Dr. Elsie Inglis

Dr. Jex Blake had founded the Edinburgh School of Medicine for Women, and it was there that Elsie received her first medical teaching. Everything was still in its initial stages, and every step in the higher education of women had to be fought and won, against the forces of obscurantism and professional jealousy.

University Commissions might issue reports, but the working out of them was left in the hands of men who were determined to exclude women from the medical profession.

Clinical teaching could only be carried on in a few hospitals. Anatomy was learnt under the most discouraging circumstances. Mixed classes were, and still are, refused. Extra-mural teaching became complicated, on the one hand, by the extra fees which were wrung from women students, and by the careless and perfunctory teaching accorded by the twice-paid profession. Professors gave the off-scourings of their minds, the least valuable of their subjects, and their unpunctual attendance to all that stood for female students. It will hardly be believed that the Royal Infirmary of Edinburgh refused to admit women to clinical teaching in the wards, until they had raised seven hundred pounds to furnish two wards in which, and in which alone, they might work. To these two wards, with their selected cases, they are still confined, with the exception of one or two other less important subjects. Medicals rarely belong to the moneyed classes, and very few women can command the money demanded of the medical course, and that women should have raised at once the tax thus put upon them by the Royal Infirmary is an illustration of how keenly and bravely they fought through all the disabilities laid upon them.

Women had always staunch friends among the doctors. The names of many of them are written in gold in the story of the opening of the profession to women. It has been observed that St. Paul had the note of all great minds, a passion to share his knowledge of a great salvation, with both Jews and Gentiles. That test of greatness was not conspicuous in the majority of the medical profession at the time when Elsie Inglis came as a learner to the gates of medical science. That kingdom, like most others, had to suffer violence ere she was to be known as the good physician in her native city and in those of the allied nations.

There are no letters extant from Elsie concerning her time with Dr. Jex Blake. After Mrs. Inglis’ death, Mr. Inglis decided to leave their home at Bruntsfield, and the family moved to rooms in Melville Street. Here Elsie was with her father, and carried on her studies from his house. It was not an altogether happy start, and very soon she had occasion to differ profoundly with Dr. Jex Blake in her management of the school. Two of the students failed to observe the discipline imposed by Dr. Jex Blake, and she expelled them from the school. Any high-handed act of injustice always roused Elsie to keen and concentrated resistance. A lawsuit was brought against Dr. Jex Blake, and it was successful, proving in its course that the treatment of the students had been without justification.

Looking back on this period of the difficult task of opening the higher education to women, it is easy to see the defects of many of those engaged in the struggle. The attitude towards women was so intolerably unjust that many of the pioneers became embittered in soul, and had in their bearing to friends or opponents an air which was often provocative of misunderstanding. They did not always receive from the younger generation for whom they had fought that forbearance that must be always extended to ‘the old guard,’ whose scars and defects are but the blemishes of a hardly-contested battle. Success often makes people autocratic, and those who benefit from the success, and suffer under the overbearing spirit engendered, forget their great gains in the galling sensation of being ridden over rough-shod. It is an episode on which it is now unnecessary to dwell, and Dr. Inglis would always have been the first to render homage to the great pioneer work of Dr. Jex Blake.

Through it all Elsie was living in the presence chamber of her father’s chivalrous, high-minded outlook. Whatever action she took then, must have had his approval, and it was from him that she received that keen sense of equal justice for all.

These student years threw them more than ever together. On Sundays they worshipped in the morning in Free St. George’s Church, and in the evening in the Episcopal Cathedral. Mr. Inglis was a great walker, and Elsie said, ‘I learnt to walk when I used to take those long walks with father, after mother died.’ Then she would explain how you should walk. ‘Your whole body should go into it, and not just your feet.’

Of these student days her niece, Evelyn Simson, says: —

‘When she was about eighteen she began to wear a bonnet on Sunday. She was the last girl in our connection to wear one. My Aunt Eva who is two years younger never did, so I think the fashion must have changed just then. I remember thinking how very grown up she must be.’

