1916 at the home of Mrs. George A. Plimpton, whom I
had met in Bermuda before her marriage, I suggested that
occasionally "the mills o God grind slowly, yet they grind
exceeding small," even when the grist happens to be simple
justice. With the promptness characteristic of Fanny Hastings
Plimpton, an effective letter was dispatched, and I soon received
the following document:

COLONIAL SECRETARY S OFFICE
BERMUDA

TO ALL WHOM IT MAY CONCERN I

I hereby certify that Rosalie Slaughter Morton, M.D., a graduate
of the Woman s Medical College of Pennsylvania, United States of
America, was registered in Bermuda on the 20th of March, 1908, as
a Medical Practitioner qualified to practise medicine and surgery in
these Islands under the Provisions of the Medical Registration Act.
1905, (No. 31) . Given under my hand and official seal this 2 ist day

of July, 1916.

W. B. JACKSON,

Colonial Secretary.

This now hangs on my office wall together with some which
are more interesting and others which are less so. It serves an
unusual purpose, for there is mischievous amusement in the

A WOMAN SURGEON

recollection of how in miniature I refought a bit of the Revolu
tionary War. "The British troops greatly outnumbered those
which were opposed to them, but the energy and endurance of
the Virginia battalion won the day!"

On my return to New York Mr. Morton teasingly showed me
a picture of a kitten with its head through a hole in a fence.
Seeing three dogs unexpectedly, it became so frightened that
its hair stood erect, its eyes blazed. The comic strip portrayed
how the dogs ceased yapping, became quiet, then frightened,
while increasing satisfaction spread over the face of the feline,
as she complacently remarked, "I bet most anything they think
I am a tiger. *

CHAPTER XIV

PUBLIC HEALTH EDUCATION

AT THE annual meeting of the American Medical Association in
June, 1909, one of the most far-reaching benefits of modern
medicine came into being. This was the first organized move
ment in history for the general prevention of disease through
specific education of the public in its causes and early care.
At this advanced, well-informed day it is impossible to believe
that such an undertaking as organized preventive medicine had
to struggle for existence. It began with an attack upon the
inconsistency of specialists at that meeting. The medical
women as a whole, and many of the men, upheld the idea, and
we have no cause to regret that battle.

As is the custom at annual meetings, I attended various sec
tions where specific diseases were being discussed. In papers
on tuberculosis and cancer medical men lamented the preva
lent ignorance of the public regarding early symptoms which, as
a result, reached the stage of futility before patients recognized
them. Pneumonia, nephritis, gastritis and other acutely serious
diseases developed, owing to lack of knowledge about the care
of common colds, diet and other easily corrected health faults,
and often progressed to almost incurable states before coming
under professional care. When there was inflammation of eyes
or ears, obviousness usually gained early attention, but most
insidious diseases grew unnoticed or wilfully neglected for
years.

In the section on Public Health similar regrets were ex
pressed, but no one offered a concrete remedy for the situation.
I rose to suggest that positive steps be taken, adding I considered
it odd that men physicians were just waking up to preventive
medicine, while women doctors had for fifty years been stress
ing the importance of educating mothers in the care of chil
dren s health, in pre-natal care of mothers, etc. Despite mascu-

165

i66 A WOMAN SURGEON

line chuckles, I introduced a resolution, prosaic but full of
dynamite, that the women physicians of the American Medical
Association take the initiative to organize educational com
mittees acting through women s clubs and mothers organiza
tions in their own localities for the dissemination of accurate
health information.

This simple "Whereas and be it resolved" precipitated much
discussion when it came before the Public Health section. An
experienced colleague remarked that women physicians as mem
bers of church and of lay women s organizations were constantly
called on for practical and expert lectures on dietetics, the pre
vention of colds, the care of the nervous child, the value of
exercise and rest in relation to the heart, and kindred subjects.
These they gave gladly. But medical men almost always re
fused to make similar addresses, even when the subjects coin
cided with their specialties. They considered it below their
dignity to be wholesomely helpful and took refuge in claiming
that they did not have time for this generous service. I ven
tured to urge the assembled doctors to respond to requests for
addresses on health topics and present them in simple, untech-
nical language. Many of them considered it a bore and a waste
of time to lecture outside a college, for they were solely inter
ested in acute illnesses against which they could match their
wisdom in defeating death.

Several men objected that such action would be self-adver
tisinga violation of medical ethics. Others retorted that its
obvious result would be to keep people from going to consult
doctors at all. Still others insisted they could not leave the
routine of office work to attend women s meetings at odd hours.

But I found a champion, Dr. William Bumby, a State
Health Officer from Texas. "Dr. Morton is right," he said. "It
is only the women who will take any sustained part in such a
program. In Texas when I went to otherwise public-spirited
men in the various cities to ask their support for a legal measure
guaranteeing pasteurization of milk and the testing of cows,
as well as better street-cleaning service, they all replied they
were too busy to be bothered with such details. They had
elected me Health Officer, they said, to attend to such duties

PUBLIC HEALTH EDUCATION 167

and they thought me incompetent for seeking their support.
It was obvious that public opinion had to be stimulated through
other channels. My wife suggested that I place my plans before
the women s clubs, which longed for something new to fill their
programs. The result was electrifying. They were delighted to
help regulate a cow instead of reading Emerson to one another.
In every town women sprang to the opportunity of helping me
protect the health of their families and communities. Through
them I obtained the legal action."

Doctors from other far-scattered states upheld Dr. Bumby
with similar accounts. As a result the resolution was passed.
I was appointed chairman of a temporary committee which
was guaranteed the support of the Association and instructed
to call a meeting for the organization of the first concerted
action in history by any professional group to remove the need
of their own services! On June 20, 1909, women from New
England, New York, New Jersey and the Middle West gathered
to help me formulate a plan of campaign for the Public Health
Education Committee. We decided to request each county
medical society to select and arrange its own programs, so that
the best physicians in each locality might be engaged to give
untechnical lectures under the most dignified auspices.

We communicated with all the women doctors in the United
States about six thousand and asked the most outstanding to
become chairmen of state committees, to organize county com
mittees, these to arrange programs to be presented by men and
women doctors on a selected list of topics covering the entire
field of preventive medicine as well as the immediate care of
accidents.

Within three months to the astonishment of even ourselves
we had authoritative lectures by medical men and women
in progress under the auspices of state and county medical
societies in thirty-three states. And at the next annual meeting
of the American Medical Association, when a new committee
is customarily expected to report modestly that plans are being
laid, we placed a 13 6-page printed report in book form in the
seat of every member of the House of Delegates, giving con
densed details o subjects, by whom presented, attendance at

i68 A WOMAN SURGEON

lectures, direct and indirect results, in every state in the Union
and also in Alaska, Hawaii and Panama.

Our motto for the work was from Spencer: It is the first
. duty of the individual to learn how to live." The main cause
of crime, misery and poverty is ill health, and the ignorance of
school children and mothers about simple physiological hygiene
had been a strong factor in spreading both disease and prejudice
against doctors.

It is amusing now to recall that we encountered difficulties
sufficient to arouse anxiety. But we had the cooperative enthu
siasm of many individuals interested in safeguarding the health
of their communities, so we made rapid progress. Many doc
tors, who had long been anxious to participate in public health
education but had hesitated for fear of accusations of self-
publicity, now gladly aided their communities. We had enthu
siastic support and cooperation through women s clubs and
other lay organizations.

But three stubborn lines of opposition confronted us. First
arose the criticism of certain mediocre men doctors worried over
their incomes. If six thousand medical women in active prac
tice proved to audiences all over the United States that they
were equals or better, these men could no longer through jeal
ous misrepresentation handicap the women s practice. We
realized our opportunity to establish beyond further quibbling
the equality of not only a few women, but of all those practising
in the United States, with the men in their local and in our
national medical organization. We knew that the women
deserved equal recognition. This was their first opportunity
to gain it.

Second, a prominent member of the American Medical Asso
ciation complained that he had no objection to Dr. Morton and
half a dozen women becoming members of an A. M. A. Com
mittee, but that the development and extension of a national
health movement should be put into the hands of medical
women as a whole was unendurable! Further, he also thought
it most ungrateful for Dr. Morton to persist in the uncom
fortable precedent of making plans which included six thousand
women! He was overwhelmed by my enormous audacity. But

PUBLIC HEALTH EDUCATION 169

his illogical argument was laughable to the fairer-minded men.
Third, others insisted that our success would give us political
ambitions and we might en masse become troublesome! An
other group flattered their ego by maintaining that women s
intellectual capacities were limited and their education inferior.
To our disappointment we found that some capable women,
who had attained outstanding positions, wished to remain excep
tional and paradoxically upheld this group of men. Other
women thought the movement tended toward the segregation
of medical women! This idea was obviously absurd, for men
in every state took an identical part in programs. State and
county societies had stamped it with their official approval, and
were unified in a far-reaching service to the American Medical
Association itself; for as Dr. George W. Wagoner of Johnstown,
Pennsylvania, had recently said in his presidential address to
the Medical Society of the State of Pennsylvania: "Doctors are
losing the confidence of, and receiving criticism from, the laity."
This had arisen from the exploitation of the public by pseudo-
scientists who affirmed that weso-called drug doctors were
commercially interested in keeping the people ill! Antivivi-
sectionists and other sobbing cliques had spread harmful propa
ganda in the women s clubs, which we as members of these
clubs were in a position to refute.

It would have been a serious reflection upon our profession
at this psychological time if we had not promptly educated the
public to a thorough appreciation of the doctor s role as pro
tector of the health of the community. Through this national
movement we emphasized the general desire of doctors to aid
the public in the prevention of disease and we credited the
American Medical Association with all our gratuitous work in
order to foster an acceptance of its altruistic concern for the
health of women and their children.

Opposition, and the zest of combating it, knit the committees
together and lessened the fatigue of strenuous work, since all
of us were carrying on our daily practice as physicians besides
this administration and lecturing. Dr. Evelyn Garrigue and
Dr. Alice Asserson, the secretaries of our central committees,
spent many midnight hours in handwritten correspondence with

1/70 A WOMAN SURGEON

Dr. William Gorgas, the President of the American Medical
Association, then in Panama; Dr. William H. Welch of Johns
Hopkins University, President Elect; Dr. Prince Morrow, Chair
man of the Executive Committee of the Hygiene and Sanitary
Science Section; Dr. J. N. McCormack, Health Officer of Ken
tucky and Chairman of the Organization Committee; Dr.
Irving Fisher of Yale University, Chairman of the Committee
of One Hundred which was interested in public health, and
with many other men sympathetic to our cause.

In some states able doctors in county medical societies timidly
hesitated about cooperating in the first programs. When I was
appointed chairman of the committee in the New York County
Medical Society, I determined to prepare as impressive as well
as valuable a series of lectures as possible, and thereby set a
helpful pattern for other county societies to copy. Much edu
cation cried to be done in the vast crowded city of New York
and prominent doctors cooperated readily. When other doc
tors throughout the country saw the list of speakers in New
York, they immediately offered their services, not wishing to
be thought niggardly.

In our first series of free lectures, held at the old Academy
of Medicine on West Forty-third Street in New York, the fol
lowing subjects were presented under the general title of "The
Prevention of Disease":

Open Air Treatment: In the Schoolroom, Nursery and Sick
room

Wholesome Food and Good Health, with the Proper Food
for School Children

Industrial Diseases

Hookworm, Yellow Fever and Malaria

Value of Early Diagnosis and Treatment of Adenoids

Health During Menstrual Period, Pregnancy and the Men
opause

Causes and Prevention of Nervous Exhaustion

Early Diagnosis of Cancer

Hygienic Care of Nervous Children

Cause and Prevention of Common Colds

PUBLIC HEALTH EDUCATION

Rest and Exercise in Public Health
Social Diseases.

Other lectures discussed mental hygiene, the relation of alcohol
and meat to disease, the cause and prevention of anemia, rheu
matism and appendicitis, infant hygiene and pure milk, deform
ities and their prevention, and other subjects.

The lectures differed to some extent in different sectors. We
noted which subjects drew the largest audiences in diverse
localities, signifying their greatest need, and planned in the
next years to arrange programs accordingly. In New York
every afternoon a miscellany of people from the man in the
street to college professors crowded into the hall. Distinguished
visitors sat beside tenement dwellers. Health is the great de-
mocratizer. Supervisors of schools of nursing required their
pupils to attend the lectures as a regular division of their train
ing. Many members of the audience took notes in order to
pass on the information. Thus the education disseminated,
sprouted and paved the way for courses in home nursing and
popular medical articles in newspapers and magazines.

On each program two men and two women specialists pre
sented different phases of a general subject. Each spoke twenty
minutes, after which they answered questions from the floor for
thirty minutes. Individual consultations were not permitted.
Replies were comprehensively informative. Charts, statistics,
lantern slides and other illustrations clarified important cli
maxes of disease.

The subject attracting most attention that first year in New
York City was the causes and prevention of nervous prostration.
Obviously every one who had not experienced it, expected to!
They were grateful for having the sword of Damocles removed
from above their heads. We determined not to allow a bit of
learning to become a Hyperian Spring, so we encouraged those
with scientific thirst to drink deep of knowledge. Printed lists
of supplementary reading, easily obtainable at libraries, were
available at the exit door. In setting a popular fashion we also
increased the public appetite for accurate information.

Our reassuring progress encountered an interruption when

172

A WOMAN SURGEON

the Chairman o the Organization Committee of the American
Medical Association decided to exploit our committee to his
own use. He granted that our work was satisfactory, but he
strongly doubted that a group of women could proceed without
the advice and protection of men. With shady magnanimity
he suggested that our committee be made a branch of his. We
thanked him for his concern, but preferred to remain free of
any entangling alliance.

The Chairman of the Legislative Committee then urged that
we promote a pet idea of his by making the grand finale of
each of our series of lectures a plea for a National Board of
Health under a Secretary of Health, as exists in other coun
tries. However, in the United States health has for years been
ably safeguarded by our Bureau of Public Health under the
Treasury Department; many opposed the establishment of a
separate department, both on the ground of increased adminis
tration expense, and the necessary relationship of the Bureau
of Health to nearly every department of our government. We
resented the efforts to make our committee a ladies* auxiliary
of the Organization or of the Legislative Committees. They
had their work and we had ours. Our wide-spread committee
agreed that we could not have the sincere motives of our slogan
"to lessen suffering and save life through education" compli
cated by political lobbying. Our independence, of course,
aroused opposition and we were branded as a very opinionated
lot.

Soon we were hampered in other diverse ways. Some one
concocted the rumor that we were not legally a committee of
the American Medical Association! As a matter of fact, the
resolution creating our work had been passed unanimously not
only in the section in which it originated, but also officially in
the House of Delegates. This stumbling-block toppled over at
a letter from President Gorgas.

Then a question arose as to whether the A. M. A. could
appropriate money to meet our committee expenses. A legal
opinion sent to us had a paralyzing intention. It stated that
no mention of an appropriation for expenses having appeared
in the original resolution, money would not be forthcoming.

PUBLIC HEALTH EDUCATION 173

I had met the initial expense of five hundred dollars to get the
work started. The woman physician, appointed committee
secretary in each state, was donating her expenses for corre
spondence, state reports, phone calls, etc. We had suggested
that each county medical society meet the expenses for printing
and distributing programs, for lights and janitor service, and
that library and other groups requesting lectures do the same.
This plan had functioned well in launching weekly lecture
programs throughout the United States. But in justice to the
large number of physicians and surgeons giving their time
gratuitously, we wanted to publish a national report, condens
ing each state report. We believed that the distribution of
definite facts about our work would lead to extension and
financial support of public health education, inside and out
side of the American Medical Association. Lacking a report
at the end of the year, the committee might be discontinued
on the ground that it had not made a satisfactory showing.
Where would we find sufficient money for this?

At this juncture Dr. Luther Gulick, then Chairman of the
Child Hygiene Department of the Russell Sage Foundation,
called to ascertain the scope of our work. Upon learning of
our wholesale education of parents, teachers and health guard
ians generally, he offered to contribute to our committee from
the Russell Sage Foundation the services of an expert stenog
rapher, on the ground that our program would become an
increasing asset in building stronger children. Later, Mr. John
Glen, head of the Foundation, volunteered the printing of our
report. He seemed an angel of grace. We were prepared for
any criticism at the A. M. A. meeting in 1910.

The printed report gave the more conservative members of
the House of Delegates a shock. Several attempted to block
this "feminist demonstration." A motion was made that I be
denied three minutes in which to give a verbal summary which
I had requested as part of the program of the annual meeting
of the House of Delegates. Our printed report was held suffi
cient. I contended that many delegates might not find time to
read it. Above the laughter the obstructionists were overruled.

Watches ticked in the hands of those who intended to inter-

174 A WOMAN SURGEON

rupt i I exceeded my time. I summarized only the high points,
explained that in one year 2,550 gratuitous lectures had been
given to audiences aggregating about 200,000 people, referred
to no difficulties and thanked the President and members of
the House of Delegates for the opportunity they had given us to
serve humanity in the name of the American Medical Associa
tion. Applause and silently closed watches in two minutes
and fifty seconds marked a triumph for the cause of women in
medicine. The test of sure success depended, however, on our
reappointment. It came, finances were arranged, and we began
a second year more advantageously. We had outgrown every
prediction of failure.

The Public Health Education Committee continued its
work for four years, two of them under the direction of Dr.
Eleanor Everhard and Dr. Gertrude Felker of Dayton, Ohio,
along the lines of its inception and then expanded in many
directions until it became an integral component of civic life.
At the beginning we benefited by coordinating the diffuse
efforts directed toward prevention of disease already attempted,
such as the A. M. A. Committee for the Prevention of Blind
ness under Dr. F. Park Lewis. Our organization enlarged the
public for these groups by placing them on national platforms,
in provincial as well as in metropolitan districts.

In practically every state we received cordial cooperation
from Boards of Health. We formed Hygiene Committees in
each of the Federated Women s Clubs, many of whose members
belonged to other public welfare groups. Their national organ
ization numbered nine hundred thousand intelligent, public-
spirited and wealthy women who molded public opinion toward
protecting the health of American citizens. We were in touch
with all educational and philanthropic agencies through the
United Charities Association. Our work became of service to
the hundred and ninety-three thousand women in the local
and national Young Women s Christian Associations through
the direct cooperation of the national secretary. We likewise
functioned through the Mothers Clubs, of which there were
sixty in New York City alone; with the State Assemblies of
Mothers and the National Congress of Mothers; with the Na-

PUBLIC HEALTH EDUCATION

tional and International Council of Women, the National
Society for Sanitary Prophylaxis, the Ethical-Social League and
with many other organizations. We learned what efforts toward
preventive medicine were already being made in various states
in order to be most helpful and not duplicate service. Pamph
lets and lists of books were given general distribution.

In undertaking this first large piece of executive work, I
discovered how well the study of medicine had prepared me for
successful organization. One must diagnose a situation, analyze
all its possible developments and prepare for emergencies. Each
situation is as individual as a person. To treat a patient, a
doctor mobilizes all the forces of scientific medicine; similarly
in executive work one must mobilize all the forces in other
people. Being dynamic, I was inclined to lack patience with
these individual forces. In the case of a sick person, a doctor
assumes authority and is the commanding executive of the
science used, controlled and directed. In executive work pa
tience is necessary when the means are personal and individual.
To look beyond obstruction to the cure, to understand oppo
nents as well as adherents, to triumph over the discouragement
of opposition and misunderstanding, all these things I had to
learn and I accepted a good deal of pommeling in the process.
But the endeavor for public health education was a valuable
training for future responsibility. Without it I doubt if I
would have been able to perform my patriotic duty in the
World War and in reconstruction. Curiously, too, executive
work concentrated my energies and broadened my tolerance so
that it made me a better doctor as well as administrator. The
benefits were reciprocal.

The resulting benefits of the Public Health Education Com
mittee were manifold and will never cease. 1 The authoritative
teaching in an ever-widening circle to people who had formerly
accepted the statements of quack advertisements made them
take steps to halt illness immediately instead of to hush it up.
The public overcame its prejudice against doctors and appre-

iThe series given at the New York Academy of Medicine, 1936, was entitled
Medicine and Mankind. The final lecture was by Dr. Alexis Carrel. Police
reserves were called upon to control the crowd seeking admission.

17 6 A WOMAN SURGEON

ciated their desires to safeguard health. People learned, too,
of the already existent health work in their localities which in
many cases they had not known to be available. Physical and
mental hygiene soon became part and parcel of every-day life
in America.

Public health education also destroyed many of the preju
dices within the medical profession. As men and women doc
tors cooperated in programs, they gained a new respect for one
another. Men overcame their ignorance regarding medical
women. And the women themselves had a chance to become
acquainted with one another. In the American Medical. Asso
ciation a powerful Council on Health and Public Instruction
was soon established, xvhich led to the publication of the popu
lar and informative magazine, Hygeia. Especially pleasing was
the realization that this educational undertaking fulfilled the
ideas of the earlier pioneer women in medicine, who because
of their maternal sense had always been anxious to prevent
suffering. Dr. Elizabeth Blackwell fifty years before had had
this in mind when she established the first Chair of Hygiene
in the world at the college of the New York Infirmary for
Women and Children. With the inspiration of women,
America had led the world in sanitation and public health.

CHAPTER XV
HAND TO THE PLOW

LIFE moved along domestically, uneventful, but never monot
onous. Happy the home which has no history.

My husband once said to me, "How lucky I am that you use
your energies during the day so that you are glad to Be home in
the evening! How do young men get ahead whose wives drag
them out four evenings out of every five? I am going to advise
my bachelor friends to marry business and professional women."

This was for us the beginning of the solution of a problem
created by, and typical of, our generation. We were a little
awed by our happiness, for we had not realized that so much
was possible. Our work-a-day lives had shown us much
unhappiness, misunderstanding and suffering. The reverse
seemed a marvelous privilege. We were grateful and deter
mined to safeguard and cherish this fulfillment of life. We
found that fantasy becoming fact gave life its magic. The love
of an hour becomes eternal, the love of years may telescope into
a moment. Much of life is endured for the anticipation or
the memory of an hour of love. Much of history hinges upon
it. Politics have revolved around it. Men and women murder
for it. Most of the forces of life come to be understood as
animated by, or derived from, love in one or all of its phases.
My husband and I were very careful with it. He knew we were
drinking the elixir of the gods, which taken as a sacred potion
would ennoble, taken selfishly would destroy us.

This perfect gift, romantic love, for which all hearts, old
and young, rich and poor, lame, halt and blind, hunger how
precious and how costly it is! The price is paid in years of,
loneliness when it ends. And how short is our vision how
strangely and swiftly our lives can be stripped to grief!

My husband had not been well for some time. Anxiously, I
urged an examination, but he laughed away his indisposition,

177

A WOMAN SURGEON

and insisted that a restful visit to his parents would cure the
troublesome cough. Instead a blood vessel ruptured.

He had entered my life with the ringing of the doorbell.
One day it rang again. With as little thought of what was on
the other side of the portal as when I first opened it for him, I
went to the door. A messenger handed me a telegram from his
mother saying that he had died suddenly that morning.

Shock has its merciful side in dulling emotion, but then, as
feeling regains its tenuous power, come sorrow, disappointment
and a thousand cloudy, stormy hours, out of which in time
perhaps a rainbow glistens sheer, as we comprehend that the
elemental forces of love and sorrow are necessary to equip one
for the greatest service to humanity understanding kindness.

If my parents had been living, if we had had children, if
there had been domestic duties, I would have found palliative
comfort in them; but with his going my domestic life was so
absolutely demolished that I could not look at silver or china,
or a hundred other vivid objects. I had them all packed away
or gave them to friends and sailed to South America for an
extended trip over the length and breadth of its continent.

When I returned to New York my dear friend, Dr. Marion
Craig Potter, said to me, "When one doors closes another always
opens. Each experience is preparatory for the next."

Could it be true? I was facing life again as after my
mother s death with a sense of emotional emptiness but with
duty holding my hand and leading me on. And then, school
ing myself not to dwell upon the past, I plunged deeper
into a busy life of medicine, with more concentration and effort
than before. And as time passed I realized that love had not
been lost, that, instead, it had enriched my life for the unselfish
work I must do.

One day Dr. John A. Wyeth, intellectual and courteous,
called on me. He had founded the first organized school of
post-graduate medicine in the world, as part of the far-famed
New York Polyclinic Hospital, of which he had been the father
also. To my delight he proposed that I should become a
clinical assistant and instructor at the Polyclinic. I was placed
on the staff of Dr. J. Riddle Goffe, a distinguished gynecologist.

HAND TO THE PLOW 179

Dr. Goffe held his clinic twice a week from nine to ten A. M.
Owing to my interest in the efficiency of women, I followed this
specialty more broadly than is usually the case, 1 supplementing
it with sociological studies of women s working conditions. It
seemed a satisfaction to the patients that they could find a
woman physician in attendance. Rapidly the number coming
to the clinic, especially of foreign born, increased. Two years
later I was transferred to the surgical clinic as assistant to Dr.
Bodine and lectured on surgery. Two years later I was made
a professor of gynecology, the first woman to become a professor
in any medical school or hospital in New York. I was permitted
to select my own assistants and chose five extremely competent
women. Dr. Frances Shostac served as the anaesthetist, Dr.
Caroline Richards, who was as interested as I in the relation of
reflex nervous manifestations to gynecology, assisted in the
medical clinic. Dr. Mary Lee Edward, later to have interesting
war service, and Dr. Anna Hubert were my surgical assistants.

When demonstrating interesting cases in the amphitheater,
as well as when operating before the physicians registered for
post-graduate courses of study at the Polyclinic, I always felt
very privileged to have the opportunity of contributing to the
knowledge of my colleagues, some of whom were old enough to
be my father, and all of whom had been out of college longer
than I. Scientific medicine had, however, made such strides in
the intervening years that, while they had been facing cold,
rain, wind and burning sun in their care of patients scattered
far in suburbs and countryside, I had had the opportunity of
concentrated study and wide observation; after their unselfish
years of hard work I was thankful to have an opportunity to
be of service to them and grateful that they felt no resentment
toward "a medico in petticoats."

These post-graduate students were experienced doctors who
felt themselves growing "a little rusty and needing to brush up."
I was bubbling over with accumulated knowledge. My in
sistence that much physical immorality is due primarily to
mechanical disturbances, congestion, adhesions and other physi-
ological imbalances, interested them. Socio-medical questions

i For published works on this subject, see footnote on p. 85.

lgo A WOMAN SURGEON

began to be asked, the answers to which were in that paper I
had so carefully prepared to read in Canada. Details of surgical
technique, they observed with surprise, I accomplished more
easily because my hands are small and finger-tips sensitive.
They were generous and commented on the speed resulting
from the deftness of feminine hands in handling tissues, tying
ligatures and taking stitches-characteristic of all women sur
geons. I was called on to give lectures at New York University,
at Pratt Institute and at Adelphi College in Brooklyn. During
the summer I was professor of applied physiology at the summer
school of the University of Vermont. Dr. John Brooks Wheeler,
author of Memoirs of a Small Town Surgeon, extended to me
the surgical privileges of the Burlington Hospital, where I
carried on my operative work with patients who came to
Vermont for the summer.

Having no children of my own and needing occasional
motherly diversion, I became interested in the foreign-born
boys who had formed the New York City History Club. The
plan of the group required each boy to study the house or
tenement in which he lived and trace back its history or
location, discovering what prominent people had lived in the
once stylish residences and linking these interesting characters
to early history. This gave immigrant boys a personal sense of
pride in American history and developed in them a sense of
national responsibility which might not otherwise have entered
their lives.

I invited about thirty members of the club to my home. As
I thought I might have difficulty in holding the attention of so
many restless boys, I arranged to have them arrive in groups of
ten. To the first I showed and gave the history of my collection
of swords, knives, flags and machetes from China, Cuba and
South America. Each of these ten boys listened as if his life
depended upon it. As I write this, I wonder why a woman
devoted to works of peace should have collected such an arsenal 1
When the second ten arrived, the first group acted as guides;
they had listened so well that each boy neither omitted nor
added anything. When the third contingent came, my niece

HAND TO THE PLOW 18 x

and I introduced them to the Lohans, Chinese books, shoes
and other new interests.

All of them were at first a little shy, but the last trace of
reserve vanished when the maid entered with a heaping tray of
ice-cream, large squares of cake and hot chololate. It had been
a task to learn and remember each of the boys last names
and what names they were! It still remains my outstanding
intellectual feat. But it was worth the effort to see each boy
beam and straighten his shoulders when addressed as Mister.
It was the first time they had experienced that adult thrill. But
under the fraternalizing influence of the ice-cream each asked
me to call him by his first name, explaining that as I was
officially adopted by the club I ought to call them Leonardi,
Francisco, Enrico, Giovanni, or by their nicknames. It was
a compliment, but a severe strain. It was, however, repaying
to learn that one can count on every boy to act his best when
he wants to be at that best, and to see the thrill of new interest
reflected in their faces.

Many people have never really been tired. I have had many
patients whose lives are so leisurely, who have had so much
done for them that sadly enough, although they do not know
it, their main objective is either entertaining or being enter
tained. It amused me pathetically when a patient would dash
in wanting to be cured instantly of nervous indigestion. When
I suggested horseback riding or driving her car to the edge of
the city and then taking a daily walk, she would look at me in
consternation and say, "My dear, I am entertaining twelve
people at dinner tonight; then we are going to the opera. I
am playing bridge tomorrow morning and having luncheon at
the Waldorf. In the afternoon some friends are coming in to
tea and we have seats for the theater in the evening."

She made a business of indigestion. She could not hope to
escape it under such a schedule, but of course she would not
change it. The general rebuke I received was "I have never
seen anybody enjoy a musical more than you, or anyone take
more delight in conversation with well-chosen dinner guests,
and yet you want me to give them up!" For me, these events
did not occur more than once in two weeks.

A WOMAN SURGEON

One wealthy patient wanted to be operated on, because her
husband s affection was waning and she thought that being in
the hospital would make him more solicitous. She had a
misplacement of the uterus, which could gradually have been
adjusted through treatment. An operation was not advis
able, since she was fat, middle-aged, and had an uncertain heart.
Being a society woman with little to do, she could easily have
found time for office treatments, but an operation was more
dramatic and would serve, she hoped, to regain her husband s
heart. Such cases are pathetic. Some wealthy women rely
upon surgery to give their lives importance. One patient
balked when I told her that since she had to have an opera
tion for the removal of a diseased ovary, there were two
smaller things which should be done while she was anaesthetized:
replace the uterus by shortening the round ligaments and
remove a chronically inflamed appendix. I was offering her
three operations for the price of one, each of which in time
she would have to have done. But being neurasthenic, she
would not consent; she preferred to look forward to other
operations in the future. Most patients, however, are sensible
and courageous.

The contrast divided sharply between patients who were
part of the social fabric of New York and those in the Clinic.
Most of the latter were pitiful and neglected, asking nothing
from life and receiving little. Among these people I spent
four mornings a week for many years, two at the Polyclinic and
two in the Surgical Clinic of the Medical College of Columbia
University. This charitable work counterbalanced the eve
nings I spent in the company of women who had lost their
psychological balance from too much wealth, or having diabetes
and being forbidden sweets in an effort to improve their con
dition for a needed operation, would steal a piece of cake from
their own pantries! These paradoxes strengthened my interest
in psychoanalysis, begun long before in Tewksbury, which
gradually extended throughout my practice into the extensive
mosaic we call diagnosis.

In surgery psychology plays a vital {fat. Although it is easy
to understand why surgery has been cfamatized in the public

HAND TO THE PLOW 183

eye as something of a miracle, the actual work it entails is simple
if the surgeon knows anatomy thoroughly and has a skilful
technique. To patients the adventure of losing consciousness,
of placing their lives entirely in the hands of a doctor, of having
themselves cut open, is exciting and frightening. If not com
plicated by other factors, surgery is easy, for much of the work
is done by nature s rapid and effective healing powers. But if
anemia, diabetes and other medical conditions exist, recovery is
difficult, as was demonstrated in war hospitals when typhoid,
dysentery and malaria complicated surgical procedure. Usually
by far the hardest part of an operation is preparing the
psychology of the patients toward rest and recovery. I never
allow them, if possible, to consider their condition as horrible
or crucial. The patient must think constructively and not
plan for death, but do his or her part by putting up a fight for
health; otherwise the operation is not likely to be a success. If
the patient does not want to recover, operation is inadvisable.
Sometimes this cannot be discovered beforehand. A young
woman was brought to me by her mother. She had gonorrheal
infection of the Fallopian tubes. An abdominal operation was
necessary to remove them and free her from infection. She
said she wished to have it done, but she knew that she would
not recover. The operation was a success and two days later
she died. Her mother came to New York and told me of a
lover who had deserted her; then I realized that shame and
defeat in feeling herself an outcast had sickened her mind and
she had no wish to live.

Another woman had a beginning cancer of the cervix. It
was perfectly reasonable that she should recover and live for
many years after the minute growth was removed. But all
during the days before the operation and after it, she was
obsessed by the memory of her mother s wasting death from
cancer. She was convinced that it would return and that she
would die from it too; even though I assured her of the early
removal protecting her from a fate due to neglect, she died.
After that I would accept no patient determined on lethal
self-hypnosis.

To patients on the verge of death I say, "Do you want to

184 A WOMAN SURGEON

live?" Sometimes even those whose lives seem the most miser
able, murmur, "Yes"; while those who appear to have every
thing lovely and loving to return to and are surrounded by
solicitous children, answer, "No/ If they say, "Yes," the case
is half won, for the mind works constructively and endocrines
stimulate the molecular fight of all the cells toward recovery.
If they say, "No," the case is usually at the point to begin to
console the family.

The "no" raises a problem. Should the doctor struggle to
bring the patient back? Perhaps return them to some un
speakable hell which they hope to escape? The surgeon has no
choice but to do the utmost to save the patient s life. There
fore, it is necessary to reeducate the patient mentally, also the
family, and discover what in the environment of the home,
what emotional disturbances, the patient seeks to avoid. Grief
is poor recompense for conscience. Sometimes a careless or
unkind husband can be persuaded to avoid the things which
have shattered his wife s will to live. Many souls awaken when
their wives or husbands lie on the threshold of eternity.

In domestic affairs a woman can sometimes more sympatheti
cally and penetratingly psychoanalyze the situation, for she
usually has an inherent aptitude for understanding these
realities and can get closer to the sorrow of crucial cases.
Women have always been depended upon to understand and
forgive men, while men have not often sought to understand
women. As the background of patients effects health, the
doctor must be a humanist.

The majority of surgical cases do not end tragically. An
operation usually makes a marvelous metamorphosis from
suffering and despair to health. This heightens the surgeon s
profound sense of responsibility in aiding human life. One
patient of mine suffered miserably from pelvic congestion,
caused by severe abdominal adhesions resulting from typhoid
fever. The bands between the ovaries and the intestines caused
her great pain at the menstrual period. She was a semi-invalid,
weak and depressed. When operated on, she blossomed into
a new woman. From invalid she became a successful amateur
athlete. The two weeks of operation and convalescence

HAND TO THE PLOW 185

changed her from a moth in the moonlight to an eagle in the
sun.

Often I am asked whether certain types of patients prefer
women surgeons. This is difficult to answer for we are, broadly
speaking,, as individual as men, but with a few exceptions are,
on the whole, more adaptable. No two patients are alike; some,
when ill, wish and need to be relieved of all decisions, even
of thought; these appreciate the "leave-it-all-to-me" attitude.
Others, made analytical by long illness are offended if the
person to whom they are going "to entrust their lives," will
not take the time to go over details with them. Such a case was
a brilliant mathematician, who had always been a semi-invalid.
On one occasion she spent six months, consulting experts, tabu
lating opinions, testing dosage and reactions in building up
what, to her, was a satisfactory outline of her health.

She placed it on a busy doctor s desk with the remark, "This
may be of interest to you." "Not at all," he said turning it face
down. "You think entirely too much about details which are
my business." He was right, she would not have selected him
if he had not been an outstanding specialist. She could not
in six months, even if willing to be a guinea pig and an analyst
in one, reckon all the factors which were evident to him.

When this young woman needed an abdominal operation,
she decided to come to me and characteristically stated that she
would not take an anaesthetic, be unconscious and helpless dur
ing what was one of the greatest events of her life without
knowing what it was all about. Good old Gray s Anatomy and
several larger charts which I had used to illustrate various
papers read before scientific societies were brought out. She
received a satisfying visual impression. With no more objec
tion or perturbation she made up her mind. Opposite methods
from different doctors had proved effectual with the same
patient. She would not have selected either if she had not
developed complete confidence. The answer is that a doctor
knows that different conditions produce characteristic reactions,
and that the mind is always a factor.

Martha Stillwell is one of the patients, among the hundreds

i86 A WOMAN SURGEON

who come trooping to my mind as I write, that I especially
enjoy recalling. Her mother had died when she was born. Her
father was a kindly, illiterate, capable carpenter, who loved
Martha but who disgusted her by frequently becoming drunk.
She had struggled up somehow; relatives had helped out; she
had been in a children s home for years where she had been
taught many useful things. She was now working in a store,
dainty and sweet, eighteen and engaged to a youth who had
made a good start and wanted to help her create the simple and
quiet home of her dreams. He came to see me as a proxy for
Martha s long-dead mother. One of my rewards has been the
deep, clean hearts and ideals of youth which have been spon
taneously revealed. They were going out West; he wanted to
be sure that all was well with Martha, that no shocks and dis
appointments awaited her. There must be three children
anyway in that future home.

She had suffered severely periodically. This was, of course,
unnecessary; a corrective operation was done. Martha spent
Christmas at the hospital. Everybody there loved the little
bride-to-be and gave her a "shower" which made the grateful
tears sparkle in her eyes as twinklingly as the stars on the big
ward Christmas tree. "This is the happiest day of my life,"
she raptured. "Only the beginning of happy days," whispered
Jack. Through the years I have kept in touch with them, and
all their dreams have come and are coming true.

Until I began this book my only writing had been along
scientific lines, the factual, almost telegraphically condensed
reporting of cases and pathological conditions of interest to my
colleagues. In portraying office reactions rather than physical
details, I find myself in a world which spiritually is as intimate
as a record which might be entitled "Behind the Stethoscope."
The human in each patient is as interesting as the pathological
findings. Some physicians are so busy their fatigue makes them
gruff and they miss this, because patients are afraid to be them
selves in their presence, congratulate themselves that they got
in at all, are reassured by the fact that the doctor succeeds in
spite of his gruffness and are convinced that he must be a very

HAND TO THE PLOW

great man! He makes money but no progress in knowledge of
human values.

Correct posture, so necessary for adequate daily living is
just as important in illness. In the successful treatment of
arthritis, it is essential. I found in surgery that a patient
recovered in less time, if any operation, not acute, was post
poned until the patient had corrected, as far as possible, postural
faults in order to secure adequate breathing space and the
normal relation of abdominal contents. These frequently are
crowded for years and, if left, will cause recurrence of the
defects which the operation corrects. All abdominal organs
are suspended from the spine by a membrane called the peri
toneum. The intestines may be compared to a bias fold on the
edge of a ruffle of peritoneum. In the erect position the ruffle
lies like a jabot. When, however, the patient is equally sup
ported on knees and extended arms, the back alternately arched
and relaxed, takes slow, deep inhalations followed by quick
exhalations, the intestines no longer overlap and after a few
full breaths feel rested and relieved, for nothing any longer
presses, the circulation is stimulated and its even balancing
improves the tone of the tissues. Before all operations I taught
my patients this and other exercises easily taken in bed. Their
minds and muscles were trained to accomplish the resulting
benefits easily. After an operation, when backs ached from
lying on the operating table, life forces were sluggish from re
cent anaesthesia, intestines were empty following even mild
catharsis, which is all that is required if a patient has been
properly prepared, and the nerve network and main nerves
through and to all tissues were temporarily fatigued by the
readjustments which have taken place, I found that even the
smallest exercises were helpful; moving toes and fingers the
first day; the second, hands, feet and perhaps a little more
when turned on the side; the third day, with the assistance of
the nurses, the knee-elbow position with three deep breathings,
straightening out slowly and lying face down for a while. These
gave each day a little more assistance to nature s reparative
efforts, insured no after-pains and speedy recovery.

i88 A WOMAN SURGEON

On one occasion I was asked to present a paper x at the joint
meeting of the North and South Carolina Medical Societies
and took with me a number of charts made by one of my
nurses, to illustrate the above, as well as a point or "two in
operative technique, which demonstrated the use of several
instruments, which, having felt the need of, I had invented.
My colleagues were so gracious it was one of the happiest days
of my life. Several said with delightful possessiveness, "You
work in New York but you belong to us." This gave me a
heart-expanding thrill, for I knew that ancient prejudices had
died. Several of the men were chief surgeons in hospitals.
They invited me to operate in their towns. One was such
a dear! He said, "If you will come, your feet shall not touch
the ground." I was tempted, but common sense prevailed;
they were kind enough to accept my refusal with good grace.
I explained that every operation was a very important event
for me, and if I could not supervise the preparation and after
care, I felt that I could not do the patient or myself justice;
that it would be very unfortunate if I operated an hour or two
after arrival and left the same day, as I would have to, in
order to return on time to my engagements in New York,
for if anything should go wrong, we could not determine
the responsibility; also, that in doing major operations with
assistants and nurses to whom I was not accustomed, things
could not go quickly, smoothly and altogether satisfactorily.

A meeting of our National Medical Association was to be
held in New York City. We were all anxious to extend scientific
hospitality. Five hundred or so medical women would come,
among them Dr. Bertha Van Hoosen, from Chicago, and other
distinguished surgeons. I had seen her operate several times
and wished to share the experience. Mrs. Frederick Wilson
came into the office a week before the American Medical Asso
ciation convened.

"I must have an operation at once," declared she. "I have
been unhappy for many years, but for my daughter s sake have

1 Colonic Distribution in Relation to Gynecology, read before the Medical
Society of the State of North Carolina, June, 1916; published in the American
Journal of Obstetrics, April, 1917.

HAND TO THE PLOW 189

avoided resenting the indignity of my position. Tomorrow she
will be twenty-one. I must have good health in order to
become self-supporting. I cannot ask my husband for money
for personal use without his resenting its diversion from other
feminine channels. When I have secured a divorce, I will be
able to earn money, but this he now refuses to permit. Will
you trust me?"

"Yes, if you will pay your other expenses and enter Miss
Alston s private hospital, with the understanding that a col
league of mine will operate and I assist and that you have no
objection to the presence of other surgeons, who will not know
who you are." Agreed.

There was a patient who had been burdened for years with
a huge fibroid tumor, and who could never get enough money
together to take the time off which convalescence required.
I suggested that she go to Miss Alston s the same day as Mrs.
Wilson. How would her room expense be met? Another
patient, who had a dermoid cyst, was promised that her oper
ation would cost her nothing if she could pay in addition to
her own, the incidental expenses of the fibroid patient. Agreed.

A fourth on my waiting list received similar consideration.
This resulted in a morning of operations for my colleagues and
obvious benefit for the patients. Five years later Mrs. Wilson
sent me a check for $150. She wrote, "This is to refund your
paying that fourth patient s hospital expenses. I want to have
a share in her getting well."

In the course of years, patients varied financially from those
in private rooms at St. Luke s Hospital to street waifs at the
Volunteer Hospital. They spoke various parental languages
and had widely different backgrounds, but each was my deepest
concern for the period in which he or she dwelt in the dim light
which divides life and death. I never became used to the idea
that some must die, nor to the mystic feeling that death s
majestic nearness brings. It keened me for the long and some
times desperate struggle to cure accident cases and those long
poorly nourished or handicapped by complicating diseases. The
patients whom it gratified me most to have consult me were

igo A WOMAN SURGEON

elderly people. I felt vicariously I did something for my
parents.

Important events slip into our lives so quietly that we can
scarcely believe they are true. When I became the first woman
professor in the Medical School of Columbia University, I
actually did not know this was the case until a newspaper
reporter called me up and asked for an interview, which,
ethically, I declined. As calmly as if it were a matter of no
moment I became the associate in surgery of Dr. John Colin
Vaughn and Dr. Gouverneur Morris Phelps at the Vanderbilt
Clinic of the College of Physicians and Surgeons, where twice a
week I instructed the medical students of Columbia during a
large surgical clinic.

Most of the students were earnest and capable, many were
sons of physicians. One day when a truculent student objected
to my correcting his faulty care of two big ulcers, Dr. Vaughn
rebuked him with the comment that embryologically women
have one more chromosome in the achromatic spindle of each
newly forming cell than men, and therefore, he considered
them superior evolutionarily. The bewildered youth became
more stubborn. So did Dr. Vaughn, I tried to smooth mat
ters by pointing out that the poor scrub woman patient lost
half a day s work by coming to the clinic and that she was
entitled to the best service, that the ulcers being large had to
be very carefully dressed and the legs so bandaged as to hold
the dressing in place, thus supporting and not restricting the
circulation. The student tried again, put a bandage on her
left leg so loosely that it dropped to her ankle before she
reached the door, and on the right one so tightly that the leg
throbbed with pain.

Since the boy seemed utterly incompetent to develop into
a physician, I took him aside and asked him why he had decided
to study medicine. He said he hadn t. His father, a plumber,
had wanted to make a gentleman of him and had sent him to
study medicine because his mother thought it would give him
the best entrance into society.

Another member of the class, the son of a distinguished
New York physician, Dr. William Bradley Coley, overheard

HAND TO THE PLOW igi

the explanation and coming forward, said, "Jim, don t you
know it s hell to be poor and sick and old all at once?"

"What has that got to do with it?" asked Jim.

"Until you find out/ his classmate responded, "you had
better assist your father in the plumbing business."

On a winter s day, in a sunny corner of one of the women s
wards in the pay section of the Polyclinic Hospital, six of my
patients, guarded by the same recovery supervision, were lying
side by side. To the casual observer they would perhaps have
appeared, with their hair neatly brushed, their heads and
shoulders resting on two pillows while they read, and the covers
smoothly drawn over them, monotonously uninteresting, but
each was living in an important world of her own.

The operations they had needed were incidental to that
world, and would effect the reorganization of life on their
return to it. The various surgical procedures were as such
things go, important; but happily the patients had now come to
regard them as trivial in the whole scheme of their various
lives, in effect, a period of rest for the readjustment of nature.

One was an artist, the wife of another painter. Their
harmony of occupation had eventuated in stimulating improve
ment in the work of each. While an exhibition was being hung,
Alice agilely mounted the ladder and her husband lifted a
picture up to her. As a nail and she held it against the wall,
he stepped back to get the lighting effect. A man carrying a
heavily framed picture miscalculated his passing distance by an
inch and ran into the ladder. Alice, lightly poised, fell; in the
confusion the ladder or the man s foot struck her breast. A
"lump" developed, which in hardness and size grew rapidly.

Intelligently she sought advice; having had no previous
medical contacts in New York, she called up the Academy of
Medicine and asked for the names of three surgeons. She told
me that while waiting for an appointment with the first men
tioned, she became depressed by the ground-floor gloom of his
office; poor light, the heavy furniture and the din of street
noises made her run away. In the office of the second she found
waiting patients who seemed to her either restless or depressed.
Several picked up and laid down magazines, some of which were

198 A WOMAN SURGEON

old, others obviously not along lines of their interest; there
were no pictures on the walls. Of course she was nervous, who
would not be, awaiting a possible diagnosis of cancer. It was
unfortunate that what was convenient for landlords to remove
as a drug on their market by advertising as "first-floor corner
apartment reserved for doctor s offices," had seemed to her to
reduce her chance of survival. The second surgeon filled her
with a sense of mental isolation, for good pictures were an
essential part of her life. None of her friends had been to a
woman surgeon. Should she blaze a trail? It would do no
harm to call. When she came into my consultation room, to
my surprise her first words were, "I need an operation. HOW T
soon can you do it?" I proceeded with the usual formality of
history of the case; her answers were cheerful and direct. She
was cooperative during the physical examination. I was sur
prised by her practicality. Her name was not unknown as a
painter, and I had expected the supersensitive reactions we
call "temperamental." Venturing to compliment her on what
we call, when we share it, common sense, she laughingly assured
me that she had diagnosed three doctors before she met me,
one of whom was Dr. Morton, and proceeded to tell me that my
waiting room being light and airy, the furniture comfortable,
the patients interested in what they were reading, the garden
pictures on the wall and the smile of my office nurse combined
to reassure and convince her that I had good judgment. In
defense of my colleagues I assured her that other types of people
had their confidence increased by more formal waiting rooms.
Her right breast was removed before lymphatic glands
became involved; she was recovering rapidly. Realizing that
she needed to give the outcome no thought, she was employing
her leisure mentally making out lists of guests to invite to the
next exhibition and planning with her husband, when he
called, several pictures she had had in mind since last summer
at the shore. When she asked for my bill, knowing that she
was rich in things other than money, I asked if she thought it
would be a fair exchange of arts if she sent me one of the
pictures she had planned while convalescing.

A peaceful, sunny beach signed by her now adds its comfort

HAND TO THE PLOW lg3

and confidence to that of colorful gardens. A note accompany
ing it gladdened me: "We are putting on a larger and more
interesting showthree cheers for ars medical"

In the second bed was a sculptor lassie who, after a few
days in a private room, had asked to be put near Alice, as they
had friends and interests in common. With the promise that
neither would speak of her own or any other illness, it was
done. When not sleeping, reading or receiving a limited num
ber of visitors requested to be cheerful, they had entertaining
half-hours of reminiscence and of forward-looking. Each left
the hospital, as dressings were always done behind a screen,
with no idea what operation the other had had.

Readers are, however gentle, more demanding, so here is a
partial case-book summary regarding Beatrice: 23 years old;
history pain growing progressively worse, recurring at regular
intervals accompanied by three days incompetency, fatigue
unduly increased by standing (to which as a sculptor she was
accustomed) ; examinationdiagnosed extreme displacement
of a pelvic organ; operation restored position to normal; re
sultssymptoms disappeared; prize winner in a national com
petition; gratitude that her ability was no longer handicapped
by congestion, pressure and pain.

