Headstrong

Mary Putnam Jacobi

1842–1906

Medicine • American

A warning from Edward Clarke, MD, professor at Harvard: “There have been instances, and I have seen such, of females . . . graduated from school or college excellent scholars, but with undeveloped ovaries. Later they married, and were sterile.” He goes on to explain how reproductive organs fail to thrive. “The system never does two things well at the same time. The muscles [note: muscles = menstruation] and the brain cannot functionate in their best way at the same moment.” These passages are from Clarke’s book, Sex in Education; or, A Fair Chance For Girls, published in 1873. The gist: Exerting oneself while on the rag is dangerous. Therefore educating women is dangerous. For a woman’s own safety, she should not pursue higher education. The womb is at stake.

Today, it’s easy to write off Clarke’s thesis as one doctor’s nutty ramblings. His descriptions of students--“crowds of pale, bloodless female faces, that suggest consumption, scrofula, anemia, and neuralgia,” as a result of “our present system of educating girls”--sounds more like The Walking Dead than students at a university campus. But when A Fair Chance for Girls was published, administrators and faculty opposed to women in education hoisted up the book as a confirmation of their views, couched in an argument about safety.

Mary Putnam Jacobi thought the whole thing was hogwash. Jacobi, an American, was the first woman admitted to France’s Ecole de Medecine. It took a bit of wrangling, but once she was in, Jacobi found her medical training thrilling. Certainly there were people who doubted her ability to succeed--even her mother did some hand-wringing over her schooling--but Jacobi proceeded with ease and humor. In 1867, she wrote home to assure her mother, “I really am only enjoying myself . . . the hospitals present so much that is stimulating, (and do not be shocked if I add amusing) that I am never conscious of the slightest head strain.”

To battle Clarke’s assertions, Jacobi could have presented her personal experience as a counterargument. Her education at the Ecole de Medecine took place after she’d already received an MD in the United States. Medical school made Jacobi neither ill nor infertile. But bringing forward an autobiographical account when evidence was within reach was like feeling for your own heartbeat when it could be measured with a stethoscope.

Jacobi challenged Clarke’s thinly veiled justification for discrimination with 232 pages of hard numbers, charts, and analysis. She gathered survey results covering a woman’s monthly pain, cycle length, daily exercise, and education along with physiological indicators like pulse, rectal temperature, and ounces of urine. To really bring her argument home, Jacobi had test subjects undergo muscle strength tests before, during, and after menstruation. The paper was almost painfully evenhanded. Her scientific method-supported mic drop: “There is nothing in the nature of menstruation to imply the necessity, or even the desirability, of rest.” If women suffered from consumption, scrofula, anemia, and neuralgia, it wasn’t, as Clarke claimed, because they studied too hard.

Her study--sweeter for its evidence than its tone--won the Boylston Prize at Harvard University just three years after Clarke, a professor at the same school, published A Fair Chance. The Clarke versus Jacobi scholarly disagreement may sound like academic quibbling, a biased doctor against a rigorous one, but in the argument over who was allowed university admission, to have science on your side was hugely important. After Clarke’s paper fortified university walls, Jacobi systematically dismantled the barrier. Her paper was greatly influential in helping women gain opportunities in higher education--especially in the sciences.

Jacobi had wanted to be a doctor since childhood. “I began my medical studies when I was about nine years old,” she remembered. “I found a big dead rat and the thought occurred to me that if I had the courage, I could cut that rat open and could find his heart which I greatly longed to see . . . my courage failed me.” Although she tabled the exploratory surgery until she was trained to do it, her interest in the body never waned. In the meantime, Jacobi wrote. Growing up in a family of well-known book publishers, she dabbled in her family’s business, placing stories in The Atlantic Monthly starting at age fifteen and later in the New-York Evening Post.

Jacobi’s father wasn’t thrilled to hear she’d decided to attend medical school. In response, he dangled the amount of her university tuition before her, a carrot that would be hers should she decide against higher education. Jacobi declined his offer, leaving for the Woman’s Medical College of Pennsylvania, in the early 1860s before continuing on to Paris for a second round of schooling. When her mother wrote requesting an update, Jacobi replied, “I think you are rather naive to ask me if ‘I meet many educated French ladies who are physicians.’ Such a thing was never heard of.”