Another niece writes: —

‘At the time when it became the fashion for girls to wear their hair short, when she went out one day, and came home with a closely-cropped head, I bitterly resented the loss of Aunt Elsie’s beautiful shining fair hair, which had been a real glory to her face. She herself was most delighted with the new style, especially with the saving of trouble in hairdressing.

‘She only allowed her hair to grow long again because she thought it was better for a woman doctor to dress well and as becomingly as possible. This opinion only grew as she became older, and had been longer in the profession; in her student days she rather prided herself on not caring about personal appearance, and she dressed very badly.

‘Her sense of fairplay was very strong. Once in college there was an opposition aroused to the Student Christian Union, and a report was spread that the students belonging to it were neglecting their college work. It happened to be the time for the class examinations, and the lists were posted on the College notice-board. The next morning, the initials C.U. were found printed opposite the names of all the students who belonged to the Christian Union, and, as these happened to head the list in most instances, the unfair report was effectually silenced. No one knew who had initialed the list; it was some time afterwards I discovered it had been Aunt Elsie.

‘She was a beautiful needlewoman. She embroidered and made entirely herself two lovely little flannel garments for her first grand-nephew, in the midst of her busy life, then filled to overflowing with the work of her growing practice, and of her suffrage activities.

‘The babies as they arrived in the families met with her special love. In her short summer holidays with any of us, the children were her great delight.

‘She was a great believer in an open-air life. One summer she took three of us a short walking tour from Callander, and we did enjoy it. We tramped over the hills, and finally arrived at Crianlarich, only to find the hotel crammed and no sleeping accommodation. She would take no refusal, and persuaded the manager to let us sleep on mattresses in the drawing-room, which added to the adventures of our trip.

‘On the way she entertained us with tales of her college life, and imbued us with our first enthusiasm for the women’s cause.

‘When I myself began to study medicine, no one could have been more enthusiastically encouraging, and even through the stormy and somewhat depressing times of the early career of the Medical College for Women, Edinburgh, her faith and vision never faltered, and she helped us all to hold on courageously.’

In 1891 Elsie went to Glasgow to take the examination for the Triple Qualification at the Medical School there. She could not then take surgery in Edinburgh, and the facilities for clinical teaching were all more favourable in Glasgow.

It was probably better for her to be away from all the difficulties connected with the opening of the second School of Medicine for Women in Edinburgh. The one founded by Dr. Jex Blake was the Edinburgh School of Medicine for Women, and the one promoted by Elsie Inglis and other women students was known as the Medical College for Women. ‘It was with the fortunes of this school that she was more closely associated,’ writes Dr. Beatrice Russell.

In Glasgow she resided at the Y.W.C.A. Hostel. Her father did not wish her to live alone in lodgings, and she accommodated herself very willingly to the conditions under which she had to live. Miss Grant, the superintendent, became her warm friend. Elsie’s absence from home enabled her to give a vivid picture of her life in her daily letters to her father.

‘Glasgow, Feb. 4, 1891.

‘It was not nice seeing you go off and being left all alone. After I have finished this letter I am going to set to work. It seems there are twelve or fourteen girls boarding here, and there are regular rules. Miss Grant told me if I did not like some of them to speak to her, but I am not going to be such a goose as that. One rule is you are to make your own bed, which she did not think I could do! But I said I could make it beautifully. I would much rather do what all the others do. Well, I arranged my room, and it is as neat as a new pin. Then we walked up to the hospital, to the dispensary; we were there till 4.30, as there were thirty-six patients, and thirty-one of them new.

‘I am most comfortable here, and I am going to work like anything. I told Miss Barclay so, and she said, “Oh goodness, we shall all have to look out for our laurels!”’

‘Feb. 7, ’91.

‘Mary Sinclair says it is no good going to the dispensaries on Saturday, as there are no students there, and the doctors don’t take the trouble to teach. I went to Dr. MacEwan’s wards this morning. I was the first there, so he let me help him with an operation; then I went over to Dr. Anderson’s.

‘Feb. 9.