Patient in bed three: 42 years old; Swedish masseuse,
inflamed bunions on both feet. For years she had endured
increasing pain while relieving others of it. She had given the
artificial exercise, which massage is, to many of my convalescent
patients and to others who could not or would not stimulate
their own circulation, working in spite of increasing discom
fort because she was helping a young Swedish girl to gain an
independent start in a new country and also make a home for
a member of her family. All operations on bones cause ex
treme convalescent pain. Svelga insisted that she could not
afford to take time for preparation by giving up two weeks*
work, staying in bed with her feet up and no pressure from
bedclothes, having daily massage by one of her colleagues and
applications to remove the swelling due to increased blood
supply and thickened tissues. So it was agreed that if I did
not refuse to operate because she insisted on working up to

1 9 4 A WOMAN SURGEON

the last day, she would not hold me responsible for the crush
ing pain she would probably feel the first three nights and
would bear the expense of a private room in order not to dis
turb other sufferersshe was determined not to have even small
doses of morphine. Did she suffer! Was she heroic, did those
splints and bandages torture, did she triumph! Yes and
declared herself rewarded when she viewed with pride the
great toes straight out instead of lying as formerly at a right
angle across the others.

"It is the one best sight I ever saw."

Mrs. Margaretta was in the fourth bed. She was so long

used to chronic indigestion she paid no attention to it until
suddenly she developed pain under her right shoulder-blade,
lost her appetite, felt a warm trickle in her stomach, spat blood
and was diagnosed as having a gastric ulcer. She had a long
stay in the medical ward; apparently there had been several
ulcers, and when they healed, the scar tissue contracted and
interfered seriously with the outlet of the stomach. A gastro
intestinal anastomosis was decided upon in consultation with
Dr. Bodine. He generously acted as my assistant at the opera
tion, the technique of which I had learned from him while
assisting many times in similar cases. The artificial opening
from the greater curvature of the stomach directly into the
intestine is a very satisfactory operation, for everything is in
clear view; the special instruments used are among the most
competently devised in the whole field of surgery and the
abdominal incision is made where, in addition to completing
the work easily and quickly, the operator has an opportunity to
see at a glance much else of importance to the patient; position
and condition of the gall bladder, colon and possible kidney
ptosis being among these.

Mrs. Margaretta was convalescing rapidly and accepting
gladly reeducation on food values and other details of diet such
as intervals, combinations, relation to activity, fatigue, etc. She
enjoyed the comic strips, Svelga the picture section; many
Sunday papers went the rounds and lasted seven days.

A student of sociology, who needed to have the impediment
of a broken leg attended to before she could climb any more

HAND TO THE PLOW

"walk-up" stairs or descend to basements, was in the fifth bed.

She was a wealthy girl with delightfully quaint ideas, which

were very pleasing to the hospital. She offered to pay for one

of the best private rooms for a poor patient of mine and occupy

a ward bed herself, as she explained, in the interests of sociologi

cal observation. Her mind was so active that her leg seldom

occurred to her. She congratulated herself that it needed no

dressing, was in a plaster cast and swung comfortably in a rack

devised for the purpose. She felt half a soldier, she explained,

as now she understood the apparatus which had baffled her in

illustrations of war hospitals. She did not wish to tell friends

why she was in a ward, so was officially out o town. This, she

confided, gave her a chance to write up a few case-histories and,

as her leg came down and her shoulders went up, to read

and have a needed rest. Incidentally, she became disinter

estedly interested in the patients in the ward and those she met

during ^ hours on the roof. She and Svelga were particularly

congenial as she had traveled in Sweden and also would find

massage helpful when they had both ceased to be hospital

comrades.

The sixth patient had a grievance. She was a very nervous
person, and I had thought it well to avoid apprehension and
excitement regarding her operation for the removal of a goiter,
so everything having been clearly understood before she came
in, the day and hour of operation were left to me. I had found
this policy very satisfactory as a routine before operating for
the removal of goiters, as the patients needing that operation
are always at a high tension. I thought it would be useful in
the case of Mrs. Thompson, so I insisted that there should be
no anxious questions regarding when. Accordingly, one morn
ing when she supposed that she was receiving an ordinary
enema, Dr. Gwathmey, originator of the method, gave her a
proportionate mixture of oil and ether which caused her to
fall asleep. 1 She was gently lifted onto the stretcher on wheels,
carried via elevator to the operating room, the abdominal pre-

l Oil Ether Colonic Ancesthesia, read before the Annual Meeting of the
American Association of Anaesthetists, June 22, 1915; published in the Woman s
Medical Journal, January, 1916.

196 A WOMAN SURGEON

paratory dressings were removed, the operation was completed"
and she was returned to bed all in the course of what she con
sidered a nap. Three days later she said, "These dressings are
bunglesome. I don t feel very well and I am tired of waiting
for that operation. If you don t want to do it, I had as well
go home." I was surprised and pleased that the ward nurses
had, when she had complained to them, left it for me to tell
her that it was all over and she was on the road to Wellville.

CHAPTER XVI
IN GRENFELL LAND

SEVERAL times prior to 1915, I had met and talked with broad-
browed, gray-haired Dr. Wilfred T. Grenfell, and knew, as
all the world does, of the great service he renders to the thirty
thousand men congregated each summer on the coast of Lab
rador, to net cod and salmon, trout and herring. Before he
began his work, most of them were hard, uneducated, intem
perate and practically enslaved by the companies which em
ployed them; their clothing and their food were inadequate.
Besides this migratory population, the three thousand perma
nent residents on the bleak shore, called liveyeres, were even
more destitute than the men on the ships.

Miss Emma Demorest, the New York secretary of the Inter
national Grenfell Association and the editor of their magazine,
Among the Deep Sea Fishers -, confided to me in the spring of
1915 that Dr. Grenfell was having a difficult time in securing
the usual volunteer medical and surgical assistants upon whom
he depended largely for hospital work during the summer
months. With the thawing of the ice, the regular small-salaried
staff had to be supplemented by volunteer doctors. But there
was a dearth of those willing to go, since American, as well as
Canadian, doctors were waiting to be called to war service in a
Europe already racked and torn by bombs.

Three groups of other volunteers had also to be secured:
first, teachers to contribute their services in one-storied clap
board shacks; second, college boys to do the rough work; third,
nurses.

My mind was turned toward possible war service at home or
abroad, but when "Demmy" told me that I was needed in
Labrador, I decided that work there might be a training for
practice overseas. Therefore, having earned a vacation from
New York practice by long hours overtime and no week-end

197

19 g A WOMAN SURGEON

outings for several years, I secured a substitute for my duties
in the surgical clinic, at the New York Polyclinic Hospitals and
at the College of Physicians and Surgeons and transferred my
private patients to a colleague. Miss Demorest and I sailed in
June on the Red Cross Line to St. John s, Newfoundland.

Our first stop was at Halifax. Many crude and anxious
soldiers, others debonair and proud of their uniforms, strolled
about. Any one who bought maps, spoke the German language
or made too many inquiries about the war, was regarded with
suspicion.

At St. John s, Newfoundland, Mr. Sheard, the tall, genial
business manager for the Grenfell Association, proudly showed
us the comfortable Seamen s Institute. It was a dream come
true for both Mission and men. The chapel was also used for
illustrated lectures; there were rooms for pool, billiards, reading
and writing; gymnasium, restaurant, shower baths, bowling al
leys and even a swimming pool. The last seemed a bit too lux
urious until I learned that, owing to the ice-filled water, few
of these men of the Far North ever learned to swim. That
evening we saw a moving picture which showed the review in
England of the eleven hundred Newfoundland lads who had
gone to war. People around us called their names and clapped
for their sons as they marched by.

War activities kept every one busy. The Governor and Lady
Davison invited us to lunch with them at Government House.
In the rooms used formerly for receptions and banquets, tables
were crowded with garments, bandages and other hospital
supplies in the making. Orders from hospital headquarters in
London were speedily filled. They had already sent twenty-
four thousand pairs of native wool socks, fifteen thousand
shirts, pajamas, and other supplies.

Governor Davison and I found public health a congenial
topic of conversation. During the time that he had been
Governor of Ceylon, no infectious disease was ever imported.
In the Transvaal he was much interested in beri-beri; one of
its characteristic symptoms is inability to use the wrists or
ankles, owing to exhaustion of the nerves. He told me that an
epidemic had been cured by the use of the oil of turtles. These

IN GRENFELL LAND 19g

creatures were considered so valuable for export that their use
as a food had been prohibited. As a result an epidemic of beri
beri ensued. The embargo was removed; turtles were again
roasted in their shells, the oil and meat eaten; presto! the ill
ness ended.

When I expressed my gratification in his medical interest,
he replied, "Every one, by the time he is forty, is either a fool
or a physician."

After three delightful days we started on the long trip up
the coast of Labrador on the S.S. Sagona through a sea of
icebergs. A government doctor, who came aboard in Trinity
Bay, gave care to the sick along the Newfoundland and Labra
dor coasts as far north as a small ship can go. He depended
upon the chain of Grenfell hospitals and dispensaries along
his route for much assistance. He told us the people as a
whole were healthy and usually lived to be sixty years old,
some to be ninety or ninety-four. Tuberculosis is the only
communicable illness from which many suffer.

When we crossed the straits between Newfoundland and
Labrador, we passed from the temperate to the subarctic zone.
On our way up the coast our little steamship was surrounded,
whenever she anchored, by fishermen who had rowed out from
their small harbors, called tickles, because the entrances and
exits are so ticklish to navigate. The Sagona was the only
vessel on the coast that year and functioned as a post office.
The men rarely asked anything about the war or for any news
of the outside world. Their one persistent inquiry was "How s
fish?"

On the Labrador coast things date by fishing events, such as
"the summer that the run was the poorest," or "the year of the
good catch." We found that there was much anxiety regard
ing the discontinuance, by command of the Admiralty, of the
wireless station. It had been installed to keep the fishermen
informed as to the condition of the ice and the locations of
plentiful fish. This year they had to depend on passing
steamers for information. They were obviously worried, ask
ing, "Where are the fish? Why do they not come? They are
late!"

200 A WOMAN SURGEON

Our ship s captain told me of a hunter who took a great
fancy to his Labrador guide and induced the boy to go with
him to England, believing that on his estate the stalwart young
liveyere would have enough freedom to be happy and also be
stimulated to go to college. The man dreamed of a fine future
for this honest, fearless, blue-eyed young Britonof oppor
tunities that he would open to him. But the lad s square
shoulders and rugged frame drooped. He was grateful, but a
vague discontent possessed him and after several months he ran
away. Working on a sailing vessel he finally reached his be
loved Labrador and the neighbors gathered around to hear
his experiences. He had nothing of interest to relate; he had
been confused and bored by the attentions of strange folks.

* Every thing/ he said, "is noise and bustle. You can t move
without bumping into somebody. And they never eat cod
they eat meat! They know a scarce lot about fishing and hunt
ing, only dull book learning." Carpets and curtains were suffo
cating thirfgs. The partridge and trout did not taste the same,
they were "cooked too fancy/ Every one who heard him, and
those to whom the word was carried in far harbors, pitied the
lad and resolved never to get caught in such a "pickle."

At Battle Harbor the cliffs rose bare with stone ribs out-
thrust, sinister and forbidding. There on the bleak hillside
stood the first of the Mission Hospitals, a two-story white frame
building. Across the entire front was printed in large white
letters on a dark board "Inasmuch as ye have done it unto the
least of these, my brethren, ye have done it unto Me."

Dr. and Mrs. John Grieve, three nurses and several of the
"Wops," as the college lads dub themselves, met us. Dr. Grieve,
a Scotchman, had been in charge of this station for nine years.
He heartily welcomed me as a coworker, but generously sug
gested that Miss Demorest and I travel north, to the limit of
navigation at Nain, on the steamer, since we might not have
another opportunity to make that trip. Beyond Nain no
passenger or freight steamers ventured, for they might be frozen
in. Dr. Grieve explained that we would see the general layout
of all Mission work in this part of the world, and also gain a

IN GRENFELL LAND 301

comprehensive idea of the coast by which to visualize the
winter practice by Komatic along the frozen shore.

Nain is a thousand miles from St. John s; on the journey we
made fifty-six stops. When we reached Nain, we found the
Moravians living in a community house. In order to have
something that was their very own, each family had built a
little tea-house in a so-called garden. There they entertained
each other with a modest Kaffee Klatsch and welcomed infre
quent guests. Back of us rose snow-covered mountains, before
us an archipelago of islands in a shimmering sea. Far and near
glittering icebergs glided majestically like gigantic vessels of
titan lords, perilous to earthly monarchs who dream they rule
the seas. In and north of Nain a Moravian Brotherhood,
mainly from Germany, established Mission stations 151 years
ago. Five now do excellent work among the Eskimos with
schools, chapels and shops for smiths and carpenters.

At Hopedale, on our way south again, Eskimos in their
summer dickey-shirts and hoods, clumsy skirts and skin boots
crowded around us to see a gramophone unloaded. They had
come from a settlement on Hudson Bay to get it. They main
tained a thrifty, independent existence, trading furs and living
mostly on what they killed. Their Moravian teachers have
made music an important part of both their secular and reli
gious education. They sang for us with great gusto, both in
German and English. The records, which they hurried to
make sure had arrived, were by their beloved Harry Lauder.

Eskimo women are usually referred to as stolid, stupid and
un couth. But these women rowed and walked as well as the
men. It is true that after they are married, they occupy the
inferior position, usual among most primitive people. How
ever, brides must be wooed and have enough coquettishness to
exact many promises, which they, as we, expect to be kept.
When the bride has an independent moment, she will not obey
until force is used; but later, as elsewhere, she accepts the
inevitable. One of the missionaries confided to me that the
brides try to see how far they can go before they submit to
domination which is never severe, for the Eskimo is a kindly

202 A WOMAN SURGEON

person. Then, too, change lessens friction. I met an Eskimo
man with his fourth wife, and he is her fourth husband!

Observing an Eskimo girl vainly in love with a Newfound
land trapper, I asked one of the Moravian ladies if mixed
marriages often occurred, to which she replied, "No, there are
no strays or waifs in Labrador." She gave me some details of
the domestic life, among others that wet clothes hung outside
freeze, but the ice is shaken out by the breeze, and then they
dry; another item, that pie made of snow-birds is very tasty.

Further south on the Labrador coast my interest in the
lives of missionaries and Eskimos was incidental to lending a
hand to our ship s doctor, S. S. Smith. Between Trinity Bay
and Hopedale we treated two hundred and fifty patients and
gave out a hundred and thirty-five bottles of medicine, besides
salts, ointments and liniments. But the doctor said that it was
not a busy trip. Whenever we anchored, a number of men,
women and children of all ages came on board with carbuncles,
wounded hands, coughs, lumbago and many other illnesses.
We had a busy time in the little cabin called the "Surgery."
He could see his patients only once in several weeks and did not
have time to attempt anything but a superficial diagnosis. Most
of the patients made their own. The doctor confided to me
that if he disagreed with them or looked them over too
much, they would conclude that he knew nothing. He had
learned never to argue with them.

One morning he pulled out half a broken tooth. The man
said that he didn t need to pull the other half and protested
against its being done.

"All right," said the doctor. Ten waiting patients appeared
pleased.

South of Hopedale at Indian Harbor lies the most northern
Grenfell Mission Hospital. Anchored there were forty fishing
schooners and eight boats laden with salt. Around the harbor
were twenty-six fish-cleaning stages; twelve strongly built, frame,
one-story houses; and twenty-six shacks, the latter used only in
the summer. There were some odd-looking buildings made
from the hulks of old sailing vessels, roofed with sod, a door cut
in the side or end, and small oblong windows.

IN GRENFELL LAND 203

Having no hospitals, the Moravians send their sick in
summer to this Grenfell Hospital. Two motor launches, the
gifts of Yale and the College of Physicians and Surgeons, bring
the patients in. During the snow-bound months Dr. Paddon
goes three hundred miles on a single trip, calling at every house
on the way north but only on the sick as he returns. Often he
has to operate with the patient lying on a kitchen table under
a smoky lamp. Winter winds rock the houses, the doors often
loosen; the noise of their rattling and the fatigue caused by cold
handicap the recuperative power of patients. Living quarters
are crowded; food is scanty and poorly cooked. To survive
they must be sturdy folk.

Further down the coast at Spotted Islands, we took aboard
two patients for Battle Harbor from a Grenfell Mission station*
And at Hawkes Harbor we visited a whaling station. The last
of our cargo was unloaded at Domino. As we drew nearer to
Battle Harbor on the return trip, I felt eager to get to work.
I had enjoyed every hour "down the Labrador" but like all
people accustomed to responsibility I looked forward to putting
on the harness that fitted me and rejoicing in pulling a load.
Dr. Grieve put me in charge of his hospital and neighborhood
practice, for he was anxious to organize a cooperative store*

The cases were many and varied. A boy who had had tubercu
losis of the lungs for fifteen years; a family of father, mother,
two boys and three girls, ranging from nineteen to four years,
all suffering from a skin disease; a child of three with pro
truding bowels who had been sick all winter; a man with a
knee that had been cut eight months before, become infected,
but had to wait until summer for treatment; a boy who had lost
his right hand from an infected thumb; a woman with pneu
monia; another with pleurisy. One man came in with a rib-
punctured lung, so weak from hemorrhage that his only hope
was through transfusion. In addition to meeting the various
needs of these people, I made an average of five out-calls a day,
which required cliff climbing and long walks.

After observing my work for a week, Dr. Grieve announced
himself a patient. He had a number of small tumors on his
neck. These he had long wished to have removed. He refused

204 A WOMAN SURGEON

any form of anaesthetic. Being Scotch, he had made up his
mind how he wished to have the operation done. He had read
of the many soldiers operated on without ether, and he wanted
to see if his physical courage and endurance equalled theirs. It
did. He did not move, or so much as change his stern expres
sion. I told him if he tensed his muscles, turned his neck, or
in any way agitated the field of operation, he not only would
prolong it, but, since many important nerves and blood vessels
are in that region, he would risk injury, as it was necessary to
remove completely the enlarged, imbedded and closely ad
herent adenomata. His experiment put a strain on me, for it
is not easy to operate knowing that the patient is suffering, no
matter how plucky he may be. The experience, however,
proved valuable; the next summer I often had to operate on
unanassthetized soldiers on the Salonica Front.

A patient of whom I became very fond was a little boy whose
rickety legs were exceedingly bowed. His father, a pearl fisher
man, begged that we make the child an able-bodied seaman.
When the lad came from under the ether with his little legs
straight, but aching in the plaster casts, he felt insulted and
humiliated by being obliged to stay in bed. He threw himself
about and was generally furious. No overtures of toys, tales or
picture-books appealed to him, for he was mad clear through
and hurled everything that he could reach at any one who
came near. However, when he felt better, the idea of straight
legs appealed to him, and when the casts came off, he insisted
on wearing shoes and stockingsarticles of apparel that he had
always scorned.

From the elastic off my sou wester hat I made garters to keep
his stockings from wrinkling over his tasseled, mission-box
shoes. He was soon the center of a circle of admiring "Wops"
as clicking the elastics he explained enthusiastically that he
loved to wear "Dotty Morton s darters/

When he was able to walk he asked if I would "cruise" with
him, climbing over the cliffs. I kept ahead of the child in
order to safeguard him from a possible fall. However, in
watching his progress I fell into a crevice and sprained my
ankle. He ran quickly, sure-footedly back to the hospital. Soon

IN GRENFELL LAND 2O5

a chair was brought with poles rigged in the sides. I felt
ashamed of my clumsiness and next morning was on duty as
usual, but as I could not make out-calls for some days I visited
more than I ordinarily had time for with the patients, thereby
learning much about the lives of Labrador dogs and cats, the
ways of netting and jigging cod, the salmon fishery and the
hazards of sealing.

"A feller has to have a good head and a good nerve to be a
sealer. It s a tough game; only them that s got no fear can play
it, hard men that take chances, and many s the man that never
comes home/

A whaler patient told me he did not want "de money wid
de gull on it (U.S.A.) , but de money wid de gallopin horse."
His spine had been injured. He referred to it as his keel.
When he was giving a history of how it occurred, he said, "In
the boat the wood was coming abroad (apart) . We had a bit
of iron for anchor, but it didn t hold. A whale was like to
graze us. It s no wonder them strings (ligaments) burst in
that strife."

Urged to further conversation, he evidently thought it would
be polite in talking to a doctor to introduce a medical touch,
so he regaled me with the information that "cold had got his
guts" and that he had "pains in em when he gulched!"

To change the subject, I asked him why he preferred whaling
to sealing.

"Wai," he replied, "one is as good as the other. Both er hell
a mile and then some, but in this hage hits hup to a mon to
ustle. Th harchangel said, Hup, hup, hup! "

At times, though, he was depressed and declared that he
would never be able to venture more than ten fathoms from his
door. I suggested in that case he might make strads (stools) ,
and that, if he was not well in six weeks, I would send him a
spy-glass. This suggestion made him so happy I decided to send
it anyway. In the course of time, however, he recovered com
pletely and went whaling.

He was much interested in my dressing an extensive burn on
a boy s leg. "Some people has it pretty hard," he remarked

2 o6 A WOMAN SURGEON

sympathetically. "This ere is awful rough on im. Doctor,
I se feared is mother s going to bate im!"

This gave me an idea that I had better go to see her and
explain how her son had accidentally let a pail of hot water
slip out of his hand. She was doing a "bit o sewin "; as we
sat chatting, I helped a bit with the mending, and was amused
when she said to me, "Heave th reel," pointing at the same
time to a spool of cotton!

The whaler s mind was relieved when he learned that there
was no danger of a "bating," for he allowed that there would
have been a "powerful noise and much voice." While we were
talking, the nurse wheeled the child onto the upper porch.

"Belay," he commanded her abruptly.

Then he saw us. He exclaimed that he used to go over the
ground like a partridge on his rackets (snow shoes) and that
if he could get new pegs (legs) he would be all right.

The nurse gave him some handwork to keep his hands busy
while his legs were getting better. He was inordinately proud
of his clumsy stitches on the cardboard and sought for approval.

"Is I sewing this fair?" he eagerly inquired. "I se afeared
I ll git awful scrond (soft) from stayin* in the ouse."

I agreed that it was splendid and, to take his mind outside
where his little self couldn t go, asked him if he liked the
Northern Lights.

"Not so bad," he tolerantly admitted. "But ain t the tea
hove up yit?"

A nautical vocabulary was essential to understanding those
that came in for treatment. A boy with a dislocation said that
he was without a scratch except that his joint had "slipped its
moorings." Another with a bad cut said that he was "scored
by a jagged gash." When the hour approached in which I
usually went for a walk, those left behind always wanted to
know if I was bound for "a cruise," which to them meant an
outing on foot, by boat, or any journey. They sometimes called
a swelling a "pitch"; when inflammation subsided they said,
"It s pitched down." "Clutch in kink bone" meant a sore
throat.

Dr. Grenfell had sent me several messages of welcome

IN GRENFELL LAND 207

although I had not seen him. He was in St. Anthony, New
foundland, the chief Mission station of the chain, busy with
hospital work. One day to my delight we heard that he would
soon arrive on his small hospital boat, the S.S. Strathcona, in
which during the summer he made trips to the settlements
along the coast. He invited me to join and assist him. At every
port people crowded the deck with all sorts of injuries, many
of which in Labrador we regarded as minor, which in the
States would have been major. The skiffs of patients were tied
around the rail of our ship so that from a distance we must have
looked like a hen with an oddly shaped brood of chickens. We
remained in one harbor only so long as we were needed, then
hoisted sail and Dr. Grenfell steered for the next. At each
place we put off a large box of books which were eagerly read
by the villagers and sent on to another town. We also left
clothing and food. Twenty first-aid boxes were entrusted to
each village.

One evening at dusk we ran up on the rocks. The doctor
said that he usually did this two or three times a season. Not a
boat or habitation was in sight in the evening calm. But
gradually people with hawsers, cables, poles, boat-hooks and
other implements appeared on the cliffs above us. They soon
cleared us, and we continued on our way to call on Tommy
and Mrs. Evans.

Tommy was seventy years old a thin little man with a bent
back and horny hands. He had spent his life struggling, with
the sea in the summer for fish, with snow and forests in the
winter for fur. Three generations ago his ancestors had come
from Old England. Now that mighty mother needed help.
Tommy heard the call and decided not to take his usual part
in the fishing but to go to St. John s to enlist instead. With
half the money he and his wife had put aside during long tpil-
some years, he went down to Newfoundland to the recruiting
office and volunteered. The officer gave him a hasty look, told
him bluntly that he was too short, too old and too bent-
Tommy, terribly disappointed, took the first boat home. Greet
ings over, he said cheerily to his wife, "Since I cannot go, \ve
must see what we can send. We have some skins which we

20 8 A WOMAN SURGEON

haven t sold yet. Fetch from the rafters the bundles of pelts. "
His only comment on his disappointment was, "It was a fact
and that is all there is to it."

Together they sorted the skins into two piles. One was for
Great Britain, the other for themselves. A gray fox that had a
thicker coat was equalized by two small pelts. A red fox with
a fine brush was generously put on the British side. When they
came to their one beautiful silver fox there seemed no way to
balance that, so they gave it to England.

Dr. Grenfell and I found Tommy and Mrs. Tom busy with
plans regarding the education of sixteen children, four of whom
were his brother s "motherless bairns, they must have learnin !"
He urged Dr. Grenfell to send to them a teacher. He hoped that
we had brought him a piece of machinery for his boat. When
he learned that we did not have it, he said, "Well, I can get
along without it; I will wait a spell to run the engine."

When I asked if he and his friends liked to read about the
war, I learned that most of them could not read or write.
Philosopher Tom replied, "It s better to do, than read about
doing!"

In another harbor Dr. Grenfell and I called on a blind old
captain and his aged wife who had recently received from
France the message, "Your son was killed in action." The day
before their youngest son had been drowned while fishing.
Neighbors were going to adopt the old pair because they also
had lost two sons. One of these had left a motherless child,
so the neighbors explained to the aged couple that they "needed
some one to take care of the wee one." These good Samaritans
had the best catch of fish on the Labrador that season. "God
knew that we had more to provide for."

Our medical cruise on the Strathcona ended at St. Anthony,
for Dr. Grenfell wished me to see the hospital there. On our
way we stopped at Forteau on the straits of Belle Isle, Nurse
Bailey s station. She had just returned from making her 1,1 84th
visit to 592 out patients in less than a year. She also had four
teen sick people for whom she was caring in her own cottage.
As we neared her harbor, there appeared on the shore the first
growing vegetables that had gladdened my eyes for months. I

IN GRENFELL LAND

was so tired of codfish and canned food that my sense of con
vention deserted me when I saw large, luscious heads of lettuce
in Nurse Bailey s garden. As soon as we landed I uprooted a
head and consumed the succulent, sweet leaves to their stem,
after which I knocked on Sister Bailey s door, confessed, apolo
gized and was forgiven.

We also stopped at Pilley s Island in Notre Dame Bay and at
Twilingate as well to see these hospital stations. As we neared
our destination, the large St. Anthony Hospital with its wide
porches for convalescing patients and the sunrooms below rep
resented the most tangible of blessingsrestored health. On its
gable and between the large windows were the words, "Faith,
Hope and Love abide, but the greatest of these is Love." The
work there elaborated the text.

Near the main building were tents for tubercular patients.
The children s home, a three-story building, was filled with tots.
The two-story schoolhouse and the spired church gave St.
Anthony the look of a city. Dr. John M. Little, Jr., from
Boston was the surgeon in charge, a brilliant man, highly suc
cessful in brain surgery. Dr. A. Andrews from California came
every summer to give his services as an eye specialist, and
Dr. S. Mallet, the dentist, was always busy.

The adaptability of all the doctors was such that one day,
when an orthopedic specialist who was visiting Dr. Grenfell
did some bone surgery, the rest of us all rolled and prepared
the plaster bandages, because the nurses hands were full with
their regular work. During my stay in St. Anthony I had the
privilege of assisting Dr. Little. The release of a club foot
from its shortened tendons; the restoration of the mind of a boy
by relieving the pressure of a piece of bone on his brain, which
had resulted from a severe fall and a crushed skull; a tumor
of the bladder; the removal of a kidney stone which had given
agonizing hours to a man; and many others were especially
interesting in view of the fact that before Dr. Grenfell began
his mission only such relief was available as a blacksmith could
give. One had cut off a man s frozen toes with a chisel and the
neighbors thought the patient lucky to have reached the black-

2 iO A WOMAN SURGEON

smith in time to save his feet. By contrast the Grenfell work
seems to the natives nothing short of a miracle.

A patient in whom I was especially interested was a woman
who was brought thirty miles in three relays, her knees and
hands swollen and deformed by arthritis. A colonic operation
was performed, and her long-endured pain came to an abrupt
end. The liquid disappeared from her knees, as she insisted,
by magic. The magic is Dr. Grenfell s faith and personality.
He has only to say "laboratory/ and one is established;
"X-ray," and it is there!

One of his charms is his constant use of nautical and old
English words which give a salty and whimsical flavor to his
conversation. "You fit in well," he said to me. "People of a
different kidney are not so congenial." Sometimes he referred
to a person feeling "liverish" or being "spleenish," as though he
was an Elizabethan physician.

One morning after a five o clock breakfast, I was taking a
walk over the cliffs with Mrs. Little, who had been a teacher
at St. Anthony when the doctor met her. She was carrying
something to a sick woman. In a few minutes I heard Dr.
Little s voice shouting to me. He wanted me to operate im
mediately on a man who had just been brought in an open
boat, three hours journey over a rough sea. His appendix had
ruptured about midnight. Learning there was scant chance
of the patient s surviving, I surmised that it was better for the
reputation of the hospital that a visiting doctor should lose a
case than a permanent member of the staff. The patient and I
were very happy when, two weeks later, he went home well in
the same open boat. That same day I returned to Battle
Harbor.

My patients gave me an uproarious welcome and thought
more of me for having returned in a schooner. After hospital
rounds for a few days I went afield over the cliffs to deliver
messages entrusted to me in St. Anthony. These social visits
gave me an opportunity to learn how the people lived, to put
together the pattern of industries, living conditions, ambitions,
defeats, love and loss which make the warp and woof of life
everywhere. Their quiet statement of great tragedies made

IN GRENFELL LAND

me feel the whaling, fishing and sealing disasters as if I had
been in them. To one wounded ship that survives collision
with a berg, a dozen perish. The rearrangement of their lives
to fit the inevitable, attests their immutable courage: "We meet
it as we must." There is no grumbling.

In Labrador sheer existence is an unacknowledged adventure.
Adjustment to cold and hunger through long, dark months,
hard physical work, loneliness, the death of large numbers in
shipwrecks, trapped on ice floes, are part of yearly living. So
are neighborly kindliness and faith in God. I wondered
whether their calm was born of the discipline of their hard
lives. It is generally conceded in milder climates that rest
lessness and crime arise from unoccupied energy and an ab
sence of the sense of responsibility. In Labrador there are
abundant responsibilities. Perhaps the liveyeres use in daily
life all the excess energy which in other climates might breed
crime. In any event, their unconscious need of the conserva
tion of strength is an asset to citizenship.

Between sealing and fishing seasons, men turn their hands
to timbering, to carpentry, repairing and building houses, ship
building, mending, cobbling shoes, making and mending nets
and fur trapping. They are happy and easy-going in disposi
tion and have little regard for time, which is sometimes mea
sured by how long it takes a log to burn out; only one end is
put on the embers, and gradually the whole log is shoved into
the fireplace.

The children have no games or toys of any kind. An ordi
nary ten-cent top caused squeals of delight. A doll placed in
the arms of a little girl frightened her so that she hid her face
and began to cry. Sometimes they make pets of an ermine or a
mink. It is rare to find a man or woman who can read or write,
for, as the mother of two boys said, "Us ain t never had no
chance." There had been no teacher in Old Ferolle for nine
years; although the pupils ranged in age from four and a half to
sixteen years, none could read or write.

One evening I put on a light dress with a low collar and a
small ribbon bow. A little girl of eight called me to her bed
side and whispered, "I likes low necks horrid well." She was

212 A WOMAN SURGEON

pleased by some raisins which had been put on her tray. "Them
ain t common victuals/ she exclaimed, "them s berries." One
of the teachers made some fancy cakes for a party. A girl,
keenly interested in the baking, said excitedly, "Oh, Miss!
Look! Your buns is rose right up to snooks!" An argument
arose one day regarding the statement, "Hisn t the bread begin
to rose yet?" This was improved to "begin to risen."

In one home I visited a lame man and his rheumatic wife.
They were sleeping with four children on rags on the floor.
They had "ne er a sup o flour left," but there was a "bit o
molasses and butterine." The Grenfell Mission folk lay away
for the winter bags of flour, corn meal, potatoes, turnips, tubs
of butter, lard, and crates of onions. Last Christmas they enter
tained one hundred and forty liveyeres on beef, sausage, pota
toes, beans, buns and pudding. It was declared a glorious feast.
The arrival of a ship in a Labrador harbor is something like
the coming of Judgment Dayevery one knows that it will
come but no one knows when. As the time approached when
I had to depart or be ice-bound for the winter, my packed
steamer trunk and duffle bag were taken to our little wharf.
Perhaps the steamer would dock in a day or two, more likely in
ten. I was due back in New York to take up my hospital and
private practice.

As I wished to be busy until the last day, however, I re
sponded to the request of a villager who asked me to call. She
confided that for ten years she had, without mentioning it,
carried a very uncomfortable abdominal tumor. She had been
waiting for a woman surgeon. She also confessed that she had
waited to see how my patients "got along." Now her mind was
made up. Would I operate? Yes, if she would come immedi
ately to the hospital. Without hesitation, she gathered together
a few things and we walked to the hospital.

The next morning, the operating room set, the patient
drifting into etherized unconsciousness, assistants in place and
everything ready to make the incision, the low toot of a steamer
sounded. The nurses and I exchanged glances. We knew that
meant that the boat would come and go within an hour. Should
I let my patient out of ether, to face years of discomfort and

IN GRENFELL LAND 313

perhaps a degeneration o this growth? I had a promise to
keep. I proceeded with the operation. The ship s whistle
sounded again, louder and nearer. Some one knocked on the
door and asked what I was going to do. Dr. Grieve insisted
that it might be impossible for me to leave for eight months if
I did not go at once. He added that it was just like that
woman who had needed an operation for ten years to insist on
having it done during the last ten minutes t>f my stay.

I am not Scotch, but I have just as much determination as
Dr. Grieve. Twenty busy minutes passed; there was another
rap on the door. Some one had hurried up the hill. A breath
less voice assured me that the captain had said I was not to
hurry. He would hold the boat until I was ready to go. I
nearly dropped an instrument. When I finished the operation
and ran down the cliff to the wharf, the captain greeted me.

To my amazement, none of the passengers was annoyed. I
told the people leaning over the rail, and calling to me as if we
were old friends, that I thought they were very generous not to
object to the delay. The captain escorting me up the gang
plank, said quietly, "You are here to help our people. Why
wouldn t we wait for you?"

But he took the edge off the elegance of this expression of
gratitude by calling to the crew, "Cast off! We ve hauled the
woman aboard!"

CHAPTER XVII
To THE WORLD WAR

THE activity of Labrador, Newfoundland and Canada in war
work sent me back to my clinic and practice in New York with
the determination to volunteer for war service. Though I had
much to occupy my medical energies at the College of Physi
cians and Surgeons and in my own clinicwith five assistants
under me my thoughts turned often toward war-racked Eu
rope. All America and most of its doctors longed to stem the
tide of imperialistic Germany with service overseas. The citi
zens of the land of my gemutlich student days could not endorse
the horrors that were reported, but I remembered that morning
in Berlin when I had seen the Kaiser pass, followed by machine-
made soldiers. I prepared my affairs for a speedy departure
perhaps never to return, as I fully calculated the danger of
pestilence exposure and cannon fire.

America s sympathies and support were being heaped on
England, France and Belgium. I contributed to many relief
ventures. More and more during that winter of 1915-16, I
heard of Serbia, of the atrocities committed there, of the hu
miliating and ghastly retreat in December of that year, and of
the tardy assistance given by the Allied Powers, even though
Serbia s position was crucial in halting German expansion from
Berlin to Bagdad.

When my friends, Dr. Hans Zinsser, head of pathology at
Columbia Medical, and Dr. Richard Strong, returned from
helping to quell a typhus epidemic in Serbia, they told me much
about conditions there. The more I heard, the more I thought
that my services would be valuable in that ripped and shattered
Balkan kingdom. Perhaps I felt that Serbia might be con
genial, for like the Virginia in which I grew up, it had been
fought over from end to end. I could understand what agony
the Serbs must be suffering. Also, I did not believe for one

214

TO THE WORLD WAR

moment that the shot at Sarajevo had started the war. I knew
enough of old animosities between France and Germany from
having lived in them. When I had attended a meeting of the
British Medical Congress in London, I had learned of the inevi
tability of war between Germany and England based on com
mercial rivalry in South America and in Africa. Serbia had
been made the scapegoat to receive the calumny of the world.
My sympathy for the under-dog flared up.

I went to Washington to confer with Colonel Kain, medical
head of the Red Cross. He looked at me with brotherly kind
ness. "Aren t there enough risks in crossing the Atlantic to
France? Why pick fever-ridden Serbia?"

I wanted to go to the place which needed help most. As to
risk, I had no parents, husband or children. I had everything
to give.

He shook hands with me, saying that he would make me a
"special commissioner of the Red Cross to take to the Serbian
Army sixty cases of supplies which they so sorely needed. I Let
ters were given me by General Ireland, the Medical Chief of
the United States Army, Surgeon-General Blue and other rep
resentative American officials to officials in England, France
and Serbia. Colonel Kain wrote to Mr. Beatty, head of the
American Clearing House in Paris, requesting him to facilitate
the transportation of my cargo to the Salonica Front.

This was -spring, 1916; I was fully prepared to leave im
mediately, but since the supplies would not reach Paris for
some three weeks, I went to England to study the war work of
the women there. Even then it was apparent that eventually
the United States would be drawn into the war on the side of
the Allies. I was anxious to see the cooperative activities
of civilians and hospitalization in a home base. In the back of
my mind a plan for organizing the medical women of America
for service at home and abroad was already dawning. The
more I learned of England s war management of hospitals, the
better I would be fitted, should my plan ever need to go beyond
dawn into cruel and bitter sunlight.

In England, thanks to my friendship with Sir Victor Horsley
and other British doctors like Dr. Mary Sharlieb, I was shown

2i6 A WOMAN SURGEON

all the hospitals and supply methods, the use of private homes
and public buildings for improvised hospitals, bases of supplies,
the strategic placement of each, expense of maintenance, rates
of intake and outgo, as well as staffing in all departments. From
nine in the morning till six in the evening, I haunted work
rooms, war vegetable gardens, markets, factories, first-aid sta
tions in munitions plants, convalescing and nursing homes in
and near London. Always interested in organization, I was espe
cially interested to see its operation under the scythe of war. I
was impressed by the adequacy of the hospitals established in
the government printing office, in the town house of my friend,
Lady Northcliffe, which like every fourth house in London
had become a haven of healing in which the beauty and com
fort of the surroundings added to the spiritual and physical
recuperation of the wounded. In the workrooms set up by
Mrs. Leonard Stokes, her husband had turned his architec
tural skill to the making of fine splints.

When night came, I walked through shrouded London with
a sense of strange foreboding, attended medical meetings in
which war emergencies were discussed, and saw demonstrated
the advances in facial surgery, new orthopedic apparatus and
aids to cripples, both mental and physical, met with medical
women who were reporting their progress in war organization
behind the lines, their plans for the future. It was interesting
to see England almost manless, being run absolutely efficiently
by women, from street-cars to politics. Here was proof of the
equal capability of women.

Late each afternoon trainloads of sick and wounded came to
"Blighty." Silent crowds gathered at the Chelsea Station while
troops from the French Front were transferred from train to
ambulance. Many English boys carried sewn in their clothes a
request that if they were shot they be taken, if possible, to
some particular home hospital. As the long processions passed
through the station yard and out through the great iron gates,
they were pelted with flowers thrown by mute-stricken civilians.
The "flower girls" saved out a few blossoms to toss as the heroes
passed. General or Tommy, dreaming of wife or sweetheart,
of fame or of rest, his first glimpse of home was usually the

TO THE WORLD WAR 217

homely, tired face of a flower vendor. It became a symbol of
the love, the appreciation felt by all England.

I realized that if America s turn came to mobilize, it would
be well for me to acquaint myself with the machinery in which
I would become a cog. The work at the Endel Street Hospital,
directed and staffed entirely by women, was the center of my
greatest interest. There the cooperation, equipment, scientific
work, administration and housekeeping were admirable. The
X-ray work being done by women, especially by Dr. Florence
Storey and her sister who had been trained in the United States,
gave me a thrill of pride in view of the fact that this work was
so new in England the great Sir Frederick Treves spoke of it
slightingly, characterizing X-ray pictures as worthless shadows
fit only to be thrown into the ditch!

Of course, I learned all I could of the home support of the
Scottish Women s Hospitals established in France and on the
Salonica Front. Kathleen Burke had lectured widely through
the United States and obtained large contributions here for the
work established by Dr. Elsie Englis with whom I had a chance
to confer at length. The first unit of this organization had a
dramatic experience in Belgium. Staffed throughout by
women, it was located in an improvised hospital not far from
the French border. Battles raged around and enemy planes
flew over them. Their work went steadily on until one day
the warning came that the Germans were close. "Evacuate at
once!" the order ran. Quietly the surgical instruments, anaes
thetics, disinfectants, bandages, etc., were returned to the
rope-handled cases, of convenient size for them to lift. They
loaded a truck, placed the wounded who were under their
care in ambulances or open wagons and in good order passed
over a bridge to safety, one minute before the bridge was
blown up!

After two weeks in England, I left for Paris, expecting that
the Red Cross supplies had arrived. But Mr. Beatty informed
me that they had not yet come. In any case permission for me
to proceed-as well as for my cases, when they arrived-had to
be on authority of M. Puissac, head of the Bureau des Strangers
of the Ministry of War and likewise of General Serrail in com-

2l8 A WOMAN SURGEON

mand of the French Army on the Salonica Front. M. Puissac
was hesitant about permitting an unaccompanied woman to
proceed through the war zone; perhaps I should wait until a
unit was being sent.

Not until I had urged upon M. Puissac the great need of the
supplies on the Salonica Front, but also the fact that I was
taking sole responsibility for my life-America was taking none,
France need not and that if I was killed en route in the Medi
terranean or there, no one would protest, did he finally consent.
However, I should have to wait for the arrival of my supplies.

The delay was spent profitably in a study of French hospitali-
zation. Thanks to Mr. Beatty and a letter from Dr. Frederick
P. Henry, a loved professor, of Philadelphia, I obtained per
mission to observe war methods in the American Hospital in
Neuilly just outside of sick, nerve-shattered Paris. The order
and cleanliness of everything were typical of our best hospitals
at home; the medical treatment, surgical operations and after
care faultless.

Word came one day that a trainload of wounded would
arrive in fifteen minutes at the Gare du Nord. "Come with
me," said a young University of Virginia graduate who was a
volunteer ambulance driver. In appointed order the twenty-five
white ambulances filed out of the hospital courtyard and sped
through the streets of Paris. At the Gare du Nord the drivers
and the two stretcher bearers from each ambulance stood in
line as the train pulled in with its freight of pain. Sick and
wounded were packed in incredible numbers in each freight
car. On both sides iron tiers held three berths, one above the
other. With the berths filled, the wounded were laid side by
side on the floor. The only blessing was that each man still
occupied the stretcher he had been placed on in the first-aid
dressing station in the trenches, or in the emergency hospital
behind the lines.

These American volunteers in the army of mercy pushed
open the heavy doors on the sides of the improvised hospital
train. They had to hold to the iron uprights in order to steady
themselves, as they worked a mere toe-space between the men
on the floor. Finding some sort of balance, they lifted out the

TO THE WORLD WAR

wounded and carried them into the large depot, where in long
lines iron posts had been fastened in the floor, with hooks on
each side. Slipping the stretcher handles onto these hooks, the
orderlies quickly transformed the Gare into a ward. In five
minutes the train was unloaded.

Each wounded soldier bore a tag, the color of which indicated
his condition. The orderlies placed those of a single color in
the same section of the depot. Those with purple tags needed
immediate care before they could be moved again to a hospital.
Yellow, blue, white and other colors indicated surgical, medical,
shocked and so forth. Doctors and nurses waited, ready to ad
minister aid as soon as the stretchers were in place. Every
soldier was examined by a doctor before being removed. Hypo
dermics were given to the men with purple tags. Desperate
cases were the first to be rushed to the hospital. Less severely
wounded rested in the Gare before being moved again. The
speed, efficiency and order of the whole action impressed me
as the best emergency organization I had ever seen.

French ladies, delicate and gracious, who had become Red
Cross nurses, passed between the rows of resting wounded,
bearing baskets of sandwiches, coffee, cigarettes. With this
kindness a half-smile flickered here and there. Like wooden
dolls with the elastic snapped, legs and arms were all relaxed.
And each wanted something different. Most of them were too
weak to resist being fed or having their "smokes" lighted for
them.

One horny-handed farmer refused everything that was
offered. He turned his head away from all the sickness and
suffering. On an impulse I went over to one of the ladies who
had some flowers in her basket and brought a daisy to the for
lorn and helpless old man.

"This is from the earth, the earth for which you fought."

He drew the stem of the daisy through his fingers. He
caressed each petal. Peace came into his face.

In the national art galleries, changed into French hospitals,
in improvised buildings of all sorts, in the regular hospitals
where the French were working night and day, I found a far
finer type of nurse than that in the French hospitals of my stu-

220 A WOMAN SURGEON

dent days. Except for the Sisters of Charity, they had formerly
been far below the dignified and capable type of women trained
as nurses in the United States and England. In war time, how
ever, the aloof upper class of France bent to the heartache of
having fathers, husbands, sons and sweethearts in the trenches;
with the grace and adaptability characteristic of French gentle
women, they had taken courses in nursing and, with great pro
ficiency and endurance nursed in home, base and field hospitals,
and on board hospital ships.

Every day I jumped on an ambulance to assist in the emer
gency work at the Gare du Nord. In the French hospitals, it
seemed to me too many persons attended physicians on their
rounds. Also the nurses uniforms were not standardized, nor
did they present the starched, immaculate appearance to which
I was accustomed; luckily I made no comment. For it was not
to be very long before I would change my mind and decide
that the French military hospital from the standpoint of men
successfully treated, in ratio to cure and to financial expendi
ture on the Salonica Front was the most efficient of all
countries.

After being in Paris three weeks, Miss Aldrich of "Hilltop
on the Marne" fame, took me over some recently devastated
battlefields, which later were to suffer again. From her I
learned something of German ingenuity in the way of war
preparations. In her neighborhood, long before the actual con
flict had opened, the department stores, and especially provi
sion stores, had remarkably obliging drivers On their delivery
wagons! They were German, it turned out later, speaking per
fect French, most agreeable in offering to put everything away
for the customers, many of whom were middle-aged women,
their men at work in the city or in the fields. The drivers
learned the status of living, how much was purchased, who
habitually kept excess stores on hand and where provisions were
located. There was conspicuous disappearance of these drivers
when Ae war began. They came again, however, but with the
invading army, knowing in just what houses food was available,
guiding their comrades to posts of military and personal van
tage, not only in this section of France, but throughout.

TO THE WORLD WAR 221

Finally came my supplies for the Salonica Front; my papers
were cleared. Instead of on a troop transport, I sailed from
Toulon on the passenger steamer, La Bretagne, transformed
into a hospital for Mediterranean service as Bretagne IL The
ship was carrying out hospital supplies and would bring back
to France the soldiers wounded in Serbia. There were two
French nurses and one English nurse on board, a Catholic priest
and a Protestant minister, several other doctors, like myself,
going to the front. Bretagne II was painted white with a wide
green stripe around her center. It gave me a feeling of elation
to know that the ship, because of its mission of mercy, did not
need to be darkened.

As we approached Cape Malea on the barren coast of
Greece, the ship slowed down. I was standing beside the cap
tain on the bridge when he pointed to a smajl cloister and
church on a rocky ledge.

"Hermits have lived there for many years. We always sa
lute as we pass."

On the lower deck the sailors had congregated, gazing to
the shore animatedly, searching for a sight of the hermit.

"There he is," cried one. "He waved to us."

They removed their hats and crossed themselves.

The captain said softly, "His benediction is on us."

Known for a certain literary ability as well as seamanship,
it seemed odd that the captain neither spoke nor understood
English. Much I had forgotten but I struggled to make my
French understandable, and he told me much of war, of
France, of Greece and of Serbia.

The next day the double line of nets protecting the harbor
at Salonica opened for us, as airplanes and dirigibles circled
overhead. Ships of all the Allies nestled in somber comrade
ship. Our vessel passed so close to the quay that I could see the
lines of ambulances going to the front, marching men, generals
in automobiles, Italian, Serbian, Hindu, Canadian, French and
Chinese uniforms shifting in kaleidoscopic movement. The cap
tain suggested that, to spare myself the custom-house formalities,
I present my credentials directly to the French military and
Greek civilian authorities. From his launch I stepped abruptly

222 A WOMAN SURGEON

into the dust and color of war. Excited, impatient, I paused to
watch the troops on the march to the front. Here I was near
the war. Loaded ambulances passed the troops, returning from
the trenches. Freight cars were being packed with men; others
were being unloaded of wounded. Rapidly there passed Ser
bian soldiers, British Tommies in shorts, men on donkeys and
horses, official messengers, members of the English Order of
St. John, French Red Cross nurses, as well as the civilian popu
lation of the city. Despite the noise and haste, a hushed order
pervaded the scene. Men and women knew where they were
going. Impetuously I started to run across the street. Sud
denly I heard the voice of the captain of Bretagne II shout from
behind me in perfect English, "If you run like that, you ll break
your fool neck." I halted in my tracks and almost wrecked a
wagon. I thought a relative had sprung up from the ground
in that brotherly admonition.

But I forgave the captain, and together we proceeded directly
to the headquarters of Doctor General Paul Ruotte, Chief of
the Service de Sante of France and her allies, medical and surgi
cal chief of the French Army in the Orient. I told him that I
wished to volunteer my services, as well as deliver the supplies.
He took me immediately to General Serrail, in command of all
troops. With handsome grace and quick comprehension, he cut
short for me all the red tape of war. I was told that when my
cases of supplies were brought ashore, they would be adminis
tered as General Sondermeyer, chief of the Service de Sante
Serbe, should direct. In the meantime, what would I like to
do? Learn about field military hospitals? Certainly. With
French kindness, General Ruotte suggested that I accompany
him on his inspection of all hospitals and sanitary formations of
the front from the base hospitals to the front-line dressing sta
tions. I shook his hand warmly. General Serrail stamped an
official seal, and from this intensive tour came one of my most
vivid experiences of the war.

