“Medicine is so broad and so closely interwoven with general interests, dealing as it does with all ages, sexes, and classes, and yet of so personal a character in its individual appreciations, that it must be regarded as one of those great departments of work in which the cooperation of men and women is needed to fulfill all its requirements.”
-Elizabeth Blackwell, First Female U.S. Physician, 1849
Women: Centuries of Care
Legend has it that the first female physician practiced medicine centuries ago. Her name was Metrodora and it’s estimated that she was a Greek doctor sometime between 200-400 CE. Not only did she blaze a trail as a practicing physician but she left another legacy: the oldest known medical book written by a woman, On the Diseases and Cures of Women.
Before Metrodora and since, women have been the caregivers of their families and their communities but, until astonishingly recent history, almost all have been blocked from practicing medicine professionally.
Elizabeth Blackwell: Pioneer
When Elizabeth Blackwell, the first female physician in the U.S., was admitted to medical school in 1847, it happened almost by accident. Every prestigious school she had applied to rejected her. The admissions officials at Geneva Medical College, a smaller, less-prestigious school on the Canadian border in NY, couldn’t quite reject her: she was too well-qualified. But they didn’t want to make the decision themselves, choosing to pass the responsibility off to their students. Believing the request for Blackwell’s admission to be a joke, the student body voted unanimously to admit her. And, so, she arrived.
But the small town that housed the medical school wasn’t ready for her. She describes being stared at “like a curious animal” as she walked through town to and from class, and the experience of being considered a “bad woman” or an “insane” woman for wanting to do “men’s work.”
Her experience in the classroom wasn’t much better. When her classmates prepared for a discussion on the male reproductive system, she was asked to leave the room so her “female sensibilities” wouldn’t be offended. As the audacious pioneer she was, she refused.
Women in Medicine in the 1960s
Today, albeit by the slightest margins, there are more women enrolled in medical school than men. But the climb to get here hasn’t been easy.
When our friend and retired movement disorder specialist Cindy Comella, MD, grew up in the 1960s, she had no real-life role models that reminded her: you, too, can be a doctor. In fact, she didn’t meet a woman physician until she attended medical school in the late 1970s and had a female professor.
Marilyn Hart, dressed in a nurse’s costume as a child.
Marilyn Hart, MD, a PMD Alliance ambassador and retired family medicine physician, affirmed Dr. Comella’s story. “When I was little in the early 1960s,” she said, “as a woman, I saw that you could only be a nurse or a teacher or a housewife. You weren’t a lawyer. You weren’t a business executive. And you weren’t a doctor.” She, too, didn’t meet her first female physician until she was in medical school.
For both these women, going to medical school meant stepping into a world dominated by men. When I asked Dr. Hart how many women were enrolled in medical school with her, she pulled out her black and blue yearbook titled “Clinic” and counted: 142 men and only 20 women.
Gender Gaps in Medicine
Dr. Comella is grateful: she went to Cincinnati Medical College, which was known for its diversity. She bonded with other women classmates, many of whom went on, she said, “to achieve incredible careers.” But respect and empowerment weren’t everywhere. “My parents raised me to think that I was as good as anyone else, man or woman,” she told me. “But as a young doctor, one thing I will always remember is the patients who would take one look at me and ask if ‘the doctor’ was coming in after I was done.”
What sticks out most in Dr. Hart’s memory is preferential treatment and the unexpected ways it showed up in a hospital’s culture. “At the time,” she said, “all the nurses were women and they wanted to marry doctors.” She remembers the nurses slipping their phone numbers into the pockets of her male colleagues or baking them brownies. “Nobody was making me brownies,” she laughed. It sounds funny now, but the social discrimination was pernicious.
Marilyn M. Hart, MD, is a recently retired, board certified Family Practice Physician, residing in Tucson, Arizona. Originally from Philadelphia, Dr. Hart attended Thomas Jefferson Medical School and the University of Virginia. She has practiced medicine in four different states and eventually settled in Tucson, where she and her husband, Philip McIntyre, raised their three children and have lived for 27 years. Dr. Hart enjoys spending time with her new grandsons, being involved with music in any form, reading, mahjong cards, museums, and being with people. In 2017, Dr. Hart was diagnosed with Parkinson’s and is actively living and participating in the PD community. She is a PMD Alliance Ambassador.
Cynthia L. Comella, MD is a Professor in the Department of Neurological Sciences at Rush University Medical Center in Chicago, IL. She completed her medical training at the University of Cincinnati Medical College and did her internal medicine and neurology residencies at Rush University Medical Center where she also completed fellowships both in movement disorders and sleep disorders. She is an active member of the Movement Disorders Society (MDS) and was the first woman officer in the MDS. She has been active in the American Academy of Neurology, serving on the Science committee, Chair of the Education committee, the Annual Meeting subcommittee, editorial board of Continuum and the Board of Directors of the AAN institute and chairs the Women in Leadership task force. She has also conducted dystonia research, working to develop new rating scales for dystonia and evaluating the safety and efficacy of oral medications and botulinum toxins for dystonia. Dr. Comella is the author or co-author of more than 165 articles, reviews, research papers, books, and book chapters related to Movement disorders. She has recently written several review articles related to Restless Leg Syndrome treatment.