MUMJ History of Medicine 33

HISTORY OF MEDICINE

Dr. Emily Howard Jennings Stowe: A Battle Half Won

Sarah M. McMullen, BSc, MSc

THE CHANGING FACE OF MEDICINE stimulation and academic fulfillment, with the added addi- he face of medicine has changed drastically over the tional benefits of financial reward, security and flexibility. last three decades. In 1957/1958, a mere 8.5% of the Due in large part to the equal access to medical schools now Tmedical student body was female; in 1970/1971, this afforded to women, the number of female is esca- number had risen, but women comprised approximately lating. Imagine, then, applying to medical schools and being 20% of all medical students.1 (Table 1) Today, women com- categorically denied based, solely on the fact that you are prise more than half of student enrolment in Canadian med- female. Welcome to the world of Dr. Emily Stowe, the first ical schools.1,2 The difference is dramatic. Ostensibly, woman to practice medicine in . women choose medicine for the same reasons as men – pur- suit of a career that marries altruism to both intellectual THE LIFE AND TIMES OF EMILY STOWE May 1, 1831 saw the birth of Emily Howard Jennings, first daughter of the six children born to Hannah and Solomon Jennings. It was the first in a long line of firsts for Emily, who would live to bring new meaning to the pioneer- ing spirit that had initially brought her family to the rugged frontiers of Victorian Era . Because of the grueling nature of the every-day tasks required for survival in the 1800s, particularly in rural Canada, everyone in the family was expected to contribute equally, mothers and daughters as much as the fathers and sons. Intimately interwoven with this ethic was that of being raised in the Quaker tradition. A progressive, non-conform- ist Protestant denomination, the Society of Friends (Quakers) believed not only in freedom of worship, but that men and women were of equal value, and that a good edu- cation for everyone was paramount.4,5 As such, and rare for the times, Emily grew up believing strongly in both her own self-worth and in her right to an education. Having been comprehensively home-schooled along with her sisters, Emily began teaching in 1846 at the age of fif- teen. Dissatisfied with her wages and desiring to improve her qualifications, Emily enrolled at the Normal School for Upper Canada, a teacher’s college, because, at this time, women were still forbidden to attend university. When Emily graduated in 1854 with a first class teacher’s certifi- cate and was offered principalship at Public School, she broke new ground by becoming the first female principal of a public school. Dr. Emily Howard Jennings Stowe (1831-1903). Two years later, Emily married John Stowe and, of her Used with permission of Formac Publishing own volition, resigned from teaching to focus her consider- 34 History of Medicine Volume 1 No. 1, 2003 able energies on homemaking, about which she is quoted as Canada upon graduation in 1867, becoming the first having said: “I believe homemaking, of all the occupations Canadian woman to practice medicine in Canada. Not sur- that fall to woman’s lot, [is] the one most important and far prisingly, given her Quaker upbringing and the struggles she reaching in its effects upon humanity.”5 Over the next seven faced to get to where she did, her practice was dominated years, Mrs. Stowe gave birth to Augusta (1858), John (1861) largely by homeopathy and women’s health. and Frank (1863), and it was a period of happiness and pros- Not long after Emily’s return to Canada, however, the perity for the Stowes. When her husband was diagnosed provincial government passed legislation requiring with tuberculosis and sent to a sanatorium to recuperate, American-trained physicians to be licensed by the however, the burden of raising and providing for the family College of Physicians and Surgeons. In addition to an oral fell on Emily, who accepted the offer of a family friend and examination, licensing by the college required participation returned to teaching at the Nelles Academy. The silver lining in at least one session at a Canadian medical school. After to this dark cloud was Emily’s decision, wrought during the several applications and several refusals from the early course of John’s illness, to become a . Not School of Medicine, Emily and colleague Jennie Trout were only were the salaries much better than those for teachers, granted admission for one session. The mistreatment and but there was a growing need for women physicians who demoralization they suffered at the hands of both their col- could cope with the “problems of women.” Until that point, leagues and professors is well documented4,5,7, and led one physical examination and care of female patients had been of the women to exclaim to their professor that if the unbear- incomplete at best, as much a function of deferring to the able persecution were to continue, she would repeat his modesty of both patient and doctor5 as it was of the general words to his wife. This tactic apparently succeeded in discrimination women still suffered in the late 1800s.6 improving classroom conditions, at least for the