CHAPTER XVIII
ON THE SALONICA FRONT

FROM the balcony of General Serrail s headquarters we looked
down on moving regiments and thrilled at their measured tread.
But during the next two weeks, while on our tour of inspection,
I saw the loads of wounded, the mutilated bodies in the hos
pitals, the bare ugliness of the trenches, and realized fully the
grim horror of war.

General Ruotte showed me the detailed arrangement for the
care of wounded in the trenches. I stood on the ledges to which
the men stepped up when they fired their guns, and from
which in some cases they had moved forward less than an
hour before. We found food on the improvised griddles,
blood-soaked dressings, shoe leather, buttons, pieces of cloth
ripped from uniforms, torn bandages, branches of trees still
green which had been used to camouflage the cannon. At
some places there were interesting historical chips of buildings
old in Turkish times, ancient Greek tear vases, pieces of am
phora. Near Salonica rose the hills on which Alexander the
Great had walked with his teacher, Aristotle both of them
Albanian born. Near by stood the hills where Paul had
preached, for the present Salonica is the old Thessalonica. St.
Paul s epistle to the Thessalonians came into my mind. Had
the world really progressed since the days of his earnest exhorta
tion? We had had his Christianity nearly two thousand years,
but we needed his words again as much as those to whom he
had first preached them.

However, as General Ruotte took me through field hospitals
just behind the lines, dressing and wayside relief stations, I saw
how French efficiency operated under fire. Each of the
wounded was brought all the way from the trenches on a single
stretcher, just as those arriving at the Gare du Nord in Paris.
There is minute hospital organization order in war to save life,

223

224 A WOMAN SURGEON

as well as shambles and horror for its destruction. People are
shocked by the destruction, because they feel inadequate in the
face of it. As we went further, the sense of helplessness began
to be replaced by gratitude that I might help the suffering.

At the English headquarters I called on General Whitehead,
chief of the British Army Medical Service on the Salonica
Front, to whom I had a letter of introduction from Mrs. White-
law Reid. He urged me to work in an English-speaking hos
pital. But I wanted to see all the hospitals before choosing the
one to work in; also, I was anxious to learn as much as possible
about the French system. America would undoubtedly enter
the war, and I wanted to know which nation s medical methods
were the most efficient as well as economical.

General Whitehead took me through the splendid Canadian
hospitals. Of the many I visited, these had the best installation
throughout. The Hindu hospitals had the worst. The operat
ing room in the Canadian hospital was lighted by a huge mov
able acetylene lamp, a model for any hospital the more
remarkable when the base of supply was half-way round the
world. Since the Salonican civilian hospitals were all in service
for soldiers, Dr. McMurchey, chief of the Canadian doctors,
was the sole hope of ill citizens of Salonica. Whenever there
was a temporarily empty bed, he took in a woman or child who
would otherwise have died.

Anglo-Saxon energy was evident. The convalescent soldiers,
cheerful and restless, cultivated amazing flower-beds, patterned
with colored pebbles and sea-shells which they gathered with
the competitive zeal of children. As their loved ones were safe
across the sea the Canadians escaped much of the shock and
war strain that victimized the Serbians and French.

Two of the most interesting English-speaking hospitals were
run by women: the American Unit of the Scottish Women s
Hospitals by Lake Ostrovo in Macedonia, and another of their
units on the Bay of Salonica. The first was financed by Ameri
can contributors with Dr. Constance Bennett of New Zealand
as its chief. The ambulance service, the tents and the rest of
the equipment were of an order to please a doctor s eye. The
serried lines of white tents stretching up the hill above the

ON THE SALONICA FRONT

lake were filled with Serbian soldiers. I made inquiry as to
the efficiency of hospitals run by women in comparison with
those staffed and directed by men. In some respects, the Scot
tish Women s Hospitals units had an advantage over other
military hospitals. They had more money to use for the
comfort and care of their patients because they had caught tEe
imagination of the public, had excellent publicity in Great
Britain and in America, and they had a systematic volunteer
service in all departments. Their unit by the Bay of Salonica,
about two miles east of the town, was truly mobile. The out
door field kitchen and all accessories were easily and quickly
transportable. Their portable X-ray outfit was the best on that
front. Three notebooks filled with condensed details of equip
ment and upkeep, as well as the advantages or possible difficul
ties of war hospitals run by women, were useful later in working
out my plan for increased service with the same- personnel and
materials. This unit and the one on Lake Ostrovo were
directed by a board in Edinburgh. The home organization
and field work functioned well together.

Italian, Gr^ek and Russian hospitals also furnished data for
my survey. t)r. Ruotte took me, also, to a hospital where a
Serbian physician cared for his countrymen. All the others
for Serbian sick and wounded, except this and two others which
I visited later, were staffed by French doctors who unfortunately
did not know the Serbian language. We were met by a tall/
gaunt man about thirty-five years of age. He spoke both French
and German, inviting us to go through his tents. They were
old, patched, brown. Inside, there were two planks to mark
off the path along which we walked. Against this plank men
rested their feet feet which were torn, bruised, muddy, some
of them tied up in sacking, some in worn sandals, others bare
except for the mud which covered them. The soldiers leaned
their heads against the canvas walls of the tents, packed so
closely together they could not turn. Many were too weak
to move; others had mangled, helpless arms.

I asked why the men were crowded so closely.

"We must shelter as many as we can from the sun," he re
plied and added, "These tents are all we have."

2S >6 A WOMAN SURGEON

I looked at their feet. "Have you a bucket? We could go
to the lake and bring water to bathe their feet. Have you
socks and soap?"

"We have nothing."

"Their uniforms are so hot. Would you let me help you
take them off? We could put pajamas on them. They would
be cooler and there would be more room."

"We have no pajamas. *

"Could we not put iodine in the wounds to save the men?"

"There is no iodine; I wanted to help many; finding it im
possible, I hoped to relieve at least one."

The high Serbian collar was fastened tight across the neck
of a man, whose face was purple. "Could we just loosen that
one man s collar and put a pillow under his head?" I urged.

With infinite sadness and a depth of pathos, my colleague
said, "We haven t even a pillow."

To think I had forced that man step by step to admit his
utter helplessness, had all but crucified him, driving nails
through his very flesh in making him realize how helpless all
his learning was when he hadn t the means with which to make
it useful. "I am sorry," I apologized, and silently prayed that
God would grant me the power to send supplies to Serbian
doctors to use for Serbian sick and wounded. That prayer was
answered, but not before a year had passed./"

A convalescent Serbian hospital we visited was also greatly
in need of supplies. I inquired of General Ruotte why they
were not available. He replied that the French Government
was loaning the money for hospitalization, and by the terms
of their agreement with the Serbian Government, they put
French medical officers in charge, and made them responsible
for the expenditure of every centime allocated to their work,
raised by taxation in France. Further, he considered the French
more efficient; their training in thrift, he believed, would make
necessities go further.

Serbian doctors wanted to help their own countrymen. They
could do so only if they received supplies sent directly to them,
instead of to the French authorities. The materials which I
had brought from the Red Cross would not go far, and they

ON THE SALONICA FRONT 227

were surgical aids and medicines, not soap, pillows and buckets.

"This is war," said General Ruotte, gently rebuking my
feminine persistence. "The first-line hospitals are little more
than a shelter from the sun, and emergency stations where .
wounded men may rest and receive first aid before being trans
ferred to field hospitals/

"But these Serbs are not having first aid." I might urge
General Sondermeyer, Chief of the Service de Sante Serbe, to
write to General Ruotte that the need of the Serbians was
greater now than it would be later, in which case he would
send part of the reserves which the French had in store
houses. . . .

General Sondermeyer, when told of the suffering and neglect
I had seen, sadly replied that he could not take that responsi
bility. How could he foretell what battles would be fought
in the next two weeks, what needs would arise even more
urgent than the present?

I went to the English. They said they could do nothing, in
that the terms of their agreement with the Serbs specified that
loans were only for ammunition and equipment, that hospitali-
zation was under the French. I then went to Mr. Fitzpatrick,
the head of the Order of St. John, which was doing on the
Salonica Front work analogous to that done by the Y. M. C. A.,
the Knights of Columbus and other voluntary philanthropic
groups from the United States in France. He said he had to
work in conformity with British regulations. I reminded him
ever so gently that many of the supplies which had been sent to
him from British workrooms had come originally from the
United States, and added I had cooperated with thousands in
helping to fill the ships that had carried all sorts of supplies to
the English workrooms from the "British War Relief Associa
tion" and other friends of Great Britain who knew that Serbia
had barred the way to Bagdad and "on to India." I intimated
that I had a claim on some of the supplies, and that during
two recent weeks in England I had learned that women work
ing to support the activities at the front were interested in all
the Allies, and that women in work-shops, markets, those raising
vegetables, and in all the other excellent activities would re-

22 8 A WOMAN SURGEON

joice in the letter I hoped to have printed in England and in
America telling how the Order of St. John had come to the
rescue of the Serbians. Somehow, his Irish heart found a way,
and it was managed. A quota of supplies was sent from a
private source to the Serbian doctors from England. Aid from
America also soon came.

The cases of American Red Cross supplies were landed.
General Sondermeyer and his staff decided which were to be
used at once and which to hold in reserve; although a thousand
times as many were needed, some must be stored against emer
gencies greater than those existing, which seemed to my Inex
perience overwhelming. However, by this time I knew better
than to make suggestions. The sinking of ships in the Mediter
ranean made strictest economy necessary. The mildly flourish
ing epidemics of typhus, typhoid, dysentery and malaria,
always beyond complete control, might become widespread in a
day. The medical complications in that hot, poorly drained
country were more to be dreaded than surgical casualties.

My duty was merely to deliver the goods with the inventory
and receive a receipt. That left me free to do war work, as I
had originally planned. Having seen all of the hospitals on
that front, and having had a fortunate glimpse into the full
administration of relief, I knew what to expect. General
Ruotte and General Sondermeyer assured me that in volunteer
ing medical and surgical service at my own expense, I would
be welcome anywhere. Every unit was understaffed. I chose
the field hospital at Sedes in Macedonia, about ten miles from
Salonica, a large tent hospital under French direction with
Serbian patients. I wanted to help the Serbians regain health
in order to win back their lost country.

In addition to the French physicians headed by Major
Damon, there were two from Poland and two from Greece.
One of the Poles was a woman expert in laboratory work. In
this international group I began my service for the cause of
Serbia and the Allies.

In our vast tent hospital on the barren fields of Macedonia
we had three thousand men under canvas, with never an empty
cot. When we learned how many mangled or fever-stricken

ON THE SALONICA FRONT 229

men we were to receive in the morning, we had to prepare
during the night to receive them at dawn, by moving those who
could be moved to hospitals nearer the harbor or to hospital
ships waiting there to take semiconvalescents to northern
Africa, Italy or France.

We worked hard and long at Sedes, never halting to con
sider that we were patching up men only that they might return
to be shot again. Our hospital routine was well systematized.
The American hospital at Neuilly averaged eighteen francs,
per man, per day. The French hospital at Sedes, with equally
successful results, i.e.,, the same number of men in an equal
number of days able to return to the front, cost only six francs
a man per day. It was a privilege to learn their routine, and
also to realize how much more comfort, better food and atten
tion the patients in Neuilly received.

The code of the American hospitals has evolved out of many
years of experience with abundance to depend upon many
clinic physicians donating services, nurses in training, graduate
supervisors, dieticians, internes and externes lately from college
to carry out experts orders and guard the welfare of patients.
We are accustomed to relying on the coordinated assistance
which makes a modern hospital efficient.

However, the organization of city hospitals in time of peace
can offer no parallel to those on a far-flung military front,
away from sources of supply, uncertain of whether a submarine
will sink the desperately needed shipments, always meeting
emergencies, improvising, straining every fiber of mind and
body, using every particle of education, ingenuity and courage.
The daily routine at Sedes developed a swift, thrifty self-reliance
which caused me to reverse completely my unvoiced opinion
in France. When I was asked to address medical societies in
America on my return 1 and spoke of comparative military
hospitalization, my colleagues agreed that the French war hos
pitals were more practical than ours. This was partially due to

1 Monroe County Medical Society, Rochester, New York, 1917; American
Medical Society, Atlantic City, New Jersey, 1917; Medical and Surgical War and
Reconstruction Service, published by Women s Medical College of Pennsylvania
in the 75th Anniversary Volume.

2 go A WOMAN SURGEON

requiring fewer paid attendants by having convalescents assist
in much of the work.

Our one hundred and fifty tents contained twenty cots each.
The floors were of hard-packed earth. The nurses on duty were
men, since we were near the front. French padres, because of
their lives of abstinence and their years of unselfish sharing of
a meager diet as they worked in and out of season to assist their
parishioners, lacked sufficient physical stamina to be accepted
when they bravely volunteered for active military service.
Working in the hospitals, these priests had dexterity in manual
work, untiring willingness to be on duty at all hours with
encouragement for those in pain, with comfort for those draw
ing a last breath.

On daily rounds on entering a tent, the single nurse assigned
to those twenty beds for twelve hours would hand me a board
across the top of which were initialed the days of two weeks,
down the left side the number of each cot. In the checker
board lines drawn longitudinally and transversely were written
the morning and afternoon temperatures, pulse and respiratory
rate of each patient. At a glance I could see the change for
better or worse in each patient and in the whole group. This
was especially valuable in times of epidemic, to observe the
trend of fevers, and saved an enormous amount of time, over
having, as in our wards, charts for each patient s temperature,
pulse and respirations.

In making rounds I was assisted by a convalescent patient,
happy to be of service to his fellows. He carried a box in which
there were twelve differently coated kinds of pills and tablets,
each in its own partition of the box. At the end was a stack
of small paper cornucopias. The medicines were plainly
labeled on the partition divisions. I had only to indicate the
color of the iron, arsenic, quinine or other tablets I wished
to give, six brown, two red, twelve white and so on. Another
convalescent with carefully washed hands scooped the required
number of tablets for twelve hours into a cornucopia, folded
down its top and laid it on the table made of a box beside the
patient s bed. The nurse made a record of the orders for
hypodermics, as soon as the visit was over went to the pharmacy

ON THE SALONICA FRONT 231

and obtained the same. The responsibility was wholly his for
this expert work. He not only administered the hypodermics
as ordered, but if any patient needed normal saline or intra
venous injection he secured the prepared solutions to be used
in this form of treatment, from the drug tent, at the same time.
There was no sterilizing of solutions and apparatus which had
to be brought to the bedside. These ampules had all been made
in France, contained the proper amount of medicine in sterile
solution, and were sealed by twisting the end of the large glass
ampule into a ring; a piece of bandage put through this was
pinned to the top of the tent which, because of its slope, pro
vided the necessary different levels of height above the patient.
The nurse had only to break the lower tubular end of the
ampule, insert it into sterile rubber tubing which had a sterile
needle attached, and insert the latter subcutaneously into a
vein, or intermuscularly, the skin having been duly swabbed
with tincture of iodine. This required less than two minutes
for each patient as against ten or more in civilian hospitals.
The nurse remained during the visit to all the patients in his
tent, reporting individual details at each cotsiHe. Convalescent
patients cooperated by arranging the covers in advance in such
a manner as to cause no delay in examining the patients.

When I recalled the time it took to visit twenty patients in a
New York hospital, as compared with the time required at
Sedes, it was amazing to find how thoroughly it could be done
in less than an hour. When the interval for medicines to be
taken arrived every three or four hours, or before or after meals,
the nurse did not go to each bedside, but stood at the entrance
to the tent, "Attention, medizin!" The patients, used to mili
tary accuracy, took from their cornucopias the proper dose,
followed the tablet with a swallow of water, which was by con
valescent patients kept freshly in the cup beside each bed. At
mealtime the procedure was equally expeditious.

Tisane made from verbena, linden, mint or other herbs
often took the place of tea or coffee. The helpers who served
the meals moved quietly but nodded or smiled a cheerful word
or brought a message from one patient to another. The head
cooks and bakers were assisted by convalescent patients who

232 A WOMAN SURGEON

before the war had earned a peaceful living at the culinary art.
Laundry and other work was done by convalescents. They dug
ditches for latrines, built roads in carefully graduated shifts and
carried water. This use of their muscles in varied work hast
ened the revitalizing of their strength, at the same time bridg
ing the nervous period between actual suffering and complete
restoration.

Our two thousand-bed hospital was thus successfully run by
only seven physicians. One nurse sufficed for each group of
twenty men, while in our convalescent tents below the hill
there were one thousand patients who were helpers while under
constant health observation. Three nurses supervised a num
ber, varying from four to six hundred, reporting to the doctor
in charge. There were no nervous demands for extra attention.
Every day men were sent from the convalescent department to
the Serbian military headquarters in Salonica to be reequipped
and redrafted into service. Immediately an equal number of
convalescents replaced them, freeing cots in the upper tents for
acute cases.

Our intake from the front varied according to whether a
battle had been fought the day, or the night, before, or whether
another epidemic had flared. If we lacked sufficient empty
beds to receive our daily average of two hundred and fifty new
patients, it was my duty to ride over the surrounding hills on
horseback to see if we might secure empty cots in another hos
pital and transfer our patients during the night. This would,
of course, depend upon the condition of men in the surround
ing hospitals and also upon whether a hospital boat waited in
the harbor to carry patients to France, or elsewhere.

We had several epidemics, including typhoid, dysentery and
typhus, but the most severe, because of the summer season, was
malaria. To cure these stricken Serbians in unscreened tents
and prevent mosquitoes from biting them and transferring
infection was all but impossible. We had nets over entrance
tent-flaps, but we lacked even sufficient chemical spray to begin
the ^ fight. Men were mowed down like grain. Their bone-
aching agues brought out the sweat on their bodies like white

ON THE SALQNICA FRONT 233

grapes. The sentry at the gate to a ruined Byzantine fortress,
inside of which the staff camped, dropped as he saluted me.

We found that ordinary quinine treatment was not enough.
Drops of bloods were taken to the laboratory at all hours. Each
patient s remission of fever was studied in relation to the plas-
modium malariae in his blood. The rate and time of segmen
tation of these were noted. Our hope of cure was that qui
nine, forty grains or more at one dose, given when the tempera
ture had fallen one degree, would kill the newly formed micro
organisms in their segmentation, most resistant stage. Quinine
distributed throughout the day might reduce the number of
parent cells; it would not destroy the nuclei of the newly
formed cells which, if not exterminated rapidly, became par
ents. We watched the variations in temperature in a thousand
patients each day and the effect of this drastic treatment, noting
the influence of huge doses of quinine upon the system, safe
guarding against variations in tolerance. A marked diminution
of the parasites occurred after the first days of potent treatment.
With each repetition of quinine these lessened until eventually
extinguished. After a short period of weakness in convales
cence, men were able to return to military duty. Many of the
doctors, nurses and convalescent helpers in all the Salonica
Front hospitals were stricken down.

CHAPTER XIX

Jeevela Serbia

MY FIELD of service was on a far frontier, in Greece near the
border of Bulgaria, some miles from the boundary occupied by
the Austro-German troops. One moonlit night the thunder of
the cannon rumbled more persistently than usual in the dis
tance. I had worked under tension all day and felt that I must
walk a little before I could sleep. The white tents spread out
over the hill which had been for hundreds of years a Greek
burying-place. This Greek funeral mound had been chosen
as a site for our field hospital because the water would drain
from around the tents more readily than from more level loca
tions near by. When staking out the tents, the men had found
beautifully fashioned small sarcophagus figures and amphora.
The tents glistened like moon-flowers in the evening light. In
fantasy my mind ran away for an hour from the immediate
pain of suffering men who lay on the rudely made cots. A
thousand weary hearts sought forgetfulness in sleep. Fifty
nurses were on duty, seeing that each man had what he needed
during the night. Visits had all been made, orders filled.

A German dirigible passed overhead. From another meadow
of the sky rose the whir of an airplane. Hiding was useless.
One place was as safe as another. I watched enemy and friend
pass through the air out over the JEgean Sea. Thoughts of
moon-flowers faded. There returned to my mind the patched
accounts, the bleeding words that I had heard from the lips
of sick Serbian soldiers lying in those tents, remembering the
glory and tragedy of their country. One of the officers that
evening, after I had dressed the wound in his side, had told
me something of the brave, unhappy tale of Serbia. I pieced it
and the other accounts together.

No greater injustice has ever been done than Austria s at
tempt to make Serbia responsible for the beginning of the

234

JEEVELA SERBIA 235

World War. Student Gavrilo Princip, the tubercular lad who,
impregnated with mistaken zeal by Vladimir Gachinovich,
jumped on the running-board of the Archduke Ferdinand s
car and fired the fatal shot, no more represented his nation
than did Guiteau when he murdered President Garfield.

The ultimatum from Austria demanded an enormous sum
of money from the little country, already impoverished from
the two Balkan Wars that had devastated her resources of men,
money, food and ammunition. Worse, Serbia was called upon
to admit guilt as a nation. She had no wish for further strife.
But unreasonable reparations were forced upon her, which her
ministers sorrowfully, perforce, conceded until it came to the
last condition: that Austria should sit in the councils of the
nation. For five centuries Serbia had worked, sacrificed, fought
and prayed for independence from the Turks. That victory
could not be lightly tossed aside. The ministers could not bring
themselves to betray the soldiers who had so recently won free
dom for their country. Rather than become a vassal to Austria,
Serbia must for her own integrity refuse to permit that enemy
to decide her foreign and domestic policies. The issue was
forced, as we now know, by Germany who had for fifty years
been planning to reach Egypt and India over Serbia s prostrate
body.

Where the history of the World War concerns great nations,
the events are well known; the fact that Serbia, invaded
by the Austrian army from the west, the Hungarian army on
the north, and on the east by the combined Bulgarian and Turk
ish forces, successfully withstood their attacks, does not stand
out so clearly in world records. She thwarted Germany s plan
of world conquest, her strategic position explained why so much
violence was concentrated against her. Her men, instead of
making truce, had voted to resist and, if necessary, perish.
Serbian valor was the one hope of the Allies on the Balkan
Front. She had held at bay tremendous powers while the
Allies on the Western Front massed for action.

The Berlin to Bagdad route could not be won by Germany
and her allies except across Serbia from Belgrade to Midl
and as winning it was essential to the realization of Hohenzol-

2g6 A WOMAN SURGEON

lern far-reaching ambitions, ruthless and horrible was the devas
tation of the "Little Flowery Kingdom." If she had made
trucefollowing the first invasion, the second, or the third,
the fate of all nations would have shaken in the balance,
for Germany would then have swept on through Mesapotamia,
India, perhaps to the Philippines and our own western shores.
Certainly, if her soldiers on the Eastern Front had been added
to those on the west, the results to France and England might
have been disastrous. But Serbia kept them occupied. We
may consequently look upon Serbia partly as a country sacri
ficed for the Allies.

Forced into war, she met her well-armed foes on three fronts
and repelled them. Her men fought as only those defending
their homes can fight. The Austrians, Germans and Hun
garians poured across the great iron bridge at the confluence of
the Sava and the Danube Rivers, while others swarmed over
in boats. Armed with farming implements, bare-handed, in
desperation, the Serbs went out to meet an overwhelming
enemy. Only one man in six had a gun or cartridge belt. They
threw themselves on the invaders with rakes, scythes, hoes, and
after two weeks of furious fighting forced them back across the
Danube. The river became so choked with the dead that one
could walk dry-shod on corpses across the river from Belgrade.
During the conflict, when a man with a rifle was killed, the man
nearest took his belt and rifle, passing his own spade or scythe
to a comrade whose weapon had been broken. They con
quered.

The dazed enemy took weeks to rally. Then from all sides
they once more crossed Serbia s borders. Armed with weapons
captured during the first attack, the Serbian troops were pre
pared somewhat better for the second invasion. Thousands of
Slavs from Croatia, Herzegovina and Bosnia who had been
forced to fight under the Austrian flag, threw down their
weapons when they found themselves on Serbian soil and ad
dressed their brothers and cousins in their native tongue.
Although technically prisoners of war, the Serbs embraced
them and gave them leave to go freely throughout the country
to visit their relatives.

JEEVELA SERBIA 337

Fateful kindness! These men brought an enemy more
dreadful than the one they had deserted. Through the length
and breadth of Serbia they scattered typhus to soldier and
civilian alike. The fever spread like oil on water. Within
a few weeks scarcely enough were left in many villages to bury
the dead. The strength of the soldiers snapped. Those who
did not themselves fall ill had tugging at their hearts the knowl
edge that wife and children were dying.

Doctors came from Russia, Poland and the United States to
help the Serbians prevent the spread of typhus. With the Har
vard Unit were Dr. Strong and Dr. Zinsser. The typhus was
brought under control, but its effects in weakening the body
and spirit would have bowed down a less courageous people.
At this crucial juncture Germany offered Serbia lasting inde
pendence if she would permit passage of the German-Austro-
Hungarian army across her kingdom. To her everlasting glory,
she took a magnificent stand. Like the little Dutch boy at the
dike, Serbia held back the flood until the Allies were ready.

Psychologically the trauma of the soldiers minds was as
exhausting as the fever of their bodies. But again they fought
with superhuman strength and again they expelled the enemy
from Serbia. Then on the northern and eastern borders Hun
gary, Bulgaria and Turkey doubled their attack. Atrocities
were committed of which I dare not write. Photographs of
deeds, snapped by those who perpetrated them, were found later
in their pockets when they in turn were killed. I have in my
possession some of these gruesome photographs of hangings,
burnings, tortures.

The strength of Serbia waned after the third attack. Her
army was surrounded, outnumbered, ill provisioned, sick in
body and soul. Their endurance was spent; there came a sinister
threat that unless Serbia surrendered all its villages would be
burned and every boy from six to sixteen would be captured
and emasculated. The towns were unguarded; all men from
seventeen to seventy were in the army where they would die.
But the Serbian race must not be allowed to perish. Some
unextinguishable flame in the hearts of these weary men re
kindled. Any hardship might be endured, but not the extinc-

2 38 A WOMAN SURGEON

tion of their people. And they already had learned to take
heed of enemy warnings. Many a Serb had been tied and
forced to look on while a series of soldiers outraged his wife.
They had not forgotten the ghastly tortures and pillaging.

The only solution was a retreat of the entire nation, soldier
and civilian, out of their country to some neutral territory
where they might repair their strength for renewed attack and
regain their land. The young boys must go ahead over the
mountains of Montenegro and Albania to the sea; the army
would cover their retreat. As the enemy troops approached,
officers were detailed by the general to ride day and night
through all the villages, calling a warning. "Like Paul Revere/
said one of my patients. The boys were sent first; then the
women and aged men; finally the army. Thus in the fury of
winter, December of 1915, an entire nation fled southward
across the pitiless, barren, rock-bound mountains of Monte
negro and Albania. During six weeks of agony the hills looked
down on the footsore, the hungry and the ill. My patients at
Sedes were the men who had survived that tragic retreat, re
turned to the front and been stricken down again.

When the first warnings came, mothers, aunts, grandmothers
and sisters packed sacks of food which could be slung over
little shoulders and bravely told the children that on the mor
row they were to start on a wonderful hike with lots of other
boys; they would surely meet this or that cousin. No, they
had never seen him, but they could take a look at his picture
so they would know him and thank him for the Christmas
present he had sent the year before. It would be jolly! With
aching hearts and tearless eyes, the women worked in preparing
their sons for these departures from their homes which would
not be there when they returned. Extra mittens, another pair
of opanci (sandals) , and woolen socks were added to their
bundles.

When night came, an older boy might cling to his mother-
perhaps with a glimmer of understanding. Why must he
go? She might be killed before he could return. He wanted
to stay to protect her. With trembling lips, the courageous
mothers told the sons of the great peril to their country, that

JEEVELA SERBIA __ 339

they must go bravely, that it was the duty o the older youths
to be valiant and hearten the little ones. Thus they must save
the race. Each mother prayed that her son might somehow
reach safety, knowing that if one in ten survived, whether hers
or not, the torch of Serbia s freedom would again be held high.

Not many of the lads hung back, nor did they cry. They
knew with some deep, awesome knowledge that they must act
like men and go a long hazardous way to be men. Some of
the smallest begged their mothers to go with them, but when
they realized that all the boys in the village were going together
and that a young soldier would be their guide, they went out
stoutly, showing how strong and how big they were. Thirty
thousand of them marched bravely through deep snow, by
narrow passes along slippery precipices; they would struggle
on to Albania and the sea. Only seven thousand of them
lived to reach the coast. There they were taken in strange ships
to far countries, as refugee exiles. Many of them died on ship
board from after-effects of the hard trek. These stalwart lads
became living sacrifice for Serbia and the Gods of War. Twenty-
three thousand of them perished.

A few of the officers had automobiles. Where the mountain
roads grew narrow and very rough, they could drive no further
and, not wanting the machines to fall into the hands of the
enemy, they headed them straight out over the precipices at
full speed. The great cars shot out into space, twisting and
turning and bursting into flames as they fell. It was a gruesome
sight. When the women and children came into the moun
tains, the passes were slippery with mud and melted snow.
Sometimes a child walking near the outer edge would slip over
the edge of the cliff and be dashed to pieces. The mother did
not scream or cry. With other orphaned children clinging to
her skirts, strapped on her back, in her arms, she struggled on,
carrying the hope of a nation. Where in history is there a rec
ord of more dauntless women? Our own westward pioneers
were brave, but they had promise ahead and left homes of
comfort, where parents were well and happy.

In the Serbian retreat there were old people, too. One of
my patients in Sedes hospital, who had been wounded and

<> 4 o A WOMAN SURGEON

went out with the civilians, told me of how they took their
kolas (two-wheeled wagons) as far as they could. In them
they had put mattresses for wounded and aged to lie on.
Some drove little flocks of sheep, others carried a few ducks
and geese. As they passed out of the village, they said farewell
forever to their homes, realizing that if they ever came back,
they would find only shell holes and ashes. Soon the carts could
go no further. The aged, unwilling to be a drag upon the rest,
in many instances, with their thoughts on a far horizon, sat
calmly down in the snow to die. Sometimes a woman fell be
cause she was too weak to go further, too hungry and too cold.
Most of these stepped off the trail to die, folded their shawls
over their bowed heads and across their breasts, so that when
the snow covered them they would look like bushes to the
men defending the retreat; sons and husbands coming after
would not know that they had died. I said to my patient,
"Was your mother one of these?" He nodded his head, "I did
not know till afterward. There was no message. She and I
had no need of that. To me she still lives."

After the civilians came the well-nigh exhausted army
through the snow, many a father to find his son s body frozen
where vultures picked and cawed. Shoulder to shoulder with
their men in that humiliating winter evacuation, marched the
old beloved King Peter and his son, Prince Alexander, on foot,
cold and hungry to the starvation point. The recent assassina
tion of King Alexander in Marseilles was a shock to the world,
the tragic end of a courageous and humane monarch. The
soldiers in my hospital spoke reverently of him. On the weary
trek, moved to deep compassion by the misery of his bare
foot and ragged men-at-arms, the Prince maintained an un
flagging cheerfulness. His confidence that bitter defeat was
only temporary, encouraged the depleted Serbs beside him. He
understood that even greater than their physical suffering was
the wounded soul of his people, as they imagined their beloved,
hard-won land overrun from north to south, from east to west,
by Austrians, Hungarians, Germans and Bulgarians. He knew
that if the Serbian soldiers strength survived this retreat, they
would win their country back again, and that they would find

JEEVELA SERBIA 341

ashes in place of homes, shell holes in place of farms, skeletons
in place of cattle. But he kept the vision of a renewed victory
constantly before them.

Beside such campfires as could be built from frozen branches,
Alexander cheered different groups of soldiers as well as his
officers. He urged with true Slav valor the values of defeat,
that strengthened by adversity they would one day enter into
lasting possession of the land they loved. When from scant sup
plies, growing scantier each day, he and his father ate as spar
ingly as possible, slept on the ground beside their men and
joined them in the national song, Jeevela Serbia, which from
time to time rang through mountain passes, their hearts ached,
but they were staunch and undismayed. This and more I
learned from soldier patients of mine.

The spiritual victory Prince Alexander kept ever before his
men was like a torch to light the way on moonless nights, when
the skies were starless and heavy clouds dropped down a
blanket of snow; he gave hope and warmth to their hearts and
so kept thousands of men from perishing on the cold, rocky
sides of the mountains. One of the Serbian doctors, who was
also a poet, told me in describing the retreat that "after days
spent in trying to keep a footing on the treacherous, narrow,
slippery defiles through which we passed, the mountains seemed
monsters gnashing their teeth, eager to devour us."

When the Serbian army, after weeks in transit, reached the
coast of Greece, then neutral, on the Adriatic, ships waited to
take them to the island of Corfu where their government was to
be set up temporarily in an ancient Teutonic palace, while the
army repaired its strength. Other ships would carry those
with scant hope of life to the neighboring island of Vido, where
some hospital care might be given them.

Alexander stood on the shore, his head uncovered, while
many knelt around him in a silent thanksgiving for survival.
The Prince looked over his wasted, hollow-eyed army men
whose sharp cheekbones protruded from their sunken cheeks,
men who tried to smile when they saluted him, their thin lips
drawn back over their teeth as if grinning in the agony of death.
The Prince prayerfully thanked them for their courage.

242 A WOMAN SURGEON

One of the lads who made the retreat told me that "when the
boys were waiting on the edge of the Adriatic for the ships into
which we were to be packed, our feet cut and blistered, our
opanci all worn through, our bodies wasted with starvation,
a strange, gray, shaggy man came up to me and asked in a queer,
thin voice where I had come from. I told him my village.
Tears came down the deep furrows in his face. What is your
name? 1 he asked me. His thin hands trembled. You are
something like a boy I knew there, only you look older/ I
told him my first name. He whispered, Who is your father? 1
I felt very lonely, so my voice shook and I think I sobbed; but
that was only because the man looked so sad and I felt trembly.
I told the gray man my father s name. He said, You are my
son! He died that night; they brought him food but he could
not eat. Others who ate died with food in their hands. They
had starved too long."

Although official duty took the King and Prince Alexander
to Corfu, as soon as he had partially rested and recovered, the
Prince went to Vido to visit the hospitals. Minister Slavco
Gruitch, later minister to America from Jugoslavia, accom
panied the Prince to the island and later told me about it. On
arrival in Vido they found men dying at the rate of six thousand
a day, their bodies placed on barges and towed out to sea for
burial.

The Prince and his companion viewed tent after tent filled
with men about to die. The Prince paled. His voice was low
as he murmured, "What a price to pay for the freedom of our
land! How great the responsibility of those who survive to keep
faith with the dead!"

Minister Gruitch, seeing how profoundjy distressed the
young Prince was, suggested they return to Corfu without
making the full rounds of the tent hospitals, but Alexander
refused. They went on past the dying who lay upon straw on
the ground, fever-ridden, famished, but uncomplaining. The
men lay so close together that if one stretched out his arm, it
fell across the face of two others, who too weak to push it
away would be suffocated. They had no cots, no blankets.

One of these stricken soldiers, exhausted in the shadow of

JEEVELA SERBIA 243

death, later became my patient at Sedes. He told me that he
had utterly lost the will to live. Packed in between two men
already dead he heard a whisper, "Our Prince is here." He
turned his weary head and with dimming eyes looked toward
the door of the tent. It must be a vision, he thought; the
Prince could not really be there.

Then like a breeze which passes gently through dry leaves,
he heard a whisper rustle over parched lips, become sibilant on
all sides. The words were low, reverent, "Our Prince is here."
He felt he was galvanized to live again. He struggled to lift
himself on his elbow, and as he glanced across the tent, he saw
prostrate men struggling, like himself, to raise a hand or head.

Suddenly a feeble cry broke in the gloom, but to his sickness
like a rolling immensity of sound: "We die, O Prince! Long
life to you!" The Prince bowed his head, while unheeded
tears fell on his clasped hands. He could not speak. But after
a moment he drew himself up and gave a military salute to his
men.

Turning, he saw near the tent a great, crude wooden cross,
encircled by a piece of canvas such as we know when fastened
around the rail of a ship s deck. In the center of this marked
off space the cross spread its arms. Alexander walked to the
narrow opening in the low canvas wall and saw the bearers of
the dead place their burdens on the west side, for it was then
morning. He was told that as the day progressed the dead were
placed in a circle, the last lying on the northeast side so that,
as the sun made its daily round, the shadow of the cross blessed
each of the dead; its arms seemed to move as if it lived and
embraced those lying in its shadow. When the sun set, the
dead were gathered up on the barges which took them to the
eternal sea. Earth had been their bed, the sun their benedic
tion, deep waters their grave.

The magnificent power of recuperation in Serbian bodies
and souls was one of the greatest revelations of character in the
World War. Early in 1916 men who had been at the point of
death in December and January were coming by shiploads to
Salonica, there to be reformed into companies, their uniforms
and ammunition furnished by loans from England, hospitaliza-

244 A WOMAN SURGEON

tion provided by loans from France. The most economical plan
for the Allies in restraining Germany on the Eastern Front was
to put Serbians back in the field to win back their country
themselves. And they, loyal and nationalistic, were anxious to
do it. Dauntless, valorous, they marched forward, slowly re
gaining plain and mountain, village after village. And when
at long last the Armistice was signed, those warriors had pushed
back the enemy far beyond the northern frontier of old Serbia
and into Slavic Austria.

During this long siege, when they were wounded or fell sick
with epidemics more devastating than cannon fire, they were
brought back to hospitals in the Salonica area, where we cared
for them.

As thinking of these things I walked in the moonlight, I
saw a shower of falling shrapnel, distant but yet visible. A line
of fireflies seemed to be making its way up the mountain. I
realized that the fireflies were the flames licking up from the
Serbian cannon and that the snorting dragon flames and smoke
along the mountain top were Bulgar cannon. My heart was on
the Serbian side. All my sick and wounded were Serbs. I
knew that every flicker of the flames which looked to me fantas
tic meant mangling and death to men.

Slowly the fireflies were creeping up the mountain, irregu
larly, but none the less creeping up. The cannon from the top
swept them with relentless fire from an advantageous position.
But that advantage was on the hills of southern Serbia soil
sacred to the Serbs. The fireflies were winning back their
mountains. No matter who might perish beside them, they
did not halt. Every man who could load and fire a cannon did
his duty with a bounding heart and dragged the heavy ammuni
tion a few feet higher. Gradually the dragons fell back and
the fireflies went over the top. I had visualized before men
going over the top of trenches; but here were sons and husbands
and lovers going over the top of the mountain and down the
other side in order to discover the fate of their homes, their
wives and children left behind in the great retreat. My prayers
went with them.

The moon had set. Through the darkness I heard a voice

JEEVELA SERBIA

calling, "Doctor, you are needed. The wounded are being
brought in." There was, of course, no sleep for any of us that
night.

In treating those courageous, battered soldiers in our tent
hospital, I came to know the depth and the breadth of the
Serbian soul. I understood what spiritual stamina pushed them
onward to victory that their race might thrive again in harmony
and peace, how even in the complete exhaustion of despair still
blazed that racial desire for a united nation on Serbian soil. I
learned what a great people they are and have always been,
misjudged by a world unable to study their magnificent heritage
of culture.

Epic, exalted in character, they have been deliberately mis
represented by those who envied them the possession of their
farms, mines and other resources. They have often been mis
understood because their language locks their poetry, history
and scientific work away from all but Slavs.

To console and to understand I talked every afternoon
during my supposed hours of rest with the soldiers lying in
the tents. Patients are always like children, revealing, sincere,
unheeding. Listening to their secret experiences on the thresh
old of eternity, a doctor realizes the privilege of hearing deep,
molding events of which, when well, they might never speak.

The Serbian soldiers adored aged King Peter. They re
garded it as no less than a miracle that this slender, frail man,
then in his seventies, had been spared to them through all the
rigors of war and retreat. They felt too, with an almost reli
gious fervor, that in his son Prince Alexander throbbed a qual
ity of leadership upon which they could rely fully when in the
course of time life must flicker out of their beloved king. They
looked to Alexander for the rebirth of their national state.

And their faith was not mistaken. The late King Alexander
was a truly great man. Some prejudiced and uninformed jour
nalists have sought to disparage Alexander. But without him
the modern, redoubled south Slavic country Yugoslavia could
not have come into existence.

Scarcely twenty-four at the time of the war, he knew his
country and his men as only a ruler who has risked his own

A WOMAN SURGEON

life many times for them can. He knew the trials of industrial
ists who under Turkish oppression had tactfully and patiently
struggled. He helped them to take hold anew of economic
hazards when they returned to their destroyed businesses and
homes. He knew every hardship of the farmers. They had
fought side by side. Before he became king he knew intimately
every act of statesmanship in his country and the historic rela
tion of all sections over which he would come to rule. Con
fident in this fearless and sympathetic prince of theirs, the Serbs
followed his vision to victory. No king in any country or era
has been so at one with his people in their suffering and in
their recovery.

A fellow Serbian on battlefields, Alexander had rejoiced
when he saw Yugoslav volunteers from every part of the ancient
kingdom flocking to his standard. Many natives of the country
had migrated to the United States while the old empire had
been under Austrian and under Turkish rule* But the heart
of every Yugoslav is true, wherever he may be, whatever he may
do. Their blood pulses with a nationalism that cannot die.
When their country was in danger of extinction, they returned
to rescue it.

Artisans and artists, inventors, farmers, miners, athletes, men
of every class and occupation, stirred by the Slavic urge, volun
teered as soldiers. From the mines of Pennsylvania, the vine
yards of California, from the business district of Chicago, from
New York and other universities in which they were students
or professors, they came. Without reckoning the cost to them
selves in relinquishing positions in America, they gathered in
the Seventh Regiment Armory in New York City and sailed in
companies to Salonica to help their brothers win back Serbia
and free the provinces of Slovenia, Croatia and Bosnia from
Austrian rule. These men who had become citizens of another
land returned like stalwart sons to save their mother.

Determination and faith won back the ancient empire.
Ninety per cent of the present inhabitants of all the reunited
provinces were and are Slav, far more alike in customs and
ideals than are the various provinces of Italy, France or Ger-

JEEVELA SERBIA

many. Homogeneous in blood and in courage, Jeevela, long
live Yugoslavia!

No one could fully know Yugoslavia who had not been with
that nation in its immortal suffering. Its history of tragedy
and triumph is an ennoblement to the human race. Today
the deathless dead whose bones line the way from Serbia to
the sea rest on the solid, peaceful earth of united Yugoslavia, a
resurrected country. Faith has been kept with those warriors.
Now at evening on the hillsides the hero songs of the guslar
troubadours soar and sing, as they have for ages, telling a new
saga of father and son who died that their country might be free.

CHAPTER XX

Music IN WAR

PEOPLE who cannot sing or play are yet sensitive to the effects
of music, for music is the most spiritual, the most emotional of
all arts. Often I have observed the stimulation of music upon
those who are ill, its influence in crises of individual life. Dur
ing the war I saw it in the climaxes of national existence.

Ever since Tyrtaeus, the lame schoolmaster and poet, some
of whose stirring verses are still sung, was sent in 685 B. C. by
the Athenians to lead the Spartans to victory in the second
Messenian War, the value of martial songs in electrifying patri
otic energy and in lessening fatigue has been appreciated. In
the World War I noted especially the physiological effect of
music in quickening the heart-beat, accelerating the flow of
blood, increasing its oxygen-carrying capacity, in relaxing the
nerves and in restoring endocrine gland balance, along with a
general sedative to mind and muscles.

My gratitude to music began early. I had scarcely outgrown
my preference for lullabies before I found that when I stretched
my chubby self on a rug before the open fire, my head resting
on my Newfoundland dog s heaving side, songs played in the
twilight by my aunt soothed me in a dreamy, iridescent rest.
As the melody progressed, I followed it with vague happy antici
pations of the next day. I expected then something stupendous
to come around the corner tomorrow fairies dancing, or
equally rare delights. Mendelssohn almost promised this. At
any rate I am certain that I sensed early how music brought
both peaceful reminiscence and invigorated anticipation.
When, in the World War, men and women went overseas to
sing to the soldiers, I saw suddenly this individual realization
become universal. During my own service with the Serbian
Army in 1916, I first understood the great potency of music in
lessening suffering and saving life.

248

MUSIC IN WAR 249

Serbia is a musical nation. The "Singing Serbs" meet every
harshness of life, as well as every joy, with song. It is like a
form of prayer. Once when I stood in the midst of front-line
devastation, I saw a bird singing on the edge of the trench.
That little bird singing amid war s destruction was not unlike
the Serbian bards, the guslars who, during the Turkish occupa
tion, sang hero tales of the race and thus kept alive the tradi
tions and history of Serbia.^ From the years 600 to 1200, the
Slavs, through their proximity to Greece, Egypt and Italy, built
up a culture in southern Europe that produced great cathe
drals, great paintings, skill in the arts of weaving, dyeing,
design and countless other handicrafts. Then when the Turks
overran the empire, prohibiting the Serbs during the next five
hundred years from having books in their own language,
schools or religious services, it was only through these bards
who sang of the glories of the past that the young were taught
national history. Music has kept their ideals and their bodies
alive in spite of conquest, defeat and battle.

Late one afternoon, while I was at Sedes, it was my duty to
go on horseback to the neighboring hospitals, the nearest of
which was five miles distant, to determine where we might place
soldiers who had recovered sufficiently to be transferred without
too great risk. There had been a bloody encounter against the
Bulgarians, and cots were scarce. Just before sunset I reined
in my horse before the tent of the director of a large French
field hospital to ask whether he had any unoccupied cots. He
suggested that I accompany him on his evening rounds and
see for myself.

As we went through tent after tent and stood by cot after
cot, I saw that not one patient could be moved. Many of these
Frenchmen had been brought down from the mountains, tied
on stretchers hung on either side of mules. Two men had sur
vived only because their intestines pierced by bullets were
empty from starvation and had no contents to leak out. Such
wounds in peacetime would have caused peritonitis. The
shock and strain of transportation had been so severe that many
of the wounded were still shuddering with pain. Here and
there a man s fingers clutched the picture of a woman, a child.

25 o A WOMAN SURGEON

When we had made the rounds, the doctor asked me to have
the evening meal there, as I still had far to ride. He suggested
that I might stay a little while and hear some Serbians sing.

The frugal evening meal was served on two boards laid
across racks, lit by red-shaded kerosene lamps. The nurses sat
opposite the doctors. As I looked into their faces, I realized
that these women of France were serving under fire because it
was the only way to still the heartaches the war had brought
them. Around their faces floated veils, giving them a madonna-
like halo.

In Salonica the August sun sets quickly out there across the
gulf. There is no twilight. As I looked, the gold and rose
turned to lavender and silver and were gone; the moon came
up. Leaving the table, we found seats on the wooden benches
in the open. Men on stretchers were being brought from all
the tents and placed row on row on the ground. Among them
were men so ill I thought they could not live an hour. I whis
pered this to my host, for if some of them died, it would have a
bad effect upon the others and make it very hard for those who
were to sing. He replied that no one would die while the music
lasted, that on the contrary, they would be better when they
had heard the Serbians sing. I was skeptical as well as curious,
asking if the men who were to sing had been trained for it. I
was told that all Serbians sang, and without accompaniment.

"Where would they come from?" I asked.

"A neighboring hospital. They are scarcely convalescent.
Tonight they come to us for an hour; tomorrow night all of
them may be dead, for although they are not strong enough to
go back to the front, such is their eagerness to win back their
country that they will be reequipped tomorrow and start for the
trenches."

They came the tall, the gaunt, the young, though suffering
had made them look old. Their skin was gray, their eyes were
haggard; they swayed a little as they stood. Perhaps they were
too weak to keep their balance. The French patients lay tensely
upon their stretchers, hands clenched, knees drawn up, faces
white and set with pain. The Serbians sang love songs, sere
nades and lullabies; gay folk-songs; marching songs, steady and

MUSIC IN WAR 251

strong; hymns, tender and reassuring. The wounded French
relaxed; their knees went down; gradually their clenched
fingers unfolded; color came into their cheeks. I saw for the *
first time two physiological effects of music: the soothing of
the nervous system and the stimulation of the circulation. The
words were all Serbian, and so awoke no reminiscences for the
French soldiers. The music alone could account for what I
witnessed. The time, the rise and fall of the beat, the depth
and sweetness of the voices, made language unimportant. No
body died, music turning the tide away from death toward life
for many in whom the energy to recover would otherwise have
been snuffed out that night. It was a deeper, more far-reaching
effect than entertainment^

On another occasion I saw the climax of exhaustion over
come and a company of soldiers saved by the power of rhythm.
This time the men were Serbians and they saved themselves.
We were traveling on a makeshift train which had hauled
freight, but now lacked the protecting sides to which inanimate
freight has a right. But one expects nothing in the midst of
war. Most of the trains on which passengers rode had been
blown up while crossing bridges. We passed them lying rusted
in streams, blocking navigation. Bits of garments floated
around them, and the skeleton arms of the drowned rose and
fell with the swish of the current as if beckoning for aid.

Our engine, courageously puffing along, made the best of
the limited amount of water which the engineer brought in
buckets from a distance to each station, as all the tanks along
the route had been destroyed. The coal dust allotted to our
engineer, by the acting mayor of each town, a crippled soldier,
an old man or woman, was just enough for our engine to pull
the train, if we had luck, to the next village, or at least far
enough for us to be prevented from falling back on that mayor s
town for food. The ration supply in each village was so scant
that the addition of a trainload of troops would probably have
meant starvation for the civilians.

We arrived at Vranja at twilight. The chatter, calling,
bartering, rushing about and general confusion of trying to get
some wayside food did not arouse a sleeping company of

A WOMAN SURGEON

emaciated soldiers lying like dead men on the ground. We
stepped over them, walked and talked around them. Through
their ragged trousers one could see the gooseflesh on their
bluish legs, which were unprotected by socks or underwear.
They slept on the hard earth as if they would never wake. Sev
eral had stones for pillows. But such is the alertness of the
subconscious mind that, although they were oblivious to all
else, when the whistle blew for the train to start, at word of
command they awakened as if by magic in response to their
military training.

