Victorian Society recoiled at the thought of a woman learning about the human body. Yet in 1847, Elizabeth Blackwell was determined to become a physician--one who would not just improve the practice of medicine, but would also provide desperately needed medical care for the women of her time. Author Nancy Kline vividly recreates Blackwell's world and her struggle to gain knowledge and acceptance in the closed, males only world of medicine.

CHAPTER 1

One afternoon in 1859, Dr. Elizabeth Blackwell returned to visit the first houseshe remembered living in as a child, in the city of Bristol, England. She foundthe house, still standing on Wilson Street, much smaller than she had rememberedit. And as she gazed around the high-ceilinged entryway, she suddenly seemed tosee herself much smaller too, herself as a young child. Above her in the hall—justthere—her own small childish face seemed to be peering wistfully over thebanister, and the memory of a scene from her earliest childhood suddenly rose uparound her.

All the others were downstairs in the dining room, talking and laughing andeating, while Mr. Burnet, a flamboyant Irishman from Cork, hilariously heldforth. Of all the visitors who came to dinner at the Blackwell house—Christianmissionaries like himself, philanthropists, social reformers, travelersfreighted with tales—Mr. Burnet was the most compelling storyteller, the mostuproarious commentator on the world and his own adventures in it. He had theIrish gift of gab. The little girl Elizabeth longed to listen to him, perchedbeside her older sisters at the children's table where they sat on festiveoccasions like this, enchanted witnesses to other people's lives out in thegreat wide world beyond the familiar house and the sugar refinery attached to itthat constituted the universe they knew. But in her exile upstairs, allElizabeth could hear was a distant burst of merriment each time the servantsopened the dining room door to clear away the dishes or to carry in the nextcourse.

She was being punished that evening for some sin, some childish piece ofmisbehavior. Her name had been written carefully into The Black Book carriedeverywhere by her Aunt Bar, who kept track of the children's failings anddetermined the appropriate punishment. She had sentenced Elizabeth to exclusionfrom tonight's party. Upstairs it was lonely—dark and silent except for theoccasional scrabbling of night creatures under the eaves. It hurt to be shutout, it was enraging; and Elizabeth was filled with guilt at having been wickedenough to get her name into The Black Book. It would not happen again, shevowed.

Forty years later, standing in the familiar entryway, Elizabeth could notremember the specific mischief for which she had been blamed, but she wouldalways remember the punishment. Nor would she forget how unquestioningly she hadaccepted it. Aunt Bar was a grown-up; she must be right: "I always accepted,without thought of resistance the decrees of my superiors," Elizabeth wroteyears later. "The fact that those in authority were capable of injustice orstupidity was a perception of later growth."

During that same visit to the house on Wilson Street, as she stood pondering theimage of herself as a tiny child excluded, something truly startling happened.She heard the front door latch lift, clicking in the lock. She turned. Suddenly,there stood Papa Blackwell—who had been dead for many years—smiling directly ather, in the white flannel suit he used to wear during the hottest summer monthswhen he went to work in his sugar house. And then he was gone. He seemed toleave behind the sweet and cloying scent of sugarcane.

Elizabeth Blackwell first arrived in Bristol on February 3, 1821. She was thefourth baby born to Hannah and Samuel Blackwell, and she was so puny that herparents doubted she would live. They had lost a baby son the year before, andnow they watched this new baby daughter's struggle. They feared for her, such atiny helpless thing. She seemed about to die.

But Elizabeth survived. She had been given her life, however tenuously, and shetook hold of it and held on tight.

At the end of many days of watchfulness, when finally they felt sure that shehad really come to stay, Hannah and Samuel called her two older sisters into thebedroom. One at a time, one rung at a time, five-year-old Anna and then three-year-oldMarian clambered up the mahogany ladder at the side of HannahBlackwell's high canopied bed and stared at their new sister. They laughed. Theysaid her name. They welcomed her.

From the very first day, the runt of the litter never grew taller than five footone. As a child, Elizabeth looked much more frail and vulnerable than hersiblings. Her two older sisters, like their dark, high-spirited mother, werecurly-haired brunettes, whereas Elizabeth took after her father, gray-eyed andsomewhat grave, her blond hair straight and pale almost to invisibility. Fromthe very first, "Little Shy," as her father quickly nicknamed her, was Papa'schild. Elizabeth resembled him in more than simply physical ways. From him shetook her stern perfectionism and her straight-faced wit and her obstinacy. Asthe Blackwell family grew and she came to have six younger siblings as well astwo older sisters, Elizabeth proved to be more stubborn than all the rest ofthem put together, making up in sheer tenacity what she lacked in size. From thebeginning, Little Shy sank her teeth so deeply and so doggedly into whatever itwas she wanted that no one could shake her loose.

Her sisters and her brothers knew this about her. If there was something shecouldn't do—a game she did not play as well as her brothers, a book that was toohard for her, a problem in arithmetic she could not solve—she kept on tryingtill she mastered it. The family knew it took her longer to get dressed thaneverybody else because she was so meticulous. And in those days there was somuch for girls to get dressed in: in summertime, flowery frocks with puffsleeves tied with matching ribbons; in wintertime, dark worsted dresses wornbeneath a pelisse; all this over pantalets and petticoats; and, on her feet,corked clogs or noisy wood-soled shoes or, if there was company coming, redslippers with crisscross ribbons.

Her family saw how her perfectionism was turned inward also. It wasn't just theoutside world she wished to conquer, but the world within her. Little Shy wasalways testing herself, trying to strengthen herself, "fighting the devil," asshe called it. In imitation of the saints, she slept on the floor of her room,until her parents made her stop. She fasted during meals. When she had to givethis up because it made her faint at the dinner table, she consented to eat, butturned down all her favorite foods. She hated being sick; it made her feel thather body was in control of her. Once when she was suffering from severe chillsand fever, she refused to go to bed and tried to cure herself by walking themoff (which didn't work). She seemed, even...