remainder The impediments to this endeavor were immense. Emily, of that particular course.4,5,7 as sole parent while John was away, had to tend to the daily Despite participating in the session, Emily risked hefty needs of her family, work full-time to both support her fam- financial fines and continued to practice medicine unli- ily, save enough money to fund her medical education, and censed. Different sources present different accounts of why study for the college entrance exams. she remained unlicensed; however, it seems that it was a These hurdles overcome, the challenge of getting into combination of factors, most notably Emily’s belief that a medical school lay ahead. Apparently, medicine was both panel of male physicians would categorically “fail” her upon “too coarse”5 a study for what was considered the ‘weaker oral examination, that she resented the authority imposed sex.’ Furthermore, it was believed that women in the class- upon her, and that the College held out against her. Finally, room would cause disciplinary problems. Victorian society in 1880, Emily was granted her license. While sources vary was preoccupied with gendered views of womanhood, regarding the situation surrounding this, Fryer suggests that expecting women to be cultured, delicate, passionate and Emily’s fame and reputation – which had grown as much, if nurturing, as expressed emphatically by a reader of one of not more, as a result of her vocal and tireless work for the municipal newspapers published during that era: “To women’s than it had out of her medical practice – think of disclosing the human from divine, over which likely prompted the College to grant her license, as much to humanity bids us throw a veil of decency, or of having the avoid further ridicule as to rid themselves of a long-standing most sacred of feminine mysteries freely discussed before a thorn in their side.7 mixed class of young men and young women is not only Dr. Emily Stowe was forever piqued that women were shocking, but is disgusting and degrading.”4* not afforded the same rights as men, and she worked tire- Not surprisingly, Emily’s application to the Toronto lessly toward rectifying the situation. While studying in New School of Medicine was categorically denied. Disappointed York she had learned much about the suffrage and slavery but undeterred, Emily did not waste time reapplying in abolition movements rising in the U.S., and met with such Toronto. She left Canada to complete her medical training at famous suffragists as Dr. Anna Shaw and Susan B. Anthony, the New York Medical and Homeopathic College for with whom she became close friends. Dr. Stowe brought Women. The school had been founded in 1863 by Dr. much of what she learned back to Canada and embarked on Clemence Sophia Lozier and was, at that time, one of sever- a mission, to such an extent that it has been said: "Ultimately al medical schools in the United States that was admitting Emily Stowe the suffragist came to overshadow Emily and training .4,7 Dr. Stowe returned to Stowe the doctor.”7 Her activities and accomplishments in this realm are far too numerous to list, but they include founding the first Canadian women’s organization to fight * Excerpt from a letter to the Editor printed in Kingston, Ontario’s, the British for equal rights, the Women’s Literary Club (1876). This Whig (January 1883). While published after Canadian universities in general, and medical schools in particular, had begun admitting women in general, was later renamed the Toronto Women’s Suffrage Hacker4 pointed out that historians feel that it is nonetheless representative of Association (1883) to more accurately reflect its mandate. In the prevailing mood of the era; it is thus used in the same spirit herein. MUMJ History of Medicine 35 addition, Dr. Stowe helped found and acted as president for which more and more universities across the country were the Dominion Women’s Enfranchisement Association granting women admission. (1883). She crusaded tirelessly for the enfranchisement of Dr. Stowe and her husband, who had since become a den- women and particularly for the right to vote. Consequently, tist, ran a joint practice in Toronto. Eventually Augusta at the First Dominion Conference in 1890, Dr. Stowe was Stowe (-Gullen), Emily’s daughter, followed in her mother’s lauded as having begun Canada’s suffrage movement.5,7 footsteps. Augusta was the first woman be schooled at, and Throughout, the doctor also worked tirelessly toward graduate from, a Canadian medical school. having women allowed into medical school in Canada, and While Emily outlived her husband by 12 years, she died along the way helped found the Toronto Women’s Medical in 1903, fourteen years before women were granted the right College (1883). In 1884, through active petitioning on the to vote. part of Dr. Stowe and fellow suffragists, women won the right to be admitted into the University of Toronto’s Medical THE MORE THINGS CHANGE… School – almost twenty years after she herself had been While more women are currently embarking on medical denied entrance – amidst a national political climate in careers, barriers do still exist within the profession. Nation-

