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Full text of "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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