The train passengers crowded together to make room for
the officers to pass into the train. The men clambered on top.
Soon it began to rain. Needles of sleet froze on our clothes.
There was no shelter. The guard came to the step and urged
me to get away from the exposed position in which I was
standing. He assured me that the Serbians would be glad to
make way for me to sit comfortably or to lie down where the
rain would not fall on me. I liked him for his concern, for it
was getting colder. I insisted, however, that as long as the men
on top were standing the sleet, I could. The guard passed on.

When he returned, he said, "You won t worry over the men,
if you ll listen when we are approaching the next station."

I had no idea what he meant. The noise of the train was
deafening. We were so jerked about that I thought we must
be going at top speed, though we were actually crawling. The
road had to be inspected ahead of us, especially the bridges,
which were frail, wooden structures, hastily put together to
replace those which had been blown up. We held ourselves
ready to jump and swim every time we crossed one.

After about two hours the station we were approaching was
called. The puffing engine wheezed less loudly, the creaking
and bumping of the wheels and the vibration of the rails died
down, and through the comparative quiet I heard a chorus,
rich and full. The men on top of the train were singing!

The guard returned. "Do you hear?" he asked. "They
have been singing all the way."

My eyes filled with tears. "All through the cold and sleet
and night?"

MUSIC IN WAR

"Yes," he said, "otherwise they would have fallen asleep and
have frozen."

Later I learned the names of the songs they sang. They
were Serbian parallels to our Annie Laurie, Swanee River,
Tipperary, Long, Long Trail, Dixie.

The enormous value of music in the field of medicine had
not occurred to me before. Church music, I knew, had minis
tered to the souls of people since the beginning of civilization,
but that gay, popular music of slight range should fit into
human necessities under so many forms of mental and physical
strain explained to me how its popularity had expanded
in ever-widening waves and descended from generation to
generation.

I wondered how comforting the preponderant monotony of
jazz would be, compared with the Serbian music which was so
rich in melody, harmony and rhythm, and filled with the subtle
something we call timbre. In much of their music the mea
sures are soft and light, the accents falling where they are ex
pected to occur, giving a sense of fulfilment, completion, rest.
Their rhythms fit the meter of their poetry, and the choral
singing in which they excel has a symphonic quality which
takes the place of instrumental accompaniment. But jazz is
the music of restlessness, of nervous excitation, of boredom,
having no lilting melodies to carry with one through life.^.

The full tragedy, the epic grandeur of the Serbian retreat in
1915, will never, can never be told. But the music of the
"Singing Serbs" more than once helped the young boys to
achieve their desperate journey over the mountains. One of
my boy patients at Sedes told me of this when I asked about the
forced marches they made. *>

"How many miles a d#y did you go?" I asked him.

"I cannot tell," he answered. "I only know every day was
much the same. And at night we burrowed under the snow
like dogs do, glad when darkness came to hide the hideous,
jagged teeth of the mountains that seemed to mock us as if
they enjoyed the thought of grinding us between their icy
fangs. At night under the snow it was warm. We tried to
find places that were sheltered by boulders or trees. In the

254 A WOMAN SURGEON

morning if there was a little hole over a boy s face, kept open
by his breathing, we dug him out or he shook himself free.
If not, and the snow was smooth, we knew that he had died and
we left him there in his grave of snow.

"One night we sat in a circle around a pile of icy twigs we
had broken off the trees. They snapped easily and we pre
tended to make a fire. We sang some little songs and then our
national anthem for our goodnight prayer, and fell asleep. In
the morning, when I awoke, the hands I held in mine were cold
in a way that was strange. The boys on each side of me were
frozen stiff. One was my cousin, one my brother."

"Did you bury them?" I asked.

"Oh, no. We had not the strength for that; we left them
sitting in the snow. As we marched on, many boys stumbled
and fell face downward. If they lay still, we left them there.
If they got up and stumbled on, it might be they would live
another day."

"How did you keep up your courage?" I asked.

"Oh," he replied, "when we thought we just could not take
another step, some one would begin to sing; then we could walk
better. We always sang. There was nothing else to do."

If these children had not unconsciously, through music, kept
fatigue and its resulting toxemia from overwhelming them, they
would probably all have died. The tempo of music is in ratio
to heartbeats. So is breathing. Something in easy march time,
like our Onward Christian Soldiers, rang again and again
through the forests which they traversed. After leaving the
mountains, the young officers in charge of this pitiful, ragged,
freezing band of youthful patriots cheered them along also with
the rhythm of Jeevela Serbia. As young as they were, they knew
they had a duty to their country. No matter how young a Serb
may be, he is always old in the sense of responsibility he feels
to his country. It is that which kept alive for five hundred
years their determination to rescue their land. They are the
only nation which ever made a day of defeat their national
holiday. They did so to keep always before them the chal
lenging reminder of the day the Turks won the battle of

MUSIC IN WAR 255

Kosova. Thus their national spirit flamed on like a sacred
fire, tended more faithfully because of persecution./

At another time the colonel in command of the Serbian
Army Medical Service permitted me to go with him on several
inspection trips. We reached the hospital at Dragomancy
about sundown. There, when the war began, the fields had
been furrowed for planting; the corrugated earth was now used
for a hospital site. The wounded lay on the ground on straw
and on the broken branches of trees, in tents which were
stained the color of the earth to make detection difficult. The
"show," as an attack was called, was thrilling, for the Serbian
cannon were so near we could see the flames lick out of their
mouths as they answered the enemy artillery thunder rumbling
over the crest of the ridge. The smoke rolled in heavy gray
and white clouds above the rain of red-hot shrapnel which
poured down upon our lines. We might have thought that w r e
were looking at stupendous fireworks, had we not realized that
men were being blown to bits with every detonation.

Dragomancy was a first-line hospital, active all day and all
night. Doctors and nurses worked until the limits of human
endurance were reached. I have seen them literally staggering
at their work. The Serbian doctors, going off duty, assembled
in the mess tent and after a scant meal, ignoring the ceaseless
rumbling of the cannonade, sang folksongs. With childlike
abandon they sang a Kola dance patter, something about "my
little shoe," for they had been through so much that they could
not bear even slightly emotional music. They had to think of
carefree children dancing the Kola, a national circular dance,
breaking at times in waving lines and coming together again in
great circles over the meadows. The repetitions in the words
and verses were restful. In the midst of death, a child s song
seemed like the renewal of life. The crash of cannon struck the
ear with a sound of doom and the little songs made one think
of things that were soft and tender.

As the appalling engines of death ripped up the ground, one
looked and listened, trying to see flowers sprinkling the hillside
and to hear birds sing, imagining the caress of a spring breeze.
But always there were the groans of dying; yet between the

256 A WOMAN SURGEON

booming of the guns, the gay lilt of the singing doctors traveled
to the men lying on the straw and withered boughs, and the
wounded would smile. One shattered man said to me, "There
were flowers in our Dragomancy fields before the war/

One evening a patient at Sedes was brought into one of the
tents of which I had charge. His temperature was 104; he had
typhoid fever and was delirious. "How spiritual his face is,"
said the priest-nurse. I had seen thousands of suffering men,
but there was something in the clear-cut aquilinity of tEis boy s
face that made a motherly tenderness come over us alL He was
so young. I felt overwhelmed with the pity of war in that it
takes all the best. In this lad s face, one saw the music, art,
history of his people. He was an epitome of the evolution of a
race.

I thought of all the prayers of mothers, the sacrifices and
hopes of fathers, that through the ages had gone into the evolu
tion of a boy with such a face, and as he lay there dying, civili
zation seemed to be fading out. I thought of all the heroes
everywhere, of their mothers and fathers, and felt that if I
could bring this lad back to life, others might also be kept from
leaving it. I whispered to the nurse, "We cannot let him die."
The reply was "What can we do?"

The lad s dry lips were murmuring, his thin, restless fingers
were picking at the sheet. "Give him a hypodermic of mor
phine," I said. "It will quiet him."

The nurse shook his head. "We have so little," he said,
"and we need it for those who have a chance to live."

"Give it to this lad," I pleaded. "He may live."

After a time the boy became semiconscious. Yearningly he
gazed at me. What I felt for him must have been in my eyes,
for his parched lips said, "At last you have come! Oh God, how
I have longed for you."

"He thinks I am some one he has prayed might stand beside
him when he died," I said to myself. Aloud I said, "Yes, I ve
come."

"I am very tired," he whispered. "Sing me a lullaby."

I cannot sing and I knew only two lines of a Serbian
serenade, but to his fevered brain it must have sounded com-

MUSIC IN WAR 257

forting. I slipped my arm under his aching head and crooned
close to his ear, so as not to awaken the men in the adjoin
ing cots.

"Spavay, spavay, laku noch. "Sleep, sleep, goodnight. :

Bog ti bio eu pomoch." God protect you."

"Laku noch" drowsily he whispered, and fell asleep.

The nurse watched and worked over him, as well as twenty
others, all night; in the morning the lad was much better; by
noon he was conscious. "I had a lovely dream," he said, and
I feel that I am going to get well. You brought me back across
the threshold of eternity."

The nurse passed by and murmured to me, "God bless you. ,
It is an omen that all the youth of the world will not die."

My experience was not so fortunate with another delirious
patient.XWhen the light of reason came again into his face, he
mournfully said, if l was beyond suffering, why did you not let
me go?" I tried to encourage him to live by telling him that
his wife and children would be glad that he had found his way
back from the misty border. With infinite sadness he said, "No,
they are waiting over there. Nothing holds me to life, for I
saw them killed/

It was terrible to realize that I had brought this man back
to remember tragedy. "Perhaps when the war is over, I can
find your village. Tell me its name."

"You will not find it. It was bombed and destroyed. My
little children s heads were cut off. Drunken soldiers played
ball with them."

I could not let his mind dwell on anything so horrible.
With an aching heart, I said, "Think of something I can do.
You must think of something."

He sighed, "When the war is over, do not forget my country.
Do something for the children." And he died. I did not forget^
I could not forget. And I kept my silently given promis>/*

One day when I was on my way home to do further war
work under my own flag, I visited a Serbian refugee camp in
Corsica, and there I learned that invalided soldiers, old men,

258 A WOMAN SURGEON

women and children in exile during the seemingly hopeless
years, had made, bit by bit, a songTamo dale ko -which freely
translated runs,

"Far away over there
Where the Sava River flows into the Danube,

My love waits for me.

There, the roses and jasmine bloom," etc.

Of course, they knew there were no flowers on the shell-torn
river-banks and that their loves had probably been killed or
taken to Turkish harems, but they could not bear to dwell on
the tragic truth; they must sing to lessen the loneliness and to
keep alive a shred of hope. Verse after verse was added as the
song traveled from Corsica to southern Italy, northern Africa,
through France and, as the desolate years wore on, gradually
back to Greece, Macedonia and to what had been Serbia.

An artillery officer sang to me the first verse of this exile
song. He was sitting by the sea, too weak to walk, too proud to
complain. His whole thought was on how soon he could go
back to his regiment. Of course, he never could go, but music
kept him from the despondency which would have wrecked his
nerves. He improvised another verse and said, "Do you know
how dear a bit of earth can be? I wish I could hold a little
Serbian soil in my hand. It is now thrice precious for it is
soaked with the blood of all I loved/

Eager to divert him I said, "Can you remember another verse
of Tamo daleko?

He began to sing. It was courage like his that eventually
won Serbia back again, inch by inch, mile by mile, until before
the Armistice the Serbs had regained not only all their former
territory but had won what is now the Banat, a new section of
Yugoslavia, north of the Danube River.

The first refugees who came back to look for homes found
only debris and graves, but they brought a song in their hearts
and soon all along the wrecked streets one heard it being
hummed. When at last their dauntless, victorious army was

MUSIC IN WAR

approaching their capital city, while it was still a long way off,
the entire population of Belgrade, as many as had been able to
come again to their beloved city, carrying flowers and waving
flags, swept out and up along the Topshider road where from
the hills they could see their King, their Prince and all their
men on horseback, on foot and on stretchers, coming back to
the emerald Sava, the blue Danube River and to them. Many
women were there who, alas, could not meet their husbands
and their sons; they had been so cruelly victimized that the
shock would be horrible to the men who loved them, and if
they stayed in Belgrade when all the other women went out, it
would seem that they failed to give a welcome because their
hearts were held by the enemy who had dishonored them.
These tortured women started with joyous impulse to join the
host racing to greet the army, and although yearning to see
once more all they held dear in life, and longing for a reassur
ing touch, they gradually fell out of the procession, and de
liberately cast themselves into wells along the wayside. There
were thousands whose men could never come back again.
These wives were desolate, but they went, daughters and chil
dren also, to hail the victors, and as they ran they all sang,
welcoming the heroes with their own exile song. Company
after company, regiment after regiment, lifted its voice. Soon
the whole army was singing Tamo daleko. The hills above
the rivers echoed and resounded to heartbeats, hoofbeats, sob
bing and singing. So death was swallowed up in victory, and
many who had deepest cause to mourn rejoiced, for their
nation was reborn.

For miles the Danube was still choked by debris of the great
bridge and wrecked boats. I looked at the railroad bridge
which had been blown up by the Germans; their flag had hung
from the arch of triumph which they erected over its ruins.
The Serbs had rebuilt the bridge. In ten weeks it was blown
up again and from its broken piers ribboned timbers and rails
still hung limply. A ferry-boat carried us from the Oriental
Express across the river to Belgrade. That once beautiful city
was a mass of ruins. Against the sky there was nothing to be

5>6o A WOMAN SURGEON

seen but the stark outlines of shattered buildings. The fortress,
the palace, everything jaggedly pierced the quiet sky.

As I gazed on them sorrowfully, at the same time thanking
God the war was over, I noticed an old blind man who held in
his hand a musical instrument resembling a two-string guitar.
He was strumming the strings; to this accompaniment he began
a recitative chant. He was a Guslar, many of whom are in
Serbia. For centuries their songs have preserved the history of
Serbia. Two or three joined in.. Soon every one was singing.
I said to the colonel standing next to me, "It is wonderful to
hear your people sing. They seem to meet every hardship with
music. I think it is song that makes you triumphant through
all the trials the years have brought since in the Middle Ages.
Your people were the scholars and the architects of Europe.
The buoyancy of music has kept you from despair. However,
I do not see how you can sing facing a skyline of ruins."

He looked at me wonderingly. "Why not?" he said. "We
have much to make us sing. We have lost it again and again,
but now we have our land, and its borders are those of the
ancient empire. We are strong. We will rebuild. It is enough.
We have the land. We have once more the empire of the
southern Slavs. Jeevela!"

CHAPTER XXI

WITH THE FRENCH FLEET OF MERCY

Too quickly autumn came to end my long summer service in
Salonica. But I had to return to take up my practice in New
York. However, I fully intended to return the next year to
Serbia with a group of doctors and supplies with which to estab
lish an American Women s Hospital. I knew that I could put
into helpful practice the knowledge of organizing and conduct
ing field hospital units, which I had gained.

The American consul and his wife, Mr. and Mrs. John E.
Kehl, General Ruotte, General Sondermeyer, waved farewell,
safe journeying, from the wharf. In those days with subma
rines attacking all and sundry ships it was no mere parting
pleasantry. They urged my speedy return with an American
unit.

Farewell gifts from some of the soldiers were touching-
faded, torn photographs, clumsily written notes. One sent a
ring made from a bit of aluminum he had obtained from a
wrecked airplane. Others sent tin candlesticks and various
articles ingeniously fashioned from oil cans, which I still
treasure.

I left Salonica on La France, then the queen of the French
trans-Atlantic fleet, but transformed into a floating hospital
under the name France IV. At that time eight ships flying
the French flag carried the sick and wounded from Salonica to
Bizerta in Tunis, and to France: the Blen-Hoa, Dugay-Trouin,
Vingh-Long, Sphinx, Andre-Lebon, Bretagne II, Tchad and
France IV. The first three were merchant vessels of the Messa-
gerie Maritime, running between French Indo-China and Mar
seilles. They had transported the native troops from Tonkin,
Anam, Cambodia and Cochin-China, who-together with the
natives of Algiers, Tunis and Senegal-composed part of the
French army.

261

262 A WOMAN SURGEON

The France IV was then the largest hospital boat in the
world with a tonnage of 2 15,000. For two and a half days she
lay in the harbor of Salonica taking aboard her precious cargo.
Two thousand three hundred sick and wounded were already
on board. In the excursion boat we carried out to the vessel
the last two hundred and twenty-six. Our launch sped past
battle cruisers, troop transports, torpedo boats, freighters, tugs,
Italian and Greek steamers, barges and sailboats. Some men
really too feeble to be moved were being sent. They begged
so earnestly to go to France it was thought that the tonic of
knowing they had started would benefit them. The patients
able to walk hobbled on board with the aid of canes. The
sick, unable to sit up, were carried on the same stretcher they
had lain upon in the ambulance.

On board the ship, the chief physician and his assistants
stood in line at the head of the gangway and directed the
stretcher bearers where to carry every patient, each of whom
wore a tag on which was written his name, military grade and
address, as well as the name of the hospital from which he came,
while the nature of his illness was indicated by the color of
the card.

All the surgical cases were taken to the salon deck where the
former "Salle de Fete" held sixty-two beds. The Louis XIV
salon held fifty-two, the one-time gilded halls now hidden by
white canvas from floor to ceiling, the lower five feet being
waterproofed with white enamel finish. The "Terrace," open
ing toward the stern, had been made into the operating room,
while the former smoking-room adjoining held thirty beds oc
cupied by the most seriously wounded in order to have them
near for dressings.

In the four days of our journey and the three days in Salonica
Harbor, seven hundred surgical dressings and minor operations
were performed in this room as well as three major operations.
Four surgical tables, with a doctor and nurse in attendance at
each, were occupied from eight o clock till noon, and from two
to six daily.

The courage characteristic of men at the front, prevailed; a
soldier, with a bad shoulder wound and another gash reaching

WITH THE FRENCH FLEET OF MERCY 263

from wrist to elbow, sat down as calmly as if to read a paper.
The deeper muscles, blood vessels and nerves were all exposed;
the dressing caused him such pain that great beads of perspira
tion stood on his forehead, and a muscular tremor, past his
control, shook him from head to foot. He made no sound,
until the doctor, seeing he was losing consciousness, said, "Lay
him down." The soldier murmured, "I am all right." Never
theless he was lifted to the table. But ten minutes later he
walked to his bed! There were fractures of the bones of heads,
arms, ribs, collar bones, hips, and punctured wounds of every
part of the body; but those with leg wounds suffered most.

The men looking on from the door showed more emotion
than the men being dressed. Nobody asked, "Will it hurt?"
Nobody said, "Go easy, Doctor." A few cried out, "Enough,
enough/ when thigh stumps were being dressed.

The former barroom of the ship was used for massage and
the "Salon Mauresque" converted into an X-ray room. The
enclosed promenade deck, well ventilated through many large
windows, provided on each side a long ward containing three
hundred beds. Fore and aft men were laid on mattresses placed
on the open sun decks; each had three blankets and kept on his
uniform. During the day many of these hardier ones sat up to
read or work at handicrafts, using pieces of fallen airplanes and
fragments of shells for material. Another deck was occupied
by the personnel of the boat officers, doctors, the nurses on duty
and those going home on leave, the offices of administration, the
doctor s office and the tiny chapel adjoining the priest s cabin.
The lower decks, where emigrants formerly traveled, were filled
with the sick to a total of 2,526.

The first day I made the rounds the patients looked very
tired; the next day there was a marked improvement. It was
cheering to see how much one day at sea had rested them.
Nobody grumbled too grateful for being on the way to France
and having left behind the bombs, the dust, the hot days and
cold nights of October in Salonica. Italy, Messina and Corsica
slipped quickly by.

Here again French organization was evident, for this hospital
ship was conducted with less than half the force the British

264 A WOMAN SURGEON

maintained. The France IV made her first voyage of mercy on
July 14, 1916. In her four voyages between July i4th and
October 8, 1916, she had carried 10,065 sick and wounded, an
average of 2,515 each trip, at an expense of } 140,000 a trip,
exclusive of pharmaceutic expenses and doctors salaries. The
ship carried a chief physician, with a grade of colonel, who
supervised all the hospital work of the ship; a medical chief,
with a grade of commandant; four surgeons, with the grade of
captain, and three lieutenants. The rest of the staff included
two pharmacists, eleven women nurses, seventy-five men nurses
and one hundred orderlies. The doctor in charge of each divi
sion had approximately two hundred and fifty patients.

The second day the Commandant allowed me to visit with
him forty-seven ill officers and two hundred soldiers under -his
care. He examined and prescribed for each with equal pre
cision, showing as much interest in the last as in the first, al
though tired lines showed under his eyes during the last hour,
and I marveled at his patience and endurance.

Each chief of a division was attended by six persons:

(1) A woman nurse, who entered in her record book the
cases needing hypodermics and what was to be given. This
method was used for the administration of many drugs, to save
the stomach and for the ease of carrying and having always
ready the proper dose.

(2) An orderly, who carried a box containing nineteen
medicines in tablet form. Whenever one of these was pre
scribed by the physician it was given at once.

(3) An orderly, who carried a pitcher of tisane, a weak tea,
which the patients liked and which helped them to swallow
their medicine.

(4) A clerical attendant, who carried a large sheet of paper
on which had been entered the patient s name, number, age,
home address, regiment and last hospital. To this he added the
record of diagnosis, temperature, medicine and food. This
bedside record was eventually bound in a book, and beside
saving a vast amount of office work, insured accurate and
prompt war medical history.

(5) A man nurse, who arranged the patient for examination

WITH THE FRENCH FLEET OF MERCY 265

and recorded all prescriptions to be filled. Immediately after
the visit he took them to the pharmacy, returning with and
administering the medicine as directed.

(6) An attendant, who carried a board on which was pasted
a large sheet of paper divided into small squares. In the first
row was entered each patient s number and in the subsequent
squares were recorded the morning and evening temperatures
each day of the voyage.

Any information the doctor wished on the case could be
instantly obtained first hand. This cooperation made possible
rapid and efficient service. Each assistant could respond
promptly to any question about what had been done for a
patient. There was no duplication of work anywhere. Nothing
remained to be done later, which could be done at once. Many
land comforts were not possible, but each patient had his own
water bottle and drinking cup always beside him. Life-
preservers were under every bed.

Rarely have I seen such heroism as was shown hourly on
board the France IV by the men of France, Serbia, Russia, and
the Bulgarian prisoners. Men of thirty-seven looked at least
fifty-five years old. Some had been in hospitals one or two
months. Many had slipped through narrow escapes. One had
an ugly wound where a piece of shell had grazed a main artery.
He showed his Croix de Guerre and his Medaille Militaire,
decorations dearly paid for. He was still in danger of hemor
rhage and death. There was a volunteer from Lille, France,
seventy years old, who had been for eighteen months at the
front and was happy in having been through the Dardanelles.
Every one, no matter how great his pain, insisted he was
improving.

As we made the rounds, the doctors always noticed the men s
decorations. Some had as many as six. The Russians were
always responsive to words of cheer, and many stalwart fellows
looked like great children when they smiled at the few words
of Russian we all learned to say.

Everything had to be done on a large scale. At eleven
o clock, the hour for luncheon to be served, an orderly appeared
carrying aluminum plates, knives and forks in a basket. One

2 66 A WOMAN SURGEON

of each was left with each patient. On the soldiers decks, an
orderly followed carrying two buckets of hot, soft-boiled eggs;
after him came two more, each carrying two buckets of meat
and vegetable soup. Two other men carried four buckets of
well-cooked cereal, and three carried pitchers of milk or tisane.
Huge baskets of bread cut in quarter and half loaves were
quickly emptied. This menu was served to those who were
not restricted to liquid food, but were unable to take the heavier
diet of meat or fish, with potatoes, beans, bread, lemonade or
tisane and dessert. The food was -changed daily, was always
well prepared, carefully inspected and cleanly served. Break
fast consisted of coffee or tea with bread at seven o clock. Din
ner was much like lunch and was served at five. Bouillon could
be had between meals. Every one was asleep by half past six in
the evening.

Most of the surgical cases had daily dressings. Some were
changed every second or third day. In addition to the seven
hundred dressed in the operating room during a day, there were
1,080 done in the four other dressing stations on different decks.
In one of these there was an average of seventy-five daily; in
the other three thirty-five daily.

The Bulgarian prisoners were treated exactly like the French
soldiers, according to their rank. The three officers, two from
Philippopolis, one from Gabrovo, were in large, light and com
fortable staterooms designed for seven passengers. The
forty-two Bulgarian soldiers lay among their former enemies.
A blinded Greek lay in the bed beside a Bulgar with double
pneumonia and a fractured hip.

I marveled that this poor Bulgar could have remained on the
firing line or raised a rifle. His emaciation made his skin cover
his long bones like a glove, with nothing between. His wound
was fresh, his life hanging by a thread. A little French nurse
drew a blanket over him and tucked it under his elbow to lift
his wasted arm from the hard pole of the stretcher on which he
lay while waiting his turn to have his wounds dressed. The
old man looked up into her young, fresh face and murmured,
"Mother!"

As I turned toward the door to hide the tears in my eyes, a

WITH THE FRENCH FLEET OF MERCY 267

Bulgar, waiting there to have his bandages changed, attracted
my attention to his fractured jaw, the lower portion o which
hung loose when the splint was removed. Noting my ready
sympathy, he pointed to his sunken abdomen, waving his hand
deprecatingly, as if to say, "It s little use to bother with me.
The end is near." Here sat this young, lately vigorous man
starving to death, because he could not swallow without using
muscles that would increase his pain. To have passed a
stomach tube would have been torture to him.

Gently the Lieutenant-Doctor in charge of the Bulgarians
adjusted the fragments and explained by gestures that after an
operation he would recover quickly.

I said to the doctor, "You handle the Bulgars as if they were
blood brothers."

He replied, "No man is an enemy after he is wounded/

On benches just outside his operating-room door, eight
mangled men sat waiting to have their wounds attended. In
side, one lay on a stretcher, two huddled over with pain on
chairs, and one lay on the operating table. All day the human
repair work had gone on and would for hours yet. Few of the
patients would ever be physically sound again.

The day before we docked in France, a second tag was
attached to every patient, giving his destination when landed.
The distribution to various parts of France was so prearranged
that trains waited on the pier facing the side of the boat, and
every hospital to receive a convoy knew a day ahead exactly
bow many were coming, how many were officers, the illness of
each, and could prepare their beds, their ambulances and re
ceiving departments.

The intense strain of the work done by the staff on the
France IV could not have been borne had it not been for the
interval of comparative rest afforded by the six days* necessary
pause: two for transferring the patients to the waiting trains,
and four for disinfecting the ship, before its return to Salonica.
As soon as the ship reached the harbor in Salonica the sick were
brought aboard, so that some patients had three days care
before sailing for France.

While the ship lay over at Toulon, the women nurses made

268 A WOMAN SURGEON

shirts, pillow slips and other necessities for the patients. They
managed, too, to prepare trifles post-cards, lozenges, old maga
zineswith which to please the lonely soldiers. This attention
they managed, despite the fact that many had 320 medical
patients under their care or were busy all day assisting with
surgical dressings.

On the voyage in October, 1916, we carried 2,191 fever cases,
nine of which died on the way. A man about to die took
into his trembling hand the tablet the nurse gave him, and
vainly trying to lift it to his lips, said, "Merci, madame." That
night he was buried in the sea. I stood beside the rude bier, a
wooden bench. The figure wrapped in burlap, sewed and tied
with rope to keep the weights of iron in position, lay beside
four others on the deck under the folds of the flag of France.
The ceremony was held quietly at nine o clock at night. The
priest, the ship s commandant, doctors and nurses off duty and
a few sailors assembled.

The ship slowed down, a little door opened near the surface
of the water. The service was read, and finally a whistle blown
as a symbol of the martial music for every soldier s requiem.
The wooden bench was lifted and the body dropped into the
sea, soon followed by another. The company broke away si
lently from the saddest service in the world; no flowers, no
music, no firing of guns, no tears, and the dead far away from
those they would have most wished to see at the last.

The next night at nine o clock I stood upon the upper deck
beside a lifeboat xvhich sheltered from view the burial beneath,
and when the whistle blew I dropped some halPfaded roses on
the waves.

CHAPTER XXII
FOUNDATION OF THE AMERICAN WOMEN S HOSPITALS

ALTHOUGH I had much medical and surgical work awaiting my
mind and fingers in New York City, the very day I landed I
placed my plan for a hospital unit of American women before
M. Gaston Liebert, the French consul-general. My heart was so
filled with pity and admiration for the Serbian people that I
wanted to do as much as possible for them as quickly as possible.
A French lady was in M. Liebert s office at the time and com
mented on the American energy which impelled a person who
had stepped off a trans-Atlantic liner in the morning to take
steps toward her return the same afternoon. I also consulted
Mr. Pavlovitch, the Serbian consul-general in New York City.
Both consuls encouraged my plan.

The following day I went to Washington to report to the
American Red Cross on the discharge of my duties as their
commissioner. I broached the possibility of a women s hospital
to Colonel Kean, after which I called on my good friends, the
French ambassador and Madame Jusserand, and on Minister
Michealovitch of Serbia. All highly approved my plans as
practical, capable of being put into effect at once, and of im
mediate usefulness. I had made extensive notes on all the
war hospitals I had seen, including detailed expense accounts
of equipment, upkeep, food, staff salaries, deterioration and
other items.

When I returned to New York and was again busy with
clinic and private practice, I heard more frequent reports o
America s entrance into the war. It seemed an inevitability.
In anticipation of being needed at home, I helped Dr. Josephine
Walter to organize a hospital to be known as the Women s Army
General Hospital No. i, in which I would do surgical work.
This plan had the approval of Dr. William Gorgas, Surgeon-
General of the United States Army, and of Colonel Randolph

269

A WOMAN SURGEON

Kean o the American Red Cross. If America did not enter the
European conflict, I intended to interest many people in the
acute needs of the French and especially of the Serbian sick and
wounded and go again to Europe, taking with me a complete
hospital outfit, from admission cards to ambulances.

Preparations for this went forward during the winter of
1916-17 in the midst of my regular work, while I also raised
money for clothing, food supplies, medicines, raincoats, ambu
lances and writing paper which I shipped to the Salonica Front
at once. In April, 1917, the United States declared war. When
the second annual meeting of the Medical Women s National
Association convened in June of 1917, throughout the United
States the thought of medical women was turning toward war
service.

Our one-year-old National Association was eager to serve; no
definite schedule of operation, however, had been formulated.
The coming together of medical women in New York City from
all parts of the country was hailed as a timely opportunity for
offering a constructive program to fit into that of the American
Red Cross and to collaborate helpfully with other organizations.

I had been asked to make an address on "The Work of
Women Physicians and Surgeons in the European War." I
spoke also on gas gangrene and its treatment, on facial surgery,
the complications of hunger, exposure and fatigue in surgical
conditions, the ratios of wound healing with the use of the
Dakin-Carrel solution, demonstrated that, and also the ambrine
treatment of burns.

An adjourned meeting was called for the following day for
"settlement of the very vital question of the part that women
physicians will take in the war. . . ." A motion was passed
that a committee be appointed to create practical organization
for this work, the committee to be styled the War Service
Committee. The President, Dr. Bertha Van Hoosen of Chi
cago, and other colleagues urged me to accept the chairmanship.
But I declined because I wanted to put my already endorsed
plans for a Women s Hospital of American doctors into action
at once. And I considered the need of my services as a surgeon

AMERICAN WOMEN S HOSPITALS 271

at the front greater than in organization work in the United
States.

It was urged that I could accomplish all my hopes under the
Medical Women s National Association. I demurred. I knew
how difficult it would be for people who had not been close to
the war to visualize its reality; also how much time would be
required to get in contact with women throughout the country,
classify and harmonize their education and enthusiasm into any
practical war activity. Doctor Marion Craig Potter, of Roch
ester, New York, and many others who had been active in
that work, insisted that organizing the Public Health Education
Committee in 1909 having put me in touch with men and
women doctors in virtually every state in the Union, I could
more easily than any one else gain their cooperation now. It
was thought an advantage that I had known General Gorgas
and many others in high official positions, socially and profes
sionally, for years; and furthermore it was considered my duty
to make my observations and experiences of use to those who
had not already had the privilege of serving abroad.

It was a good argument, but I frankly believed that a scat
tered committee of members in different states would not be
able to work together with coordinated promptness. I sug
gested that Dr. Van Hoosen, with the assistance of other women
centrally situated, would be in a more favorable position to
conduct the work. I would, of course, be glad to offer them
assistance and information from Europe. But, I was reminded,
New York, the clearing port, was nearer to the scene of im
mediate action than Chicago. Mrs. Margaret H. Rockhill,
editor of the Women s Medical Journal, offered to relieve the
committee of a sizable weight of correspondence. But the
meeting adjourned without a decision.

That afternoon I talked it over with Dr. Potter, Dr. Emily
Dunning Barringer, of New York City, and with other women
whose judgment I especially valued. They persuaded me that
I should renounce my own wishes and do everything in my
power for the cause of women in medicine by launching this
vital project through the Medical Women s National Associ
ation. That evening they spoke to Dr. Van Hoosen, the presi-

A WOMAN SURGEON

dent, before the banquet. She insisted that I choose my own
committee and carry forward the work as seemed to me best,
but this meant that I must set aside any hope of returning to
the front. My plan of taking an American unit back to Serbia
appealed to me tremendously, for knowing the organization
of women doctors in the field, and having contacts with army
staffs, I could have managed an American unit of women with
that greatest of all rewards for a doctor: meeting an emergency
successfully. Our ancestors and our experience provide us with
two things: the capacity to meet emergencies and the energy to
carry them through successfully.

Instead of turning my observation and training into the
formation of a single front-line unit, I would have to extend
my plans into a national scope. A small endeavor would thus
become a large endeavor. And I did want other women to have
the privileges I had already enjoyed in emergency service. To
be worthy of the pioneer women in medicine, I could not be
selfish. Through a national organization women doctors in
America would be able to potentialize their individual ca
pacities for meeting emergency which in small towns would
remain undeveloped. Staying home to do organization work
would be harder than going back to the front and would be less
rewarding to me personally. But it offered a wartime challenge
of campaign plans for attack and skirmish.

In the presence of three hundred women Dr. Van Hoosen
assured me, "You have carte blanche and we will all co
operate." The official reports read: "Much to the satisfaction
of all concerned, she finally agreed to accept the position, which
will indeed require most strenuous and self-sacrificing work.
Dr. Morton should have, and doubtless will have, the coopera
tion and assistance of every medical woman in working out this
tremendous problem."

The following day I placed before a group made up of the
officers of the Medical Women s National Association the
women whom I had invited to serve on the committee and
several who had volunteered to assist. In plans for many
American Hospitals in Europe, I combined what I had seen in
the working of many mobile units on the Salonica front into

AMERICAN WOMEN S HOSPITALS 373

what was most practical, and suggested, in addition, as a means
to increase the service with only a fractional increase of ex
penses, surrounding the central hospital by movable outlying
dispensaries. To this I added items, which totaled a program
for fifteen divisions of work to be followed if the war should be
prolonged or extend to our country. They were:

1. Women s Hospital Units to the U. S. A. Army in Europe

(R. C.) *

2. Women s Hospital Units to Allies* Armies (R. C.)

3. Service in Europe in Already Established Units
(S. G. A.)

4. Maternity Units to Devastated Part of Allies Countries
(R. C.)

5. Village Practice in Allies Countries (R. C.)

6. Women s Army Hospitals in Home Zone for Acute
Cases (S. G. A. through R. C.)

7. Women s Army Convalescent Hospitals in Home Zone

(S. G. A. through R. C.)

8. Substitution Service in Private Practice (G. M. B.)

9. Care of Soldiers Dependents (R. C.)

10. Hospital Service for Prisoners of War (R. C.)

11. Medical Service to Interned Alien Enemies (S. G. A. or
R. C.)

12. Sanitary Inspection Work (M. H. and P. H. S.)

13. Laboratory Technicians for Work in Europe of U. S. A.,
not necessarily M.D. s

14. Substitution Service in American Hospitals (R. C. and
G. M. B.)

15. Permanent Clinic Appointments

My whole program met enthusiastic acceptance and was
printed in detail in the June, 1917, Women s Medical Journal.
A registration blank under sixteen headings with explanatory
notes was appended.

1 The initials indicate under what auspices they would probably be: R. C.
American Red Cross; S. G. A. Surgeon General of the Army; G. M. B. Gen
eral Medical Board; M. H. and P. H. S.-Marine Hospitals and Public Health
Service.

274 A WOMAN SURGEON

From that moment I concentrated my work as chief of a
gynecological clinic at the New York Polyclinic Hospital and
Post-Graduate Medical School, and my work as associate in the
surgical clinic at the College of Physicians and Surgeons of
Columbia University and at the Beekman Street Hospital, as
well as my private operative and office work, into seven hours
a day, employed two additional secretaries and spent another
seven hours a day in intensive work for the founding of the
American Women s Hospitals. My interest and enthusiasm,
born of the knowledge that men, maimed and fever-stricken,
were in hourly need of our surgical and medical services, urged
me forward. Fortunately all my friends and patients became
interested. They contributed generously and gave endless vol
unteer work.

At the home of one of these, Miss Mary Mandel, while hav
ing a hasty lunch, I designed the American Women s Hospital
insignia. I wished this to consist of wings symbolic of carrying
us to far lands, combined with the doctor s emblem the staff
of ^Esculapius, so I cut some tiny wings out of paper and tried
them in various positions to make an insignia that could be
varied slightly for nurses, doctors, ambulance drivers and for
volunteer aids. Miss Mandel found a jeweler who cast them
for us in bronze; and her enthusiasm further grew into the
donation of an ambulance. The staff of ^Esculapius, sur
rounded by sheltering wings and surmounted by the letters
A. W. H., is still worn by all members of our units in France,
Serbia, Armenia, Greece and Russia. The code word "Awotal"
that I formed from key letters in American Women s Hospitals
has borne many messages for speedy relief to sufferers.

Our administration was organized on the same lines as the
American Red Cross. Dr. Van Hoosen was consulted on all
matters of importance, but she found it difficult to give close
cooperation with our work. Her already large surgical practice
had Increased with the departure of many other Chicago sur
geons to Europe, so she repeated the "carte blanche" authoriza
tion. A registration blank with full particulars on the back was
sent to every woman physician in the American Medical Asso
ciation directory, about five thousand. The replies were re-

AMERICAN WOMEN S HOSPITALS 275

ceived by Dr. Caroline Towles in Baltimore, Maryland, who
correlated the preferences and abilities of the applicants to the
positions available in hospitals staffed throughout by women.
We planned not only to aid soldiers but also to care for civil
ians. I had pityingly observed the unavoidable neglect of
women, children and old men, where every bed was occupied
by men to be returned to the front.

Dr. Marie Chard and I had observed an airy building on
the corner of Madison Avenue and Fifty-ninth Street, con
veniently near her office and mine. It seemed to have an empty
floor. Mr. Otto Schlessinger, the owner, graciously offered us
four large rooms, rent free for a year, and the free use of a
Masonic hall on the top floor once a week for public meetings.
Dr. Chard and I planned which rooms should be used for a
committee office, which should have a large work table installed
for the women eager to make supplies, and where the packing
of large cases could be done. Furniture was loaned or donated,
so that in three days we were installed.

To a mass meeting we invited the president of each of the
three hundred or more Women s Clubs in New York City,
also the presidents of international, national and state organiza
tions, and women chairmen of each Church Auxiliary, Christian
Endeavor and other groups, the alliance officer of each war
relief organization and many individuals anxious to cooperate.
More than five hundred packed the Masonic hall, all of one
mind, all eager to help. Every Thursday thereafter we held a
mass meeting attended by men and women from the South, the
West, New England, New York, New Jersey and Pennsylvania,
who came to learn of our work, and in many cases to return
home to organize affiliation units.

All foreign delegates to Washington passed through New
York. English, Belgian, French and Serbian officials, knowing
what valuable adjuncts the Scottish Women s Units had been
in war hospitalization, warmly encouraged us. Lieutenant-
Colonel Dr. George Danjou, whom I had met in his Salonica
hospital, was especially interested. General Rasitch; Colonel
Prebechevitch; Lieutenant Yovanovitch, of the Serbian Army;
together with Professor Lozanitch, professor of chemistry of

A WOMAN SURGEON

Belgrade University, and other delegates, spoke for us one after
noon on the Serbian situation and emphasized their people s
crying need of our relief.

Reports from our committees and from affiliated organiza
tions were published each Thursday to inform the public of
our progress. Dr. Louise Hurrel, representing the doctors in
western New York who had been organized under Dr. Marion
Craig Potter, reported on her return to Rochester that so much
business was transacted at our Thursday meetings that the
chairman in arranging for, conducting and following them up,
must give a year of life energy each week. But the burden of
the continuously evolving work could never have been accom
plished without the devoted cooperation of hundreds of women.
We were all carrying responsible activity in medical lines, and
had to do our war work, not in leisure but in extra hours. No
one waited until she could conveniently find the time. My
colleagues understood and helped visualize the necessity of
haste.

If we had not believed in the ideal of the war for the estab
lishment of international peace, we could not have gone for
ward, planning, organizing, so strenuously. One day when we
had been to church together, I said to Dr. Alice Wakefield,
"The music, the strength and the harmony of religion s mes
sage of peace keep us going."

She replied, "I could not bear the war if I were not working
purposefully every hour."

Just then we met a man and his wife who were friends of
mine. We told them about the American Women s Hospital.
Generously they gave three thousand dollars. And so it went
on, built by the generosity of Americans. Our inspiration
strengthened with this readiness of individuals to help America s
part in the conflict. Mrs. Henry Mason Day and Mrs. Stanhope
Philips of New York City were among the first to give am
bulances. Thanks to my long-time friend, Dr. Alexis Carrel,
and Consul-General Leibert, we received many valuable sug
gestions and the assistance of French officials.

A uniform practical for all ages and sizes had to be designed
with its many details of shoes, hose, gloves, hats or caps. The

AMERICAN WOMEN S HOSPITALS 277

head of a department in Abercrombie and Fitch worked with
me from three one afternoon until after midnight, spent the
night and began again at dawn on the depth of hem, amount
of flap and so forth. I gained a new idea of how much time
an apparently simple thing requires. Next day I received a
telegram saying that I had been appointed chairman of the
Woman s Uniform Committee for the American Red Cross.
I accepted on condition that all doctors wear the khaki I had
approved.

Dr. Elizabeth Van Slyke, superintendent of the Women s
Hospital, banded all her nurses together during their time off
duty for making refugee children s clothing and babies layettes.
She asked me to give two addresses to both the day and night
relays on the pitiable condition of the Serbian refugee children
I had seen in Macedonia, Corsica and France. She then asked
me to address the Board of Managers. I chose as my subject
the relation of water supply to the epidemics of typhus, typhoid,
dysentery and malaria, which I had worked through under fire
and showed photographs of the brick and cement water tanks
built by the French for the storage and disinfection of water,
as well as of the rest of the sanitation system and suggested that
a practical gift would be a motor truck equipped as a laboratory
to be sent with the army to test water and do other field labora
tory work. Mrs. Frederick F. Thompson, President of the
Board, contributed $5,2100 for this.

We consulted on the truck s construction with carpenters,
plumbers and other technicians, as well as with engineers and
architects. The driver s seat was arranged so that it could make
a comfortable bed with another berth to be dropped above it.
The test-tubes, chemical reagent racks, etc., should be guarded
to withstand the roughest shell-holed roads. Special construc
tion was necessary for such details as the drainage from the lab
oratory sink, while towels and supplies were stored with the
compactness of a ship s locker. We requested that this movable
laboratory be attached to the Serbian Army, and if possible,
put under Colonel Petkovitch, Director of the Service de Sante,
First Serbian Army. On the Salonica Front it fulfilled its mis
sion and at the end of the war was converted into a Serbian

278 A WOMAN SURGEON

Government mail truck. The microscopic and other scientific
equipment went into the biology department, when the war-
shattered University of Belgrade was rebuilt.

The financial success of our exhibit at the Allies Bazaar at
Grand Central Palace, New York City, was due principally to
the cooperation of the National Society of Patriotic Women of
America, of which I was a charter member. We cleared $1,010.
The Southern Women s Patriotic Society of New York also
pooled all their war activities with the American Women s
Hospitals. These two organizations, among many other things,
complied with an emergency request from several French hos
pitals to send to them extra-large sheets, as they were accus
tomed to having them fold half-way back over the blankets.
We shipped sixty-four dozen. Eighty-six cases of miscellaneous
supplies, including all sorts of men s, women s and children s
clothes and shoes, were sent across; also, large amounts of surgi
cal dressings, old linen, bolts of gauze and outing flannel, frac
ture and other hospital pillows, comfort-bags, bed-spreads, etc.

A small convent in Paris had been converted into a hospital
which became Hopital Auxiliaire 263. We kept in correspond
ence with the gracious Superior and forwarded many things fox
the comfort of soldiers under her care, as well as supplies desig
nated for expectant mothers and for destitute children. We
also cooperated with the American Fund for French Wounded,
and through the Serbian Relief Committee sent clothing and
other things to Serbian infants. We furnished wool to women
in Highland, North Carolina, anxious to knit sweaters for
soldiers, and also enclosed for the mountaineers themselves
several cases of magazines and books.

Our Committee on Home Zone Hospitals registered those
already staffed by women and prepared to care for soldiers in
Boston, New York, San Francisco, Chicago and other cities.
Among these were four hospitals and a large sanitarium in
Philadelphia, also dispensaries, volunteering special service to
soldiers and sailors, were registered with details as to extent of
laboratories, X-ray equipment, etc.

Our Committee on Industrial Surgeons found that women
doctors were needed in the active mining, munition and tex-

AMERICAN WOMEN S HOSPITALS 279

tile companies to replace men eager to go to the front. The
services of our Committee on Substitution in Hospital and
Clinical Service were sought to recommend resident physicians,
internes, doctors in tuberculosis clinics, insane asylums and
prisons, as temporary consultants in absence of members of
their regular staffs.

The National Dental Association cooperated with us in regis
tering women dentists thirty-six of whom signed for foreign
service, twenty-two for service in the United States, thirty-six
for work in their own towns and seventy for service an hour
or more a day gratuitously for soldiers. This volunteer service
of women dentists vastly aided the United States Government
by conditioning the mouths of soldiers in the new national
army, and the sailors of Allies temporarily stationed in America.

Under our Foreign Service Committee we not only regis
tered three hundred and forty-five doctors, eight dentists, seven
nurses and eighty-five lay workers for our own units, but also
sent the names and qualifications of one hundred doctors, eight
dentists and twenty-seven lay workers to the Red Cross; seven
doctors to the Commission for the Prevention of Tuberculosis
in France; two to the Rockefeller Institute; one to the Smith
Unit; one to the Wellesley Unit; ten to the British Expedition
ary Force in Egypt; and two to Refugee Hospitals in Serbia.

The request of the Red Cross that our American Women s
Hospitals Committee recommend all the women doctors will
ing to serve under them increased our work at headquarters,
already heavy with correspondence, conference and lecture ap
pointments. A squad of stenographers typed and filed at all
hours. Part-time services of my office nurse and secretary I
contributed, as well as two extra stenographers, so that between
patients I could dictate letters and reports. Five evenings a
week I lectured to raise money with which to send my colleagues
"over there/ After a busy day this strained each twenty-four
hours further.

In addition I was obliged to go to Washington on official
business each week. Surgeon-General Gorgas had designated
me a member of the Medical Board of the National Council of
Defense to represent officially all the women physicians and

s8o _ A WOMAN SURGEON

surgeons in the United States, as well as scientifically trained
women in allied fields anaesthetists, laboratory workers, etc.
Dr. Franklin Martin, the chairman of the Medical Board, asked
me to propose the names of women in different sections of the
United States as members of a Committee of Women Physicians.
I was determined to keep this committee in harmony with the
American Women s Hospitals and, therefore, proposed the
names of several colleagues who had recently helped me origi
nate that work, three of whom were chosen: Dr. Carolina Pur-
nell of Philadelphia, Dr. Carolina Towles of Baltimore, and
Dr. Marion Craig Potter of Rochester. I also proposed and he
appointed Dr. Adelaide Brown of San Francisco, Dr. Emma
Culbertson of Boston, Dr. Mary Lepham of New York, Dr.
Louise Strobel and Dr. Mary Parsons of Washington. Soon
after, Dr. Florence Ward of California and Dr. Cornelia Brant
of New York were added. The first meeting was held July 29,

On the Council of National Defense my task was to reregister
all women doctors in the country and find out if they were
ready to offer service instantly. In two weeks the names of
5,788 medical women were on file. Dr. Martin asked that a
questionnaire be sent to all colleges in which medical women
were being educated to list not only those graduating that year,
but those who had graduated a year earlier and were now fill
ing hospital interne positions, as well as to those recently re
tired, on the supposition that the war might continue ten years
and that trained women would be needed in all medical and
social fields. This required correspondence with the fifty-seven
coeducational medical colleges for women. We obtained lists
of all their women registrants then at college as well as of grad
uates during the previous two years, since many of these would
not yet have finished their post-graduate work and therefore
would not be members of their County Medical Societies. Also,
we wrote to all the hospitals where women were internes,
anaesthetists and laboratory experts.

We placed on file in Washington also all the registrations
which had come to the American Women s Hospital. How
ever, most of these women wanted to go abroad with women s

AMERICAN WOMEN S HOSPITALS 281

units. There still remained other women who had not regis
tered because they were opposed to any form of sex segregation.
These we knew would be willing to register under the govern
ment to work in hospitals staffed jointly by men.

Before questionnaires could be sent it was necessary to com
pile an up-to-date directory. Dr. Marion Craig Potter made by
mail a canvass which resulted in her recording 5,989 women
in active practice, 201 retired, thereby adding a thousand names
to those printed in the American Medical Association s latest
directory.

One of the men on the Medical Board in Washington picked
up the directory and remarked truculently, "We will see how
accurate this is. I will judge of its merits by one name."

I held my breath while he turned the pages quickly to the
list of one of the midwestern states, to the name of a doctor he
happened to know, who had carried on a large practice but had
retired only a week before. There it was, so recorded, and he
found the compilation absolutely accurate throughout.

