Pioneers of Excellence: The Women of Hopkins Medicine Jane Sellman ---------------------------- Special to The Gazette In 1896, a distinguished middle-aged man accosted Dorothy Reed as she disembarked from a trolley near an imposing red brick building on Broadway. "Are you entering [here]?" he asked, gesturing toward the Johns Hopkins School of Medicine building. "Yes," she answered. "Don't," he said. Reed, undaunted, ignored the advice of then Hopkins physician-in-chief William Osler. It was a decision that worked out well for both parties. Reed would go on to excel at her studies and as a physician, and Hopkins would go on to benefit from the accomplished scholarship, research and clinical practice of Reed and the dozens of other women who were pioneers in the male-dominated field of medicine. Women have always played a vital role in Hopkins medicine. While the hospital accepted its first patients in 1889, the establishment of the medical school was held up several years because of "a precarious financial situation," writes John C. Schmidt in Johns Hopkins: Portrait of a University. The problem was substantially resolved in 1892 through the efforts of the Women's Medical Fund, led by Mary Elizabeth Garrett's $354,764 contribution. Garrett was happy to help the school reach its $500,000 funding goal, in part on the condition that women be admitted on the same basis as men. Mary Packard was the first female graduate of the School of Medicine. Since then, 1,290 women have graduated from the school. Many have been leaders in their fields of scientific inquiry and medical practice. Here are profiles of but a few of the first women at Hopkins who went on to gain international prominence in their respective disciplines. Like Dorothy Reed (Class of 1900), many women of varying backgrounds, temperaments and interests made that journey to Hopkins, but Garrett's ideals were not always realized. Women had to battle for admission to the school, as well as for internships, fellowships and residencies. They even had to fight for the privilege of renting space for an office practice. In some ways, that was the easy struggle. Oftentimes more difficult was having to contend with rude and uncouth behavior and personal indignities among fellow students and faculty. And it was not uncommon for women to be barred from particular lessons or demonstrations and to have to listen dispassionately to off-color stories told by professors in lecture halls. Dorothy Reed does not complain much in her memoirs of her treatment at Hopkins. But she had her share of battles to fight, including having to confront Henry Mills Hurd--the first superintendent of the hospital--in order to keep her spot as an intern in medicine, one she had earned rightfully due to her class standing. A friend and colleague even complained to her that he thought it unfair she should get an appointment that he wanted in medicine, though she had graduated far ahead of him in the class. When Dorothy Reed entered Hopkins in the late 1890s, she and the rest of the medical world knew little of Hodgkin's disease, and in fact thought it to be a form of tuberculosis. During training she worked in the pathology labs of doctors William Welch and William Osler. While there she began studies that led to the association of a particular cell and the microscopic changes in that cell with Hodgkin's disease and the recognition of it as a neoplastic disease of the lymphatic system and not a form of tuberculosis. The cell became known as the Reed cell or Reed-Sternberg cell. Reed's work in maternal and child health had possibly even more widespread influence. Though she married Charles Menden-hall and retired briefly to raise her children, she returned to her research in epidemiological studies on infant mortality. (Two of Reed's children died in infancy, one as the result of a mishandled delivery.) She developed a test to establish norms of size and weight for infants. When her husband's work during World War I took him to Washington, D.C., Reed became a medical officer for the U.S. Children's Bureau and worked on behalf of war orphans in Europe. Later she traveled there and in Denmark conducted a study on methods of childbirth. She became convinced that American medical practices, which already relied heavily on technology, could be detrimental to mother and child. She published a book, Midwifery in Denmark, in which she advocated the use of midwives and a return to more natural methods of childbirth here in the United States. Reed's friend and classmate, Florence Sabin (Class of 1900), also found her strength in research. She developed an interest in the workings of the body's lymphatic system during her medical training. In fact her studies helped and influenced Reed's work. Sabin's extensive research and writing on the lymphatic system led to a series of monographs and to her work being recognized in 1913 by George R. Minot--an expert on hematology who developed a treatment for pernicious anemia--as one of the five most significant developments in biology. Sabin became a full professor of histology in 1917. But she was unhappy about being passed over for promotion to directorship of the anatomy department at Hopkins, so she eventually moved on to the Rockefeller Institute for Medical Research where she could concentrate totally on research. When she retired, she volunteered her time as an advocate for public health reform in her home state of Colorado. A president of the American Association of Anatomists, Sabin also became the first female member of the National Academy of Science. Helen B. Taussig ('27) may be the most well-known woman to earn her medical degree from Hopkins. She lent her name to the Blalock-Taussig procedure for correcting congenital heart defects, and she alerted the medical profession and public to the dangers of thalidomide. Growing up in Massachusetts, Taussig attended college at Radcliffe and Berkeley. She hoped to study public health medicine at Harvard, but the dean told her that while she could matriculate there, she could not earn a degree. "Who is going to be such a fool as to spend two years studying medicine and two years more in public health and not get a degree?" she asked. Having not gotten a satisfactory answer to that question, she took an anatomy course in Boston, where her intelligence and skill came to the attention of