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Science Has No Sex: The Life of Marie Zakrzewska, M.D.
http://www.100md.com 《新英格兰医药杂志》
     Do women lack an innate aptitude for science? This question was debated in Boston more than 150 years before the January 2005 conference at which Lawrence H. Summers, then president of Harvard University, said it was worth considering. In this scholarly, engaging biography of Marie Zakrzewska, the first in more than 80 years, Arleen Tuchman untangles the complex life of a pioneering 19th-century physician who believed that men and women do not have different scientific abilities.

    Tuchman draws on her earlier scholarship in German history to show how Zakrzewska's worldview was shaped by the secular German bourgeois society into which she was born in 1829 and by the economic hardship that caused her mother to break with its ideals, stepping outside the confines of home and class to become a midwife. Zakrzewska also trained in midwifery but chafed at its limitations. In 1853, she left for the United States, the only country then awarding the M.D. degree to women.

    (Figure)

    Marie Zakrzewska, circa 1870s.

    From the Archives and Special Collections on Women in Medicine, Drexel University College of Medicine.

    After a heroic effort to earn her medical degree, Zakrzewska assisted Elizabeth Blackwell in establishing the first American woman-run hospital, and came to view medical training for women as part of a greater struggle for social reform. Moving from New York City to Boston, in part to be near the German radical Karl Heinzen, she dedicated her life to change. Her platform was the woman-run New England Hospital for Women and Children, which she founded in 1862.

    Tuchman argues that Zakrzewska's primary goal in founding her hospital was not to create a separatist institution but to provide female physicians with the postgraduate hospital training they had been denied elsewhere. Zakrzewska believed that both male and female physicians should base their practice on reasoned, rational treatments — too much sympathy in medicine, she argued, clouded judgment. In this regard, she differed from Blackwell and others who based their argument in favor of female physicians in part on the superior qualities of empathy and nurturing they ascribed to the female sex.

    Zakrzewska's use of her hospital as both a showcase for women's achievements and an institution that served the poor shifted in emphasis over the years. One of the strengths of Tuchman's book is its use of detailed records, including quantitative data, to show how the hospital's social mission changed as Zakrzewska's views toward the "worthy poor" evolved. Tuchman also details how the hospital was at least equal to mainstream institutions in adopting advances such as asepsis, thermometry, microscopy, and hospital design.

    Hardly a lonely spinster, Zakrzewska headed an unconventional household that included Julia Sprague, her companion for 40 years, as well as Heinzen and his family. Tuchman provides a rich analysis of Zakrzewska's "Boston marriage" to Sprague, placing it in the context of a pre-Freudian time when close, even romantic, relationships between women were common and did not meet with societal disdain.

    All along, Zakrzewska enjoyed the strong support of notable Boston physicians, including Henry Bowditch and Walter Channing, partly because of her rejection of "irregular" medical practices such as homeopathy and hydrotherapy and partly because these men were leaders of the intertwined abolition, women's rights, and social welfare movements, whose epicenter was Boston. Tuchman does a superb job of placing Zakrzewska and her cause among others in a city teeming with radical discourse and experiment.

    As the century closed and stunning scientific advances in bacteriology reduced disease causation to specific pathophysiological aberrations, Zakrzewska criticized the grounding of medical practice in knowledge produced in the laboratory rather than the clinic. Even then, however, she did not characterize laboratory research as male and patient care as female, as did many of her contemporaries. She also began to lose favor with a younger generation of female physicians, who demanded autonomy and favored integration with male institutions.

    Tuchman ends her book by summarizing how the rapid changes in medical education that took place after Zakrzewska's death, in 1902, led to the virtual disappearance of American women physicians by 1910. Zakrzewska's hospital suffered a painful, slow decline, finally closing in 1969, just as a new wave of feminist activism was again forcing open the doors of medical schools to women. This superb biography, arriving at a time when comparing the brains of men and women is again all the scientific rage, is a welcome addition to the long debate over sex and science.

    Deborah Cotton, M.D., M.P.H.

    Boston University

    Boston, MA 02118

    cottond@bu.edu((Studies in Social Medici)