In Paris, an American was considered enough of a curiosity that after months of lobbying, Jacobi was able to claim the first spot at the Ecole de Medecine ever awarded to a woman. There were a few stipulations attached to her attendance. She had to enter lectures through a door not used by other students and sit near the professor. Jacobi joked that hers would be the first petticoat the school had seen since its founding. However strange the circumstances, Jacobi found assimilation easy. She wrote, “I . . . feel as much at home as if I had been there all my life.”

Upon returning to the United States after five years in Paris, Jacobi began lecturing at Women’s Medical College of the New York Infirmary for Women and Children, practicing medicine and carving out more opportunities for women in the field concurrently. Jacobi helped found the Women’s Medical Association of New York City in 1872, opened New York Infirmary’s children’s ward, and became the Academy of Medicine’s first female member. When she was diagnosed with a brain tumor, Jacobi documented the symptoms just as thoroughly and objectively as if she were responding to Clarke’s ridiculous claims. She titled the result, “Description of the Early Symptoms of the Meningeal Tumor Compressing the Cerebellum. From Which the Writer Died. Written by Herself.” Jacobi did like to get in the last word.



Anna Wessels Williams

1863–1954

Bacteriologist • American

Although Anna Wessels Williams believed collaboration was essential, she seized every moment of solitude. In her free time, she went up in stunt planes, teetering between the stomach-dropping danger of pre–World War I flight and the sublime feeling of gliding where so few others could. On the ground, she piled up speeding tickets, the allure of zipping around those in her way apparently too tempting to resist. Williams was alone, this time in the New York City Department of Health’s diagnostic laboratory, when she made one of the lab’s greatest discoveries. In 1894, she isolated a strain of diphtheria. That strain became crucial in developing higher yields of an anti-toxin needed for fighting the infection.

Diphtheria is under control now, but when Williams was working on the problem, it had reached “near-epidemic levels.” The disease hitched a ride on spittle transferred from one person to the next on a cough or during conversation. At first it just caused fever or the chills, but when it really settled in, it could wreak havoc on the heart and nervous system. Children were dying, and those living in poverty were disproportionately at risk.

An antitoxin for diphtheria had been discovered just four years earlier in 1890 by Emil von Behring. It was a major accomplishment, a breakthrough that would earn von Behring the Nobel Prize in Medicine in 1901. Finding a method of infection therapy is one thing, but deploying it globally is entirely another. His antitoxin needed a toxin to activate it, and in the intervening years, scientists were stuck with a low yield of the starter. There wasn’t enough of the serum to go around. Meanwhile, the disease continued to leap from person to person, killing thousands of children per year.

Under the guidance of William H. Park at the Department of Health’s diagnostic laboratory, Anna Williams got to work on finding a strain of the bacteria that could produce a powerful toxin to activate the antitoxin, and in high enough volume to produce it at scale. The breakthrough came while Park was away on vacation. Williams isolated a strain of bacteria that could produce a toxin 500 times more potent than what was previously available.

The strain was named Park-Williams No. 8. Gracious about her boss’s inclusion, she said she was “happy to have the honor of having my name thus associated with Dr. Park.” Williams recognized the necessity of collaboration in research. After all, Williams’s own experiments were bolstered by von Behring’s initial breakthrough. But over time, Park-Williams No. 8 proved too many syllables for the people who worked with it; informally, it became known as Park 8. Just like that, Williams’s pioneering work was clipped from view.

Name recognition wasn’t why Williams got into science; she wasn’t concerned with how many strains of bacteria her name was slapped on to. Her sense of purpose originated from addressing a medical need. Where real-world good is concerned, Park 8 succeeded spectacularly. Since the new strain increased the antitoxin’s availability and slashed cost, Williams was instrumental in slowing down the spread of disease. Within a year of her discovery, the diphtheria antitoxin went into mass production. To address the staggering demand, mass quantities of the preparation were shipped to physicians in the United States and England without charge.

Williams’s decision to go into medical science originated from a time when she witnessed one bad event spin out of control without the knowledge or training to intervene. For Williams, the stillbirth of her sister’s baby in 1887 and the near death of her sister during childbirth would have at least been partially avoidable had the attending physician been more thoroughly trained. The horrific incident gave Williams resolve. She would battle such medical ignorance with her own education.