In two weeks 1,916 additional women registered for service
as contract surgeons or in other branches of Navy, Army or
Marine Hospitals, and Public Health Service. Every state in
the Union was represented. We placed on file their qualifica
tions, including the languages they could speak and how soon
they could leave. Through correspondence with the County
Medical Societies of which they were members, we learned which
women were most active, willing and capable in group work,
as well as which were contributing scientific papers, holding
hospital positions, and so forth. It was gratifying to receive
excellent reports from every state.

In view of the fact that nearly all the women had depend
ents, aged parents, invalid relatives, brothers or sisters, nieces,
nephews, or their own children to educate, their patriotism was
the more evident in the assurance that almost every one could
be ready to sail within two weeks! Many volunteered to go
without salary, especially where there were "no sons to go for
the country." I knew, then, the high standard of character of
America s medical women.

With pride I announced at the next meeting of the Medical

A WOMAN SURGEON

Board o the Council of National Defense that forty per cent
of the women physicians of the United States were ready to go,
surpassing, not only in percentage but in promptness, the men
doctors. Dr. Martin to our gratification called attention to this.

In the four branches in which medical women were in de
mand in Army, Navy and Marine Hospitals, we called on the
American Women s Hospitals to cooperate with us in contribut
ing the data they had assembled on anaesthetists, laboratory
workers, roentgenologists and sanitarians. By return mail we
received a list of 180 anesthetists experienced in giving ether,
chloroform, gas, spinal or colonic anaesthesia. An equal num
ber of laboratory workers divided into bacteriologists, patholo-
gists, research, general chemical and other laboratory work
also cooperated handsomely.

This demand for research service opened an opportunity for
war training to college women with sufficient education in
scientific methods. Under Dr. William Park and Dr. Anna
Williams of the New York City Department of Health and
under Dr. Elsie L Esperance of Cornell Medical College classes
were established. Twenty students entered the first class on
November i, 1917, of whom five were appointed laboratory
technicians in the Army Medical School in Washington the
first women ever admitted. Others received appointments as
bacteriological technicians in base hospitals in the United
States xvhile one went to Palestine with a Red Cross unit. The
second class of thirty began July i and received certificates in
three months. The demand for this course led to the establish
ment of similar courses in other cities. The American Women s
Hospitals also sent to Washington the names of thirty-three
X-ray and fluoroscope experts, a list of the hospitals in which
they worked and a survey of the courses of study in this
specialty.

About one third of the registrants preferred, on account of
their family responsibilities, to have industrial or substitution
positions in the United States or in the Sanitary Service of the
Red Cross. Twenty-six were recommended to the Bureau of
Sanitary Service in the Army Cantonments. The majority were
willing to accept positions as army contract surgeons, but pre-

AMERICAN WOMEN S HOSPITALS 283

ferred to be in the Medical Reserve Corps o the army, as they
would then have rank and pay parallel to men of equal educa
tion and experience. Many women, as a matter of principle
and precedent, refused to register without this guarantee. But
it required an act of Congress to inaugurate such simple justice.
Most of those who could leave home were more anxious to
serve than to have recognition, although they knew that to
insure their authority as physicians in army work, a law giving
them commissions as superior officers would have to be enacted.

Dr. Strobel, the able secretary of the Committee of Women
Physicians, presented, in addition to all the classifications re
quested, a supplementary list of the registrants in the fields of
administration, dermatology, dietetics, gastro-enterology, genito
urinary, neurology, pediatrics, psychiatry, public health, ortho
pedics, eye, ear, nose and throat, surgery, tuberculosis, electro-
and hydro-therapy, hygiene. The Medical Board in Washing
ton was impressed by the listing of 199 surgeons, twenty of
whom were chiefs of surgical staffs. By this time our Com
mittee represented 8,600 women scientifically trained or in
training.

When all this had been accomplished, Dr. Martin to my
amazement told me that continuation of the American
Women s Hospitals was not regarded favorably by some officials.
It was their opinion that women ought to be restricted to sub
ordinate positions, dressing wounds, anaesthesia, laboratory
routine, and practically doing nurses* work! How thankful I
was that I had consulted the big chiefs about my plan for the
American Women s Hospitals before making a move to organ
ize them. They could not retract their written endorsements
no matter what pressure might be brought to bear. Evidently
they had thought well of one unit of women as in my first plan,
but when they found that I had paved the way for many, on
a basis of continuing after the war was over to alleviate the
distress of reconstruction, they decided my plan was larger than
anticipated and gave women too much influence and impor
tance.

How I had to fight for the life and growth of my child. Dr.

284 A WOMAN SURGEON

Martin inquired cryptically, "Do you love Jonathan or David
more?"

"What mother could, or would, make such a choice?"
"If you resign from the American Women s Hospitals and
confine your interest in war work to this Committee of Women
Physicians of the Medical Board of the National Council of
Defense, you will have enough to do."

"Yes/* I replied, "I am strained a bit, I admit; but all the
promises given to me personally before I put my work under
the Medical Women s National Association could then be
broken." He smiled. "I owe it," I continued, "to the cause
of women in medicine to continue both undertakings, for
evidently many men are still medievally minded. They don t
seem to know that we have women specialists in all divisions
of the ars medica^ who are on a par with the men of this or
any other country. It is only fair to all the women of our
country, and to men like you, who believe in our scientific
progress, to demonstrate that the American Women s Hospitals
will do as well, or better, than those composed of British,
French or Russian women."

"You win," he laughed. "You are a good fighter."
Not only did many of the members of the Council of Na
tional Defense insist that, at best, the American Women s
Hospitals should be only an auxiliary group of the Medical
Board, some urged action "to put us in our place and keep
us there." Deciding that a counterattack was the order of the
day, in the form of official praise to offset official criticism, when
at a social function I met my old friend, Justice McReynolds
of the Supreme Court, I talked to him about the medical
women s plan and the importance of our accomplishing a great
deal quickly, since we had entered the war so much later than
the other combatants. Next I spoke to Surgeon-General Blue,
of the United States Public Health Service, who had been
chairman of the Public Health Section of the American Medi
cal Association when I was its vice-chairman, of the superb
work being done by Dr. Louise Garrett-Anderson and Dr. Flora
Murray in the Endel Street Hospital, London, and of the Scot
tish Women s Hospital units in Belgium, France, Corsica and

AMERICAN WOMEN S HOSPITALS 285

Serbia. In conference with Surgeon-General Ireland of our
Army, and with my lifelong friends, Senators Martin and Swan-
son of Virginia, I emphasized the fact that in America citizens
depend upon the democratic interests of our leading men to
give their stimulating approval to high endeavors such as the
American Women s Hospitals. Naturally, as there were 141,-
ooo men doctors in the United States, 21,000 of whom had
registered, with places in military services for only 1 1,000, many
men should be opposed to women having an opportunity to
serve until we had been in the war for years.

Dr. Martin and his immediate associates were, I hope,
pleased to receive several letters from high officials commend
ing the liberality of his mind and good judgment in establish
ing the Committee of Women Physicians and endorsing to the
fullest the participation of all groups of scientific women of
America.

On the day, when, as I had been privately warned, an action
against the American Women s Hospitals was scheduled for
the meeting of the Medical Board, I went into the office of Dr.
Martin a few minutes before the committee assembled. While
waiting I remarked to his secretary that I had found a four-leaf
clover that morning and had put it in my shoe for luck.

She looked at me with a twinkle in her eye and said, "I won
der if you know how lucky you are!"

With a twinkle I echoed, "I wonder!"

The meeting progressed serenely. No more was said of
abolishing the American Women s Hospitals and cordial ap
proval was expressed regarding the work of the Women s Com
mittee of the Medical Board. The American Women s Hos
pitals endeavor was unique in that it was originated and carried
forward entirely by physicians, whereas similar ventures in
other countries were organized by the laity. We all volunteered
money, time, energy, ideas, and called for assistance on the
friends we had made as physicians and surgeons through years
of professional work. The only persons who received payment
were the office secretary and the stenographers working under
her.

On October 14, 1917, we were able to send our first com-

2 86 A WOMAN SURGEON

plete unit of women overseas to northern France. Already Dr.
Regina Keyes and Dr. Mabel Flood had joined a joint Red
Cross-A. W. H. unit in Monastir, Macedonia. Our ship was
launched, but there was still work to do in maintaining our
treasury so that we could keep the units well supplied. Dr.
Matilda Wallim, our second vice-chairman, arranged a meeting
at the home o her devoted friend, Miss Emily O. Butler, and
persuaded her to become chairman of our Auxiliary Board.
Leading women in philanthropy, education and public spirit,
such as Mrs. Andrew Carnegie, composed the Auxiliary Board,
whose membership included the wives of the Secretaries of
State, Treasury, War, Navy, Interior, Agriculture, Commerce,
Labor, and the wives of the Postmaster-General and Assistant
Secretary of the Navy, as well as the wives of several Senators
and of the Chairmen of the Legislative Committees on Foreign
and on Naval Affairs, the wives of the Governors of twelve
states, and other distinguished women.

Dr. Belle Thomas, chairman of our Committee on Organiza
tion, wrote to the medical men and women who had helped
to organize the Public Health Education Committee of the
American Medical Association, and found them ready to coop
erate. Soon we had state chairmen in forty-five states. They
in turn appointed county and district chairmen, as many as
eighteen in Missouri, sixteen in Pennsylvania, and other states
in proportion. All the doctors active in helping us worked
quietly, avoiding publicity, depending rather on personal
contacts.

By the beginning of 1918, our treasurer, Dr. Sue Radcliffe,
of Yonkers, New York, had received $23,975.08 designated by
the donors to be used as follows:

General Fund $ 9*097.05

Account of Serbia 7478-95

Account of France 3*547-8

Hero Land Committee 1,010.00

Campaign Fund 2,530.00

Dental Laboratory 160.00

American Volunteer Aid 30.00

North Carolina Mountaineers 122.00

(Night Schools)

AMERICAN WOMEN S HOSPITALS 287

This was encouraging, but if we were to fulfil our wish to
send additional units to France and to Serbia and have enough
money, not only to equip and maintain them, but also to be
prepared to replace them promptly in case of disaster, we must
have a "drive." We must decide quickly whether each of us
was prepared to give practically full time for two* weeks to reach
our goal a quarter of a million dollars in ten days! Already
I was putting in an intensive fourteen hours daily. Along with
the two nation-wide organizations, my colleagues had also
elected me president of the Women s Medical Association of
New York. Luckily I am always as exhilarated as a race horse
must feel by the sense of being pushed to make each hour
count.

But before we could decide to have a drive for funds it was
necessary for us to learn whether the Medical Women s Na
tional Association was incorporated. So great was the urgency
that our corresponding secretary, Dr. Mary M. Crawford, sped
to Chicago to confer with Dr. Van Hoosen on whether this had
been done, or whether she would authorize the incorporation
of the War Service Committee under which we had organized
the American Women s Hospitals. To our great relief, Dr.
Crawford returned with the assurance that the legal steps had
been taken by the parent association to protect in the soliciting
and dispensing of public moneys.

We immediately employed a publicity agent, who remarked
that ours was the most congenial organization in its aspirations
and willingness to follow a leader that she had ever campaigned
for. By this time I felt that every member of our committee
was a leader, and hoped that they would conduct the drive
without any increased duties on my part. I wanted to be ready
to go to Washington on call, as we were running aground with
the American Red Cross. Their general policy discouraged
independent work. They wished us only to recommend women
physicians for their own placement.

Essential to our success was the hearty endorsement of the
Red Cross so that our hospital units could be established and
function without danger of scattering the members. We, there
fore, offered to send them the names and full qualifications of

288 A WOMAN SURGEON

as many women as they required for hospital positions, and
urged that our work might be known as the American Women s
Hospitals of the American Red Cross, wherever they could use
one of our units, but that we be left free to establish our own
units independently wherever the greatest need was indicated in
France, Serbia and possibly other countries. After some tug
ging back and forth this was agreed upon and brought letters
and telegrams from Red Cross officials, at home and abroad,
which palpably strengthened our national drive. The national
and local Red Cross became convinced that our drive would be
of advantage to them, for wherever we established hospitals
their funds would be released. Furthermore, both sides would
gain a more solid esprit de corps by not scattering the interest
of medical women.

The members of our executive committee were not willing,
they said, to undertake the drive unless I would promise to set
aside everything else throughout its duration. I must expect
to be called hither and yon, for whenever a "contact" was made,
the potential donor would want to have first-hand knowledge
of the reason for donating to us directly instead of through
the Red Cross, the Community Chest or other avenues to
which he or she might be already pledged. The committee
members emphasized the fact that only a person who had been
in war hospitals could present the need of funds directly to a
hospital unit organization with convincing colors. I succumbed
to their pressure and we went to work.

The drive was inaugurated March 26, 1918. Two hundred
and fifty workers took part in it. For three weeks we were in a
whirlwind of activity, but a well-ordered whirlwind.

My patients cooperated splendidly. They were coming to
me as before the war from South America, Newfoundland, as
well as from New York and various parts of the United States.
Their excited interest in war work took their minds off their
own surgical conditions, and they convalesced more quickly
than in times of peace. One patient sent from my office to our
headquarters the first $1,000 contributed to the drive.

Concentrated excitement filled those two weeks. Daily at
the Biltmore Hotel the members of each team conferred dur-

AMERICAN WOMEN S HOSPITALS 289

ing lunch, after which each reported her financial intake for the
previous twenty-four hours. A large tabulated diagram
stretched across the wall behind the long table where our offi
cers sat, divided in one direction by days, and at right angles
by teams. There were additional spaces for the amounts
brought in by members of the executive committee and for
contributions from other states. Telegrams were read. One
from Mr. Burleson, the Postmaster General, said, Tour work
for humanity follows in the path of the battle for human
liberty and appeals to the sympathy of every American." We
thrilled with the realization that enthusiasm was nation wide.
Checks arriving from every state were cheered, especially when
$100 came from Alaska; from Arkansas came $200; Kansas,
$250; New Jersey, $564; Vermont, $605; Texas, $665; Nebraska,
$900; Michigan, $956; Pennsylvania, $980; Ohio, $ 1,009;
Oregon, $1,090; Maine, $1,210; Wisconsin, $1,165; Iowa, $5,-
376; California, $6,050; New York, $22,258; Massachusetts,
$52,158.

Mrs. August Lewis donated an ambulance in the name of
her friend, Dr. Emily Dunning Barringer, who had been the
first woman ambulance surgeon and also the first woman interne
in Bellevue Hospital.

In an appeal from the steps of the Public Library at Forty-
second Street and Fifth Avenue, four young women costumed
as nurses held a stretcher upon which passers-by heaped silver
and notes. Two of our ambulances were sent to Wall Street.
The psychological effect produced $1,000.

The American Committee for Devastated France, through
Miss Anne Morgan, Mrs. Dike, Miss Hedden and others, asked
us to place an American Women s Hospital near their work in
Blrancourt, France. Accordingly it was arranged that Miss
Morgan and I speak at Town Hall on this cooperative plan.
The ushers passed bushel baskets to take up a collection for
the joint work; four baskets were filled to overflowing.

In a window at the corner of Thirty-fifth Street and Fifth
Avenue we were given space to display an animated poster of
a ship on a papier mach ocean. Our slogan read: "We are
ready, put us across." When the drive began the ship was

2QQ A WOMAN SURGEON

moored to the American shore. Each day its progress across the
painted ocean indicated our financial intake. Posters, cartoons
and magazine articles helped push the ship along.

One of my friends arranged for me to speak at the Wall
Street Lunch Club. Knowing that minutes were extra precious
there, I condensed facts as if they were transmitted on ticker
tape. And how those men emptied their pockets! Checks
fairly flew through the air. Next day I spoke at India House.
The members of that ancient and honorable importing house
came prepared for giving, checkbooks and fountain pens in
every hand. Mr. John Mitchel, the most generous of them all,
had seen to that. He and his wife gave three thousand dollars
twice during the drive. I returned to headquarters exhausted
but happy, with my uniform pockets bulging in an unmilitary
manner. Most of these checks were turned in by members of
the committee, who made out the transmission slips attached
to each check.

Fatigue was extreme before the drive was over. When, late
at night, I sought a few hours rest, I thought of all the refugee
women I had seen in Corsica, women of my own class compelled
to live on scanty food, in ragged clothing, restricted with their
children to a chalk-marked space on the bare floor of a room
into which many other families were crowded; of the focusless
eyes of refugee children, world-weary, half-starved and ill, who
would be saved by the money our drive would bring in; of the
wounded and sick men and women who would be not only
in our first hospitals, but in all the others that would follow if
our drive went over the top. Remembering these, I could not
soften with fatigue. Were not soldiers falling in the trenches
and women s hearts breaking? So, after a few hours of relaxa
tion, I was writing, telephoning, planning in another day. I
spoke three or four times each day between numberless confer
ences and had to perform some emergency operations.

About half the checks I brought in were reserved for an
nouncement at the final campaign meeting at ^Eolian Hall on
April 5. It was a triumphant evening. Representatives of all
the Allies came from Washington for the occasion. The ushers

AMERICAN WOMEN S HOSPITALS 291

were Yugoslav men and women who wore the colorful costume
of their Sokol Athletic Association. The international assem
bly on the stage, backed by the flags of America, Belgium, Brit
ain, France, Italy, Serbia, Japan, Greece and Russia made a
stunning sight, as every one sang My Country Tis of Thee.
Within ten days we had raised $300,000 in cash and in pledges
promptly paid.

The last patient I had operated on just before the drive
began had come from Newfoundland. All had gone well. Two
weeks later on the day of our final rally, she insisted that I
must be the one to remove the stitches, although my assistants
would willingly have done so. I shall never forget how heavy
the scissors felt in my hand, and what concentration it re
quired for me to handle them deftly. I was exhaustedwill
ingly and utterly exhausted. But we had gone "over the top."

Thanks to friends and coworkers all over the United States,
our dream was a reality. We immediately sent $3,000 to aid
refugee Serbian children in Paris through the Serbian minister
in Washington. Hospitals were established in Vodena and in
Monastir, Serbia; in Luzancy, La Fert6 Milon, Blois and in
Bterancourt, France, with dispensaries in twenty French vil
lages. 1 "Les Dames Americaines" as our doctors became
known, also called twice a week at the Mairies of other villages
to collect memoranda left by those needing attention. All re
quests for aid were promptly followed up. Each dispensary
ambulance carried a doctor, nurse and chauffeuse, a container
for sterilizing, a stove for boiling water and all necessary medi
cines. They reported visits in seventy-seven villages. This last
was done in association with the American Committee for
Devastated France.

The A. W. H. contributed $25,000 toward the establishment
of a children s hospital in Blois under the American Red
Cross and $5,000 toward the establishment of a dispensary in
Levallois, a suburb of Paris, each to be under the joint auspices
of both organizations. They, on their side, handsomely con
tributed $50,000 to the work of the A. W. H. When I went
to Europe some months later, as commissioner of the Medical

iThe Battalion of Life, published in the Forum, April, 1918.

292 A WOMAN SURGEON

Women s National Association, I saw where this work had
been carried successfully along.

When after the Armistice the French physicians returned to
their villages, our dispensaries, in order not to conflict with
their practice, moved many times, and in 1919 the equipment
was transported to Veles and to Pristina in Yugoslavia.

The American Women s Hospitals were founded on a plan
fitted to the full expression of the ideals of medical women,
not only in war, but also during reconstruction for men, women
and children. There has, therefore, been no change in the
original program which provided for all future extensions and
developments. My inspiration in laying this foundation was
two-fold to be worthy of the pioneer medical women and to
work side by side with the fine doctors of our day on the side of
mercy and of health. I rejoiced that the women doctors of
America had collaborated in an immediate and lasting service
to a shattered world.

In every wartime organization there came inevitable splits
and rivalry, simply because every one was so eager to work.
This eagerness made people irritable and jealous. If things
were well organized, they resented the fact that they could not
enthusiastically create an organization of their own. At a time
when cooperation was a vital need, many people still wanted to
send off their own pillows with their own names attached.
People expected to carry their personalities into a solid organi
zation. But the war aided the progress of women in showing
them the value of working together as bolts and beams in a
common ship, sailing toward a single horizon, not exaggerating
the importance of any separate part. Inevitably the war relief
organizations multiplied with the developing capacity of
women, as they saw things they could do in groups. Those
who could not launch a new field of service were disappointed,
sad or jealous from their very patriotism.

There were times of discouragement in the founding of the
American Women s Hospitals. But the haste of those days put
the doctors with whom I worked under heavy strain, both
from fatigue and anxiety. The patients they treated under an
increased schedule were also overwrought. I was amazed to

AMERICAN WOMEN S HOSPITALS 293

discover that some people who had promised to stand by,
withdrew for hyper-sensitive reasons, for patriotic jealousy. As
Dr. Robert Morris said to me one night when the idealism
seemed to be slipping, "Their jealousy is the measure of their
own disappointment."

The potency of the drive lingered for weeks after it was over.
Many contributions still heaped our mail basket, along with
requests for aid. With ample money on hand things moved
quickly and confidently. Our units were soon ready to sail,
and we were proud of the report our War Service Committee
turned in to the Medical Women s National Association at
their third annual meeting in June, 1919, for it made history.
So has each yearly report since then. Hundreds of thousands
have been healed and helped in France, Serbia, Turkey, Pales
tine, Greece, Armenia, Russia, the Isles of the JEgean and
Macedonia. The work continues to this day, under other chair
men, supported in part by some of the original contributors,
fulfilling the plans and hopes on which it was founded.

CHAPTER XXIII

VIRGINIA

THE war was over.

But I knew that there was still as urgent a need for hospital
equipment, for medical and surgical supplies, among the doc
tors of Serbia. Thousands of semi-invalided would require
years to recuperate. Badly nourished children, who had of
necessity been hungry all through the war, and posthumous
children, born of mothers enfeebled by mental and physical
anguish, needed, for their nation s sake, especial care.

The women of Serbia had set their lips and grimly borne
privation and suffering during the hardships of the Balkan
Wars from 1912 to 1914, and together with the children were
neglected during the World War from 1914 to 1918, for money
and the ability of doctors and nurses had had to be devoted
to the care of soldiers.

When I returned to my clinical work and private practice,
the hospitals into which these took me were so well furnished
with all modern methods of treatment, so thoroughly organized
for efficiency, I felt keenly the discrepancy between these and
the war-shattered buildings in Belgrade, Nish, Sklopje, Veranje
and other towns. I was anxious to hasten the fulfilment of the
prayer I had made, in the midst of dying men in a field hospital
near the firing line in Macedonia, to be enabled to help their
restoration to health.

Many times I had spoken of health needs in Serbia. When
I had mentioned orphan waifs, individuals and groups had
quickly responded to the appeal. But for the adults I had as
yet done nothing.

Members of my family and many old friends in my home
town, Lynchburg, Virginia, urged me in 1918 to stop over
there on my way to Florida, where I was planning to have ten
days rest in Winter Park. It was good to climb again the

294

VIRGINIA 295

steep streets and to walk on Garland Hill where as a child I
had accompanied my father every Sunday afternoon to make
a round of family calls. Many and varied had been my experi
ences since I left at eighteen to go to medical college. Study
in Philadelphia and Europe, practice in Washington and in
New York, had been so full of responsibilities, and the branches
of my family had scattered, as families do, so that we had had
no reunions. Nieces and nephews homes were in China,
Colorado, Texas and other places too distant from Virginia.

As the train crossed the bridge over the James River, two
memories became poignant: my passing it when my mother
was dying, and when I returned, for sentiment s sake, to Vir
ginia to be married.

My sister-in-law and her son met me. For several days
we were busy visiting and reminiscing. The earthworks thrown
up by General Jubal Early s command north of the city to
prevent its destruction; the reservoir; the mountainsides where
the arbutus grew; my grandmother s, Aunt Kate s and Aunt
Mary s houses and gardens, remained just as I had played in,
and loved them, when a child. Many new modern houses with
landscaped grounds had now climbed Rivermont Hill. All
over Lynchburg s seven hills were the homes of families whose
makers I had known when they were boys and girls. The dances,
horseback moonlight rides and the picnics on the river all
came merrily trooping back. Lynchburg had gone far since the
days of my mother s diary. 1 Shoe factories, tobacco warehouses
and all that went with them, inartistic as they were, had brought
much prosperity. Clubs, hotels, a whole new city suburb and
Randolph Macon College had become part of the picture.

Returning from my stroll to the home of my brother, Dr.
Samuel Garland Slaughter, I mused before the old mirror which
reached from floor to ceiling in the living-room. It had re
flected crystal chandeliers in my old home, weddings, funerals,
New Year s parties, Thanksgiving reunions, Christmas merry
makings when our family was intact. I looked into it, wishing
for celestial television.

"Today we will lunch at the hotel," said my sister-in-law

1 Published in Virginia Quarterly Review, December, 1934.

2Q 6 A WOMAN SURGEON

Maymee. Feeling a little sad, I gathered up my gloves. When
we reached the lobby, its dim light revealed enchantment.
Waiting there were twenty of my girlhood s dearest friends.
They all clustered chattily around. Their beaming smiles,
bright eyes, glowing cheeks, pretty dresses and hats made a
dancing pattern of color and happiness.

Years vanished. I hugged and kissed each one. I marveled
how those who had married and moved away had assembled.
Margaret Payne, Meta Glass, Marion Bannister, Mamie Black,
Mattie Watkins, Dora McGill, Julia Meam, Kate Pryor and all
the rest had returned to honor me. I could scarcely believe my
delighted eyes.

"We have followed you in fancy," they chorused. "Do not
think you will ever escape our love/ My heart thrilled.

One after another declared, "You haven t changed a bit!"
My sense of humor could not accept this, but I responded
banally, "You have not either."

As we approached the dining-room, perfume of jessamine
and roses filled the air. The room was a bower of branches.
The tables were garlanded, and best of all, each plate, as the
courses were served, was surrounded by either periwinkle, pan-
sies, syringa, bridal-wreath blossoms, violets or other flowers
from the gardens in which we had all played as children. The
"girls" had made this just like one of our best parties, which
we then thought so "grown-up."

We were all very happy. I was eager to hear about all the
new homes and babies, so with every course those on each side
of me changed. When the coffee was served, some one proposed
a toast to "our Rosalie,"

"Now tell us all about what you have been doing over
there!" exclaimed several. "Until the war came and you could
serve in it, we resented the belle of our town going off to
study medicine," fondly chided others. "Although that gave
us a chance at some of your old beaux," laughed another.

"Sh!" said I. "Stop that teasing. You know well enough I
could never compete with Norvell s eyes and Carrie s curls."

Soberly, Norvell Otey Scott, as befitted a State President of
the U. D. C., called us to order.

VIRGINIA

297

"What are we here for?* demanded she.

To feast our eyes on Rosalie and thank God she came home
alive/ giggled my cousin Katherine Diggs.

"No/ said Norvell, emphatically. "It is to see if there is
anything she would like to have us do to help her. We know,
every one of us, that reconstruction is as hard as war. Born
after the war, we still know the scars of craters, ripped open
with shell fire. We can all remember the brave stories we
heard of how hardships should be, and had been, met. We
have only to compare our lives today with the past, although we
did not know it then, to realize that those were meager days/*

A thought blazed across my mind. Here was the answer to
my battlefield prayer. In a moment purpose crystallized. There
was a hush. I rose. I never saw before or since so many eyes
that had a love-light in them when they looked at me. I had
been so far away, so many dear to me were in the churchyard
I had visited that morning. The flowers before me seemed for
a fleeting moment part of those I had left on my beloved graves.
Here were warmth, love and unselfish purpose; a tear hung
on my lashes, and in it years floated away. I winked it off.
The present came back again.

"My dears/ I said, "a lie is on my soul. I told you all that
you had not changed, and you have/ Backs stiffened. "Now
you are about the ages your mothers were when you were
children. Norvell, I see in you not only the energetic little
girl I loved, but also your wonderful mother gracious, execu
tive, unselfish. Do you remember our first act of charity? A
little crippled girl was the smallest member of a pitifully poor
family, which your mother was supplying with food. One
day as we sat on our little stools at her knee, she told us about
the thin white flower on a broken stem and suggested that, as
we had both learned to sew, we should dress a doll for her.
In fact, she had the doll ready for us to begin at once. How
well she knew us. We were happiest when busiest, and what a
crowded two weeks we had. There were lessons and school, but
in the afternoons underclothes, wrappers, dresses, coats, hats-
such a wardrobe was fashioned! My mother helped us to cut
them out.

298 A WOMAN SURGEON

"Carrie Daniel Harper, I thought your father was super
human because people put such stress upon his name as Senator,
and your mother s gentle sweetness I knew made her half divine.
What fun you and I had fox-hunting and how game you were
the day you were thrown, as your horse was jumping across the
creek. You look now, tenderly, as your mother did when we
took her shivering daughter home.

"Kate Langhorne, do you remember the day we picked many
ears of very young corn and made fairies out of them? Ladies
with corn-silk tresses and gowns, kings with flowing white
beards, a flaxen-haired queen and a gorgeous Prince Charming
in pale green, attended by a huge following of courtiers. Your
mother was having a glass of sherry and a slice of cake with
my mother and my aunt Sue when we came in to exhibit our
treasures, and tell them the tale of adventure we had made up.
But your mother was embarrassed and my mother was decidedly
disapproving. Nothing was said until after your departure.
Then my mother was emphatic. You children have wrecked
half the corn. The gardener tells me you have trampled under
foot as many stalks as you stripped. When what is left ripens
and is cooked, remember, Rosalie, you have had your share/
When I told you this, you remarked that the fairies were
worth it/ "

Virginia Goodwin, always just, remarked, "Kate did not
have to share the penalty."

"Belle Shumate, do you remember what a difficult time we
had keeping out of the apple-tree, where we loved to swing, and
spending our time instead hemming towels to earn the money
to buy a big picture-book for a little boy who had broken his
arm by falling out of a tree, and how your stately mother s
approval cheered us on?

"Alice King, do you remember the day we hid in the well-
bucket and let it half-way down the well and were spanked?"

So all around the table things we supposed long forgotten
came to life, a sigh here, a tear there, pensive smiles, hands
clasped and unclasped. All our mothers were what the world
calls dead.

"No, my dears, you do not look as you used to. You are

VIRGINIA 299

far finer and more beautiful. I see life s discipline and develop
ment in your aristocratic faces. I see in you your mothers love
and their training of the character that has shaped your lives.
You show how valiantly you have met inevitable sorrows, dis
appointments, losses. Some of you have buried your little
children. Others have lost husbands, brothers, nephews and
fathers in war. Consoled by our belief in the resurrection, you
have fulfilled your mothers prayers and dreams, so I see your
mothers in your faces; ennobled, you fulfill the traditions of
your people. In memory of our own, let us unite to do some
thing for the motherless in Serbia. Let us send supplies to
doctors who need them for sick women, children and men.
Virginia was a battleground. Serbia likewise has been devas
tated."

Colonel Otey, Norvell s father, had been one of the men
whose decision and courtesy had charmed my mother when as
a Quaker lass she visited Virginia in 1853 an( i chanced to fall
in love with the young lawyer who became my father. Norvell
and I were, therefore, hereditary friends. She was always for
quick and decisive action.

"Let us send supplies for a whole hospital/ she said. "We
will organize the entire state. Tonight the Elks are having a
meeting at the Men s Club. We will turn it, Rosalie, into a
lecture audience for you. If you will tell your plan, we will call
up everybody in town."

"Yes," enthused Lucy, "and we will telephone to Richmond,
Norfolk, Staunton, Charlottesville, Danville, Petersburg, and
get committees started in all of them."

It takes Southern women to do things like that. They were
related to leaders in all the key cities. They knew the warm
heartedness on which they could rely.

That night the hall was packed. Men and women I had not
seen for years were there, all, as if by magic, grown-up: Dan
Payne, John Witt, James Gilliam, Tom Watts, Bernard Moore,
presidents of banks, leading lawyers, able physicians, men of
affairs, builders of Lynchburg-all of them. I was so excited, so
happy, my voice vibrated with appreciation of them. I spoke
of Serbia s heroism. I was talking to sons and daughters in

300 A WOMAN SURGEON

whose veins hero blood flowed, men and women whose parents
homes had been raided and burned* Their response was elec
trifying. Applause, tears, laughter, banknotes, checks, never
was there such enthusiasm, and when I spoke in each of the
other cities my friends were equally generous and cordial. No
where in the world could there be such audiences. In the blood
of all these Virginians flowed the inheritance of courage and
the dignity of war-caused poverty of their ancestors; they could
understand the needs of Serbia. All of them remembered the
reconstruction days in Virginia, how a ham had to be borrowed,
and china and silver, when guests were expected.

At places where people wanted to do something more
personal than contribute to a hospital, I suggested that they
contribute toward the maintenance of some Serbian orphan.
They had heard of Belgian and of French orphans. In Yugo
slavia there were 500,000 fatherless children, of whom 150,000
were absolutely destitute. They could, through my connections
in Serbia, adopt a young boy or girl, whose parents both had
been killed, or whose widowed mother struggled to keep even
herself alive. I raised money toward the yearly support of
twenty Serbian orphans.

* At length, through the kindness of Virginians and the
administration of the district chairmen, we had collected
150,000 for a Virginia Hospital for Women and Children.,
Also the women of Virginia had contributed specific supplies
of medicine, food, clothing and other necessities, enough to fill
four freight-cars. The next problem was how to administer
the money in order to get the most for the sum. Through
Senator Martin of Virginia and Surgeon-General Ireland in
Washington, I learned that there were many excess United
States Army supplies still in France, which had been left over
after the Armistice, awaiting disposal. Surgeon-General Ire
land gave me letters to General Krautoff, head of the liquida
tion board in Paris, from whom I might purchase at reduced
prices goods being salvaged.

I sailed for Europe in June of 1919, believing that my
mission would be a speedy one. General Krautoff was very
helpful, and from him I was able to purchase many things; but

VIRGINIA ^^ 01

I also^ had to call on General Booth in Lyons for additional
supplies. Hospital goods were scattered in many depots
throughout France. The French wished to prevent anything
leaving which they might be able to use, and as a consequence
involved formalities were pursued for many days in order to
gain permission to buy equipment from Engineering, Quarter
master, Motor and Medical Divisions of the Army. But, thanks
to the abundance on hand, I was able to buy for $50,000 three
times what that amount would normally have purchased. I
had supplies enough to equip a five hundred-bed hospital, even
to water buckets, gasoline and axle grease, all the things neces
sary to a self-sustaining unit, which the Ministry of Health in
Belgrade said was so well supplied that "it could function in a
desert."

With the assistance of my friends, Miriam Dole, from Maine,
and Wilhelmina Drummond, from Georgia, everything was
assembled. The transportation difficulties of railroad and ship
were overcome. In Marseilles they supervised the loading and
I went on to Belgrade to make official arrangements for receiv
ing and conveying the equipment through Greece and Serbia.

The shattered condition of buildings in Serbia, together
with the high price of building materials, delayed the construc
tion of our hospital. The Government undertook to supply
one, but so much had to be done to rebuild the devastated
nation it could not be done within a few months. Furthermore,
barracks which it was proposed to improvise were still needed
by the army, which was forced to remain mobilized, because of
the menacing attitude of Italy, due to dissatisfaction regarding
Dalmatian partitioning and D Annunzio s Trieste affair. Labor
also was scarce because so many men had been killed or were ill.
It eventuated in a division of the supplies. I held long con
sultations with the American Minister to the Kingdom of the
Serbs, Creates and Slovenes, with war workers, the Serbian
Red Cross, the American Red Cross and the Serbian Minister
of Health.

t When the supplies reached Salonica, the large shipment of
dolls to come with them, which I had purchased in Paris for
the sick children who had not seen toys for years, was nowhere

302 A WOMAN SURGEON

to be found. The officer in charge grinned sheepishly when I
belligerently demanded what had become of the huge box of
dolls, and confessed that soldiers returning home had passed
all the other cases by, but when they saw the one marked
"Dolls/ it was more than they could stand. Each thought of
his own little girl. They broke open the box and stuffed dolls
under their uniforms.

I laughed, forgave him and them. He assisted me in
obtaining the free use of a long train of freight-cars to transmit
the five hundred-bed hospital to Belgrade. There were dangers
for our precious freight on the long, slow road up to Belgrade
through areas of want. Necessities were irresistible. This was
called "salvage." Through a French official I secured an armed
guard for the train; the trains were still commandeered by
France, until Serbia should repay France s war loans. The
protection granted, the supplies started northward.

Again there was delay. The freight had halted at a town
midway on its northward journey. Fearing that it had been
raided, I took a bouncing freight back to investigate.

The train was stalled.

"Dr. Morton, we are very sorry, but we had to use some of
your axle grease in order to move the train."

To insure my women colleagues the recognition they
deserved and had long hoped for, with official support, in the
name of Virginia I presented the corresponding amount of com
plete equipment, as well as sewing machines, and hospital
clothing, to the Ministry of Health on condition that the Gov
ernment accept responsibility for the construction of a building
within a reasonable time and employ women physicians in it.

Owing to the endless difficulties of reconstruction, after one
year and nine months the Ministry of Public Health had not
commenced the building. The women doctors appealed to me
to urge the Government to give the supplies directly to them
and volunteered the promise that they would erect the hospital.
They had formed a society, were ready to solicit funds.

The Government turned over the equipment and made no
storage charges. A Serbian gentleman gave a fine piece of
ground, and building began. I added $2,000 -to buy cribs and

VIRGINIA

other necessities for women and children, not in army equip
ment, and for memorial name plates to be placed over beds, in
accordance with a list I presented.

Construction of the hospital proceeded on money raised by
Serbian women and a gift from the Scottish Women s Hospitals
organization, anxious to commemorate their founder, Dr. Elsie
Inglis. So two buildings were erected, equipped, and soon
functioned.

In Belgrade the City Health Officer urged me to contribute
one of our eight ambulances to the city, for the only conveyance
which they then possessed for transporting both the living and
the dead was an old cart drawn by a scrawny horse. Equipped
with pillows, blankets, etc., the ambulance went into service
that afternoon.

One hundred and fifty beds with corresponding supplies and
ambulance, on the advice of the Minister of Health, were sent
through the Health Officers of Croatia to equip a hospital in
Gospic Lika. The nation was grateful for the return of Croa
tian volunteers from America. Two years later when I visited
this hospital, the grateful doctor escorted me up to the en
trance. Over the door, to my amazement, I read: "The Morton *
Hospital."

Dr. Lockert enthused, "This is the only hospital in Europe
named for a woman who is not a queen." *~ -"

An old peasant standing by the door said, "To us she is a
queen."

It was one of the happiest days of my life, when I was shown
gratifying records of medical and surgical service for the last
two years. The mayor, the priest, officials and ladies assembled
to send a message to express appreciation.

The remaining hundred and fifty beds, ambulances, gaso
line, spare parts and hospital supplies, including the largest
tents, were given to the Serbian Red Cross. Some of the latter
they sent to Macedonia to shelter returning refugees. Others
were used, together with beds, and all necessities, to establish
a large camp at Topshider near Belgrade for frail children
subject to tuberculosis.

In 1923 and 1924 moving pictures made at this camp by the

g04 A WOMAN SURGEON

Red Cross of the Kingdom of the Serbs, Croats and Slovenes
were shown throughout Yugoslavia, and did much to promote
interest in methods of caring for the health of children.

Also, a rest home for women and children was established
on the Dalmatian coast, so the supplies purchased in the name
of the State of Virginia were widely and well used, in addition
to which blankets and clothing were given to orphanages.
Children throughout the kingdom received toys on that first
bare Christmas after the Armistice.

To the Kola Sestara musical instruments and clothing were
given for invalid soldiers. To this organization, from a group
of North Carolina mountain farmers, I gave $100, with which
to establish an agricultural kindergarten in Sklopji. The
farmers in North Carolina had each planted "a row of corn for
Serbia" and wished the money earned through this to produce
happy results in vegetables and flowers on the tragic field of
Kosova, famous in Serbian history.

Also, there was money to equip two dental clinics in
Dalmatia, and $2,000 to make up the necessary balance to
secure a hospital for the cure of the tubercular in Novi-Maroff,
under the Department of Public Health. This I also supplied
with hospital clothing.

After the war the Yugoslav women made it their first duty
to establish and conduct nursery schools, orphanages and other
relief organizations. In some of these I had the privilege of
cooperating.

* Eighty Serbian orphans throve on the kindness of Americans
who helped me to keep my promise to a dying soldier, and act as
a faithful steward in transmitting the helpful sympathy of Vir
ginians to men, women and children whose home land was also
a battleground.

CHAPTER XXIV
THE INTERNATIONAL SERBIAN EDUCATION COMMITTEE

BUT there was other and different work that could be done to
assist the reconstruction of Serbia: spiritual and educational
regeneration.

On my way for a short visit in Florida in the autumn of
1918, my mind was filled with the fortitude of Serbia, Croatia
and Slovenia, in rebuilding their ancient empire, and their
hope for permanent peace. The doctor was on a vacation, but
the mother in me was formulating a plan that was to be my
greatest adventure and to entail the most difficult work I had
ever undertaken.

Saturated as I was with war psychology, I could not adjust
myself at once to the life o pre-war days. I sat in a comfortable
pullman, looking out of the window at luxuriant greenness
great trees, full-leaved, strong-boughed, their thick trunks ready
to be made into lumber for building houses, barns, railroads,
into pulp for newspapers and books, into fuel. The beauty of
vines, flowers and productive fields would soon yield harvest.
Here in America were all the blooming native materials ready
to build; here, too, was the lasting spirit of growth and resur
rection. Then I thought of the shell-torn little Balkan king
dom, now a desolation of uprooted trees, wrecked farms and
burned homes, as I had seen it through the broken side of a
freight-car. I wondered how long it would take that sturdy
nation to recover from the destructive fatigues of three wars
and reestablish its morale, when like an echo I heard again the
prayers of the dying man who had begged me to do something
for the young people after the war.

As my train sped southward, I thought of our universities.
Why not bring to these universities a group of Yugoslav stu
dents to receive scholastic education and learn the values of
home and economic life in a democrary? The most ad-

305

36 A WOMAN SURGEON

vantageous way to enable young people to become factors in
the progress of our time would be to select some of those who
had both seen and suffered from the aggressions of dynastic gov
ernments, remove them from the obstructive influences of suspi
cion, discouragement, hate and unhappiness; place them in an
atmosphere of appreciation, kindness, aspiration and oppor
tunity; substitute for neighbors who were age-old enemies
neighbors who would become lifelong friends; in short, ex
change for the contentions of Europe the comradeships of
America.

The difficulties of reconstruction were perhaps more over
whelming in Serbia than in any other country. And its field
of education so vital to its rebirth lay shattered like a devas
tated battleground. Adolescent youth for six years had been
deprived of parental and scholastic guidance. Instead, starva
tion, anxiety, ruin, death, breathed on every side. Lads sixteen
years old were in the army. Adolescent girls in the hope of
safety slept wherever they could find shelter-under bushes, in
trees, in hay mows, in gullies, or barricaded in attics. Germany,
realizing the value of education, had sanctioned the death of
all educators who might keep alive Slavic traditions and ideals,
while young women brought before German officers were sen
tenced to be hanged, unless they could prove they were not
teachers. They must begin again now as though there had
never been a school in the land. So by the time I reached
Winter Park, Florida, I had decided to bring a few Serbian
young ^ men and women to this country for education, on the
condition that they accept it as one channel of our service to
their country and return to Jugoslavia to participate actively
in its rebuilding y

The Reverend Calvin H. French, then president of Rollins
College, asked me to speak to the students in the chapel. I
told them something of the courage and endurance of Serbia in
the World War, of the destruction of the University of Bel-
grade^and suggested that the faculty and student body join me
in an invitation to a Serbian boy or girl to come to America as
our guest for four years. Immediately two tuition scholarships
were offered. The members of the Glee Club who were sitting

SERBIAN EDUCATION COMMITTEE 307

on the platform, after quickly whispering to each other, offered
twenty-five dollars toward the traveling expenses of their pro-
tgs. Thereupon the International Serbian Education Com--
mittee was born." President French offered to act as temporary
secretary-treasurer.

My vacation was fast becoming an enterprise. I went on to
Cuba to visit friends and spoke at the American Club in
Havana. After reviewing the modern history of Serbia, I
stressed the values of tobacco in Serbian rebuilding, and de
scribed how before the World War the peasants had produced
most of the famous so-called Turkish tobacco." The industry
had been conducted on primitive lines, but the Government
guaranteed to buy, at a fixed and fair rate, all a man could
raise, which was then manufactured and exported. This Gov
ernment monopoly long had been an important source of
revenue for education, for farm loans and for other national
expenditures. I suggested that the training of a student in
Cuba s advanced methods of tobacco raising, curing and pack
ing, would, in addition to a regular course in agriculture in the
University of Havana, be a great contribution toward Serbian
rebuilding. The Minister of Agriculture, Commerce and
Labor, General E. S. Agramonte, immediately offered scholar
ships for six young men.

Greatly encouraged by this beginning, I decided to accept an
invitation from cousins living in New Orleans, and from a col
league in Houston, Texas. At Sophia Newcomb College and at
Southwestern Institute in Lafayette, Louisiana, I met with a
warm-hearted understanding of my hope to make the Serbs
feel that our effort was a method of showing our appreciation
of all that they had suffered while barring the way from Berlin
to Bagdad. The students of these two institutions of learning
offered to form subcommittees and meet all the expenses for
four years of the three girls whom they authorized me to select.

In Texas I found the State University willing to grant a
scholarship in engineering and also one in medicine with main
tenance at one thousand dollars each year, making a total o
eight thousand dollars. Dean Taylor and Dean Keiler con
sented to serve on our advisory committee. They became like

3 o8 A WOMAN SURGEON

older brothers to the two young men who eventually studied
there.

On my way back to New York, I stopped at Converse Col
lege, South Carolina; at Greensboro, North Carolina; at Ran-
dolp Macon College, Lynchburg, Virginia; at Sweetbriar; at the
Universities of Virginia and Pennsylvania; and at Princeton.
Everywhere scholarships were granted. In Washington I con
sulted the Director of the American Council of Education, Dr.
S. P. Capen, who agreed to serve on our executive committee,
together with Miss Cassity Mason of the Castle School and the
Reverend Frederick Lynch of the World Peace Movement. I
also interested Ernest L. Crandall of the New York City Board
of Education, Dr. E. E. Brown, Chancellor of New York Uni
versity, and others. Our committee was incorporated and we
immediately made an effort to raise enough money to supple
ment the various educational offers. The project gained wide
interest, but very few contributions were made in cash. Many
said, "When the students are here, we will contribute toward
their expenses/* Churches explained that their home and
foreign missions and fixed activities absorbed all their incomes,
but they would be willing to have me address their congrega
tions and the proceeds of a collection could go to the treasurer
of the International Serbian Education Committee. Men s and
Women s Clubs felt they could not pledge future officers for
sponsorship or any definite amount, but they assured coopera
tion if I could lay the plans and progress before their audiences.

Great encouragement came from Rochester, New York, from
Dr. Marion Craig Potter and Mrs. Henry Strong. Doctor Pot
ter has for years been as a sister to me, encouraging, advising,
restraining just when each was most needed. Having made a
success of life as the daughter, the wife and the mother of dis
tinguished physicians, she had also achieved great success in her
private practice, and found time for public work. In organiz
ing the Public Health Education Committee, in founding the
American Women s Hospitals, she had been my counselor and
comrade. I knew she would now help me accomplish my
heart s desire in this work for Serbia. She did valiantly in many
ways, and Mrs. Strong was also a tower of strength.

SERBIAN EDUCATION COMMITTEE 309

On my way to Europe I counted up all possible sources of
income, as well as what I had in hand, and decided I might risk
inviting twenty Serbian students to come over with all expenses
to be paid from the time they left Belgrade until their return as
graduates. The length of their stay in America was to depend
upon their collegiate application and progress. I could depend
upon the fulfilment of nebulous promises, for I had seen the
generosity of all classes of Americans during the war. I was
willing to give all I could spare myself and work without re
muneration.

When I reached Belgrade, I presented the letters from the
American colleges to the Minister of Education and asked him
to appoint beneficiaries. I called on the Ministers of Foreign
Affairs, Commerce, Education, Health, Agriculture, Interior
and Finance, all of whom I knew, and found them thoroughly
interested in the plan.

The Minister of Health graciously said, "Dr. Morton, you
are known in every village. The men you restored to health
and usefulness have made songs about you. If we published
your plan, you would be overwhelmed by the number who
would apply."

The Minister of Education said, "All must have an equal
opportunity. It is best for me to announce in the daily paper
that a lady* has come from the United States to take seventeen
students to colleges and three to schools, that those who can
present proper credentials may make application tomorrow af
ternoon at two o clock at a place I will designate, and must
bring their certificates of education with them/ I admired his
diplomacy when he added, "This does not give any one a long
chance, but it gives them all an equal one."

The room placed at my disposal was of generous proportions,
at least thirty by one hundred feet. I borrowed seven tables,
pens, ink, blotters, as well as seven chairs, and found six Serbian
people, who could speak English, willing to cooperate. We
formulated a questionnaire and expected to spend one after
noon registering the applicants. Perhaps a hundred would
apply. Each of the ministers upon whom I had called was to
send a representative to help in selecting those who would be

gio A WOMAN SURGEON

best fitted for courses in medicine, dentistry, agriculture, engi
neering, architecture, banking, finance, etc.

At one-thirty o clock I started to my temporary office. Al
though I passed an unusually large number of people on the
street, I merely supposed a distribution of Red Cross goods was
about to be made. As I neared the building, I found the street
choked with young people. The stairs were so crowded that I
had difficulty in reaching the room. Scarcely had I greeted
those who had come to help me and made sure that all was in
order, when the door opened. We had intended to admit six at
a time. But a Niagara of humanity poured into the room. In
two minutes there was not an inch of vacant space. People
stood on tables, chairs and window-sills. I do not know what
became of the ink. The secretaries of the ministers looked
aghast, while I stood for a moment, dazed. How could we
choose twenty out of this eager mob? All the rest would be
disappointed! The little good I had hoped to do seemed so
trivial in comparison with the disappointment I would have to
inflict. More and more young people edged in, flattening them
selves against the walls. In order to attract attention many held
up diplomas in thin, clawlike hands. Emaciated faces were lit
with starry eyes. It was tragic.