Table 1. Number of MDs Awarded by Canadian Universities by Sex, 1968-2001

Source: Canadian Medical Education Statistics, 2000, Association of Canadian Medical Colleges, www.acmc.ca 36 History of Medicine Volume 1 No. 1, 2003 wide statistics indicate that, with the exception of obstet- entirely populated by men; to wit, cardiovascular and tho- rics/gynecology in which 34.2% of practitioners are women, racic surgery, neurosurgery, orthopaedics and urology are all many medical and surgical sub-specialties remain almost specialties in which 90% of physicians are male8 (Table 2).

Table 2. Number and Percent Distribution of Physicians by Specialty and Sex, 2002

Note: Excludes residents and physicians over the age of 80; includes non-clinicians Source: CMA Master file, January 2002, Canadian Medical Association MUMJ History of Medicine 37

In contrast, women tend to gravitate toward family practice and sub-specialties such as pediatrics, community medicine, dermatology and medical genetics8 (Table 2), a trend that appears to be continuing.3 Reed and Buddeberg-Fischer3 suggest that the main obstacles for women in medicine include domestic responsi- bilities, rigidity in career structures and, even today, overt discrimination. Inter-related to these identifiable obstacles is that female work on average ten fewer hours per week than their male counterparts9 and in other parts of the world, are more likely to work part-time.3 A major consequence of working shorter hours and choosing a more family-friendly work pattern is that women may be bypassed for promotions; academic advancement tends to benefit those working almost 80 hours/week10 or those (pre- dominantly men) who engage in advanced clinical research. Thus, although women now constitute more than 50% of medical graduates, the ‘glass ceiling’ does exist in a manner analogous to that experienced by women in law, politics and business. And, although overt discrimination of women no longer exists, many women in the profession recognize and decry more subtle, systemic barriers to women’s advance- ment. The question is – where is the next Emily Stowe to take up this battle?

ACKNOWLEDGEMENT The author gratefully acknowledges Dr. David Wright, Hannah Chair in the History of Medicine at McMaster University, for thoughtful editing and enlightened sugges- tions. Jennifer Shapiro and Orli Goldberg are also thanked for their editorial contributions and support.

AUTHOR BIOGRAPHY Sarah McMullen BSc, MSc, is a medical student in her second year at McMaster University. She hopes to practice Internal Medicine in Eastern Canada upon graduation in 2005.

REFERENCES 1. Association of Canadian Medical Colleges. (2000). “Canadian Medical Education Statistics, 2000”, www.acmc.ca. 2. Dhalla, I.A., Kwong, J.C., Streiner, D.L., et al. (2002). “Characteristics of first- year students in Canadian medical schools.” Canadian Medical Association Journal, 166(8): 1029-35. 3. Reed, V., and Buddeberg-Fischer, B. (2001). “Career Obstacles for women in medicine: an overview.” Medical Education, 35: 139-147. 4. Hacker, C. (1974). The indomitable lady doctors. Clarke, Irwin & Company Limited: Toronto/Vancouver. 5. Ray, J. (1978). Emily Stowe (The Canadians). Fitzhenry & Whiteside Limited: Don Mills. 6. Dodd, D., and Gorham, D (eds). (1994). Caring and Curing: Historical Perspectives on Women and Healing in Canada. University of Ottawa Press: Ottawa. 7. Fryer, M. B. (1990). Emily Stowe, Canadian Medical Lives No. 6. Dundurn Press Limited: Toronto. 8. Canadian Medical Association. (2002). CMA Masterfile. 9. The JANUS Project (2001). College of Family Physicians of Canada. http://www.cfpc.ca/research/janus/janushome.asp. 10. Benz, E. J., Clayton, C.P., Costa, S.T. (1998). “Increasing academic internal medicine’s trends among female physicians from 1992-1999.” Academic Medicine, 74: 911-9.