anatomy professor Alexander Begg, who encouraged her to attend Hopkins and specialize in cardiology. She entered Hopkins in 1923 and specialized in pediatrics and cardiology. In 1930, Taussig administered the cardiac clinic at the Harriet Lane Home, where she became interested in rheumatic fever and congenital heart defects. With Alfred Blalock and his technician, Vivien Thomas, she developed an idea for an operation to help children with cyanotic congenital heart defect, the "blue baby syndrome." This syndrome involves a malformation of the heart that interferes with the amount of blood passing through the pulmonary circuit. The Blalock-Taussig operation redirects the blood flow so that an adequate volume passes through the pulmonary circuit. In the early 1960s a colleague alerted Taussig to the possible link between a commonly prescribed tranquilizer thalidomide and a devastating birth deformation called phocomelia (defective development of the arms or legs, or both.) She traveled to Europe where the drug had been commonly prescribed and reported her findings to her colleagues and the public. Caroline Bedell Thomas ('30) became a pioneer in the treatment and prevention of acute rheumatic fever. The major obstacle to her earning a medical degree proved to be neither prejudice nor societal disapproval. It was a microscope. While in training, she used a monocular scope and experienced severe headaches and vision problems. One international authority on ophthalmology told her to give up, that her condition could not be cured. But a friend recommended William H. Wilmer, professor of ophthalmology at Hopkins, who discovered the cause of her vision problem and corrected it with eye exercises. Going on with her studies, Bedell Thomas became drawn to the mysteries of streptococcal infections through the influence of her classmate and friend, Ann Kuttner, and by the work of Rebecca Lancefield, who was a pioneer in the identification of various strains of the bacteria. Bedell Thomas became interested in the relationship between streptococcal infections and acute rheumatic fever. Such infections preceded rheumatic fever, and she theorized that knocking out the strep infection could prevent acute rheumatic fever, a debilitating and recurring disease that eventually killed its young victims. She learned from colleague Perrin H. Long of success treating beta hemolytic strep with sulfanilamide and decided to try it with the patients in her clinic. Treating those patients prophylactically with the drug, she not only prevented the strep infection but the bouts of rheumatic fever as well. Though she first announced her findings in 1937, she was met with opposition and discouragement. This prophylaxis against rheumatic fever did not receive official recognition until 1952. Despite a lack of support, she and her unpaid staff continued to treat patients with sulfanilamide donated by the manufacturer. In 1957, she received the Bruce Award in Preventive Medicine from the American College of Physicians. Baltimoreans are likely familiar with the Cone Collection at the Baltimore Museum of Art. With her sister Etta, Claribel Cone assembled the impressive collection dominated by the work of the French Impressionists. In the 1890s Claribel took postgraduate courses at Hopkins, studying with doctors Welch, Osler and Flexner. While there she met Gertrude Stein (who eventually flunked out). Legend has it that Cone typed the first draft of Stein's book Three Lives for her friend. But in any case the friendship influenced her, as it is Stein who has been credited with acquainting Cone with the work of artists like Henri Matisse. Cone, who served as president of the Women's Medical College of Baltimore in 1903, became an expert on tuberculosis and one of the judges at the International Tuberculosis Congress in Washington, D.C., in 1908. She also developed such a wide-ranging knowledge of art that she lectured frequently in Baltimore. "Art is the reflection of the spirit of the age in which we live," she said. Somehow she also found time to lend her energies to a variety of organizations including the Women's Civic League, League of Women Voters, Baltimore Museum of Art, the Baltimore City Medical Society and the American Association of Pathologists and Bacteriologists. Ruth Bleier also did postgraduate work at the medical school in the early 1950s. During her studies she acquired a particular interest in neuroanatomy and in the cause of social justice and peace. While living in Baltimore, she chaired the Maryland Committee for Peace, with an office just a few blocks north of Hopkins on Broadway. The committee promoted a peace ballot, advocating the banning of atomic and bacteriological weapons and supporting a meeting between the Soviet Union and the United States to negotiate for a world peace. The group, which collected signatures on the peace ballot and presented them to the U.S. and Soviet missions at the United Nations, was labeled communist-inspired by the House Un-American Activities Committee. Bleier later testified before that committee. And the Baltimore City Medical Society denied her membership in 1953. "The ultimate irony," she told the Evening Sun, "is that my interest in and work for peace, an effort to save human life and prevent the barbarism of mass murder by war, should be used as grounds to deny me membership in a medical society whose highest dedication is the saving of life." Bleier became a professor at the University of Wisconsin at Madison and there helped to found the Women's Studies Program. She studied and published in neuroanatomy, and as a feminist, critiqued what she felt to be bias in scientific inquiry and research studies. In 1984, she wrote Science and Gender, a summary of her conclusions. Stories of women in fields heretofore closed to them usually emphasize the indignities suffered at the hands of prejudiced men and women: of ill-treatment and rejection, of being socially outcast. Dorothy Reed's relatives, for instance, were embarrassed to tell people what she did at the medical school and lied about her whereabouts. But at a time when society recognizes Women's History Month, emphasis should remain on the accomplishments of these women, and on the lives they improved and saved. The lesson of their lives is not just for women but for anyone fighting an uphill battle or following a dream.