I turned to Major Stephanovitch, a distinguished physician
and poet, whom I had known on the Salonica Front, and who
represented the Minister of Health, "What shall we do? *

"Send them all home/ he replied,

I hated to do that. In the hope of winking a tear away un
observed, I looked out of the window. To my horror and
amazement I saw the street blocked by other young people try
ing to get into the building.

"How many do you think there are?" I asked the major.

"At least two thousand/ he replied, "and tomorrow all will
be here who can walk or come on trains!"

It seemed to me remarkable that so many people had read
that newspaper notice and acted with such prompt confidence
in the United States. There was nothing to do but take the
advice of Major Stephanovitch.

He announced authoritatively to the applicants, "It is im-

SERBIAN EDUCATION COMMITTEE 311

possible to do anything in this crowd. In the paper tomorrow
morning the requirements which you will have to meet will be
printed in full. Do not come again unless you can fill all of
these. Remember, only twenty can be chosen." Quietly they
left.

I sat up nearly all night making out the list of qualifications
and restrictions in order that the newspapers should make them
perfectly clear. The next morning at an informal conference of
all the war workers who were in Belgrade I asked them to ad
vise me. From them I learned that the French Government
had educated 3462 Serbian refugee students, and that England
was educating 300. At the moment I did not realize the im
portant political reasons for this generosity. In comparison the
twenty I was intending to bring to the United States seemed
altogether too small a number. The fact that our venture was
being undertaken by individuals and through the private co
operation of scholastic groups, faded a little from my mind. I
felt ashamed that a country as large as the United States, which
had lost so little in the war, was taking only a paltry few. Con
sequently, when a French lady inquired how many I really
intended to take, as she thought the number stated in the paper
must be a misprint, I hedged and replied that the committee
had not yet decided.

While hearing what results had been attained by the Serbian
students in other European countries, my subconscious mind
was filled by an argument between my Quaker and my Virginia
ancestors. My mother s side reminded me that I must have the
backbone to stand firmly by my decision to take only twenty,
that it was a sufficiently dignified number. They seemed to
whisper, "Thee will be fortunate if thee can accomplish that."
My father s side suggested with true Southern hospitality that I
double the number! A voice seemed to say, "You have hardly
started and every one is with you." The Quaker spirit inter
rupted, "Only a few have promised to take entire care of a
student. What will happen to the rest if thee is ill or dies?"
Virgina responded, "All the college presidents have said the
presence of war heroes would appeal to their student bodies.
When you draw a picture of the misery from which the young

A WOMAN SURGEON

Serbians come, and tell what they have suffered, the Y. M. and
the Y. W. C. A. will probably each support one." Between this
argument I was approaching a new decision. A mathematical
calculation started.

Through correspondence and lecturing I had received prom
ises of one hundred tuition scholarships. That amounted to
approximately one tenth of the cost of the college year; there
would be special fees to meet laboratory, breakage, etc., then
books, clothing, such medical care as might be needed, vacation
and summer maintenance, travel to and in America to the far-
scattered college destinations. Common sense was taking sides
with the Quakers. American pride tugged hard against it.
The assembled audience did not know that a battle was being
waged behind a calm forehead. But I made a truce by sub
tracting from the one hundred tempting tuitions the twenty I
knew I could manage. This gave me eighty. It seemed fair
then, everything considered, to split the difference, play the
possible against the impossible and add one for good measure!
So I added forty-one to the twenty I had intended to bring, and
we actually gave sixty-one Yugoslav students an educational
opportunity in American Colleges and Universities.

The requirements published in the Belgrade paper specified
the choice of young men and women between the ages of sixteen
and twenty-four years who were of straight Slav descent. They
must be free from communicable diseases as testified by a recent
doctor s examination, since many had contracted tuberculosis
in the privations of the previous six years and could not be ad
mitted to the United States. The age and state of health of
parents was to be considered, for the students were to remain
in the United States for four years; no one whose parents were
very old or infirm would be taken. The applicants must indi
cate the languages they spoke, for we intended to take those
who, knowing French or German, could more readily learn
English. They must also state the course of study they pre
ferred, since we wished only those with definite ambitions.
They must submit their original educational credentials for
which no substitutes would be accepted letters of character
recommendation, and last but most important, a pledge to re-

SERBIAN EDUCATION COMMITTEE

turn to their own country to utilize their education in its na
tional life.

A Serbian division of the International Committee was
formed of the representatives of the ministers, exchange pro
fessors from Cambridge to the University of Belgrade, the
directress of the Girls Normal School in Belgrade, and the
American consul. All of them gave their time to meet the most
likely applicants and examine the papers of those who fulfilled
the requirements. Even though pressure of every sort was
brought upon the selection, absolute fairness was maintained.
Even His Majesty the King, who was not informed of the many
requirements, wrote suggesting a farmer s son. But the letter
was put into a drawer with the rest, until we could ascertain
what education the lad had received. The father had distin
guished himself by such bravery on the field of battle that the
King had said to the peasant, "Some day you may wish to ask a
favor. It will instantly be granted." This man had asked His
Majesty to recommend his son to go to America. As, however,
he had had no high-school education, we regretfully declined
him, even though we ruled that when choice had to be made
between two of equal scholarship, the one who personally or
through his family had suffered most in the war should receive
preference.

The Belgrade members of our committee suggested that
applicants be chosen from all sections of their newly amal
gamated nation, as well as from Old Serbia. Therefore, we
selected. some from Montenegro, Bosnia, Hertzogovenia and
Croatia, stipulating only that all should be of direct Serbian
lineage.

After six weeks of careful selection sixty-one were chosen to
sail to the United States, there to enter fifty-three different edu
cational institutions. My subconscious mathematical computa
tion was only the beginning. Next arose the problem of how to
get the money to pay their way over. I cabled home for every
thing I had in the bank, but that was not enough. I wrote to
all my patients; fortunately there were many. I suggested that
if they felt a bit of gratitude for their health and safety, they
might like to show it by contributing to our transportation

314 A WOMAN SURGEON

fund. More daring still, I wrote to the relatives of the patients
I had lost and suggested they make a memorial gift. Enough
money came to pay the way to "New York of the sixty-one young
people and to take them from that port to their colleges. The
Serbian Government contributed $14,67640. The banks were
just beginning to function again. A dinar worth twenty cents
before the war was now worth two cents. Roads, farms, stores,
needed rebuilding loans from the Government, while hospitals,
orphan asylums and other institutions were in crying need.
Thus it was a profound expression of their belief in the benefits
which would come to their youth in America when the Council
of Ministers authorized the contribution of such a large amount
to our committee work. One of them said to me, "It is our
duty," and the Minister of Foreign Affairs wrote me the follow
ing official letter:

18-9-1919
Belgrade
No. 11545
DEAR DR.MORTON:

It was with greatest pleasure that I was informed of the founda
tion of the International Serbian Educational Committee made by
your personal effort, and of its splendid work already realized in
our country through your personal presence here, the result of
which was that 60 Serbian Students, boys and girls have been sent to
American colleges for higher education. It not only is our duty to
help you materially in this noble work but also to assure you of our
highest admiration and the most cordial gratefulness, both for your
personal efforts in this work and for the kind interest of your
friends and of the American Colleges which offered scholarships to
our students.

I write to inform you that we regard the International Serbian
Educational Committee as the official channel for the education of
Serbian Students in America, and that therefore all questions con
nected with this shall in future go through your committee, and
you personally as its founder and chairman.

Expressing once more my personal admiration for your work and
my thanks both for the work you have already done and for that
which you still plan to do, I beg to remain, dear Dr. Morton,

Yours very sincerely,

MICHEL GAVRILOVITCH.

SERBIAN EDUCATION COMMITTEE 315

Such cooperation on the part of the Serbian Government
doubled my responsibilities to see that the students got only
what was best in our vast land to bring back to their own
country.

Great was the excitement of the students on setting out for
America. One emaciated ex-soldier clad himself for the jour
ney in his very best outfit, a broad-striped pajama top for a
shirt. No one had a collar or a tie; few had hats. All were
pitifully clothed in faded, worn garments left from their once
comfortable wardrobes or in ill-fitting donated clothes. But
their dauntless spirits looked far beyond any immediate annoy
ance. When they reached New York in the fall of 1919, to the
amazement of the members of the committee who received them
they were already speaking a little English! All Serbians are
linguists. Their own language is even more difficult than Rus
sian, which it closely resembles, and all others seem to them easy
to acquire.

Once in the United States they knew they were safe when
together or when accompanied by a member of our large com
mittee. But when they found themselves alone, the terrors of
past years gripped them. Their nervousness was doubly pa
thetic because they tried so hard to conceal it. One of the girls,
when she was put on the train for Louisiana, smiled gratefully
and nodded that she understood all the carefully explained in
structions. However, during the journey she would not leave
the day-coach for meals nor go into the pullman at night, even
though berth tickets had been given to the conductor in her
presence and he was attentive to her. She made the box of food
we had provided as a snack last three days. Exhausted from
fear, lack of sleep and hunger, she was almost in a state of col
lapse when she reached her journey s end. After several weeks
she explained that she had thought the food might be poisoned
and that the train might be bombed or derailed during
night.

CHAPTER XXV
EDUCATING A FAMILY OF SIXTY

BRINGING my proteges to America was merely the beginning of
the task. Hazards and hurdles were the order of the day every
day. I have a profound and lasting gratitude to the people in
every state who helped to make a success of this adventure in
education, for, lacking an endowment, it became a financial as
well as a mental adventure. I could not have undertaken it nor
carried it through if experienced educators had not been ready
to advise me on specific problems. Furthermore, it was for
tunate that cooperation was widespread geographically and
varied in scholastic requirements, since all the students were
not fitted for grade A colleges.

The majority of our problems arose, however, from the com
plexities of Slavic temperament. Luckily, since I had been in
their country and knew what they had left and what they would
meet, sympathy helped me to be patient. In adjusting them
selves to their new environment there was much nervous strain.
In many cases this evoked pity.

Beautiful Marjya Jovanovitch was welcomed at Mount Hoi-
yoke College with gentleness and cordiality. But when she
went to call on the president, a large pet dog came quietly
across the lawn toward her. He did not jump, growl, nor bark,
merely moving sedately forward to examine the visitor. But
Marjya was riveted to the spot. Her slender graceful figure
shook from head to foot, as her terrified eyes watched the dog,
expecting it to demolish her. Six weeks later she sent me a
photograph in which, smiling happily, she had her head on the
dog s and her arms around his neck.

When Zora, whose name in English is Dawn, began to study
medicine, the dissecting room brought vividly to her mind rav
aging murders she had witnessed. She dreamed of a professor
she had seen hanged, of the body of a slain statesman which she

316

EDUCATING A FAMILY OF SIXTY

had seen dragged through the streets of Belgrade, and of other
ghastly memories which oppressed her for weeks. She was
forced to abandon her course and eventually decided to TO
home.

But these were inevitable psychological cases. Most of the
young Serbians responded gratefully to their welcomes. The
reception given to the two girls who went to Randolph Macon
College in Lynchburg, Virginia, and to the two assigned to the
State Normal and Industrial College in Greensboro, North
Carolina, were typical of the sisterly interest felt by the. Ameri
can students in their guests. Before the strangers arrived all the
girls contributed to the dainty underclothes, handkerchiefs and
stockings, which they decided should be waiting in the bureau
drawers. Skirts, sweaters, coats, shoes, hats, as good as new and
in perfect style, were assembled in the closet. The window
curtains and cretonne hangings were freshly laundered; flowers
filled the tables. When the train pulled in, the Serbs were be
wildered and a little frightened by the demonstration of cheers,
waving pennants and enthusiastic hugs. Soon, however, they
got used to being loved and cared for, as not only the students
but the professors took especial pains in teaching them Ameri
can ways.

The boys in a different way were as heartily welcomed, and
all made firm friends. The Y. M. C. A. came up to my expec
tations. One of the Serbian boys who went to North Carolina
State College in Raleigh was deeply impressed by the religious
life of his American chums. He told me he had never known
that religion could be a part of everyday living. He had thought
of Our Father in Heaven as a Majestic King on a throne, and of
pageants and processions as a necessary part of all worship, as
they exist in the Greek Catholic ritual of the Serbian Church.

In the fraternal democracy of unprejudiced friendships, self-
confidence was slowly reborn in these neurasthenic youngsters.
And gradually they came to accept it wholeheartedly. One of
the boys, who eventually graduated cum laude at the University
of Syracuse, told me that the greatest thing he had gained from
American life was its complete fairness of judgment and op
portunity.

gi8 A WOMAN SURGEON

Of course my family of sixty developed petty jealousies and
unreasonable whims. They were not only perversely human,
but high-strung. Those in Boston wished they could change
places with the ones in Ames, Iowa. One in Texas demanded a
shaggy sheepskin coat such as we had provided for the boys in
Vermont. And they who had been so recently hungry unani
mously denounced American breakfast foods. But discounting
their sensitive natures, we were gratified to see them rejoice in
study and to measure their surprising progress.

Each of the students received approximately one hundred
dollars a month to meet current expenses: board, room, books,
college incidentals, clothing repairs, and so forth. We carried
the whole project on an average of $1,000 a year for each stu
dent, which made an annual expenditure of $60,000; i.e., $240,-
ooo for four years plus necessary traveling expenses, clothing,
dentist bills, occasional hospital expenses for an appendix re
moval or other emergency funds. This meant that I had to
raise a quarter of a million dollars; see that it was wisely dis
tributed, accounted for, and audited; correspond with fifty-
three colleges, as well as individually with the students; make
arrangements for and deliver a minimum of eight lectures a
week for four years; and write follow-up and propaganda letters
to contributors.

A newspaper campaign for funds through the usual publicity
channels was impossible. The children of martyred people who
had opposed their enemies and ours with bare hands, shattered
bodies and wrecked homes must not have their dignity lacerated
as well by public begging for their clothes and food. Yet sev
eral newspapers wished to exploit these Serbian students when
they saw good copy in the story of how a girl had seen her
mother beaten to death or of how a son had witnessed his war-
maimed father further mutilated and hanged, especially if I
would allow photographs of the students to be published. The
reporters protested they could help me raise all the money I
needed in a short time. I had photographs and authentic ac
counts which would have made the blood of any human being
boil, and no doubt would have brought from shocked readers
many contributions, but I stoutly refused to release them, know-

EDUCATING A FAMILY OF SIXTY 319

ing they would have only harmful effects on the students. I had
brought to America those who had suffered agonies; I was try
ing to cure their neurasthenia by forcing into the background
painful memories of horror and bringing to the front all that
was wholesome and hopeful. I tried to keep them so busy with
new impressions that they could have no time to dwell on the
old. "Sob stories" would have rendered them self-conscious
and self-pitying, thus undoing all our intentions. Therefore I
lectured on "Serbia s Heroic Part in the World War," and
never stressed individual calamities. I tried instead to arouse
in my hearers enthusiasm for the intellectual status of Serbian
statesmen, artists, architects, authors, generals, musicians, whom
we had been misled by enemy nations newspapers to believe
were all inferior. I found it easy to arouse a sense of gratitude
to Serbia for all she is and has been. Americans are open-
minded and generous-hearted. From the magnificent response
of the men and women I addressed, our treasurer received as
stirring stimulus as they from the subject presented.

In order to lecture again and again in the same cities, often
to the same audiences, it was necessary to become an ardent
student. Fortunately, Slav art, literature, folk ways, music, etc.,
afforded new topics. Friends within a radius of one night from
New York, and that covers a wide area, arranged lectures for
every Saturday and Sunday morning, lunch, afternoon, eve
ning, sometimes an extra one to a Christian Endeavor or Sun
day-school class! The response was remarkable. Business men
and women, who had had a hard time to keep one child at col
lege, swelled the collection of funds. Many remarked, "This
will help to keep them in shoes," when they gave a small
amount. Some in gratitude that their son had come safely
home from the war gave a thousand dollars a year for four
years. Lantern slides were a great help; photographs taken
when the young people reached these shores, wan, wistful,
anemic, were mounted beside others taken a year later plump,
happy, full of courage. These were talismanic.

Sixty students was a tiny number to bring, but from a par
ental standpoint it was sufficient. The Serbian Bishop Nicolai
said at one of our committee meetings that he would not have

32Q A WOMAN SURGEON

undertaken this work, even if all the money had been provided
and he had received a salary, because the education of such war-
hypersensitized boys and girls in a foreign country bristled with
difficulties from beginning to end. But he reassured us that
every student, whether able to graduate or not, was receiving
the great benefits of a broadened vision which would ultimately
bear fruit in the life of each.

In 1921 a professor member of our Committee said, "It is
interesting to measure this unique expression of practical ideal
ism by university schedule. The average professor gives ap
proximately five hundred lectures a year. Dr. Morton gives
approximately six hundred lectures yearly; therefore, she is in
effect a professor. She directs the education of students in a
diversity of subjects covering the range of collegiate teaching;
she is in effect a dean, with her faculty extending from Maine to
Texas, from Massachusetts to California. In successfully ad
justing the students to their colleges and to the fifty-four nation
alities with which they come in contact, she is a diplomat!"

For the summer months we secured work for each of them,
through which they could be partially self-supporting. So many
American students arrange for summer occupation long in ad
vance it was difficult for me to find it for my proteges, and in
the first summer more difficult to persuade them to accept the
jobs. They considered it their duty to go to summer school for
special courses until college opened again in the fall. One of
the greatest lessons they had to learn was the dignity of labor.
In Europe all physical work is considered menial, and intellec
tual attainment elegant. When my Serbs saw the sons and
daughters of American professors going to work on farms, they
were aghast. Our committee had to issue an ultimatum that
any student who refused summer work could have a return
ticket to Jugoslavia. This seemed hard, but it forced the
decision and afterwards they were so pleased with the money
they earned that by the second summer they were finding em
ployment for themselves.

As camp councilors, both boys and girls learned much of
value in administration, health, recreation and outdoor study,
as well as developing their personal self-reliance. Two of the

EDUCATING A FAMILY OF SIXTY 321

girls who had learned English at Smith College their first year
in America and had taken up the study o dentistry at Tufts
Dental College in Boston, realized that dentistry is more thor
oughly taught in the United States than in Europe and were
eager to lose no opportunity to learn. They refused camp-
councilor vacation work, electing instead to go as dental hygi-
enists to the State Hospital for the Insane in Rochester, New
York. The women doctors there saw to it that they were not
frightened by the patients, and the girls, Stana and Rugitza,
observed and treated a wide variety of dental patients. The
following summer, to my amazement, they again refused a re
creational outing with swimming and horseback riding, ex
plaining that they preferred to return to the State Hospital,
"because we can now do so much more for the patients." They
told me many pathetic and humorous stories about their ex
periences with the inmates; they had convinced one that she
could swallow, another who had not smiled for years that she
must smile to keep her teeth in good condition.

When I urged, "My daughters, you can have equally valu
able educational work in some other hospital/* they quickly
responded, "No, we have suffered so much that we understand
these people. We want to show our appreciation of all America
is doing for us by choosing what is difficult, and we are anxious
to see the progress our patients have made in the past year/*

One of the girls, Stana, formed a close friendship with a
Turkish girl medical student in Boston. In speaking of it to
me, she safd, "Our people have been enemies so long it will take
all we and our children can do for a hundred years to make
them friends. We now realize our duty, for all nations are
friendly in America/

This idea appealed to all of them; gradually a transforma
tion of spirit took place. Germans, Austrians, Hungarians, Bul
garians, Turks, had been their bitter, warring neighbors, while
Italy was avowedly unfriendly. The Serbs came to America
thinking every man s head, hand and heart against them. They
even mistrusted kindness. But when they had been here two
years, they all joined cosmopolitan clubs; in the colleges where
there were no international clubs, they formed them; they de-

A WOMAN SURGEON

bated issues impersonally, and accepted as close friends the
students from other lands. The alchemy of kindness changed
the apple of discord to the fruit of content.

But none the less one of our constant problems was keeping
the students cheerful. Letters from home often depressed them.
One of the boys, who was specializing in agriculture at Cornell
University, worried a great deal about his sister who was dying
of tuberculosis. He blamed himself for having left her and
thought that if she could only have enough food she might live
until he returned. He felt very badly about having three meals
a day when she had scarcely one. Once, to relieve his mind, I
gave him twenty-five dollars to send to her.

But his scholarship report continued to show that he was not
applying his mind to his studies. Our committee suggested that
he should return to Yugoslavia, but he maintained that in a
railroad job, of which he had heard, he could earn some money.
He wished to remain under our auspices, but wanted to give up
college and go to work for an indefinite period. We explained
that we could not be responsible for him in a hazardous occupa
tion, and that according to our immigration and labor laws he
could not remain here except on an educational basis. He was
bewildered and clung to his idea.

Later he asked me to support his sister. I regretted that it
was all I could do to help meet the needs of the students in
America, and reminded him that they all had temporarily desti
tute relatives between whose needs I could not discriminate.

His face grew pale, his lips thin, his eyes half closed. With
the tension of a steel -spring released, he sprang to his feet and
said in desperation, "I cannot have her die. I will kill myself!"

Seeing that he had become utterly unreasonable and feverish
enough for desperation, I moved toward the door and stood
against it saying, "Krista, you cannot go out until you are calm."

"Krista!" he screamed. "One of the boys here is named in
our language the gift of God, another is named light. When
I was born, my mother named me for the cross. I have always
to carry it. I will not carry it any more. I tell you I am
through."

Quietly I said, "You are not yourself."

EDUCATING A FAMILY OF SIXTY 333

A murderous gleam came into his eyes, his face distorted in
fury. Standing tall above me, he lifted his powerful hands to
my throat. "I will kill you/ he shouted.

Danger makes me very still inside; I thought fast. "That
will be quite all right with me, my son," I said, looking steadily
into his face. "Sort of a favor, for the burden I am carrying is
so heavy I will be glad to lay it down." His eyes flickered; he
dropped his hands, but his face did not relax. Without moving
I continued, "My only regret is that since I have spoken so
highly of your people, I would be sorry to have you disgrace
them and break your sister s heart by becoming a criminal and
by being electrocuted in this country." His expression changed.
I did not move. "The newspapers here and in Yugoslavia
would say you are a coward to have killed a woman, and be
cause your nation considers me a benefactor, they would prob
ably put up a monument to me."

"I will not let them do that," he grunted, and turned away to
collapse in a chair. After a few minutes he began to cry. I
have never heard such sobs. His chest heaved, as he held his
breath and then emitted a bellowing sound. After the emo
tional storm had passed, he threw himself on his knees and
begged my forgiveness.

It was too much to expect that they would all keep well.
No family does. Tonsils and appendices had to be removed
from several, teeth had to be put in order for all, and eyes for
most of them. In courtesy to me our doctors bills were light,
but hospital and nursing rates were standard. Did I worry?
No, I was too busy. We never had enough money to see the
way one month ahead, and yet we never failed at the end of a
week to pay all the bills to date. I felt as if I hung by my eye
lids for four years, and I know I never drew a truly long breath.

Once in the midst of duties fate hit me a sort of submarine
attack." I had three gastric ulcers which kept me flat on my
back taking a tablespoonful of iced milk every hour for a
month. But I went on interviewing people and dictating let
ters, while my doctor raged. When I was sufficiently convales
cent to walk, Milun Laposavitch, who was studying medicine
and working as a hospital orderly in the summer, came one

324 A WOMAN SURGEON

Sunday afternoon to take me to a concert in Central Park. He
had never attended anything like it before and was delighted
with the group singing. The old ladies with cracked voices, the
men who could not carry a tune, those who were a beat ahead
or a bar behind, all fascinated him, as, despite individual dis
crepancies, a great group harmony poured from the throats of
thousands of happy people and the melody outrode the discord.
The late afternoon sunshine lit up their faces. The band was
vigorous and tuneful. Milun put back his handsome head,
closed his eyes, and his voice rang out like a trumpet, clear and
sweet. When a pause came, he commented, "I wish they could
hear this all around the world. Fifty nationalities singing here
together! This is your great America. In Serbia we all sing,
but not like this. How ignorant we are in Europe about this
country! We thought everybody was rich."

One day I planned to give myself a treat. Arandjel Stoilko-
vitch was going to have a birthday and I decided to present him
with a new suit his first since the beginning of the World War.
To clothe sixty-one people from the ground up, and skin out,
was no small item, so I was very grateful for all that my friends
gave me for them. In fact, I urged new clothing on all the men
I knew, and argued that they owed it to themselves to keep
strictly up to date and that I would value the retired suits. In
one way and another I secured everything from out-worn khaki
uniforms to dress suits, matched them to the sizes of my young
men, had them pressed, and made the boys proud possessors.

However, I managed to give once in two years one new suit
to each boy. This was ArandjeFs turn. I had secured summer
work for him at one of the municipal hospitals on Welfare
Island. It was his afternoon off duty and he was coming over
to tea. I had recently received from the Bishop of Southern
Serbia a beautifully illustrated volume of their ancient cathe
drals. I knew Arandjel would be interested.

A little upset by my pallor, he began our conversation in a
gratifying manner. "Mother, how any of the students can ever
argue with you is beyond my comprehension. You are so good
to us. If you told me to jump out of the window, I would do
it."

EDUCATING A FAMILY OF SIXTY 325

"Oh, Arandjel/ I said, "that is going too far."

"Not a bit," he stoutly maintained. "I would know there
was a safety net below to catch me. I would have perfect faith
in you."

Very much touched, I felt especially glad I could respond
handsomely, so I said, "Son, that is fine. I have a new suit for
you over in that box."

I expected him to break the string delightedly, remove the
lid, and draw it out with bursting pride. Instead he only lifted
a corner of the box, and shut it at once. "I do not want it," he
said firmly.

"Son, you do. Of course you do. Don t think I cannot
afford to give it to you. It is your turn. I want to see you in it.
Try on the coat."

"No," he said stubbornly.

"Well, what about all that high-sounding talk of a few min
utes ago? You are arguing with me."

"Oh, that was different," he rejoined. "If I try it on and
you like it on me, you will make me keep it, so I will not try
it on."

Completely baffled, I resorted to the only way out of the
impasse: complete surrender. I realized that I was thinking
with an American, he with a Serbian, mind. It was my duty to
try to understand him, so I said, "I am sure you have a good
reason. If you will give it to me, I will accept it."

A little ashamed he confessed, "I have such a queer reason,
you will laugh." I promised not to, "Well," he began bash
fully, "this is the first new suit I have had for six years." He
hesitated.

"Yes?" I encouraged. "You have been dreaming of it for a
long time."

He brightened. "How did you guess?"

"Go on," I urged.

"When I was in the trenches, in rags, in the slush and mud,
covered with vermin, the bags in which my feet were tied up
gnawed by rats, I thought some day I might have a new suit. It
sort of helped me to endure the rain and cold to think about it,

326 A WOMAN SURGEON

but I thought when it came it would be brown, and that suit
is blue."

"Did you think, perhaps, of brown shoes, and hat also?"

He hung his head. "Yes, and gloves," he blushingly con
fessed.

"Fine," I rejoined. "We will have Brooks Brothers ex
change this tomorrow. At Christmas you shall have the hat,
on Valentine s Day brown socks and gloves, and at Easter the
shoes."

A radiantly happy boy breathed a deep sigh. "Mother, it is
wonderful how you understand a fellow."

"Now," I said, "try on the coat so that we can see how you
like the style."

He did; then in the chivalrous European way he kissed my
hand. "I really would do a big thing like jumping out of the
window," he said, "but I am very stubborn about small things."

"Never mind," I said, "the worthwhile thing is that our
minds went a little way together."

My family of sixty-one began their studies in the fall of 1919.
In the fall of 1920 many were transferred from the colleges,
where they had learned English, to the professional courses they
had elected. By June, 1921, we could judge their capacities, dis
positions and possibilities of success. We sent a formal letter to
each student stating that although they had been fully informed
before leaving Belgrade as to what they might expect to find
here, they could not then, nor could we, foretell how they
would react, and in the event that any regretted having come,
or for any reason wished to return home, we would be glad to
make arrangements for them to sail on a set date. One, whose
aunt had died and left three children for her niece to care for,
decided to return. Several who were not scholastically able to
meet the required standards were told that we could not con
tinue their education. Two whose health had not built up as
we had hoped and who were homesick decided to go. Two who
feared the college diplomas they would receive would not be
accepted in Europe as equivalent to university degrees decided
to leave. They could not comprehend the status of a college.

EDUCATING A FAMILY OF SIXTY

Their colleges correspond more nearly to our high schools,
there advanced work is always taken at a university.

But most of the students showed progress, as they lost their
suspicion of kindness they had been taught to fear Turkish
kindness and adjusted their vulnerable, defensive tempera
ments to a serene environment. Especial development was
shown by one seventeen-year-old girl who had come from an
excellent family, at one time owners of a large estate, whose
father and older brothers had been killed in the war. We had
sent her to Miss Mason s Junior College at Tarrytown, where
she was highly contented. The friendship of all around her
quickly warmed her heart and she found the Hudson River
even more beautiful than the Danube. The security of being
in a stone castle appealed to her and helped to stabilize her
nerves.

After she had been studying English for six months, in addi
tion to carrying nearly a full course of other subjects, I asked
Mara Nicolitch to accompany me to a meeting of the New York
City MacDowell Club, at which I was to speak on Serbian
music. My fellow members were very sympathetic toward the
work I had undertaken. The sensitive Serbian girl must have
felt this, for she was calm and unruffled in facing her audience;
I expected her to say a few shy words when introduced. With
out the slightest embarrassment she made an excellent five-
minute speech. We were all surprised.

Later I said, "Daughter, I was proud of you! How did you
do it?"

Simply and reverently she replied, "God helped me."

There was a day when I thought a traveling salesman was a
person outside the social pale; but there came a time when I
began to think a "drummer" was the pluckiest type of man! I
was traveling from New York City to Burlington, Vermont,
hoping to interest the townspeople, whom I had known since I
had been a professor of physiology in the summer school of the
university, the faculty and students in the idea of sustaining a
scholarship for a Serbian young man who wanted to study en
gineering. Mile Jeftitch had nearly finished his preparatory
year. It was hoped that he could board in a home off the

328 A WOMAN SURGEON

campus in order to experience American life in a normal fam
ily circle from day to day. I wanted the people of the town to
invite him to Sunday dinners, take him with them to church
affairs; in a word, to make him feel at home; and I wanted the
professors to give him special coaching so that he could gradu
ate in three years. There were fifty-five other young Serbians
for whom I was trying to do the same thing.

The train reached Burlington at five o clock in the morning
ih the midst of a deep snow. I had a severe cold and had been
coughing most of the night. When the colored porter told me
it was time to get ready to leave the train, I said, "I hope I have
not kept every one awake."

He replied, "Lady, between you and the traveling man at the
other end of the car, I don t reckon anybody has slept much.
He has got a sick wife and three children. He has been travel
ing over this road for ten years, sick or well. He has got to go.
But, lady, why are you taking a trip when you ought to be
home in bed?"

I replied, "That man has only three children. I have over
fifty/

He exclaimed, his eyes starting from their spckets, "My God,
lady, how many widowers has you married?"

As I sat waiting in the station, cold ancf tired, holding a box
of lantern slides, knowing that I had to give three addresses in
the next twelve hours, with force and convincing vitality in each
of them if I would sell my idea, I realized that the drummer,
no matter how he feels, must tell a good story, must interest the
prospective customer. His employer expects him to go on the
road no matter who may be sick at home, to joke with other
salesmen he may encounter, but always to keep one step ahead
of them in getting business in selling the goods. I felt a great
admiration and fellowship for the drummer, concluding that
many of life s greatest men and women may be unlettered;
surely, they are unsung. I made better speeches that day than
I had expected to.

My self-imposed labor of educating the young Serbians had
a million spiritual rewards the best of which was that the chil
dren called me "Mother" and felt nearer to me than to any one

EDUCATING A FAMILY OF SIXTY 329

else in America. They talked their minds and souls out to me:
at first in pieced-together English, French and German, with a
Serbian word thrown in or some phrase which they vied with
each other in teaching me. To nullify their sense of isolation
from their home land, I bought Serbian victrola records, songs
and piano music which delighted them when they came to visit
me.

I arranged to see each student except the most distant per
sonally at least once a year in order to take up the things which
do not get into letters and to judge of their local contacts.
Some I saw more often than others because of their geographi
cal nearness and through them I learned intimate details of the
rest; for they all wrote fully to one another. This helped, for I
was constantly anxious to smooth out the hatreds and morbidity
in their minds that they might take their places as normal indi
viduals, fit for active life. With each of the thirty-five boys and
twenty-six girls I had, at times, heart-to-heart talks. All of them
showed a profoundly abiding reaction to the best characteristics
of our commonwealth. One day a reporter asked me their
collective impression of American life, as if it could be disposed
of in a sentence. I said, "If I must summarize, I might say they
have rainbow reactions, all blends and shades of color and line.
Each student is a distinct individual, and as such is individually
interesting."

More than once I laughingly remarked that an advantage in
having so many temporarily adopted children was that I could
not be uneasy about all of them at the same time, and an ad
vantage in having so few was that they could each have indi
vidual consideration. For instance, during every Christmas and
Easter vacation, as well as from two to four weeks during each
summer, each of them was invited to an American home to be
treated as a son or daughter. The friends they made in this
way kept in touch with them throughout the years of their stay
in this country, and some have since.

Another duty was the interpretation of many aspects of our
post-war moral life. One of the boys, handsome, graceful and
socially inclined, was quite shocked by the behavior of our
supposedly well-bred girls. "Mother," he remarked, "in Europe

3go A WOMAN SURGEON

a girl who paints and perfumes herself is not nice, and yet
nearly all the girls who come to our college dances do both. Yet
you say that they are fine and clever girls. I think they are
either bad, and do it intentionally, or stupid and do not know
the impression it makes. Some of them," he blushed, "say very
daring things. What do they mean?"

"Oh," I replied lightly, "they use slang instead of correct
English and think it sounds smart to talk like that."

"It sounds very misleading. What is slang?" Just then one
of the Serbian girls came in. He ignored her and went right on
with our conversation. He had braced himself for it and was
not going to be diverted. "A pretty, young married woman
invited me to spend the week-end with her. She said her hus
band was away. No lady would do that, would she?"

"No," I flatly replied.

Helena joined in and said to him sharply, "Pipe downthat
is slang. It means, Shut up/ "

In 1921, after the students had been in America for two
years, our committee decided that it would be advisable for me
to go to Europe on a double mission: first of all, to determine
the caliber of Serbian students before the war when many had
studied in Germany, France and Italy, so that we might form
some conception of how our young people would turn out;
secondly, to have a talk with the educational officials in Bel
grade to assure their acceptance of American credentials. I
took the catalogues of all the institutions of learning in which
the students had been, or would be, to show to the presidents of
the Universities of Belgrade, Zegreb and Llubdiana, and to
prove to them that the number of hours of our scholastic work
is the same in a year as theirs, although the weeks in attendance
are fewer, and that we offer more laboratory and other practical
work to balance less theoretical teaching. In conference I
learned that according to law no one could fill any position who
did not pass his or her examinations in the Serbian language;
it did not matter where the education was acquired. This was
to prevent foreigners from crowding out their own graduates.
Before 1914 many students in training for diplomatic service
had gained degrees in Paris, Prague, Berlin, Vienna, Rome and

EDUCATING A FAMILY OF SIXTY

33 1

Milan and had subsequently taken their Serbian examinations.
This precedent settled the matter, for our universities are the
equal of, or superior to, those of the old world. I had no anxi
ety regarding the ability of those who graduated here to pass
any required tests in a language in which they were at home.
Also, those who gained a medical degree in the United States
would be required to take their interneships in Serbian hos
pitals.

While in Yugoslavia, I saw at least one surviving, even if
distant, member of each of the families of the few students not
to continue with us and softened their disappointment. I de
livered greetings and simple gifts from the others to their
kinfolk, answered endless questions, received innumerable
messages and took kodak pictures of loved ones to give to those
across the sea.

Then I traveled north to obtain in Vienna, Prague and Ber
lin information on the caliber of the young men educated there
before the war. My reception was surprisingly friendly, prin
cipally because I did not come to talk about the war. President
Masaryk of Czechoslovakia had been educated in the United
States and his wife was a sister of my dear friend, Dr. Evelyn
Garrigue, of New York. Several capable Serbian students were
studying in Prague at the time.

In Vienna records were not available, but I found my reward
in Berlin. The university official, to whom I was referred,
within fifteen minutes had placed before me the careful record
of the five years preceding the World War, with specific data
on Serbian students: ages, number, study, subjects chosen,
grades. Although I found some of the friends of my own stu
dent days bitter toward Serbia and also toward the United
States, in the university I realized the absolute internationality
of learning a mental atmosphere free from prejudice. When I
asked the registrar what impression had been made personally
by the Serbs, I explained that all whom I had seen were to some
degree war-shocked and that I wished to learn from him their
normal capacities and behavior.

Without hesitation he announced, "They are upstanding,
honest, capable, and have a positive passion for study/ To fur-

332 A WOMAN SURGEON

ther questioning, "They did not waste time in drinking bouts,
as our students do, so they kept clearer heads and passed excel
lent examinations."

In Italy records were not available, but several deans told
me that the Serbians who came to them were inclined to insur
rection and mentioned one of those who had come to America
under our committee as having been a trouble-maker. This
was a relief to my mind for I then understood that his egotism
had been rampant before he came to the "land of the free," and
in both countries he had excited his fellows to restlessness and
Bolshevism. Perhaps the environment of study in Italy lacked
the methodical discipline of Germany.

In France many had been, and were, employed in munition
plants. Those I saw were sad-eyed. Scant consideration had
been shown to varying personalities; they had no contacts with
private homes and, hence, had received no impressions of social
life. Those in Paris had spent intensive hours in study but
many had also absorbed the lax moral viewpoint of the boule
vards. In England the majority had done well, although show
ing precisely the same temperamental characteristics that had
troubled our American committee.

In France I learned for the first time that the education of
Serbs during and after the war had been financed by the French
Government on a basis of loans to the Serbian Government.
Both France and Serbia considered economic and educational
connections advisable to their political interests. In London
Mrs. Carrington Wilde of the Serbian Relief Committee told
me that when she had become concerned with the plight of
Serbia during the war and learned that a large number of fu
ture statesmen of that country were being educated in France,
she had brought this fact to the attention of the British Minis
ter of Foreign Affairs and other officials. They at once realized
that, because of Serbia s strategic position near Egypt, the Suez
Canal, Mesopotamia and India, England must attach herself
closely to the men in that country whose friendship would be
of vast importance when they came into high positions. Con
sequently, a sum of money was entrusted to Mrs. Wilde and her
committee for the education of Serbian undergraduates with

EDUCATING A FAMILY OF SIXTY

333

the promise that those of greatest ability be given post-graduate
training at Oxford and Cambridge. She confessed that her
committee received from the English Government more money
every year than their budget required.

Reassured of the intellectual potentialities of the students,
and with a sense of pride that our American education was not
being conducted with any political motives, I placed before my
friends the records from Germany, France and England. They
were delighted by this justification of their support.

Some of the students graduated in less than four years be
cause they had been more advanced when they came. But
many remained five years, so that the total expenditure worked
out as we had anticipated. If we had had the money in hand,
the adventure would have been less exciting for them and for
the committee. I personally came forward with marginal
amounts almost every week, and contributed, on the whole,
fifty thousand dollars to the sociological experiment. Some
one had to stand back of it and I was the logical person. But
it left me financially just about where I was when I started to
practise, for I had spent approximately the same amount in
war work.

My grandmother s advice often came back to me: to look all
around a proposition, reject it without regret, or accept it and
stick to it with no thought of turning back. If we had admitted
the possibility of failure on the edge of our precipice, we could
not have won. But having no children or dependents, I was
quite free to use the money I had earned in practice as I saw
fit. If I had not contributed, I could not have asked others to
do so. However, additional funds for things needed were hard
to raise. Birthday and Christmas presents, when American
students had them, I wished to give, but could not. To have
my children return some of the courtesies shown them by others
was another thing for which I could not provide money. So in
speaking to Women s Clubs, I asked them to send to our com
mittee all the bridge prizes they had and did not want, all the
presents they had received and found to be misfits in their
scheme of things, costume jewelry, party and other dresses they
were tired of. Eventually I had a pretty white graduation dress

334

A WOMAN SURGEON

for each girl and sent her four presents at Christmas time to
give to her best friends, and one on birthdays to keep for her
self. Presents for the boys came in the same way. Then at sail
ing time many of them asked if I could spare each something
to take to a cousin, aunt or some one who would especially prize
a feminine bauble from America.

It was a sort of game, this big family of mine. Having had
five brothers and a sister, I regretted that with my husband s
early death I had no real family of my own. Perhaps a thwarted
mother love found expression in this work the maternal ten
derness that had been my own mother s shining virtue, just as
into war service I had pushed all my father s passionate energy.

I do not wish to detail nor defend the failures of the inter
national educational experiment, for with two thirds of the
students we succeeded beyond our expectations. To those who
could not pass examinations we gave tickets back to Belgrade,
warning them that if they remained in the United States after
the steamer s sailing date, it was on their own responsibility,
and would break their pledge. Several took advantage of our
kindness and tried to stay where they believed they would have
better opportunities; two, we came to realize, had intended
from the first to use our committee as a means of getting to
America. But we strove to discourage this rebelliousness, re
minding them they were honor-bound by a pledge to return to
Yugoslavia, and explained to them that they could accept bene
fits with self-respect only as representatives of their country,
pledged to pass them on, but if they used the opportunity only
for their own selfish interests, they immediately became objects
of charity. The majority, racially proud and honest, looked
forward to the work of reconstruction in which they would be
able to take part in Yugoslavia and accepted the responsibility
of their return with vigorous hope. The restlessness, the self-
pity and the irresponsibility of the minority arose, as we had to
remind ourselves like forgiving parents, from their post-adoles
cent psychology: the desire to be independent, the indulgence
in remembered tragedy, the fluctuating ambitions, the sowing
of wild suggestions in their minds by thoughtless comrades.

From the selected and healthy young men who enter West

EDUCATING A FAMILY OF SIXTY

335

Point free of anxiety and strain, there is an average graduation
of only two thirds. In some of our leading universities only
one third of the group that enters the freshman class is
graduated. Due to family, financial, health, scholarship or
deportment reasons, a large number regularly fail to receive
diplomas, while the senior class is reinforced by transfers from
other colleges and students who are taking an extra year. If
some of those whom we brought over were unable to adjust
themselves to the regular routine of our college life, the same
would have been equally true of sixty American ex-soldiers
placed in foreign universities immediately after the World
War. Our committee, therefore, concluded that if the
American colleges, to which we had sent half-sick, war-shocked
foreigners, so guided and developed them that two thirds
returned to Yugoslavia well-trained men and women, we
should be satisfied.

And that satisfaction came, for many of our students in
competition with Americans, excellently equipped from every
standpoint, were winning prizes. One girl at the University
of Maine won a prize in botany over a thousand other con
testants, her herbarium adjudged one of the best ever
submitted. A student at the Massachusetts Institute of Tech
nology gained honorable mention on an intercollegiate contest
and received two prizes in three years. A student of architec
ture was awarded a prize for the design of a stage set for a
Boston theater. Another young man had an article accepted
by the Atlantic Monthly. One was president of the sophomore
class of engineering at the University of Texas, and stood fifth
in point of scholarship. He was, however, not in the least
spoiled by either of these achievements; he gladly complied
with the committee s requirement that he be self-supporting
during the summer and chose to lay pipes in the oil-fields
of Texas. Three graduated cum laude, many received class
honors, and nearly all attained high standing. Two graduated
from Barnard College, New York, in two years.

Several departments of our national government expressed
warm interest in our psychological-sociological-educational-
economic enterprise and additional surprise at its success. The

336 A WOMAN SURGEON

students were invited to Washington to inspect our capital
city. Several were given summer work under the Department
of Agriculture, which also invited nine who were specializing
in that field to remain in Washington for two weeks observa
tion under experts in plant and animal husbandry.

When in Yugoslavia in 1921, by purchase and gift I acquired
several of the beautiful national costumes. Since all of my
foster sons and daughters sang and were eager to take part in
college activities, these were used for theatricals, concerts, fancy
dress and parties; gradually the history which costumes teach
was absorbed by thousands of young Americans, and they gave
great joy to the Serbs: heads were lifted, eyes brightened, feet
moved in Kola time, chests swelled, clear young voices rang
out in old-world melodies. While they were collecting
American songs, they also taught Slavic lullabies, hymns,
marching songs. Music once more proved itself the happiest
of harmonizing forces. Their comrades in kindred feeling
rejoiced over the progress our proteges made, both scholasti-
cally and in health, as the lines of suffering which had aged
their faces cleared away and they regained the radiance of
youth. Expressions of despair, desolation, resentment, yielded
to hope, calm, energy, forceful purpose, judgment and, best
of all, poise. These psychological changes were in large mea
sure, due to the care and interest shown by the teachers and
were also an index to the basic quality of our colleges the
constructive idealism of America.

Only one of the sixty died. Persida Mladenovitch was the
daughter of a professor and the niece of a distinguished physi
cian, who had been one of thirty-seven in Serbia to survive the
war! Persida had magnificent scholastic grades but was very
emaciated and wan when she was recommended for America
by Professor Jivoin Georgevitch, a world-famed zoologist on
our Belgrade committee. She was at Vassar College, had
gained in general health, was plump, full of energy, distin
guishing herself in mathematics and carrying a full schedule.
Suddenly she complained of a pain in her side. X-ray revealed
that she had a tumor in the liver. Diagnosis decided that it
was one of several ecchinococcus cysts, which had slowly

EDUCATING A FAMILY OF SIXTY 337

developed as a result of her eating infected dog or hog meat
during the war. Surgeons I called in consultation agreed that
an operation was inevitable, but not immediately necessary. I
therefore wrote to her mother, who was a teacher, and to her
uncle. A member of our committee, Miss Margaret Hopper,
volunteered to travel to Belgrade with Persida, and to remain
there two weeks. We offered to pay the expenses of Persida s
mother from Vraje, in southern Serbia, to and in Belgrade, so
that she might be with her daughter, and also pay a substitute
teacher s salary, so that she would not lose her position. We
explained to Persida that her condition was so grave we
thought she ought to be with her own people, that when she
recovered we would bring her back to college here. She
absolutely refused to go, because, she said, she knew they
would not let her come again, and she would rather take the
chance of dying away from home than to lose the hope of
graduation. So we decided to operate here.

When the leathery walls of the four cysts were opened, it
was obvious that her life hung by a slender thread. My
anxiety and sorrow could not have been more acute if she had
really been my own child.

Twelve hours later she murmured, "Mother, am I dying?"

"There is no death," I replied. "The soldiers who died
for Serbia live eternally in its progress. You are a soldier, one
of those whose effort it is to bring nations together to forward
Christ s kingdom."

She smiled, closed her eyes and repeated, "There is no
death. I pass to the other side of life." Those words are on
her tombstone.

My heaviest task in all those years was having to address an
audience that afternoon. It could not be postponed. I had
expected to give a happy report of how well all the students
were doing. Instead, I had to make an appeal for the money
to pay Persida s hospital, X-ray and burial expenses.

CHAPTER XXVI

THEY RETURN TO THEIR NATIVE LAND

AT THE end of four years the committee felt my faith had been
justified. And I was proud of America. Throughout its
length and breadth international education had been sup
ported, and that support had lessened every handicap and
difficulty. In my own heart I felt my debt to society was paid.
Having no children of my own, I had wanted to do something
toward the progress of the next generation. If I had had five
children and had provided for and educated them till they
were twenty-one, it would have cost me just about the same as
the amount I contributed for my Serbian children. I was
content, anxious now only to know whether the effort had been
worth while.

When they graduated, it was thought advisable for me to
return to Yugoslavia with them in order to overcome theii
initial embarrassment at presenting letters of introduction to
new officials, complimenting their development and emphasiz
ing their training. On our steamer from New York to France
debates were the order of the day. Such topics as "Which is
more vital to progress, music or architecture?" ranged the last
twenty-five graduates in teams, allowing no time for prepara
tions or consultation. It was an excellent test of their
information, logic, courtesy and power o expression; we
enjoyed it immensely.

We arrived at the French port of debarkation soon after
midnight. We had to sit up all night in the crowded boat-
train. When it was about to leave each French station a
sharp little whistle was blown, as it is in Serbia. In gentle,
rapt exultation several exclaimed, "We are really nearing
home."

Soon after dawn we reached Paris. The station was dismal.
The porter from the hotel, to which I had telephoned for

338

THEY RETURN TO THEIR NATIVE LAND

339

rooms, was nowhere in sight. We went to a near-by caf for
breakfast. The young people whose appetites were usually
vigorous declined to eat. In explanation they said the china
did not look clean and the table-cloth definitely was not.
Remembering my student days in Paris when I had reveled
in hot chocolate and croissants, I ordered them. My children
shrugged their shoulders. They complained that the bread
had been handled by many people and was not wrapped in
paper. They had observed that the long loaves had been held
against greasy jackets and put on the steps of trains. No,
they did not care for any, thank you. Concluding that they
were tired, needed baths and sleep, and that things would look
different after that, I found comfortable hotel rooms, and all
of us rested until lunchtime. Appetites were excellent,
tempers improved. None of them had been in Paris before.
A ride on a sight-seeing bus would be a lesson in history and
art; they would enjoy the Place de la Concorde, the Place
Vendome, the superb buildings and the boulevards.

On the contrary, they were distinctly bored. The
announcer, through his megaphone, faithfully paid a tribute
to Napoleon, conducted us to his tomb and sold post-cards of
it and of Les Invalides, The Serbs were unresponsive. The
fountain which marked the spot where a king had been
beheaded, a palace built for his mistress, the site of the Bastille,
all failed to arouse enthusiasm. I wondered whether they had
become prigs, were homesick for America or eager to go on
to Serbia.

When the drive was over, they all piled into my room for
tea.

One remarked, "It is all very dull. We are not interested
in the past. We belong to the future.*

Another added, "Nothing is clean. That railroad station
was nothing like the Pennsylvania or the Grand Central in
New York, or the Union Station in Washington."

"Of course not," I said. "It was built a hundred years ago.
Ours are modern."