Williams quit her job as a schoolteacher almost immediately after the incident in order to enroll in classes at the Women’s Medical College of the New York Infirmary. She found her schoolwork thrilling: “I was starting on a way that had been practically untrod before by a woman. My belief at the time in human individuality, regardless of sex, race, religion or any factor other than ability was at its strongest. I believed, therefore, that females should have equal opportunities with males to develop their powers to the utmost.” By 1891, she’d earned her MD.

At the New York City Department of Health, opportunities to tackle nasty diseases appeared almost immediately. That diphtheria breakthrough? It happened in 1894, within her first year at the organization, when she was still just a volunteer. She was added to the payroll the following year and given a title: assistant bacteriologist.

Creative and fearless, Williams took a sabbatical in Paris in 1896 to research scarlet fever at the Pasteur Institute. There she was met with a culture of deep secrecy, where discussion of time-sensitive research was strictly off-limits and research tools like cadavers were not to be shared. She hoped to do for scarlet fever what she’d done for diphtheria, but the research was a bust.

The trip was redeemed by rabies, or rather by the problems of diagnosis and prevention that the disease posed. When it was time for Williams to return to the United States, she took a culture of the rabies vaccine with her. In her lab at the New York City Department of Health, she cared for the culture, coaxing it to grow. Eventually she had enough to produce vaccinations for fifteen people. Following Williams’s interest in it, producing the vaccine became a major initiative in the United States.

Having handed off one part of the problem, Williams flipped back to studying detection. Rabies was maddeningly difficult to diagnose, and by the time scientists concretely pinpointed the disease in a patient, the opportunity for a vaccine had already expired. Rabies affects the nervous system and brain, so Williams started to look for flags the virus plants inside the body that might be used for early detection. And sure enough: Williams noticed that the virus was manhandling the structure of cells in the brain. It was major news, but Williams lost the headline again. While meticulously checking and double-checking her results, an Italian physician named Adelchi Negri independently discovered the cells. He beat her to the pages of a scholarly journal. Those rabies-affected cells are now called Negri bodies.

From rabies, Williams worked her way through research on venereal disease, eye infections, influenza, pneumonia, meningitis, and smallpox. Early on, her studies were powered by the drive “to find out about the what, why, when and where and how of the mysteries of life,” she explained. “This trait had increased with the years, and finally had become a passion.”

In 1934, Williams and nearly one hundred other workers were forced to retire by New York City mayor Fiorello La Guardia because they were over seventy years old. The mayor sent Williams packing, calling her “a scientist of international repute” on her way out the door. The mayor’s name became an airport. Williams didn’t need that kind of recognition; she was the one who actually flew.



Alice Ball

1892–1916

Chemistry • American

Jack London called Kalaupapa, a tile of land on the Hawaiian island of Molokai, “The pit of hell, the most cursed place on earth.” On three sides, the area is surrounded by ocean. On the fourth, it’s fenced in by a sheer two-thousand-foot cliff. It wasn’t easy to get in. It was even harder to get out.

The area’s occupants were struck with what was called the living death. Beginning in 1866 and lasting for eighty years, some eight thousand people with leprosy were ripped from their homes, arrested, and relocated to Kalaupapa, never to be seen again. For families, these departures were treated like deaths. A funeral was held, property was distributed, and families mourned the loss of a person still living. But sufferers were considered dangerous disease-spreaders and, without a cure, a lost cause.

Leprosy ravages the skin. It attacks the mucous membranes in the eyes, nose, and throat, and it goes after the peripheral nerves, located outside the brain and the spinal cord. The ability to feel pain goes, as do chunks of skin that develop into lesions. The damage is caused by a relative of tuberculosis. Although the disease is not as contagious as most think, to this day, doctors still don’t understand how it moves among patients.

For hundreds of years, the closest thing to leprosy medication was an oil that came from the seeds of a chaulmoogra tree. People smeared it on the skin, swallowed it, and even injected it, but each delivery method was problematic. Rubbing it on like lotion didn’t have any negative effects, but it also didn’t do much good. The oil’s acrid taste made swallowing it nauseating. When it was injected, the treatment just sat under the skin in a lump getting along exactly as you’d expect oil and water to. The injection became a subcutaneous snail; as it traveled, it burned. There were no good solutions.