‘This morning I spent the whole time in Dr. MacEwan’s wards. He put me through my facings. I could not think what he meant, he asked me so many questions. It seems it is his way of greeting a new student. Some of them cannot bear him, but I think he is really nice, though he can be abominably sarcastic, and he is a first-rate surgeon and capital teacher.

‘To-day, it was the medical jurists and the police officers he was down on, and he told story after story of how they work by red tape, according to the text-books. He said that, while he was casualty surgeon, one police officer said to him that it was no good having him there, for he never would try to make the medical evidence fit in with the evidence they had collected. Once they brought in a woman stabbed in her wrist, and said they had caught the man who had done it running away, and he had a knife. Dr. MacEwan said the cut had been done by glass and not by a knife, so they could not convict the man, and there was an awful row over it. Some of them went down to the alley where it had happened, and sure enough there was a pane of glass smashed right through the centre. When the woman knew she was found out, she confessed she had done it herself. The moral he impressed on us was to examine your patient before you hear the story.

‘A. is beginning to get headaches and not sleep at night. I am thankful to say that is not one of my tricks. Miss G. is getting unhappy about her, and is going to send up beef-tea every evening. She offered me some, but I like my glass of milk much better. I am taking my tonic and my tramp regularly, so I ought to keep well. I am quite disgusted when girls break down through working too hard. They must remember they are not as strong as men, and then they do idiotic things, such as taking no exercise, into the bargain.

‘Dr. MacEwan asked us to-day to get the first stray £20,000 we could for him, as he wants to build a proper private hospital. So I said he should have the second £20,000 I came across, as I wanted the first to build and endow a woman’s College in Edinburgh. He said he thought that would be great waste; there should not be separate colleges. “If women are going to be doctors, equal with the men, they should go to the same school.” I said I quite agreed with him, but when they won’t admit you, what are you to do? “Leave them alone,” he said; “they will admit you in time,” and he thought outside colleges would only delay that.

‘This morning in Dr. MacEwan’s wards a very curious case came in. Some of us tried to draw it, never thinking he would see us, and suddenly he swooped round and insisted on seeing every one of the scribbles. He has eyes, I believe, in the back of his head and ears everywhere. He forgot, I thought, to have the ligature taken off a leg he was operating on, and I said so in the lowest whisper to M. S. About five minutes afterwards, he calmly looked straight over to us, and said, “Now, we’ll take off the ligature!”

‘I went round this morning and saw a few of my patients. I found one woman up who ought to have been in bed. I discovered she had been up all night because her husband came in tipsy about eleven o’clock. He was lying there asleep on the bed. I think he ought to have been horse-whipped, and when I have the vote I shall vote that all men who turn their wives and families out of doors at eleven o’clock at night, especially when the wife is ill, shall be horse-whipped. And, if they make the excuse that they were tipsy, I should give them double. They would very soon learn to behave themselves.

‘As to the father of the cherubs you ask about, his family does not seem to lie very heavily on his mind. He is not in work just now, and apparently is very often out of work. One cannot take things seriously in that house.

‘In the house over the Clyde I saw the funniest sight. It is an Irish house, as dirty as a pig-sty, and there are about ten children. When I got there, at least six of the children were in the room, and half of them without a particle of clothing. They were sitting about on the table and on the floor like little cherubs with black faces. I burst out laughing when I saw them, and they all joined in most heartily, including the mother, though not one of them saw the joke, for they came and stood just as they were round me in a ring to see the baby washed. Suddenly, the cherubs began to disappear and ragged children to appear instead. I looked round to see who was dressing them, but there was no one there. They just slipped on their little black frocks, without a thing on underneath, and departed to the street as soon as the baby was washed.