"That is not all," they said. "The windows, floors and
benches were not clean. The cafe was horrid. Those taxi

34<> A WOMAN SURGEON

drivers who came in for breakfast took absinthe or something
with their coffee. How silly! Alcohol in the stomach the
first thing in the morning! No wonder they were slouchy and
shabby looking."

"Napoleon was an interesting character/ I ventured.

"A heartless egotist, who cared nothing for how many died
or were killed for his glory. His memorial is fittingly sur
rounded by invalids."

"And what do we care about a fountain where a king was
beheaded? We have seen too many killed to see anything
but blood when we look at that. The palace of his mistress
what of that? A monument to profligacy!"

I was astonished and delighted.

They continued in disgust. "That old Bastille why mark
the place where it stood? We have seen model prisons and
alms-houses in America. We are looking forward, not back
ward. You have taught us to do that."

"Would you like another day in Paris?" I queried.

"No," they said, "we would rather be on our way to what
we want to do to help to make a better Europe."

They were so unanimous my heart sang for very happiness.
They had gained much besides their college degrees in the
United States. They had learned the meaning of applied
patriotism: steadfast purpose toward real progress. It had been
impossible to tell beforehand which of them coming out of
turmoil would return to be apostles of peace. That night my
prayer was of humble thankfulness.

On our arrival in Belgrade leaders in Government, Church
and Education gathered to welcome our children, now returned
to be their children. It was the happiest day of my life. From
the Prime Minister down all were genuinely pleased. Each
of our graduates made a graceful and sincere speech in Serbian,
according to a brief program they had arranged among them
selves. They made clear their pleasure in this hour, which
fulfilled the dream they had cherished since they had left,
speaking modestly of what they hoped to do with the training
they had received and of education in its widest aspects. Each
dwelt on a different phase of the advantages in their American

THEY RETURN TO THEIR NATIVE LAND 341

training, emphasizing their desire to make the fullest use of
them as the best expression of gratitude.

The next morning I called on the ministers, most of whom
were new and unfamiliar with the work of our committee. I
took with me to each official those students who I thought might
find employment in his department, and explained that salary
was of secondary importance. In the name of the American
universities which had shown such a practical desire to cooper
ate with their country, I asked that they give the graduates
appointments to prove what their education was worth.
Yugoslavia had free education for all with a law that each
student sent abroad to study must give five years service at a
stated salary in government employ, after which he or she
might continue in an advanced position with an increased
remuneration, or do whatever each preferred. I requested the
same ruling for our graduates, as it would be unwise for them
to apply, or be accepted, on any but the regular terms.

The Department of Health placed the doctors in interne
positions and asked the dentists to work in morning clinics for
school children and afternoon clinics for soldiers, to be jointly
provided for by the Ministers of Health and Education. The
engineers went to work under the Minister of Communications,
and so on down the line. They were again part of their
own country. But I knew that after the excitement of return
ing home wore off, they would have almost as hard a time
adjusting themselves to the nation which had developed during
their absence, as they had had in adjusting themselves to the
new world s ways when they came to us, also that the jealousy
of those who had returned home or had been in European
countries would develop irritations, when I would no longer
be there to comfort or counsel. But I had to leave them.

At our farewell meeting I was rather brusk, but necessarily
so. "I love you all, you know that, else I could not have
worked for you. I have given, you five years of my life. Are
you worth it? Will you be? No one can tell now, it will
take five years for us to find that out. But it is up to you now.
Write to me whenever you wish. I will answer your letters
and never lose sight of you, but I will not see you again for

342 A WOMAN SURGEON

five years. I must go home and give all my time to my
patients, if I am to provide for an independent old age."

"You do not need to," they cried in chorus. "We will take
care of you. * The dears, they meant it.

"If you stand on your own feet and in your turn help those
who need a lift, it will square the account," I called to them
as the train pulled out.

It was all very serious. At least I felt so until a French
officer friend on the train said, teasingly, "Sort of a fairy god
mother exit, was it not?"

"No one would believe fairy tales," I retorted, "unless they
sometimes came true."

As the end of the fifth year approached, many letters came
saying, "Mother, dear, come and see whether we have made
good. We have much to tell you. And we want to show you
our babies." I had to reply that I could not come, because I
was preparing to take the Florida State Medical Board exami
nations. "We will wait one more year/ they wrote. "Then you
will surely come, because you have promised." I went in the
summer of 1930.

Any one who has been a grandparent can imagine what a
thrill it gave me to find I had become one. And any one who
has been a parent can Imagine what a thrill it gave me to see
again my Serbian sons and daughters their faces, their homes,
their happiness. To each one I listened for hours. The homes
of all who had married, as well as the rooms of those who had
not, wore a distinctly American appearance. I liked all my
in-laws immensely. Each had married some one who had not
been in the United States, thus avoiding a clash of opinion
about how things should be arranged to conform with differ
ent types of homes in America. In fact, although a variety of
styles of interior decoration had been followed, their homes
were all comfortable and colorful much prettier than the stiff
arrangement usually prevalent in Serbian homes.

To my joy I found our graduates had all more than made
good. One of the girls, Danitza Arandjilovitch, employed in
the Government Agricultural Experiment Station, had made
a collection of the weeds of Macedonia, mounted them and

THEY RETURN TO THEIR NATIVE LAND 343

written a book on their eradication which the Government
proposed to buy. The dentists, Stana Popovitch, Rugitza
Aichnovitch and Darinka Mladenovitch, had installed card
catalogs, indexing and all the modern clerical, as well as
scientific, methods of America in the clinics they had set up
in the many stations to which the Government had moved
them. Darinka, graduated from the University of Pennsyl
vania, had been especially instrumental in this. Rugitza
Aichnovitch, true to her philanthropic tendencies, had elected
to work in small towns where the people were poor, and where
at all hours she was relieving pain and building up general
health through expert dentistry. Mara Nicolitch had devoted
herself to social service in hospitals, where she tactfully fostered
American cooperation, tolerance and sympathy between nurses
and patients. Among the doctors, too, she spread the doctrine
of spiritual encouragement as well as healing. Another girl
had established a chemical laboratory. Another had a general
medical practice and was also examiner for a large health-insur
ance company. One conducts a drug store, one is the principal
of a large school, two are professors, one is a child-welfare
expert, one is a leader in the Yugoslavia Junior Red Cross, two
are consultants on welfare work, one has married a member of
the Yugoslav Legation in London, another a similar official,
two have married judges, one represented the university women
of Yugoslavia at an International Conference of University
Women, while two others have been national representatives
at conventions.

One of our men graduates who gained a literary scholarship
at Columbia University writes prose and poetry successfully.
Another who won a scientific research scholarship at Woods
Hole, Massachusetts, is now in charge of a laboratory under
the Minister of Health, at Belgrade, experimenting with the
growth of nerve and other tissues in line with the work of Dr.
Alexis Carrel, with whom he is in correspondence. The work
of Peter Martinovitch is being published and read throughout
Europe. Alexander Militchevitch, civil engineer, is supervising
thirty sanitary projects a month under the Department of
Health. Dr. Milum Liposavitch is a tuberculosis expert, and

344 A WOMAN SURGEON

Dr. Luca Djuritch is a surgeon; both are in charge of hospitals.
Mile Jeftic, electrical engineer, is in charge of the electric light
and power company in the northern section of Yugoslavia.
Three are financial experts. Three represent the Government
in expert agricultural advice to farmers in different sections.
One is an architect who at standard prices is erecting better-
ventilated, better-drained and more comfortable homes for
the peasants than they have ever had before. Miodrag Mrse-
vitch is one of the ablest men in the administration of the
tobacco monopoly. Arandjel Stoilkovitch, sent to Egypt to
study the irrigation system there, is now associated with a
district governor in Central Yugoslavia. One has become a
distinguished sculptor, another a banker, several have become
able writers. Each is contributing in some form and measure
to the future of the country.

We did not consider the service of the International Serbian
Educational Committee finished, although its books were closed
and finally audited in 1925, until we could report on the use
made of their education by the graduates whose work is here
briefly outlined, and also until we could compare their capac
ities with those of students educated, during the same period,
in other foreign countries. In 1930 I found that England
maintains official personal touch with her students. An Anglo-
Yugoslav Club in Belgrade keeps the English graduates in
accord with things British. The French do even more. They
have formed and financed clubs in the small towns throughout
Yugoslavia. Books, magazines and lectures are utilized for an
informal extension of education.

The president and the secretary of the Anglo-Yugoslav Club
asked me to urge our graduates to join the organization in order
to keep up their English through conversation and the British
magazines. At a farewell family dinner at which all our
graduates living in or near Belgrade were present, I asked
them their opinion on this point. They appreciated the
courtesy but said, "We would always be in the minority and
unless the club recognizes us by changing its name to Anglo-
American-Yugoslav Club we do not care to join. But, Mother,
we have one request to make. Please send to us and to the

THEY RETURN TO THEIR NATIVE LAND 345

club some American magazines/ The American Minister had,
for diplomatic reasons, joined the club. He appointed a com
mittee to take the matter up formally; the club s name was
made inclusive and many of them joined it. From Ajnerica I
sent them many magazines.

Through the gracious courtesy of the Mayor, the Vice-
Mayor, and the City Council of Belgrade a street in a beautiful
section of the city was named the Dr. Rosalie Morton street.
The Mayor said that the street had been chosen because it
was crescent shape and symbolized ever-increasing light, which
he thought typical of the education the Yugoslav students had
received in the United States. The Vice-Mayor said that the
street had also been chosen because it had on one side homes
and on the other a park, symbolizing my love of home through
my voluntary maternal expression, and my love of trees and
space as representing fresh outlooks and harmony with life.

King Alexander of Yugoslavia proposed that the Interna
tional Serbian Education Committee be honored by the con
ferring of a very high decoration on its founder and chairman.
I urged that since I had been decorated for war work, of which
this had been an outgrowth, and since I had really done this
work as much to honor the men, women and children who had
lost their lives as for the future of the land for which they had
died, it would make me happier not to receive a decoration,
but instead to recommend for that honor those who had worked
most closely with me. This was kindly granted and my asso
ciates in this Serbian work have been so decorated. I am
deeply grateful; for without their cooperation I could not
have accomplished the work which it has been our joint
privilege to contribute to the evolution of our time.

CHAPTER XXVII
NEW YORK AFTER THE WAR

WHEN a sudden peace descended upon the acute destruction of
war, many of us thought that our minds would slide comfort
ably back into pre-war channels of thought as our lives resumed
where they had left off. But we, whose hearts beat a new
rhythm in tune with war s havoc, found the tempo of life in
America strangely altered. Like many others in 1918 I fitted
into social life again only with the greatest difficulty. Things
which had seemed to be a reasonable part of that life before
the war now seemed extravagant. My energy had been serving
battle and pain. I was ungracious when asked to relate my
experiences, because the suffering and privation which had
composed them made me resent the renewed ease about me.

As a consequence I plunged into my medical practice with
more intense vigor. I was more fortunate than many doctors
returning from the front, for my post in the Surgical Clinic at
the College of Physicians and Surgeons awaited me, also those
at the Beekman Street and the Pan-American Hospitals. I had
the privilege of taking private cases to St. Luke s, the New York
Infirmary for Women and Children, the Misericordia and
several other hospitals. Many of my colleagues who had served
abroad found that their positions had been filled by those who
had cared for the lame, halt and blind during their absence,
and who, justifiably, had earned promotion. It did not seem
fair to dismiss or retrograde men and women who had done
valuable work for two years in- order to reinstate those who
had had enviable experience in the war.

The Polyclinic had been turned into a military hospital and
still functioned as such under a staff of army medical and
surgical specialists.

As I resumed my morning clinical work, I felt a heightened
interest in the foreign born, a tenderness for the aging poor

346

NEW YORK AFTER THE WAR

whose sons had been killed while serving in our army, the land
of their adoption. I contributed the invention of ten instru
ments to the aid of surgeryfive specifically surgical and five
of apparatus. 1 Occasionally I was called on to present a scien
tific paper at the Academy of Medicine.

In my office I observed a change in the psychological attitude
of many people, as if something had dropped out of their lives.
At least the foundations seemed to be sagging. They missed
the stimulus of all they had fed themselves about heroism. Now
they had misgivings about the behavior of their sons and
daughters, many of whom had returned from foreign service.
As parents they would not have kept them at home, for they
were proud of the wish to go. The girls had been able to take
care of themselves, to be trusted in unusual and untried posi
tions. The war had helped the advancement of women in
comradely endeavor with men. But somehow, somewhere,
now that the emergencies no longer existed, the code of good
society was broken, the pattern gone.

As an overseas woman I have associated, during and since
the war, with 25,000 other women who served over there in
hospital, canteen, clerical and entertainment service. They
were dignified as well as joyous, and their comradeship was
heart-warming to lads who would have fared badly without it.
Their contacts were with, and for, the soldiers as such, not as
with the butcher, the baker and candlestick-maker who wore
the uniform. They were with men whose behavior could be
trusted as restrained and disciplined. They were all as safe
guarded as the nurses in their fatiguing, life-saving work. They
were not dashing off for night rides in automobiles, spending
the evening no one knew where, frequenting night clubs of
vulgar entertainment. But all over the world after the war
a heedless lack of principle and taste became the vogue. What,
I asked myself, was the explanation?

Before 1914 we accepted life with a serene, unchallenged
faith, admitting what seemed to be progress. The .war

1 Three presented to the Surgical Section of the New York Academy of
Medicine, October 2, 1925; others to the Orange County Medical Society,
March, 1934.

348 A WOMAN SURGEON

sharpened many a life which had never known any conscious
ness of its civic purpose. We were stirred immediately to unite
our efforts for a great result. Trivial differences were dis
carded; inequalities evened up. Each American put his energies,
hopes and fears into an impersonal gamble. And we grew. In
training camps our boys grew stronger; no one was pampered
with special privileges. We worked muscle and mind conscien
tiously into a national mold, until what had been an aggrega
tion of states became a unified country. What had been a land
filled with petty, ignorant sectional antagonisms began to
develop integrated self-determination. President Wilson s
decree that regiments be composed of companies from far-
distant locations developed fellowship such as only comes from
living, fighting and dying together, a comradeship which is
having its harvest in an America that pulls together far better
than ever before, one which will eventually, like Kipling s
"ship which found itself/ learn the interdependence of bridges,
bolts and beams, of engines, holds and men.

But at first when the comradeship of war that had found
employment for every one in every country no longer became
necessary, unrest bristled in the cessation of crucial activity.
Men who had been out of civic employment for years came
trooping back. Though not invalided in service, many found
themselves unfit for civilian responsibility. The old routine,
on a farm, in a store, seemed suddenly binding and distasteful,
for two years or more their clothes, food and recreation had
been supplied to them and their working hours had been spent
in the heated excitement of battle. To earn a quiet living again
seemed the greatest imposition, remote from praise, the back
wash of heroics or the cosmopolitan world. They had left
home simple lads, useful to a town or country. When they
came back from seeing the world, from the dim philosophy of
the trenches, they met a glowing tribute of admiration, and
then the parade was over and every one on the sidewalks went
home. They felt themselves suddenly outside a peaceful, pre
occupied society, where a murderer was abhorred, where
blasphemy was not the common tongue. And in sudden resent-

NEW YORK AFTER THE WAR 349

ment many of these young men revolted against their unwanted
isolation by defying the society they no longer fitted.

In the seaboard towns they loitered, squandering the gov
ernment money given to them for tickets to their homes. In
the metropolitan centers energetic men crowded, unemployed
and those unwilling to work degenerating into loafers; slack
ening industry was often unable to absorb those who might
want to work again. The mental reaction of this physicial use-
lessness and maladjustment grew into cynicism, into immorality.
Economic values had gone awry; there was plenty and there
was privation.

One day I wished to buy a pair of curtains to supplement
some I had purchased four years before. Without difficulty I
found a pair which exactly matched my earlier purchase, and
was told that they had lain on the shelf since that time. The
price, however, hacl increased threefold. While I was demand
ing an explanation of this, a woman not yet accustomed to
the expensive clothes she wore asked for some Italian lace cur
tains which must have a "fillet or a valet," she wasn t sure
which. To her obvious relief the clerk supplied the word
"valance." She asked for costly and yet more costly wares.
After gradually reaching the most elaborate and expensive lace
curtains in the shop, she sighed that the neighbors might talk
if she bought the very finest, so she would take the second
best. Her husband, she explained, would come in at noon to
pay for them. I returned at that hour. A man in overalls,
a dinner pail in hand, drew from his pocket a large roll of
bills and handed the clerk a hundred dollars with the ease
he would have handed him a dollar before the war. The
clerk had lost an eye in a war which had made this munition
worker rich.

The sins of munition manufacturers were the sorriest sins
of the war. Englishmen sold cannon to Germans with which
to mow down their fellow countrymen. They sold cannon to
the Turks with which to bathe Gallipoli in Anzac blood. No
one country is more, or less, guilty of greed than any other.
Though it assumes different forms greed is paid for more dearly

35Q A WOMAN SURGEON

than any sin, except neglect. Refusing to recognize all human
needs as one is civic destruction.

Though the war changed us all, upon youth it left its most
grievous scars. In the midst of front-line service my associates
had been active, courageous and unfailing; with a peace treaty
they could slowly readjust their adult minds to ordinary
labors. But the adolescents, in their flashing, impetuous ego
tism, were not so fortunate. In war years they lost sight of
the constructive, thoughtful progression of the world and visu
alized instead their desire to be heroes. They heard, read and
dreamed about war, its ruthless philosophy, its butchery.

Youths once trained in fair play, in consideration, in coordi
nation of muscles and mental balance moved into military
camps where the lessons emphasized that the opponent in
this contest should not be given a sporting chance. From there
they moved eastward to fields where success was counted in
the number of men killed, wounded or imprisoned; the demoli
tion of roads and bridges; in sum, the subversion of logical
thought toward which all education aims. They aided the
crucifixion of the Christ spirit in themselves and their fellow
men.

It was only natural that in picking up a normal society where
they had dropped it, youth found the old way strict, outworn,
conventional, dull. To defy parental restraint, to release
behavior into egotistic self-expression, to establish a faulty code
of impulsive sensation, were inevitable results. Broad-minded
and cynical sophistication extended into a degenerated artistic
taste that concerned itself with abnormality. There were times
when only the supposed family chronicles of the comic supple
ments seemed to retain any memory of virtue or idealism in a
high-speed world of flappers, necking and perversity. To these
easily disillusioned young people it did not occur that the
most modern expression of energy is its direction into uselul,
self-governed, creative endeavor. Scorning pretense, they mis
took what was enduring and genuine for prejudice.

Such laxity and sense-infatuation does, however, carry its
own seeds of discontent. Blind alleys of dissatisfaction soon
brought mad independence to a cold stone wall, where the only

NEW YORK AFTER THE WAR

way out and up was to pursue the old, the common road of
earnest purpose and sincere industry. The standards they
had damned were the only ones that could bring them self-
respect and peaceful hearts. We can now look back on the
absurd gamut of post-war psychology as we do on Elizabethan
fluted collars and cuffs, for a new seriousness has superseded
the neurotic aftermath of war. The virtues of self-development
and idealism have steadied silly youngsters into an increased
satisfaction with their homes, with hope of happy marriage and
wholesome children, with the vital problems of the state.

But during those sad furious years I was often called by
parents to speak to girls and boys, to help steer them safely
through the temptations of indulgence. Usually I made a
direct appeal to common sense with a plain statement of
biological and psychological facts. In those dangerous years
education of youth in the dignity, the hazard and the respon
sibility of sexual experience was a crying need.

When my friend, Lillian Elliot, superintendent of an
evening high school for girls in New York City, asked me to
address the two thousand young business women preparing
themselves for college in night classes, she chose the subject,
"The Responsibility of Girlhood to Motherhood." Here was
a topic of vast importance neglected in the popular superficial
discussions of sex. Before that earnest and quiet audience I
stressed the duty of good health, both mental and physical,
to the next generation, the proper choice of a mate and the
responsibilities of family life. I spoke to them as though each
were individually my daughter or my niece.

When I walked from the lecture hall down the two blocks
to my street-car, I found the street lined on each side with
girls, their hands outstretched, many with tears in their eyes,
a few murmuring, "You have given us a new vision." All
women doctors have had similar experiences. Such sane educa
tion is one of the social services they have always rendered,
far-reaching in its results.

Years before I had presented lectures at New York Univer
sity on sex hygiene, which were among the first along this
line. I was grateful that I might continue such work and

352 A WOMAN SURGEON

bring sound, candid knowledge to the chaos of post-war
morality. Its scope broadened when the University of the
State of New York requested me, under the New York State
Board of Health, to give similar lectures throughout the state
as often as I could arrange a free evening. I covered a wide
radius in an automobile between the close of office hours and
eight o clock. The ride would refresh me and my hope that
to young mothers and fathers I might bring the solemn beauty
of parenthood.

The creation of life requires long preparation and entails
many responsibilities. Mystery hovers over the human trans
mission of strong hereditary qualities, as well as the minor
shades of appearance, tone of voice, even manner and gesture,
all of which expand, seedlike, into the blooming child who
may rock an empire or pay no attention to it, may bless his
parents or wrench their hearts. The two tiny microscopic cells
that bear this potentiality of life have never ceased to cause me
wonder. The instantaneous coalescence and metamorphoses of
the merging nuclei in their electronic activity undergo micro
scopic changes into single glittering diasters whose spindle
growths contain threads that will each become some part of
the complete human being. Every chromosome cell which
forms a spindle thread holds some specific material whether
toe or bone or ear to complete the mosaic of the physical
body. In the first small subdividing cells the power of discrim
inating selection begins the delicate interweaving of heredities
which parents have released for their creative collaboration.
Youth, learning of this supreme art, forgets the destructive
negation of war lust and looks into the future toward the
affirmation of its race.

One morning in the clinic while treating a thin, bedraggled
woman dressed in black, I noticed that she wore a gold star. I
tried to take her mind from her physical pain by referring to
the pride she must feel in being a gold star mother. She looked
at me searchingly, her eyes lusterless, then lowered them. Her
son, she explained, had been her sole support and now, alone
and old, she was as forlorn as dust. She sighed with resignation,

NEW YORK AFTER THE WAR

"Yes, I know that he was brave. Yes, that is true. But what
did he give his life for?" Her thin neck quivered with a sob.
"Doctor, when you look right into it-what good did it do?"

It meant nothing to my patient that world-wide suffering
had taught us a lesson which remotely paved the way for an
eventual abolition of war. Plaintively she repeated her ques
tion and added, "My cousins across the seas are asking me that,
too. None of us knows." In ages past women blandly accepted
the excuses men gave them for waging war. Wonderingly
mourning their dead, they never made a study of the causes,
the course, nor the possible cure of war. They had never
thought in terms of economic and political interdependence;
hence, they saw no way in which to stem the barbarism of
man s greed for power. But the World War has taught them
they have a role to play in preserving peace for their homes and
for their countries. Instead of bland acceptance they now take
an assured part in comparative study of the temporary benefits
of war as against the succeeding injuries-in health, ethics,
economics, patriotism all in the promotion of national pride
at the expense of racial and international justice. From cave
days war has been man s occupation, responsibility and hazard.
From 1914 it has also been recognized as woman s responsibility
and hazard. In every country they oppose it.

Could international justice come, I wondered, through the
League of Nations? In 1924 I went to Lyons in France as a
delegate from the American Society for the Promotion of the
League of Nations to a world-wide congress of groups sympa
thetic to the League. My hope for harmonious amity was
discouraged by the speeches of various delegates denouncing
the United States, its selfishness and its dollars. I knew how
much the dollars were contributing to the valuable work of the
League s health organization. Since 1922 the Rockefeller
Foundation had met the entire international expense of gather
ing and distributing information about communicable
diseases, published under the League, as well as meeting all
expenses of many health experts studying hygiene and sanita
tion methods in the United States. Furthermore, this American
capital has taken a part in League affairs which to me, as a

354 A WOMAN SURGEON

physician, seems especially vital: the financing of a general
international interchange of public-health personnel which
has bred cooperation in the control of communicable diseases,
and which has trained government health officers in improved
methods of collecting and tabulating health statistics. America
has hastened the standardization of sanitary codes and
organized special missions for the study and control of com
municable diseases whereby vaccines and sera might be
standardized, and in many places controlled malaria by its
prevention.

As I listened to an ignorant orator from Haiti rant against
America, I smiled, for I had just seen extensive work in Mon
tenegro for the extermination of malaria, which seemed to me
a good and human use of the dollar. 65.2 per cent of the
whole expense of the health organization of the League was
met by United States money. America has cooperated with
the International Labor Office on questions of industrial
hygiene, has supported committees investigating traffic in
women, infant welfare, rabies, codification of international law
and countless other subjects. And yet here at a supposedly
congenial conference, designed to promote the League of
Nations, jealousy and prejudice ran rampant. There was little
we could do. France condoned the misguided statements; Italy
had apparently forgotten our merciful and prompt Red Cross
relief work. I could see that the amity of peaceful nations had
yet a long struggle for existence.

From Lyons Mrs. Kate Upson Clark and I went to Geneva,
where we spent a month listening to arguments placed before
the League of Nations Assembly. Every speech was like a claw
sheathed in a velvet glove. Every representative sat there
obviously obligated to obtain as much as possible for his
country and to grant grudgingly as little as possible to any
other. The powers who had won the war defended every
imperial inch they had gained, while the losers schemed to
retrieve their losses. And the battle went on day by day, a
battle of wits with very limited international viewpoint.

Europe is far from sincerely desiring international welfare.
The pot still boils with individual greeds and antagonisms

NEW YORK AFTER THE WAR

bubbling into occasional war, moving ever short-sightedly
toward the self-aggrandisement of dictators and political
entanglements. Some work for better things, but many mis
called statesmen play grim cards. Men again blinded will be
forced with bayonet and cannon to kill their fellow men./

As long as martial music stirs the blood and we are jostled
out of the isolation of individual living into the comradeship of
a common cause, war will retain a spiritual thrill, whose
power will lessen only when we find campaign methods applied
to the nobler ends of fellowship between classes, between indus
tries and professions, between parties and between nations.
International and cooperative peace will dawn upon the earth
when every life is accorded value for survival instead of
applause for extinction.

CHAPTER XXVIII
SOUTH AFRICAN SUNLIGHT

IN THE spring of 1926 my thoughts began to turn toward a
vacation. I had taken no rest since 1923, when I went to the
Pan-Pacific Congress in Australia as a delegate, and visited New
Zealand, Tahiti and Hawaii. Since then my doubly active life
with my Yugoslav sons and daughters and my hospital and
private practice had so consumed my energy as to cause me to
sigh for new scenes and experiences free temporarily of any
responsibility. Furthermore, I have always believed that a
physician must do much more than cure by operation or with
wisely prescribed medicines. There is an intangible spirit of
vitality and health which can be imparted to a patient only
if the doctor possesses an abundance of such inner strength. I
felt that my batteries needed recharging.

Several times two cousins of mine in Johannesburg had
invited me to visit them on the other side of the equator. I
began to consider the invitation seriously after I had enter
tained the delegates from South Africa to the International
Council of Women, which had met in 1925 in Washington,
D. C. They had told me of their clubs and philanthropies,
their universities, their racial problems, the clashing of Boer
and British pride, economic and climatic peculiarities. Here
was an intriguing study of sociological interest. Perhaps South
Africa was the very place to recharge my cells.

In all voyages to foreign lands I have been primarily inter
ested in the health problems of the people, the mental, moral
and physical aspects of health as well as the economic habits
and social traditions which interweave with it. Consequently
my interest in South Africa would doubtless have remained
inactive had I not begun to think of its health problems. The
use of Alpine light and other sun-ray treatments in the cure
of disease was becoming popular in America. In sun-baked

356

SOUTH AFRICAN SUNLIGHT 357

Africa I could observe at close hand the true values of sunshine.
The treatment of decrepit people sitting in a hospital circle
with arms, legs, chests and backs exposed for short periods to
sun-ray lamps was a fragmentary field for study while a whole
continent lay in the south Atlantic filled with tribes who for
ages had lived and worked in direct, fierce sunlight and whose
multiple ills must be more acutely related to heat, cold, water
and wind than our sheltered sicknesses.

My cousin Robin Curtis, chief engineer in the Crown
mines in Johannesburg, had written me that the native
laborers were lowered six thousand feet below the surface of
the ground shortly after dawn and not hoisted up in the crude
boxlike elevator until dusk. How long could these black men
used to sunshine stand working by artificial light in the damp
ness? How long would it be before this change affected their
lungs, hearts and nervous systems? How did the native stand
the separation for months and years from family and tribal
life, duties and recreation? Were there riots? What percent
age of natives, under training, developed ability, and in what
lines? The more I thought of these problems, the shorter the
distance to South Africa grew, and it was not long before I
called up a steamship company.

On June 16, with a friend, Elizabeth Morris, I sailed for
Cape Town. We had especially chosen a slow boat that made
several stops along the way that we might absorb as much of
the exotic atmosphere as possible. As we coasted down the
shores of Portugal, we saw buildings which in Europe are
sure to be castles and in America would doubtless be institu
tions for the deaf, dumb or tubercular; and when we paused
at Lisbon, Elizabeth and I went ashore for a few hours to
observe a revolution in progress. It did not seem to bother
anybody, for the many light skirmishes appeared to be a form
of entertainment. Merchants placidly set out their wares while
shots were heard from the hills and enthusiasts scribbled, "Viva
Anarchic," along the sea-walls. More significant to me were
the poor physique, the unhealthy color and general lassitude of
the average person on the streets. It was plain why the glory
had departed from this nation once so great.

358 A WOMAN SURGEON

Perhaps I put too much stress on the value of health as a
necessity for achievement, for there are those who like to point
out the large number of semi-invalids who have accomplished
brilliant results in spite of their handicaps. However, these
are exceptions to the general rule; nationally speaking, health
is a prime necessity the basis of which is child hygiene. Even
an ordinarily unobservant person would be impressed in Lisbon
by the sickly look of the children and by the large number
of minors on the streets at 11:30 at night. Their eyes had a
pitiful, hollow look such as one sees in neglected baby animals.

We made brief stops at Las Palmas in the Canary Islands
and at four or five ports along the West African coast, where
we began to become acclimated in earnest. At Loanda we
watched the embarkation of a hundred natives from the Bel
gian Congo and at Lobite Bay of a hundred more from Angola,
Portugese West Africa, all of whom were going to work in the
diamond and gold mines. The sight was reminiscent of our
country s slave-trade days, for these men were being turned over
to their new masters by tribal chiefs.

At last we arrived at Cape Town, "the tavern of the seas."
As we approached the harbor, sailboats, with red, brown and
white canvases spread to the breeze, came out to meet our
steamer. The gulls dipped into the exquisite blue of the
water against the background of Table Mountain towering up
3,500 feet almost directly from the shore, while Cape Town
itself clung to the base of the mountain as if afraid of being
crowded into the sea.

During the five days that we spent in Cape Town, we
learned that in order to understand anything about South
Africa, one has to know its historical and political background.
Antagonism between the Dutch and the English still ran
almost as high as it did in the days of the Boer War, since
the Boers consider that they have been treated as a conquered
people ever since the truce. The English were unable to win
against Boer marksmanship, peace was made and certain agree
ments signed, one of which decreed that both the Boer and
the British flags should fly over all public buildings. This was
not carried out, and afforded one of the principal sources of

SOUTH AFRICAN SUNLIGHT 359

resentment. One Dutch mother told me that the Boers would
not allow their children to wave the British flag on national
holidays. I asked how the difficulty was met, as all children
love to wave a flag. She answered, "On those days, our
children, because it is the emblem of freedom, wave little
American flags/

This division of feeling was carried into almost every branch
of life. All government addresses have to be spoken and
printed in two languages, English and Afrikance, making it
necessary for people to be able to converse in both mediums.
It took no little tact to avoid taking sides in the constant fric
tion. The English seemed to go out of their way to avoid
giving credit to the Dutch, who had opened the mines and who
had, long before the English arrived, built homes and raised
cattle in the face of starvation and drought.

On our sight-seeing trips from Cape Town we were im
pressed by the mulitude of flowers growing everywhere. The
"Happy Valley" near Hongkong is the only other place in the
world that has nearly so many. In South Africa there is the
Leucadendron grandiflorum which resembles a yellow chrysan
themum; this flower alone has two hundred more species than
any of the blossoms of England. Even in their winter season
I counted fifty-five species of flowers in bloom.

As we moved on to Johannesburg, I learned more about
the native s mode of living. The Negro s custom of greasing
his skin seemed, at first, rather repulsive, until I found what a
great protection it offered against sun and rain. One of the
natives, whose intelligence had responded well to education in
a school established and maintained by missionaries, had gone
to England for several years of study and then returned to his
tribe. He found himself always either too hot or too cold.
His brothers could stand the glare of the tropic sun for days
without blistering and the cool of the nights without becoming
chilly. It was not long before the educated African made up
his mind that three years of tub baths and no grease on his
skin was no asset. His only solution was to go native again.

This grease covering takes the place of soap and water, just
as it does with women who use only cold cream on their faces.

360 A WOMAN SURGEON

The natives take a "bath" in grease. A long sliver of bamboo
or ivory, worn in the hair when it is not in use, is employed
daily as a scraper. The entire surface of the body is gone over
to remove the accumulated mixture of dirt, sweat and grease.
Then they reanoint themselves. In this way their skin is
kept clean, pliable and resistant.

While we were at Johannesburg we had the good fortune
to receive an invitation for luncheon from General and Mrs.
Jan Smuts. On the forty-mile ride to Pretoria, my cousin told
me that the General had no fence around his yard so that he
could step from his door onto the veldt which he loved; and
that, although he looked like a cosmopolitan, he was really a
part of the great Africa for which he has done so much.

As we neared the house I noticed antelopes walking around
as calmly as if there were no civilization within a thousand
miles. A couple of lion cubs tumbled out of the way of our
wheels./ I began to see what Katherine had meant about the
General s love of the country. / But stranger things were to
come. When we stopped at the front door, a blue heron
approached with the manner of a well-trained butler. As he
walked, his undulating body presented a sort of bowing motion.
With great dignity he came up to the car and stood by the door
as it was opened. .

Hurrying from the front porch came General Smuts, both
hands extended, while a little way behind him Mrs. Smuts
carried a mearcat, a kind of ferret. When she held out her
hand to greet us, the little animal fell from her shoulder; at
once the heron dropped his dignity and with his long beak
made a lunge at the frightened creature. Mrs. Smuts gave a
scream. The General bumped his hip against the bird, ward
ing it off without allowing it to attack him. Mrs. Smuts
snatched the mearcat from the ground.

/After lunch we went into the library wing. General Smuts
was expecting a call from the Mayor. We should know ahead
of time, he said, of the Mayor s approach, for the butler-heron
would announce him. I have an adaptable mind, willing to
believe a good many things, but my credulity faltered here.

"He is very domestic/ General Smuts continued. "He has

SOUTH AFRICAN SUNLIGHT 361

his nest near the house and will have no contact with another
blue heron, also a bachelor, whose nest is beyond the garage.
These birds have a keen sense of hearing and the butler can
hear a car coming seven minutes before we do. He will come
to the window and bark." My eyebrows lifted. "Well, you
will see in a few minutes."

In a short time the heron came to the window and barked
with a yapping like a spaniel. "Look at your watch." We did,
and in seven minutes we heard an automobile far down the
road. Two minutes later as the car drove up to the door, the
heron-butler went out to meet it, bowing as he went.

The witch doctors of Africa are curious practitioners. By
their fearsome masks, head-dresses, grass skirts and painted
bodies they set themselves apart from the other natives as more
important, awesome. The principle on which they work, psy
chologically, is just the opposite from the one which we more
modern physicians use; nevertheless, many of the native witch
doctors, in their dignity, reminded me of some of our impres
sive specialists. And often, from the native point of view at
least, their bedside manner is effective. As a matter of actual
fact, the combination of wisdom and superstition in these men
is worthy of scientific notice. With shrewdness and quick
observation, they often achieve interesting results. One man
had a remedy for "black water fever," which was more effective
than any cure known to our pharmacopoeia.

Black water fever is a malignant illness. Hemorrhages into
the kidneys cause the disintegrating blood to get to the urine,
turning it black. It is usually fatal. This native doctor was
sent for far and wide by those who were ill, and he saved many
lives. Naturally, I made every effort to find out what he used,
but he would admit nothing more than that they were native
herbs. Knowing that much of our knowledge of drugs has
come from more or less chance information, I urged him still
more insistently to tell me. He replied that I would not recog
nize the roots which he used or know how to prepare them, and
even if I could learn these things, he could not impart his
knowledge to me unless I was in a position to pay him enough
to care for himself all the rest of his life. Furthermore, I would

A WOMAN SURGEON

have to provide for his children to the third and fourth genera
tion, as this secret was a family matter, having come down to
him; on it the family based their livelihood. Economically,
this was an interesting problem, but as I was unable to meet the
requirements, I had to bid him goodbye with my scientific
curiosity disappointed.

Another popular witch doctor procedure is the placing of a
frog over the lungs in cases of pulmonary tuberculosis. More
than likely the rest, sunshine and fresh air are responsible for
the improvement often tangible. The natives will send many
miles for a certain frog.

Another unusual custom, reminiscent of ancient Roman
feasts, is the native s method of relieving himself after several
hours of gorging on the remains of some bloody animal killed
in the hunt. Several skins and gourds full of water are carried
up a hill and the contents, or as much as can be swallowed, are
drunk, after which the native lies head down on the slope and
lets the water run out of his mouth again. This usually has to
be repeated three times after which the dinner guest is quite
thoroughly washed inside and feels well enough to go back to
his usual diet.

Courtship is an interesting phase of life on any continent.
When a young African wants to marry, he enjoys little of that
side of romance which we think most important. At a festival
he waits for some damsel to throw him a "come hither" look;
then he says joyfully to the other watchful young men, "I am
chosenl" He and the young lady retire to the palm grove or
some other secluded nook, where the novelty o revealed per
sonality and expressions of admiration are made as acceptable
as possible. Maidens have their preferences in Africa, even
though there is less flirtation than at Palm Beach. If the man
is gentle, understanding, adaptable and sympathetic, by nature
or by pose, or perhaps has the fascination of the caveman, in
short, if he suits her fancy, an engagement is on.

If the period of acquaintance in the palm grove is not satis
factory, another young man is selected at the next fiesta. This
is not thought to be capricious, but discriminating. It is only
fair to point out that these jungle romances do not go as far as

SOUTH AFRICAN SUNLIGHT 363

many collegiate week-end parties, for the maiden has been
warned beforehand for the good of the tribe, by an old grand
mother, just how far she may let the young man s advances go.
The lucky selected man then approaches the girl s father to
settle the lobolo, that is, the price in cattle to be paid for the
damsel. This varies according to beauty and rank. There is
no talk of a dowry, because daughters are a distinct asset to
their parents in Africa. The young man knows he will get his
money s worth, for once the maiden is paid for, she will work
for him uncomplainingly the rest of her life. Her gay and
independent moment is a fleeting one. If her lover has not
enough cattle to seal the bargain, he must go to work. He may
serve seven years for his Rachel, only to find that she has been
sold to a more affluent suitor, and he must perforce take Leah.

The main purpose of my trip was to study working condi
tions in the diamond and gold mines and the hospitalization of
the workers. The mines themselves I found were well venti
lated by modern forced-draft methods. Sanitary conditions
were also excellent. But still I wondered how the Negro work
ers, who for centuries had been used to the sun, could adapt
themselves to ten hours of continuous labor under ground.

All new workers are put under contract to work for at least
three months, after they have passed a doctor s examination,
including X-ray pictures of their lungs. At the end of this
period another X-ray is taken and about fifty per cent of the
workers are usually found to have lung irritation and probable
infection due to the fine dust in the air of the mines. Natu
rally, however, the natives still feel in average health; they are
given an opportunity to sign a contract for another three
months or be discharged. If they sign, the mining company is
relieved of any responsibility in connection with a breakdown
of health. As the workers have just received their first pay and
have become used to the routine and lost their homesickness,
they sign for another period.

As a whole, the natives were quite contented with their new
life, different as it was; this was partly due to the dances, similar
to the tribal get-togethers, which the mine companies encour
aged. There is a peculiar rhythm to the African black man s

364 A WOMAN SURGEON

life consisting of periods of marked contrast. When they live in
the jungle, days and even weeks of inactivity are always fol
lowed by a tribal war or a game hunt and riotous feasting. So
these dances in the enclosures at the mines served as outlets for
pent-up enthusiasm. In this way there were no riots. Even
the throbbing beat of the drums did not sustain the periods of
revelry for very long, as the edge of each man s vigor had been
worn by the day s work.

From the standpoint of hospitalization, the mines seemed
primitive and the equipment looked inadequate. But further
investigation proved that conditions were not lax. The natives
were kept in bed during sickness with the greatest difficulty,
being thoroughly afraid of a mattress. Bed-springs seemed to
them to be actually trying to throw them on the floor every
time they moved. The beds in the mine hospital were, there
fore, made of only a small mattress on cross slats, but even these
seemed dangerous to the natives and every time the nurse left
the room all the patients would get out and lie on the floor, or
the ground if they could get that far.

In cases of pneumonia no attempt was made to keep the
patients in bed. Quite the opposite. I was amazed when I
came upon several patients lying exposed on the ground;
according to our technique of protection, such a measure was
sure to be disastrous. For comparative observation I urged
that at least three of the six be taken back into the hospital and
covered. After a few days I had to admit that the South African
plan as applied to Negroes was best, for the natives who
remained on the sun-baked ground, absorbing the actinic rays,
revived like wilted flowers which had been placed in a vase of
aspirin water, while the patients keot inside showed no improve
ment.

The value of the sun as a tonic is better known today per
haps too well known and we are not surprised to hear of its
benefits. The fact that the ultra-violet rays release a substance
called ergosterol from the skin into the bloodstream to poten-
tialize as energy is fairly common knowledge. But as I see the
thousands who lie all day on our Florida beaches, I know that
they do not realize that there is also a danger in too much sun-

SOUTH AFRICAN SUNLIGHT 365

shine. The sun quickens the action of the thyroid gland, and
naturally we feel more active, but if this stimulation is taken
constantly over two or three years, this gland begins to work
less and less efficiently. Then the reaction is demonstrated by
increasing laziness and lack of enthusiasm.

On the return journey we sailed up the East Coast of Africa
where such places as Mozambique, Zanzibar and Mombasa,
instead of being comic-opera settings on the stage, became
actual towns and places. But most jnemorable of all were the
great falls of Victoria. Three times as high and five times as
wide as our Niagara, their beauty and grandeur are a colossus
of nature.

One hundred yards before the great cataract begins there are
shallows near the banks, so quiet that the water scarcely seems
to move at all. But, nevertheless, it is drawn noiselessly into
the deep current, dashing a moment later over the precipice
into the deep gorge with all its pent-up power suddenly released
as is the thunder of the heavens. It seemed, as I looked at the
still water under the bank, that I could see the quiet moment
in the lives of all of us, when we stand on the brink of some
great change in destiny. Thoughts of Livingstone and Stanley,
of birds and the wind in the swaying African trees, of the mean
ing of civilization, slipped through my mind.

In the afternoon we went to the rainbow forest, opposite
Victoria Falls. The waters of the Zambezi River drop into a
ravine so deep that the force with which it falls on the rocks at
the bottom sends a spray far up into the air, and when the sun
is level with the floating mist the whole sky seems filled with a
magic rosy light. At other hours in the dense, dank and beauti
ful forest, kept always moist by the drifting spray, a hundred
thousand rainbows seem to be woven through the glistening
trees. Here, I thought, if anywhere, I should be able to find
the pot of gold. Just ahead of us, through lacy, bejeweled
foliage, the rainbows danced with their feet on the ground.
Elizabeth ran forward. She had the same idea.

"Move a little to the side just two paces more/ I called. "I
want to see you in the rainbow. There, it arches above you

366 A WOMAN SURGEON

now. Reach out your fingers; they touch it! How wonderful
to see a person really standing in a rainbow."

"Nonsense," Elizabeth said, "I am not in the rainbow. It is
you. It s all around you. You are part of it."

I looked around; the wet grass and the dripping leaves held
no color. "Are you sure?" I called.

"Of course I am." Her sincere laugh at my perplexity came
to me over the deep roar of the crashing water like delicate
Japanese wind-chimes against the volume of a carillon. "It s
beautiful. You re in fairy-land."

And then I realized that no one can ever know the moment
when standing at the foot of the rainbow.

CHAPTER XXIX

A SOCIAL LEAGUE OF NATIONS

LIFE in New York had changed me from a somewhat shy young
physician trying to do my bit with integrity, as a cross-tie in a
railroad track does its part, into a confident person who real
ized that manifold responsibilities of a physician, not only from
the scientific standpoint, but also from the observant social psy
chology of medical life, rested upon me with an obligation for
some public service. Every professional person, in addition to
his chosen field of work, must have some type of family life. I
have found mine in the comradeship of peoples. This has given
me a deep sense of the neighborliness of nations. To develop
understanding and appreciation of so-called foreigners is a
foundation stone in a social as well as in a political League of
Nations.

As is the case with all medical men and women, life in New
York permitted me to accept few social invitations, but I had
the blessing of rare friends who contributed much to my happi
ness and I had to find a way to return their kindnesses. Since
I could not go to them, they were good enough to come to -me.
About once a month we had an afternoon together at my home,
arranged so that guests should not miss me if I were called on a
case in the midst of my own parties. Informal hostesses Mar
garet Payne Gatling, Sarka Hrbkova of Czechoslovakia, Edith
White of New Jersey, her eighty-two year old mother and others
introduced guests to one another. Thus I could give a dinner
for fifty people or an afternoon of mental hospitality, bringing
heads of many diverse activities together, and still be free to
slip away if duty called me.

In these gatherings I learned the similarity of apparently
diverse people, artists and scientists of all kinds came for the
interchange of thought. Katherine Dreier brought Archipenko,
the sculptor; Dr. Alexis Carrel brought Dr. Noguchi from the

367

j68 A WOMAN SURGEON

Rockefeller Institute; Deaconess Elizabeth Chappell, head of
St. George s social service work, came and heard Mrs. Elizabeth
Custer, widow of the great general, tell of life on the prairies
and how she had acted in the midst of Indian raids; Johanne
Spilleanar of Holland played for us her piano improvisations of
Javanese drum, club and gong music. Gena Branscome and
Harriet Ware, composers, spoke on American music; John
Emerson, Alexander Kirkland, Eleanor Gates, Rachel Crothers,
on drama; Dr. William H. Park and Dr. Ward Crampton, on
health; Mary Lewis and Faith Vilas, on poetry. Gertrude
Atherton, Rose O Neal, Grace and Thompson Seton, Amelia
Earhart, Lilian Wald, Mr. and Mrs. John Hays Hammond,
were among the many who often came. A doctor from Korea
told us one day of the skill and the history of his people, espe
cially in regard to their armored medieval navy. Madame
Naidu, a Hindu poetess, explained the underlying forces in
India which brought about Gandhi s leadership. Small,
graceful, intelligent, she was an example of the type of Hindu
women who will help India to progress. Dr. Sorrabji, also
from India, told us of her practice as a physician, and described
a Ranee princess who played a chess game with living ladies,
by directing from her balcony their movements on a square-
marked lawn. Another afternoon a Parsee brought to us the
Persian aspect of life and the application of Zoroastrian
teachings.

To meet the Yugoslav sculptor, Ivan Maestrovitch, came one
afternoon Bishop Nicolai of Ochrida, Serbia, Professor Michael
Pupin, Gutzon Borglum, Mr. and Mrs. Daniel Chester French,
Brenda Putnam, Harriette Frishmuth, Mrs. Jacob Riis, Dorothy
Scarborough, Blanche Colton Williams, Mrs. Gordon Battle
and John Frothingham, founder of the Kamanitza Serbo-
American Institute for Children in Yugoslavia. This Institute
was both a home and a school for the education of orphans
rescued during the retreat through Albania. Mrs. Frothing
ham had been Helen Losinich, daughter of the professor of
chemistry at the University of Belgrade. All these friends
opened vistas into other worlds, and from them I caught the

A SOCIAL LEAGUE OF NATIONS 369

contagion of verve without which I would have been only half
as much help to my patients.

One day in the midst of a brilliant afternoon I was called to
a case. Dr. John Collin Vaughn, who had been telling of his
adventures as the doctor of a North Pole exploration party,
accompanied me part of my way. He delighted me with a tale
of his experience on a committee appointed to improve hygienic
conditions in the city prison on Welfare Island. One of the
first steps was to increase the ventilation in the prison cells.
They were small, hot in the summer and cold in the winter. It
was decided that many small openings must be made in each
metal door to admit more light and air. One by one the pris
oners were shifted in order to remove four doors each day.
These were taken to the foundry where with a great deal of
noise and long work the drilling of small, open, parallel lines
was made.

One of the professional criminals, imprisoned for opening
safes and removing their contents, had become a "trusty" and
worked in the foundry. He said to Dr. Vaughn, "I have a
friend who could lend us a safe-blowing torch that would make
the openings in these doors so fast that fifteen could easily be
done in a day instead of four. The way you re doing this is
clumsy and slow. If you will get me a day off the island and
give me your word that I won t be followed, I ll go to my friend
and get his acetylene torch. He s a good fellow and will lend it
to me for as long as we need it, if I assure him he will get it
back."

Here was a quandary for the doctor. Should he let an
extremely clever criminal loose? Ought he to put himself
under obligation to an equally dangerous criminal? Should he,
having obtained the apparatus with which the second criminal
committed his robberies night after night, return it to him?
Could the city afford to buy burglary tools to improve the
hygienic condition of prisoners? He talked this over with Mr.
Osborne, a lawyer of vision and clear humanity, and with Dean
Kirchway of the Law School of Columbia, and they agreed that
it would not only be in the interest of economy, but of psycho
logical value to show confidence in the "trusty" who had volun-

370 A WOMAN SURGEON

teered assistance. A gentlemen s agreement. Result: rapid
improvement in the prison doors was made with the aid of a
criminal who had been behind them, and another who prob
ably would sooner or later reside there, too.

This caused me to tell Dr. Vaughn of an experience I had in
visiting the Tombs prison in New York. A young minister of
the Episcopal Church took me with him to visit the boys in that
gloomy old jail; noting my interest in the lads, he suggested
they would be interested in hearing a talk on some subject
entirely foreign to their own lives and experiences. Several of
them expressed preference for China, and how things were done
there. Yes, they would like that. I collected my Chinese
souvenirs, and, as an added feature went to a florist to buy a
bouquet for the chapel in which I was to speak, thinking that
the boys would enjoy looking at the gay blossoms. My florist
did better than that; he contributed in addition, a box filled
with what seemed to be the entire reapings of an old-fashioned
garden. Few of these city boys had ever seen except behind
glass more than a few flowers at a time, perhaps only a strug
gling potted geranium. The perfume in the bench-filled room
where the boys had gathered turned it into a countryside in
spring.

At first, they were bashful under the watchful eye of the
guard, and a little confused by the array of Chinese art, but
when these valuable curios were passed around for each boy to
handle, they were completely won. Most of them had come to
feel that no one would ever trust them again. When they saw
a Chinese lady s ancient shoe and realized the suffering the
babies and young girls experience during the years of feet bind
ing, the look of pain and sympathy on every boy s face showed
how far they were from being "tough guys." But more impor
tant, it indicated how impressionable they were and how easily
they could be led. This was what had brought most of them to
the Tombs, instead of into more constructive fields.

At the end of the talk I presented the guard with a large rose
and asked if each boy could come up to the table and pick a
flower for himself. This created immense excitement. I said
that I would take the remaining blossoms to the women s ward

A SOCIAL LEAGUE OF NATIONS 371

for distribution. As the boys filed by, one lad about twelve
years old declined to take a flower for he was afraid that he
might deprive some one else and he knew women liked flowers
even better than boys.

When I took the flowers across to the women s section, I was
informed by a stern matron that such an outlandish procedure
was against the rules and that I was a silly, nosy, sentimental
woman the kind that ruins prison discipline and tries to break
down the true objects of justice. All my arguments proved to
be ineffective, so I returned to the boys jail and sought out the
guard who had been in charge during the lecture and told him
about the rebuff; he admitted that giving the flowers was against
the rules, but since he had accepted the rose and as I had
brought out the fact that he had been a soldier in the Boxer
War and a football star, he became something of a hero to the
boys, and felt that he couldn t very well deny them the flowers.

I asked this sensible guard to tell me more about the boy who
had refused a flower. The youngster s face and manner sug
gested a fresh, eager, normal American boy. The guard s an
swer was that he was awaiting trial for murder!

His dying father had asked him to take care of his mother,
and when a few weeks later a boarder had forced caresses upon
her to such an extent that a violent struggle resulted, the boy
had picked up a kitchen knife and plunged it into the man s
back, merely carrying out his promise to his father. There was
no vicious, criminal streak in the boy s nature, and yet he was
being held in the company of ill-balanced mentalities for
months awaiting trial. I asked Dr. Vaughn who would be to
blame if this boy became warped in viewpoint, his health im
paired with consequent damage to his psychological reactions,
so that in later years he would turn to crime, cause untold
misery and cost the state thousands of dollars. Dr. Vaughn was
interested and soon the lad was tried and released.

A doctor s practice often touches matters of law. One day in
New York I was called to the home of an artist, whose husband
had said over the phone that she had a gash in her head which
would need surgical attention. When I examined her, I could
find no trace of any wound from the severe blow she claimed

A WOMAN SURGEON

to have received in a taxi accident, but she insisted that there
had been half a basin full of blood when her husband bathed
her head. I did not like to suggest that it might have been the
henna dye from her hair. He winked. She was obviously set
upon believing that she had been grievously wounded, and
would need an operation.

She wanted me to appear in court in a suit for damages. I
could not justifiably take the witness stand to uphold any such
claim. She went to a nerve specialist who treated her with
elaborate patience and sympathy. She was so pleased with this
thoughtful concern, this consideration of her suffering, and so
forth.

I was naturally interested to discover how such a renowned
psychiatrist could thus humor her and even go so far as to agree
to appear in court in her behalf. He explained that directness
was not the most advisable procedure with highly strung, nerv
ous patients, that the proper manner in which to treat her was
to bring her around to mental balance easily and gracefully,
without giving her a cold bath of truth. The psychiatric treat
ment by his method was the wisest means of bringing her mind
back to normalcy. With the gradual rebuilding of common sense
through first gratifying her whims, and the subsequent training
of her subconscious, she was more likely to recover. In the end
he would not have to go to court. The specialist explained that
he realized my attitude was based upon a patient s normal desire
to be well again, but that many men and women wanted to have
much made of their illnesses.

The brother of the artist called on me to express apprecia
tion of my way of acting in the matter, and said that her mother
had been temperamentally much the same. I thought him
practical, but heredity was obvious when three months later he
turned on the gas in his apartment, in a burst of vague, unneces
sary heroism, "to lessen the economic burden" for his wife and
their two children.

Peculiar mental factors develop in many cases. Once I was
called to the bedside of a dying man. He and his wife had been
in a violent automobile crash, which had killed her and left him

A SOCIAL LEAGUE OF NATIONS 373

unconscious for forty-eight hours with a fractured skull. I
wanted to call a relative. His daughter came.

She was amazingly indifferent, hard and casual. Her mother
had died some years before, her father wanted his daughter to
keep house for him, but she selfishly wanted to live what she
called her own life. Seeing that she was restless, he wisely
remarried, choosing a very domestic woman, who highly dis
approved of her step-daughter. The father was now only inter
ested in his new wife. The daughter, though she wanted to be
free, was inconsistently angry. She wanted to be employed, as
all her friends were working. But resentment lingered.

When she learned that there was no hope of her father s
recovery, as he also had internal injuries, she remarked coldly,
"I ll go back; there s nothing for me to do around here. He
probably has it all figured out in his will just how he wants to
be buried."

But he did recover. When he came to, he looked like a
human being on Judgment Day returning from the dead,
gaunt and ghastly. As he lay in the shadow of death, his
features had taken on the majestic appearance that many indi
viduals attain when they lie on the borderline of life. Death s
nearness seems to bring out in their faces all the spiritual
quality that they possess. It is a religious moment for the sen
sitive doctor, to stand by a patient so close to eternity. When
he came back, however, he was commonplace in the same way
that the girl was and expressed no wish to see her. She had
evidently inherited hardness from him.

What helped him to get well? The molecular integrity of
his physical body brought him back to life. The physio-
chemical quality in his cells made him able to withstand the
results of a crushing accident and revive. In certain cases cells
that are shocked with a stiff impact may come back, while a
similar shock may kill another person. We believe that the
endocrines and the electrons in the human organism supply
this resilient force, making possible the molecular fight.

If there is insufficient suprarenal secretion in the blood for
this fight, the molecules will retire from the onslaught. If the

374 A WOMAN SURGEON

suprarenal glands are normal, and the blow is not in the kidney
region, they can potentialize their fight quality. In the survival
of life the suprarenal is a prime factor.

When this man was better and his memory returned he tor
tured himself with mental agonies about where he would con
valesce, how he would make a living. The unconsciousness had
been merciful, for if he had had those worries added to the
physical trauma, the cells could not have carried on their molec
ular fight for recovery against the powerful warring agency of
mental negativism.

A surgical operation can often restore and rechart the
psychology of a patient. Physical conditions in both men and
women 1 may cause for a long period a variety of depressions
and moods. The restoration of health transforms to a vivid,
joyous, successful person one who, subject to moods, has been
a social and financial failure.

It is equally important to know when not to operate, and
before a decision is made, every function of the individual must
be fully considered. 3 I avoid alarms. If the case is not of an
emergency nature, I prefer to wait a week or ten days to get the
system as a whole into the best condition. This has sometimes
been defeated. Several such patients, on going for independent
consultation to some other surgeon, were advised to "be
operated on immediately, go into the hospital tonight." After
this happened several times, I asked this colleague the purpose
of making every case appear to be an emergency. I did not
necessarily resent his taking patients away from me, but I won
dered why he used the same alarm methods with all who came
to him. His explanation was feasible. He explained that it
was less of a shock to patients to be hurried into the hospital.
This did not permit them time to talk over possible casualties
with their friends, which he had found caused them fear and

1 Constitutional States in Relation to Gynecological Conditions, published in
the New York Medical Journal, August i, 1914.

Neurasthenia in Relation to Gynecology, published in the American Journal
of Obstetrics and Diseases of Women and Children, Vol. LXXIII, No. 4, 1916.

2 Neuro -psychiatric Reactions in Association with Operative Procedure, read
before the New York Academy of Medicine, Section of Neurology and Psychiatry,
Oct. 13, 1925.

A SOCIAL LEAGUE OF NATIONS 375

depression. I still think it best to treat the average patients as
rational human beings, and besides give them time to have their
hair curled, to buy a few pretty extra nightgowns to wear in the
hospital and to leave things in good order at home, instead of
burdening the whole family with anxiety, which always harms
far more than it helps.

It is always gratifying to be called in consultation, but on
several occasions I wished that I had not been. One of these
was a medico-legal case, which gave a history of a woman s
having gone with her husband and sister to a small hotel. She
and her husband had had a talk regarding some jewelry, which
she was to have valued in the morning. He had received at the
hotel a telegram calling him elsewhere. Scarcely had he gone
his wife and her sister, who were in adjoining rooms, were
drifting off to sleep when two men appeared. They had come
through a door against which a bureau had been placed. One
threatened to shoot the sister if she made any outcry. The other
demanded the jewels from beneath the pillow. In a struggle,
the woman who became my patient had her right shoulder
violently wrenched. Suit was brought for the injuries, the need
of possible operation and also for the fact that the hotel did not
safeguard its guests. My sympathies were wholly with the
woman, but I was the cause of her losing the case! The hotel
cleared itself by a notice on the door regarding keeping valu
ables in the office safe; they assumed no responsibility for
thieves chancing to be in the next room. I discovered that she
had had for some years previously chronic rheumatism in that
shoulder, which had, it is true, been aggravated by the struggle.
But I was forced to testify that the shoulder would not have
been so painful if she had not had calcareous deposits in the
joint, that her case was wholly medical.

On another occasion, I was called in consultation regarding
a young woman who had received a blow while driving a car,
by a slight head-on collision, which threw her forward and made
the driving wheel press against her stomach. She had gastric
ulcers, which she claimed were a result of this. I found her
very anemic, the stomach contents hyperacid, and she gave
symptoms which showed that she had suffered from hyperacidity

376 A WOMAN SURGEON

for some time before the accident. Also, in the artificial pearl
factory in which she worked, a number of the girls had become
anemic from their contact with the chemicals employed. I
wanted to explain all this to the girl and her mother, but my
duty was solely to report on whether the accident had caused
her illness, and whether an operation would be of benefit.
Both answers were negative.

Often a mental attitude turns life s tides. A poet who had
been very ill for two weeks with broncho-pneumonia decided,
objecting to the codein which had been prescribed, to change
physicians. This was facilitated by the doctor s enforced ab
sence from town for several days. The patient complained to
me of the somnolent feeling which caused fear of becoming
an addict. It was meant to induce relaxation, but I did not
argue. Would you prefer something which contained wild
cherry and eucalyptus?" "Of course, it sounds like spring and
renewed health, I am sure it will make me well." It did.

Health interest is a medium of unity in humanity. I have
been urged to put San Michele episodes into this book. I can
not bring myself to do it, for the most tragic and curious cases
seem to me untellable. My respect for the sterling qualities
with which the average man and woman meet physical infirm
ity, my intimate association with the mental agony through
which many have passed, puts a barrier between my pencil and
my paper. I am unwilling to recall to former patients, past suf
fering, by writing of their cases even with the usual disguises.

In some instances so anxious are they and I to forget their
past that one whom I met recently feigned not to recognize me.
Six years ago I had spent anxious hours fighting for her life
after an operation in which there had been only a narrow
margin of hope for success. She was grateful then; now she
could not maintain her poise if she recollected it. As we passed
on the street, the sudden tensing of her lips and the blanching
of her cheeks showed me that she still struggled to forget.

Doctors learn to probe the mystery of life by coordinating its
forces as they contribute to a single act, and at times fathom
death as a part of life.

The afternoon of a day in which I had spent the morning

A SOCIAL LEAGUE OF NATIONS 377

operating, I wended my way across the park toward the honor
grove, and stopped to rest under a tree to speak to an office
scrub woman, who I happened to know would go on duty at
five o clock to clean the floors of a lofty office building. To
endure the monotony and weariness of her job, she was satu
rating her soul with the April buds on the trees and fresh new
grass.

The plan for an honor grove of trees in Central Park had
been instituted as a means of paying tribute to people still liv
ing, with a decoration designed by nature. At the planting of
the first trees four women whose work had added much to the
happiness and welfare of many Americans were to be thus
honored: Mrs. Clarence Burns, Angelique V. Orr, Mary Garrett
Hay and Cynthia Westover Alden.

As I approached the place where the four trees were to be
planted, I passed some young policemen on duty who looked
utterly bored. All the women gathered on the spot were
middle-aged, or nearly so. Not the type to create any excite
ment, or to make life interesting in any way for policemen.
They looked away, uninterested, annoyed.

However, when a short, well-deserved tribute had been paid
by Park Commissioner Gallatin to Mrs. William Albert Lewis,
the founder of this plan of recognition, and the Mayor had
thanked her for her municipal services, and she had spoken
appreciatively of their cooperation, a group of scrawny, ill-
nourished little children came forward, endeavoring to lift the
large spade to put earth in place around the first tree which had
been only partially planted. The policemen took an interest
in the sympathetic, shining expression in the face of dear Mrs.
Clarence Burns. They thought of poor children they knew on
East Side, West Side and all around town, not as yet reached by
her plan to give them seashore and country outings, and to
train them in homecraft as "Little Mothers."

Next the tree for Mary Garrett Hay was planted. The great
value of her national services in helping to improve laws was
stressed and of the courage with which she and others had stood
ridicule for the sake of justice to women through equal suffrage.
The policemen were not interested.

378 A WOMAN SURGEON

When a tree was planted for Angelique V. Orr, some aged
men and women reverently completed the planting, for she was
the first who organized a society to show friendship and love to
the aged poor. The policemen s young Irish voices joined
hesitantly at first, then fully, in singing with the crowd, "Should
Auld Acquaintance Be Forgot," and no more shoulders were
shrugged. Their crusty exterior showed signs of weakening.

When the tree for Cynthia Westover Alden was planted-
she had established homes for blind children and was president
of the International Sunshine Society a bevy of blind little
boys and girls joyously tried to gather around it, but their steps
were uncertain until their feet were guided by the policemen,
who held their trembling hands in place on the handle of the
shovel and guided the tossing of the earth. Big, warm-hearted
boys developed in the uniforms of the hovering policemen.
When the tree planting was over, one of them said to me in his
rich brogue, "Faith, ma am, it is the foinest thing we ve ever
had in the Parrk."

When the National Society of Patriotic Women of America,
who gave splendid service in helping to establish overseas the
American Women s Hospitals, decided to plant a tree for me in
the honor grove, I argued that many men and women should
have trees planted there before I; furthermore, that I expected
to live for many years and my turn, when I had done more to
deserve it, could come later. Mrs. Lewis looked at me seriously
and reproved, "That is just what Mrs. Burns said, but within a
year she was dead. This is an honor grove to the living you
had better not delay." I felt as if the hand of the grim reaper
lay on my shoulder, and I protested no further.

The day of the planting, April 17, 1926, was cold and windy,
but the impressive ceremony defied the weather. A large Ser
bian battle flag was draped over the speakers platform and
American flags were carried by members of the Veterans of
Foreign Wars, the Women s Overseas Service League, the Red
Cross officials all in uniform, the Dixie Club, the Zonta Club,
the Society of Virginia Women in New York and the escorts of
the consul generals. Many members of medical societies, na-

A SOCIAL LEAGUE OF NATIONS 379

tional and local, were present, hosts of friends among them;
many former patients helped to plant my oak-tree v

Dr. Wilfred T. Grenfell made one of the addresses. He
stood on the platform, as if on the cliffs of Labrador, his white
hair blowing in the cold wind. "In this rugged atmosphere/
he said, "I feel quite at home/ I was touched by his kindness
when he said that I had "planted on the Labrador coast trees
of kindness which bore leaves of healing/

Miss Mason of the Castle School, Dr. Henry P. De Forest,
Madame Carlo Polifeme, president of the Society of Jeanne
D Arc, Baroness Dahlerup, president of the Danish-American
Women s Society, all found kind things to say. Dr. John Colin
Vaughn made me very happy when he said my surgical work
and teaching in the Vanderbilt Clinic had been a factor in
opening Columbia University to women medical students. I
hope this may have been so.

CHAPTER XXX

FLORIDA ON THE EDGE OF THE TROPICS

AND then one day I had pneumonia, a microbe altered my
whole life. Still outwardly robust and active at the peak of my
work in New York, I substituted the unending stimulus of the
city for the graceful serenity of a Florida town. It was a sudden
decision, but apparently foreordained, and brought about by
nothing more profound than a ball.

The Veterans of Foreign Wars had asked me to assist them
in organizing their annual entertainment for the raising of
money to build a home for the orphaned children of soldiers.
It was necessary to dictate more than a thousand letters, and
write a pageant for eight hundred people to enact in Madison
Square Garden. The evening ended with a magnificent ball of
five thousand distinguished people. My escort, a doctor, has
tened me home. In the taxi I realized that I had a fever. I
sniffed the cold January wind joyfully after the close air of the
auditorium, and unwisely left my fur coat unfastened.

Once home, I knew I was desperately ill. My temperature
had reached 104 and I ached from head to foot. Another col
league was called and added little encouragement, in fact ruth
lessly stated that I would be lucky if pneumonia did not end my
career that very night. This attack was the second stroke of a
fate which had evidently decided on my moving to Florida.

The first had occurred years before in Serbia during the war.
While traveling in a box-car crowded with a company of sol
diers, I had been gassed when the train was wrecked in a tunnel.
Much scar tissue was still in my lungs; their resistance was poor.
Pneumonia, therefore, was a hazard which made future winters
in New York a virtual impossibility. ;

As I lay convalescing, destiny took on the guise of a postman
who delivered a letter from Hamilton Holt, president of Rol
lins College, informing me that I had been chosen to receive an

380

FLORIDA ON THE EDGE OF THE TROPICS 381

honorary degree of Doctor of Humanities and must come to
Winter Park for the ceremony. With a dear friend, Marion
Dwight, I made the trip to a town like one vast garden. People
said to me, "Do come here to live. We need a woman physi
cian. There isn t one in the northern part of the state."

Marion and I looked at each other. Could I give up my
well-established practice in New York, my friends, the theaters,
the opportunities for many charitable services, to come to live
in a small town? The exchange did not seem to balance; but
President Holt introduced me to a genius in the form of a
realtor and I was charmed by two flowering acres on the edge
of a lake sparkling in the sunlight, vivid with tropical trees and
vines. On the way north I toyed with the idea of buying that
place. It was unfortunate that our steamer landed in a fog
near the fish market.

When I went to have breakfast with Marion the next morn
ing I passed twenty garbage cans and the memory of bougain-
villea and jacaranda crossed my mind. Over the coffee Marion
asked me, "Are you really thinking that you might go to Florida
to live?"

"It would not surprise me."

She looked horrified.

"Well," I went on, "I must live where the winters are
warmer. Thus a pneumo-coccus has decreed. With fast trains
and airplanes my patients here can eliminate time and space.
And in Florida my increasing interest in arthritis and endo
crinology will have a chance to express itself, as many middle-
aged people seek health there every winter. I will probably
have to build my new practice in these specialties. Every
summer I can return to the New York clinics to keep up to

date."

Marion nodded her head, seeing that the lure of Flonda was
potent. So it seemed decided. But there was more to moving
my offices and my ambitions to Winter Park than a decision.
I must pass an extremely rigid State Medical Board examina
tion before beginning to practise there. I had no intention of
retiring in the prime of life, for I believe that the years from
fifty to seventy are and should be the most rewarding.

382 A WOMAN SURGEON

Florida had found that a great flock of physicians flew south
each winter, and so in order to protect the practice of its local
doctors, refused to accept certificates from any other state or
even for having passed the national medical examinations,
demanding that every doctor pass a severe test. New Hamp
shire has been forced to institute the same ruling, to prevent a
similar influx of doctors in the summer. I welcomed the chal
lenge, anxious to see whether I could, after fifteen years during
which scientific methods had changed radically, pass an exami
nation expressly designed to prevent my doing so.

The examinations were held that year in Miami. I attended
them with high spirits. Doctors of all ages, men and women,
assembled. Many of them were nervous. We were examined
on successive days. The questions were fair. Some of them,
without specific preparation, could be answered only by recent
graduates; others only by doctors with considerable experience.
My hasty review stood me in good stead. A month later at
Christmas time I received a congratulatory letter stating that I
was entitled to practise in the state of Florida. Written in
pencil on the announcement was: 98%.

An artist and a poet who lived in Winter Park had written
me that they would meet me at Indian River City. All the way
up from Miami I was so excited about coming to live in Winter
Park that I talked with every one who would listen, and even
wrote a poem on Florida and promised to exchange flower seeds
with passengers from Montreal!

The train drew up to a small freight shed. The only person
in sight was one colored man asleep. The shed stood in the
middle of a dreary Florida waste. For half an hour I looked
eagerly north, south, east and west across sandy pine lands but
no friends appeared. A few drops of rain began to spatter on
the platform and I wondered how I could carry my two boxes, a
suitcase and a hatbox to a crossroads over a mile distant. A
handcar came down the tracks but the Negroes on it refused to
take me aboard, it was "agin de rules," so I set out for the main
road after trying to make my baggage as inconspicuous as pos
sible in the corner of the shed. It rained harder, and by the
time I reached the crossroads carrying my heavy package of

FLORIDA ON THE EDGE OF THE TROPICS 383

books I was about to drop. I plodded toward a small grocery
store. A woman there urged me to rest. After a while a
man drove up in a Ford and bought a few groceries; I offered
to pay him to take me as far as the station. But he replied that
his wife was sick at home and that he did not have time to do so.
Effectively, although inexcusably, I lost my temper. I ex
pressed the opinion that it was no wonder most people pre
ferred California to Florida; obviously, southern hospitality no
longer existed; human kindness was at a low ebb, and if I ever
got the sand out of my shoes and the burrs off of my stockings,
I would leave the state forever! This seemed to soften the
hearts of the car owner and the lady grocer, for they urged me
at once to get into the automobile. I climbed into the car,
apologizing for my rudeness. At the bus station half a mile
beyond the grocery store the man in charge told me my friends
had been there to meet the bus and had returned to Winter
Park. I tore up the poem about Florida and told the man that,
whichever appeared first, bus or train, I would be taking it for
New York.

My feet were wet, I was covered with burrs, and I was very
hungry. I slumped into a chair, feeling more defeated than I
ever have in my life. A tear trickled down the side of my nose.
I have faced many tragedies, made many decisions, have always
found courage equal to the emergency, but this series of petty
misfortunes coming after the excitement and fatigue of the
examinations was too much. A second tear trickled down my
nose when I heard that the next bus did not come through for
three hours.

I made an absurd figure sitting there, moist and bedraggled;
the young, well-fed station-master was not inclined to take my
troubles very seriously. I had to find some explanation, but I
could think of no logical reason why I should be feeling de
spondent. Finally I told him that I was upset by the sand-spurs
on my stockings and the Spanish needles on my skirt.
He laughed. "If that is all, lemme pick them off."
Skies began to brighten. A young orange-grove worker came
by in his Ford and was willing to cart me and my baggage to
Winter Park. This Florida " cracker " seemed to me a Galahad.

384 A WOMAN SURGEON

In adjusting myself to this small community and it to me, I
have encountered struggles different from any I had ever met in
active, demanding New York. Here in the village-unit life of
America I have, however, found new compensations. Of course
I would have a smaller practice than I had enjoyed in New
York, even though patients began to arrive before my office was
half built and told me their symptoms to the clang of hammers.
Natural rivalry would arise with other doctors, because the
field is limited and necessarily intimate. I was warned that the
town had been split into factions between two doctors, each
having devotees and opponents, and that the first thing on
which they had mutually agreed in ten years was that there was
no room for me! This was probably an exaggeration, for they
have since been very courteous. It seemed to me wise to make
no attempt to establish a surgical practice here, so I turned my
attention to a new field, one in which I had for several years
been developing interest, as it carried out my ideal of preven
tive medicine.

The prevention and treatment of arthritis is an acute need,
for more than three people in every hundred Americans suffer
from it.

In New York practice I had avoided treating cases which
were not partly or wholly surgical. A fine line must be drawn
in saying that a case is purely surgical. Few, except in war or
accident, occur in people medically sound. Therefore, before
an operation it is vital to consider a patient s circulation, heart,
kidneys, and the intercurrent pathologies, all of which affect the
capacity for recovery.

It is well known that an individual suffering from diabetes is
a surgical risk. Arthritic patients are also risks. This led me
into renewed study of the chemical as well as microscopic com
position of the blood in this constitutional disorder, for anemia
and other deficiencies are always associated with arthritis.

Fascinated as I was by the accuracy of surgery, its definiteness
of action, which gives radical relief within a short time, it had
seemed the only means of immediate relief to physical pain and
deformity. But gradually animal experimentation has made
medicine equally as definite and immediate; thorough knowl-

FLORIDA ON THE EDGE OF THE TROPICS 385

edge of the electricity and chemistry of body cells and fluids and
of the endocrine gland secretions, has made the practice of
medicine just as certain and equally as scientific.

In a small town it seemed practical, in addition to a general
practice, to give special attention to the diseases of middle and
old age. Arthritis is prominent among these, and none of the
other doctors was interested in it, although it is the very reason
why many visitors spend their winters in the South. Its vic
tims often regard their chronic conditions as hopeless and vision
inevitable progression toward life in a wheel-chair. I looked
forward to proving that they were not doomed to any living
imprisonment, and it would give me a new opportunity to
apply the years of previous study in nervous strain.

In the new analysis of arthritis many factors come into
prominence which have been considered unimportant, such as
the accumulation of fatigue, as produced by poverty or excessive
riches, by overwork or overindulgence, the importance of sys
tematic rest, the influence of occupation, worries and responsi
bilities, or the lack of them.

Furthermore, it was interesting to observe in the New York
clinics, as I prepared to come to Florida, the racial differences
often influencing reactions to this disease: between hyper
sensitive Jews and lethargic Negroes, between alert Frenchmen
and methodical Germans. It is important to determine when
a person complains of pain, whether he or she is more sensitive
to it or has less self-control than another, whether the complaint
is for emotional effect or from too long endurance at last giving
way, whether there is lowered resistance of nerves, blood pres
sure, or toxemia.

No field in medicine offers as many elements for careful
consideration as does arthritis. In the advance of the disease
the whole constitution takes part, suffering from deficiencies of
one kind or another which may affect different localities of the
body. The patient s age, weight, height, posture, heart, kid
neys, gall bladder, tonsils and teeth must be individually con
sidered. Of vast importance are the strains at the time of the
menopause, with its attendant endocrine changes. Also, the
anatomical changes in the joints due to deposits of misplaced

386 A WOMAN SURGEON

calcium; the size of blood vessels supplying the joints; and
changes in the chemical constituents of the blood in phos
phorous and sulphur, as well as calcium; also, disease of any
organ may cause undernourishment throughout the system.
The individual and combined effects of all of these are essential
to diagnosis and correct lines of treatment.

Crile has shown that the alkaline tide is lowered by pain,
worry, fatigue and insomnia. In arthritis all of these are usually
present to produce acidosis. The doctor must, through ascer
taining the causes, break the vicious circle of these mental
factors, and gain the cooperative interest of the patient for a
complete study of the case, instill hope and courage so often
absent because of the acidotic, depressive effect of anxiety.
Patience is a prime virtue in the treatment, since no illness
which involves the entire body can be cured with the prompt
ness of an acute local condition.

In meeting the distinguished specialists in arthritis I have
been impressed by their personalities. They are always buoy
ant. This quality, added to detailed skill, has helped them to
lift many discouraged patients out of chronic depression or
irritability. This transference of healthful energy from the
doctor to the patient is more vital in treating chronic than acute
cases. Surgical practice is stimulating, for there is a thankful
thrill when rescuing a life that hangs by a thread. Nothing can
sap vitality more than the gnawing disheartenment of a person
determined to suffer. I never accept any patient unless he or
she wants to get well, and will dauntlessly do his or her some
times difficult part toward that end.

Can arthritis be cured? Yes. How long will it take? That
depends upon how intelligent is the cooperation of the patient
and upon the extent of existing destructive processes. "There
are as many varieties in the symptoms of arthritis as there are
people who have it." Public interest in this disease is due to
the fact that every one has a friend or relative who has suffered
for years from it.

The Orange County Medical Society, in its annual series of
radio addresses by members, asked me, January 30, 1934, help
fully to present this subject. I called attention to the fact that

FLORIDA ON THE EDGE OF THE TROPICS 387

it is only after the thorough study of a case, for each one differs,
that a decision as to medicinal and other forms of treatment can
be outlined.

Broadly speaking, at the outset any source of infection must
be remedied along with the results of that infection. Some
patients think that if they have a tooth extracted, they will be
able to dance that night. But whether the infection is in the
teeth, tonsils, sinuses, gall bladder, colon, or elsewhere, its
effects on the system do not cease immediately.

Since arthritis takes so many widely divergent forms, self-
diagnosis is impossible, no matter how many invalids an ill
person may compare notes with. An accurate diagnosis brings
great mental relief and assists improvement as patients see them
selves rebuilding strength in the correct combination of treat
ments for this many-sided illness. With some suggestions re
garding sorts of baths, exercises, etc., I concluded my address.

After living for twenty years in a great city, every one who
moves to a town, no matter how charming it may be, has the
same experiences, so I have found much congeniality among
artists, writers and others who have taken up their abode in this
little Florida town. Many of the people who come for the
winter are half sick and want only to be entertained lightly. At
first I felt I was marooned on the edge of the running stream of
life. But I soon realized that these people have gladly left their
responsibility behind them and feel peacefully that their days
of strenuous living are past. Their children, too, have made it
obvious that it is youth s turn to be tied to the wheel of time
and events. This transition stage which comes to every mature
life is for some as acute as a surgical procedure in the severance
of many parts, cutting deeply. But many who come here to
pass their middle or old age in rest and idleness soon find they
are ready to live again with zest. The very air is tonic. There
are new outlets and interests, new satisfactions.

There is something lovely and tender in these gray-haired
visitors who are gracefully moving up to the golden gate. The
college students speeding by on the other side don t yet know
that there is a gate. We who are between these two feel at
times winnowed out between the stars, but when we need a

g88 - A WOMAN SURGEON

change we can go away to New York or Europe. The general
exodus in the summer has caused our witty neighbor Orlando
to say that we roll up our streets and put them away in moth
balls until the fall! It is, however, now August. The summer
has been delightfully cool among our lakes. There is such a
breeze at this moment that my paper is held in place by a lead
fishing-line weight!

The setting of life here is contrastingly beautiful. There are
sandy stretches with scrub pine and oak, such as I looked on in
my blue moments at Indian River City, but near by were
luxurious vegetation and the blessed sea. In this section it is
the lakes which reflect the sky. All day we hear the harmonious
conversation of birds. There are no obstructing buildings to
shut out sunrise and sunset. Gradually beauty lifts the soul
and mind toward a triumph of spirit. Serenity may be
achieved. There is a joy in owning a bit of the good earth and
in having a garden to cultivate and live in, as my grandmothers
had theirs in Mount Holly and in Lynchburg, and my mother
had hers. To see things grow explains much of life and so
makes us feel nearer to God. There is happiness here in every
day living that comes not from people or from material things.
It is the certainty of nature s hourly resurrection. Floridians
feel it. A young carpenter said to me, "It would not pleasure
me if I could not see the cypress greening in the spring."

Many interesting people gather in our frequent outings,
lawn parties and other informal expressions of comradeship.
Drives in different directions soon prove that Florida in its way
is the most interesting and cosmopolitan of states, a land of
romance and adventure. Pirate gold lies buried in its sandy
soil; ruins of missions older than any in the country are here;
enchantment lies in Silver Springs.

My gardener tells me voodoo tales and is a man to reckon
with. Recently, when I insisted upon his moving some plants
to a location which I thought would prove an artistic setting for
a delightful little bronze boy, one of Brenda Putnam s contribu
tions to the joy of living, he replied that he was my most hum
ble and respectful servant and would do it if I insisted, but "I
sure would cancel that vegetation."

FLORIDA ON THE EDGE OF THE TROPICS 389

My abiding interest in international affairs is echoed in my
garden s neighborliness of nations. From South Africa, China,
Brazil, Madagascar, New South Wales and other countries come
our blooming trees, our grasses and our buds. To take root and
bear fruit, even in Florida s favorable climate, requires two
years for all trees and many flowers; so it has been for me in
taking root in this community, where in miniature I see the
problems, difficulties and triumphs of big cities. To be a vital
part of any community furnishes a key to all the rest and fosters
a comprehension of the local, the national and the international
citizen.

In my practice here I am in close contact with patients in
their daily interests and so understand their individuality with
more thoroughness, able to see their lives in round as they per
form their many local activities. Many interesting cases keep
my congenial secretary, Ruth Irwin, my nurses and me busy,
and I find increasingly that most psychological disorders are the
result of endocrine imbalance.

Normal metabolism can avert such systemic diseases as
arthritis. In the study of chronic cases the rapid strides of
endocrinology have helped me to concentrate upon the means
of keeping the balance which fundamentally assists the body to
be fit for abundant living.

Many middle-aged people have so nearly exhausted their
thyroid glands their psychological reeducation would be more
easily attained if they were given the proper amount of thyroid
extract at correct intervals. This neurasthenic type, however,
never seeks the advice of a physician until he is practically in
extremis. One of the greatest medical discoveries in our time
has been the knowledge of the effect and intereffect of endo
crine gland secretion upon every hour of life. These^ seven
major enzym-producing factories may be restored to active in
dustry by proper treatment. In supplying the deficiencies in
thyroid, suprarenal, pituitary, and other ductless glands, a doc
tor can give many additional years to those past middle life;
for the difference between youth and old age lies in the chang
ing chemistry of each cell. The thrilling conquests of modern
medicine make us wonder how the early physicians and sur-

39 A WOMAN SURGEON

geons labored so successfully without them, until we recall how
comparatively simple life was in those days. Along a steadily
advancing line of experiment, the history of medicine has cul
minated in the comprehensive and ready service of our day.

In fifty years there has been such constant progress in meth
ods of conquest of illness. General knowledge of hygiene is
now such that if men and women would apply to the care of
their health the same degree of forethought they use in fueling,
lubricating, cleaning and repairing their automobiles; avoid
quacks; have their teeth examined once a year and a definite
detailed health check-up every two years, they would retain
youth, strength and happiness longer than at present.

Many people who are otherwise intelligent are absolutely
reckless regarding their most precious possession. They accept
neighborly health suggestions, friendly in intent but unsuited
to the individual, or they follow advertisements and lectures
based on ignorance and gullibility, when they would not think
of having an incapable person repair the brakes on their
cars. If they placed their health in the care of experienced
physicians, they would double their capacities, mentally and
physically, within ten years.

To return to a consideration of endocrinology: When I go to
New York it is not for vacation pleasures, but among other
professional experiences to see, at the Academy of Medicine,
moving pictures demonstrating the physiology of the cortical
substance of a cat. It is exciting to continue the study of the
vital importance of the endocrines, as it reaches ever nearer to
life s very essence.

The thin cortex membrane of the suprarenal glands contains
an essential substance without which the body in a few days
dies. But when hypodermically, even at the last gasp, this sub
stance is restored to its blood, the animal revives with a com
plete reanimation of its former health and character.

The suprarenal is also the "the fight and flight" gland; those
who have excessive secretion of its chemical output are hyper-
aggressive. Deficiency of it causes withdrawal to the point of
shirking responsibilities. In cases of sudden danger, this is the
gland which mobilizes the forces of resistance. Through its

FLORIDA ON THE EDGE OF THE TROPICS 391

normal strength the body is able to carry on its molecular fight
for recovery from accident or disease. This molecular integrity
may be regarded as God s mercy to the maimed.

Each of the glands has its own distinct and tremendous influ
ence on the individual and, through disposition, on the com
munity. The thyroid secretion energizes, gives a sense of ade
quacy and well-being. If it is hyper (too much) , the person, to
mention easily recognized symptoms, is excitable and apprehen
sive; if hypo (too little) , he feels imposed upon, being unable
to meet the demands of life, and is depressed by the deficiency.
Balance restores cheerfulness and poise.

Early in my practice, a young woman of nineteen, whose eyes
sparkled and protruded, came with her mother to consult me.
The latter stated that for "absolutely no reason" the girl refused
to help her with housework and that when it was insisted upon,
she became nervous and often dropped a plate or glass. The
parents had four more children, their income was small, they
thought their eldest should get work and go to night-school for
secretarial training. The girl s neck during this recital became
splotched with red; she fluttered her hands, but seemed to be
making an effort to control herself.

One glance showed that she was instinctively wise in refusing
the business course; she could never have gone through with
it. She was typically a hyperthyroid glandular type. This was
confirmed by history of insomnia, restless desire to make efforts
for which she soon found herself mentally and physically inade
quate, irritability, excitability, too rapid heart action, feeling
of pressure and suffocation when her neck swelled, as it did at
set intervals.

An operation was the answer; when I mentioned it, the girl
confessed that she had gone with a friend to a clinic and had
learned that the throbbing in her neck but she was afraid,
besides she did not want to have a scar all across her throat.
She blushed and looked down. I surmised that romance was a
factor in her agitation.

It was obvious that Kathleen had worried more than her
mother realized. I asked if they would like to understand her
condition; both sighed gratefully. I explained the relation

392 A WOMAN SURGEON

between ovarian, pituitary and thyroid gland functions and
disfunctions. This convinced the mother that her daughter
was neither capricious nor deliberately lazy and disagreeable.
I advised regular hours of rest, various appropriate forms of
medical treatment and the soothing effect of family understand
ing, with the suggestion that, if these did not suffice, we con
sider an operation.

In a few days the lassie came in with her fiance, a nice chap
who was beginning the study of medicine and wanted to under
stand details. At times an endocrinologist must be sociologist
as well as surgeon! A number of waiting patients were in the
office. I suggested that the young couple stroll about until an
appointment two hours later. Then I explained that it would
be advisable to avoid ether, as it is important for the patient to
be calm before and during the operation. Its inhalation pro
duces a period of excitation before relaxation ensues, and also
the covering of the patient s mouth and nose with an ether
cone, the pressure on the angle of the jaw to facilitate respira
tion and other handling close to the neck, which the method
necessitates, are hampering to the operator. Therefore, I pro
posed the use of a mixture of scopalamine and morphine which
produces "twilight sleep/ and promised that there would be no
noticeable scar. The look of relief in her eyes convinced me
that opposition was -at an end. I suggested that she go talk to
my office nurse, as I wanted to consult my future colleague. We
had a mother-son talk. It was heart-warming to find that all
the baffling detriments, such as how to make a nervous wife
happy, how to be sure that his children would not be "hateful
little kids," and how to persuade her to remain in a home where
she felt that she was not wanted, until he was able to marry,
vanished by my anticipating his senior year and giving a brief
diagrammatic lecture on endocrine reactions and the energizing
influence of the thyroid gland.

A week later she was operated on in spite of its being near
Christmas; it was well for her to be away from the noise of
merrymaking. My present to her was the bandages off and no
scar. This had been simple to accomplish with the use of a
small needle and a continuous subcutaneous suture held taut

FLORIDA ON THE EDGE OF THE TROPICS 393

at the ends by passing each through a pearl button, easy to have
sterilized by boiling and kept in place by an adhesive loop
under each ear. The fine white line in a natural crease of her
neck soon became the color of the skin and my promise was
kept.

Mental attitude is important from the standpoint of cause as
well as of effect; for when a patient is relieved of anxiety, nerv
ous tension is relaxed, normal circulation is restored, and con
structive thinking, combined with these, stimulates the thyroid
cells, which gradually regain normal functioning. The cycle
completed establishes a psychological affirmation which assists
the rebuilding of tissues and mental stabilization. An active
thyroid prevents patients from accepting disease as inevitable.
They acquire respect for good health and responsibilities
toward it, and do not speak unnecssarily about infirmities. As
has been emphasized in relation to surgery and arthritis, knowl
edge of the separate and related effects of each of the major
glands, and the modifications due to the smaller ones, enables
physicians to prescribe the proper amounts, often minute,
which relieve the strain on wearied tissues, until they recover
tone. So medicine assists nature, and patients are trained for
health, while being treated for temporary ailments.

Owing to the relation of the mind to tissue tone, I made it a
rule to request that no hospital patient of mine be plunged into
melancholy by the visit of an interne, on the night before an
operation, dutifully inquiring and recording the history of all
the former deaths in the family. Instead they solved a cross
word puzzle, read an entertaining short story or had other diver
sion, which kept the mental pattern constructive and so helped
recovery. Also I insisted on a cheerful attitude toward clinic
patients.

I could never be happy without a certain number of the
handicapped to treat. Out in the country districts of Florida,
which we call "the pines/ I visit many of the sick poor, who
correspond to those who used to come to the dispensaries in
New York City, to South Third Street in Philadelphia, to the
hospitals in Germany and in plague-stricken India. My reward
is in learning to know the courageous life of these people. Doc-

394 A WOMAN SURGEON

tors cannot look only at the woof of life; the warp is as essential
to the tapestry. Humor is also woven in sometimes. One of
the Florida Negro midwives told me that she had "kitched two
hunderd an one chillern and been paid in all fifteen dollars an
a double han ful ob pecan nuts."

During the recent depression all doctors did a vast amount
of charity work, but we did not call it that, for it was a privilege
to meet basic needs. The business side df practice is necessary,
but its art and humanics are what carry us on. One day, when
it temporarily seemed to me that all my work was outgoing,
with no prospect of income, a farmer in a rickety old car arrived
with a wife whose condition was even worse. I could not
understand how, with nearly every part of her machinery out
of order, she was able to do farm work. No symptoms indicated
a hopeless condition, but she was so far below normal that her
health would probably require a year s upbuilding.

After I had given an hour to a complete physical examina
tion, my nurse had handed her a page of written instructions
and several samples of foods sent by manufacturers to the office,
her husband presented me with a bunch of radishes and said
that they would be glad, whenever she came to see me profes
sionally, to bring some farm produce. The next consultation
was rewarded with a bunch of turnips, and the following one
by some slightly withered corn. As I do not keep house, these
payments, making my treatment fee approximate ten cents,
happily were accepted on their sentimental value and given to
the next poor patient.

When the farmer and his wife realized that my care of her
health would have to continue for several months, they, honest
souls, wondered how they might meet the situation. They
were proud of not having had to go on government relief. I
wished to help them maintain self-respect and, as I had a patient
who needed broth, I endeavored to manage professional philan
thropy tactfully and so suggested, "Since you have brought me
so many vegetables, perhaps a little meat would be a change."
They shook their heads dolefully and we changed the subject.

The next week, however, they brought a scrawny, belligerent
goat and offered him to me with a grand gesture. As my garden

FLORIDA ON THE EDGE OF THE TROPICS 395

is a distinct asset to my life in Florida, I felt dubious about
accepting an animal which would probably break down all the
shrubbery inside of a week. From the recesses between his ribs,
I was sure he would nibble the grass off two acres of land in a
few days, for he had already broken away and made a devas
tating start.

In order to avoid hurting my patient s feelings, I remarked
speculatively, "If he were a nanny-goat the milk would be good
for a patient who greatly needs it."

Promptly it was objected, "If it had been a nanny, we would
have kept it for ourselves."

The embarrassment which ensued was resourcefully met by
the farmer. "Now, Doctor, the goat is yours. He pays for all
my wife is going to need for the next three months."

"Yes," I agreed, "that is satisfactory to me."

He drawled, "If you don t want him around here, I can board
him for you."

So through the years there has been much joy in practice.
All types and conditions of people with many and varied ill
nesses have enlarged my interests, and they have taxed my
resourcefulness and sympathy, as well as enabled me to use
constantly hard-earned scientific training and experience. In
retrospect and in anticipation of the future I rejoice that I
elected to be a physician and surgeon.

In meeting the challenges of life I have looked beyond the
immediate ^toward some goal, or have striven to triumph over
everyday encroachments. Adaptability is a cultivated virtue. To
find what is best in a situation where the odds are heavy re
quires persistence; and determination is necessary to retain
ideals when they are flouted. But it is sheer weakness to acqui
esce in the lowering of high standards. Every experience must
be treated as educational, not ignored nor regretted, but seen
through to the end. Everything in my life up to last Monday
I was able to use subconsciously between Monday and Wednes
day. Each new week pools all past experiences in its needs.

In addition to professional work there is a parental quality
which enables me to steer from the precipice an impulsive girl
or encourage those who are depressed to challenge difficulties.

396 A WOMAN SURGEON

All doctors heal sick minds as often as bodies. This draws upon
the resources of past observations and living knowledge. We
do not know specifically how, or when, we garner this educa
tion, but the individual richest in experience responds most
happily to the greatest number of stimuli and learns more truly
what are the essentials of life, what are trivialities, vanities and
other brittle playthings.

The change of home and office and setting up a new practice
have necessitated the greatest adaptation of my life, because the
difficulties have been the most subtle. The years ahead grow
more interesting. The summation of experience equips us to
enjoy more fully. I have grown to love Florida and its people,
to appreciate responsiveness that is not found in quite the same
general, and yet personal, way in a big city.

There is here more freedom for reflection and comprehen
sion of the human values underlying life in all countries, for
perspective is advantageous. There is no more appropriate
place for mental living than a garden. Mine is a constant joy.

As I look at my magnolia tree I am carried back to those
beside my home in Virginia and simultaneously transported
into the future. It is emblematic of resurrection. Its perfume
is as etherial, incomprehensible and immutable as immortality.
Its leaves symbolize eternal life; those that fade and fall are
immediately replaced in the continuous renewal as the half-
opened blossoms lift their communion chalices in the incensed
air.

Many fulfilments have come to me. None has touched me
more than when Doctor Emily Dunning Barringer, in June of
1934, at a banquet during the American Medical Association
meeting in Cleveland, with a most gracious speech, presented
me with a silver loving-cup on behalf of a hundred or more of
my old friends and colleagues in recognition of my work as
founder of the American Women s Hospitals in 1917. This
surprise honor was planned by Dr. Barringer, Dr. Irene T.
Kenney and Dr. Isabel MacMillan to record once more my
devotion to the service of women physicians during the World
War. It was a happy night full of cheer and "auld lang syne."

The practice of medicine has fortunately been both an

FLORIDA ON THE EDGE OF THE TROPICS 397

avocation and a vocation. It has pooled all of my resources,
hereditary and acquired, in concentration on the major re
sponsibilities of diagnosis, treatment and cure, success in which
is possible only when each patient s background is taken into
account in all its aspects social, economic, psychological, in
dustrial, etc. This has intensified my life and caused me to
comprehend broader family and racial values which do not
limit themselves to the United States but lead to an increasing
realization of the medical as well as the economic interdepend
ence of nations. The study of imported diseases, effects of alti
tudes and latitudes, resistance to certain climates, national diets
and occupations, is part of the progress of medicine.

Impersonal thinking has many advantages. I have, of course,
had defeats and discouragements; been disappointed in things
and people; found earnest efforts unavailing, misunderstand
ings persistent. But life has its compensations. As cruel as
personal emotional reactions have been at times, I have found
consolation in activities which keep my mind vibrant toward
the progress of our day.

My philosophy of life has been one of action. In retrospect
I realize that has been the keynote of my thinking and my do
ing. It has brought me happiness. To the physician the value
of clear vision lies in its manifestation as patient and good work.
Insight and inspiration take many forms of service as they are
personalized to benefit humanity. Once propelled into action
for a specific end, the vision cannot falter, cannot admit of pos
sible failure. Each of us strengthen our practical idealism by
persistent faith in the justice and value of what we do and this
has guided me through all of my undertakings. But in those
ventures there has been another faith faith in the best in every
one of my fellow human beings. I would never have launched
the American Women s Hospitals, the International Serbian
Education Committee, or any other philanthropic effort, if I
had not been confident that I could rely upon the noblest quali
ties in other people to respond. In hours of stress or seeming
defeat, this faith has helped me to look beyond temporary
jeopardies to that inner virtue in all mankind. It has not failed.

As the years approach, in which fireside companionship is

398 A WOMAN SURGEON

considered life s compensation for years of active work, I have
instead the world comradeship of people in New Zealand, Fin
land and other countries where the same developmental forces
which have activated me bring a reciprocity of friendship that
outrides time and space. For example, a man whom I have
never met, whose present existence I am not sure of, remains
one of the most stimulating forces in my life. He built a bridge
over the Tsavo River in Africa. In a book of his experiences
he recorded with simple dignity the marvelous achievement,
which included months of planning and effort, the management
of thousands of black natives and Hindus during the long hot
task, the killing of ten man-eating lions. On the completion of
his work his best friend came to see it and asked, "Is that all?"
I rode over his bridge and would like to have him know the
deep appreciation I felt for all he put into its building. An
other literary friend who has been dear to me was the curator
of the Maori Museum in New Zealand. His knowledge of the
anthropology of a people, their conquest, adaptation and
piquancy, has added zest to my life although I knew him for
only two hours.

How do I spend my evenings? Variously. At twilight in a
rowboat or a canoe or in walking by wooded lakes. By listen
ing to music, by visiting and receiving friends, by general read
ing and by keeping up with scientific journals because I cannot
bear to have any important item escape me.
? For six years I have made a special study of arthritis, and as
with any specialty, everything else seems to relate to it. Each
year I have followed my winter practice in Florida with inten
sive summer study in New York City of this age-old disease,
stirred always not only by the possibility of making cripples
walk, but by the opportunity of assisting the restoration of
mental as well as of physical efficiency. It is now five years
since I have had a vacation.

The secondary interest of my life has been the development
of women as it relates to evolution throughout every civiliza
tion. I have decided this summer to put an accent upon this
interest and call it a vacation. I am going to Persia, or Iran as
it is now called, to observe the amazing social changes there;

FLORIDA ON THE EDGE OF THE TROPICS 399

electrifying modernity alongside age-old traditions, people
living next to one another illustrating every significant change
during the past two thousand years. I am anxious to meet
Mohammedan women and see how they, with the help of pro
gressive men, are making a new concept of life.

THE END

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