‘Three women with broken legs have come in. I don’t believe so many women have ever broken their legs together in one day before! One of them is a shirt finisher. She sews on the buttons and puts in the gores at the rate of 4½d. a dozen shirts. We know the shop, and they sell the shirts at 4s. 6d. each. Of course, political economy is quite true, but I hope that shopkeeper, if ever he comes back to this earth, will be a woman and have to finish shirts at 4½d. a dozen, and then he’ll see the other side of the question. I told the woman it was her own fault for taking such small wages, at which she seemed amused. It is funny the stimulating effect a big school has on a hospital. The Royal here is nearly as big and quite as rich as the Edinburgh Royal, but there is no pretence that they really are in their teaching and arrangements the third hospital in the kingdom, as they are in size. The London Hospital is the biggest, and then comes Edinburgh, and this is the third. Guy’s and Bart.’s, that one hears so much about, are quite small in comparison, but they have big medical schools attached. The doctors seem to lie on their oars if they don’t have to teach.

‘Feb. 1892.

‘I thought the Emperor of Germany’s speech the most impertinent piece of self-glorification I ever met with. Steed’s egotism is perfect humility beside it. He and his house are the chosen instruments of “our supreme Lord,” and anybody who does not approve of what he does had better clear out of Germany. As you say, Makomet and Luther and all the great epoch-makers had a great belief in themselves and their mission, but the German Emperor will have to give some further proof of his divine commission (beyond a supreme belief in himself) before I, for one, will give in my submission. I never read such a speech. I think it was perfectly blasphemous.

‘The Herald has an article about wild women. It evidently thinks St. Andrews has opened the flood-gates, and now there is the deluge. St. Andrews has done very well – degrees and mixed classes from next October. Don’t you think our Court might send a memorial to the University Court about medical degrees? It is splendid having Sir William Muir on our side, and I believe the bulk of the Senators are all right – they only want a little shove.’

In Glasgow the women students had to encounter the opposition to ‘mixed classes,’ and the fight centred in the Infirmary. It would have been more honest to have promulgated the decision of the Managers before the women students had paid their fees for the full course of medical tuition.

Elsie, in her letters, describes the toughly fought contest, and the final victory won by the help of the just and enlightened leaders in the medical world. ‘So here is another fight,’ writes the student, with a sigh of only a half regret! It was too good a fight, and the backers were too strong for the women students not to win their undoubted rights. Through all the chaffing and laughter, one perceives the thread of a resolute purpose, and Elsie’s great gift, the unconquerable facing of ‘the Hill Difficulty.’ True, the baffled and puzzled enemy often played into their hands, as when Dr. T., driven to extremity in a weak moment, threatened to prevent their attendance by ‘physical force.’ The threat armed the students with yet another legal grievance. Elsie describes on one occasion in her haste going into a ward where Dr. Gemmel, one of the ‘mixed’ objectors, was demonstrating. She perceived her mistake, and retreated, not before receiving a smile from her enemy. The now Sir William MacEwan enjoyed the fight quite as much as his women students; and if to-day he notes the achievements of the Scottish Women’s Hospitals, he may count as his own some of their success in the profession in which he has achieved so worthy a name. The dispute went on until at length an exhausted foe laid down its weapons, and the redoubtable Dr. T. conveyed the intimation that the women students might go to any of the classes – and a benison on them!

The faction fight, like many another in the brave days of old, roared and clattered down the paved causeways of Glasgow. Dr. T., in his gate-house, must have wished his petticoat foes many times away and above the pass. If he, or any of the obstructionists of that day survive, we know that they belong to a sect that needs no repentance. They may, however, note with self-complacency that their action trained on a generation skilled in the contest of fighting for democratic rights in the realm of knowledge. It is a birthright to enter into that gateway, and the keys are given to all who possess the understanding mind and reverent attitude towards all truth.

‘Nov. 1891.

‘Those old wretches, the Infirmary Managers, have reared their heads again, and now have decided that we are not to go to mixed classes, and we have been tearing all over the wards seeing all sorts of people about it. I went to Dr. K.’s this morning – all right. Crossing the quadrangle, a porter rushed at me and said, “Dr. T. wants to see all the lady students at the gate-house.” I remarked to Miss M., “I am certainly not going to trot after Dr. T. for casual messages like that. He can put up a notice if he wants me.” We were going upstairs to Dr. R. when another porter ran up and said, “Dr. T. is in his office. He would be much obliged if you would speak to him.” So we laughed, and said that was more polite anyhow, and went into the office. So he hummed and hawed, looked everywhere except at us, and then said the Infirmary Managers said we were not to go to mixed classes. So I promptly said, “Then I shall come for my fees to-morrow,” and walked out of the room. I was angry. I went straight back to Dr. K., who said he was awfuly sorry and angry, and he would see Dr. T., but he was afraid he could do nothing.

‘So here is another fight. But you see we cannot be beat here, for the same reason that we cannot beat them in Edinburgh. Were the managers, managers a hundred times over, they cannot turn Mr. MacEwan off.

‘The Glasgow Herald had an article the other day, saying there was a radical change in the country, and that no one was taking any notice of it, and no one knew where it was to land us. This was the draft ordinance of the Commissioners which actually put the education of women on the same footing as that of men, and, worse still, seemed to countenance mixed classes. The G. H. seems to think this is the beginning of the end, and will necessarily lead to woman’s suffrage, and it will probably land them in the pulpit; because if they are ordinary University students they may compete for any of the bursaries, and many bursaries can only be held on condition that the holder means to enter the Church! You never read such an article, and it was not the least a joke but sober earnest.

‘I saw Dr. P. about my surgery. The chief reason I tried to get that prize was to pay for those things and not worry you about them. I want to pass awfully well, as it tells all one’s life through, and I mean to be very successful!

‘Dr. B. has the most absurd way of agreeing with everything you say. He asked me what I would do with a finger. I thought it was past all mending and said, “Amputate it.” “Quite so, quite so,” he said solemnly, “but we’ll dress it to-day with such and such a thing.” There were two or three other cases in which I recommended desperate measures, in which he agreed, but did not follow. Finally, he asked Mr. B. what he would do with a swelling. Mr. B. hesitated. I said, “Open it.” Whereupon he went off into fits of laughter, and proclaimed to the whole room my prescriptions, and said I would make a first-rate surgeon for I was afraid of nothing.

‘It is one thing to recommend treatment to another person and another to do it yourself.

‘Queen Margaret is to be taken into the University, not affiliated, but made an integral part of the University and the lecturers appointed again by the Senators. That means that the Glasgow degrees in everything are to be given from October, Arts, Medicine, Science, and Theology. The “decrees of the primordial protoplasm,” that Sir James Crichton-Browne knows all about, are being reversed right and left, and not only by the Senatus Academicus of St. Andrews!’

The remaining letters are filled with all the hopes and fears of the examined. Mr. MacEwan tells her she will pass ‘with one hand,’ and Elsie has the usual moan over a defective memory, and the certainties that she will be asked all the questions to which she has no answering key. The evidences of hard and conscientious study abound, and, after she had counted the days and rejoined her father, she found she had passed through the heavy ordeal with great success, and, having thus qualified, could pass on to yet unconquered realms of experience and service.

CHAPTER V

LONDON

THE NEW HOSPITAL FOR WOMEN

DUBLIN

THE ROTUNDA

1892–1894

‘We take up the task eternal and the burden and the lesson, Pioneers, O Pioneers.’ – Walt Whitman

After completing her clinical work in Glasgow, and passing the examination for the Triple Qualification in 1892, it was decided that Elsie should go to London and work as house-surgeon in the new Hospital for Women in the Euston Road. In 1916 that hospital kept its jubilee year, and when Elsie went to work there it had been established for nearly thirty years. Its story contains the record of the leading names among women doctors. In the commemorative prayer of Bishop Paget, an especial thanksgiving was made ‘for the good example of those now at rest, Elizabeth Blackwell, and Sophia Jex Blake, of good work done by women doctors throughout the whole world, and now especially of the high trust and great responsibility committed to women doctors in this hour of need.’ The hearts of many present went over the washing seas, to the lands wasted by fire and sword, and to the leader of the Scottish Women’s Hospitals, who had gained her earliest surgical experience in the wards of the first hospital founded by the first woman doctor, and standing for the new principle that women can practise the healing art.