Essays in medical sociology, Volume 2 (of 2)

In the short time that we meet together to-day I will ask you to let me dwell upon the way in which the most beneficial influence of women in the medical profession may be exercised. I wish also to point out certain dangers, as well as advantages, with which medical study is now surrounded.

The avenues by which all may enter into the profession are now so much more widely thrown open that there is little difficulty in the way of any man or woman who may wish to acquire a legal right to practise medicine. In Paris all the public medical institutions, both college and hospital, are thrown open to students without distinction of sex. Not only as ordinary students, but as internes and externes, sex is no longer regarded there as a barrier to opportunity and position. The democratic principle is everywhere steadily gaining ground, and the individual allowed to try his strength in the great battle of life. Large numbers of women are taking advantage of this wider individual liberty to enter the medical profession. In Great Britain our seventy-three registered lady-doctors are few compared with the 3,000 in the United States, yet the nine students who are now connected with our London school, with, in addition, the Edinburgh classes, the Dublin students, and the latest fact that the Glasgow Medical College has just opened its doors to women, clearly indicate that the movement has taken sturdy root in our country, and when our English work has been carried on for forty years, there is every probability that our British lady-doctors will equal numerically our kinsfolk across the ocean.

I think, therefore, that all will see the importance of considering the future of this growing army of medical women, and I particularly desire that our students of medicine should realize the far-reaching character, the social effects, of this medical career which they are entering on. It is quite certain that the wide adoption of the medical profession by women cannot continue to be an insignificant matter; it must exercise an appreciable effect on future society for good or evil.

If we were children entering upon a course of education, it would be premature to take stock of the results of education, and cast a far-seeing glance into the future.

But it is different with adult women--women of education, somewhat impatient of restraint--entering upon a larger liberty, and legitimately jealous of any interference with that liberty. It is therefore imperative upon us to consider very seriously this matter of self-guidance at the outset of medical education, to take in a large view of future responsibility, and ask ourselves that most important question respecting a medical training: What will be its effect?

The flippant or superficial person may at once reply: Our object is to gain money and pursue a remunerative calling by looking after sick people. Women find so much difficulty in honestly supporting themselves, that it is reason enough that they can in this way do so, and the labourer is worthy of his hire. But I say emphatically that anyone who makes pecuniary gain the chief motive for entering upon a medical career is an unworthy student; he is not fit to become a doctor, and he will be a labourer not worthy of his hire. What should be thought of a statesman who aspired to the direction of national affairs on account of the salary of £10,000? The nobleness of motive must enlarge with the nobleness of occupation, or the unworthy occupier sinks to a degradation measured by the height to which his career should have raised him.

Now, there is no career nobler than that of the physician. The progress and welfare of society is more intimately bound up with the prevailing tone and influence of the medical profession than with the status of any other class of men. This exceptional influence is not only due to the great importance of dealing with the issues of life and death in health and disease, but it is still more owing to the fact that the body and the mind are so inseparably blended in the human constitution, that we cannot deal with one portion of this compound nature without in more or less degree affecting the other. Our ministrations to body and soul cannot be separated by a sharply-defined line. The arbitrary distinction between the physician of the body and the physician of the soul--doctor and priest--tends to disappear as science advances. Every branch of medicine involves moral considerations, both as regards the practitioner and the patient. Even the amputation of a limb, the care of a case of fever, the birth of a child, all contain a moral element which is evident to the clear understanding, and which cannot be neglected without injury to the doctor, to the individual, and to society. But probably it will be generally agreed that the hope of gaining money must not be the primary motive for choosing a medical career; but that interest in the line of study and kind of life, with a perception of the wide and beneficent influence which it can exert, should form the determining motive for becoming a physician.

If, then, we recognise that, although just reward for honest labour is fair, we must not enter upon medicine as a trade for getting money, but from a higher motive, this motive, as it influences conduct, becomes on that account a moral motive or an ideal which should guide our future practical life as physicians. Now, this ideal necessitates a distinct conception of what is right or wrong for us, in medicine, both as human beings and as women. Simply sensuous life, without an ideal or without higher principles of action than the limited needs of every day, tends to degrade the individual and all who surround him.

What we need is a clear idea of what is really right or wrong, with the reasons on which the judgment is based, instead of a confused notion or a vague and ever-shifting standard.

No woman student of medicine can safely ignore this subject. It is a vital one for us, and only a true answer to it will make our entrance into the profession a marked advance in social progress.

I do not attempt to disguise the difficulty of laying down the law of right and wrong in medicine; not only because medicine, as every other part of social life, is subject to the growth of evolution, but because in a state of society that has not yet succeeded in moulding itself on the fundamental principles of Christianity, we are involved in faulty social conditions which prevent us from embodying our moral perceptions in every phase of practical life. But, remember, thought and endeavour may live a righteous life, no matter what faulty conditions surround us. When we have a clear view of right and wrong, we can mentally repudiate whatever appears to violate the moral law. We can strenuously resist the deadening force of habitual wrong-doing, and never cease the effort to find some way of shaping our mental protest into practical opposition to all forms of immorality.

You will see in the course of your medical studies--particularly if you study abroad--much to shock your enlightened intellect and revolt your moral sense. In practice also you will be subjected to strong temptations of the most varied character. But just for the reason that as women we ought to see more clearly the broken bridge or approaching danger, in the onward rush of the male intellect, I now dwell on our special responsibility, and shall endeavour to give the reasons for it.

My object is not to limit, but to enlarge our work in medicine, when I seek to define our ideal. It is true that the great object of this human life of ours is essentially one for every human being, man or woman, barbarous or civilized. It is to become a nobler creature, and to help all others to a higher human status during this brief span of earthly life. But as variety in unity is a law of creation, so there are infinite methods of progress, producing harmony instead of monotony, when the individual or classes of individuals are true to the guiding principles of their own nature.

For the ideal of every creature must be found in the relation of its own nature to the universe around it. Right and wrong are based upon the sound understanding of this positive foundation. It is this fact of variety in unity, in the progress of the race, which justifies the hope that the entrance of women into the medical profession will advance that profession.

In order to carry out this noble aspiration, we must understand what the special contribution is, that women may make to medicine, what the aspect of morality which they are called upon to emphasize.

It is not blind imitation of men, nor thoughtless acceptance of whatever may be taught by them that is required, for this would be to endorse the widespread error that the race is men. Our duty is loyalty to right and opposition to wrong, in accordance with the essential principles of our own nature.

Now, the great essential fact of woman’s nature is the spiritual power of maternity.

We should do miserable injustice to this great fact if, looking at it with semiblind eyes, we only see the shallow material aspect of this remarkable speciality. It is the great spiritual life underlying the physical which gives us our true womanly ideal.

What are the spiritual principles necessarily involved in this special creation of one-half the race--principles which lie within the material facts of gestation and the care of infancy and childhood, which constitute the distinctive material domain of women?

They are the subordination of self to the welfare of others; the recognition of the claim which helplessness and ignorance make upon the stronger and more intelligent; the joy of creation and bestowal of life; the pity and sympathy which tend to make every woman the born foe of cruelty and injustice; and hope--_i.e._, the realization of the unseen--which foresees the adult in the infant, the future in the present.

All these are great moral tendencies, and they are necessarily involved in the mighty potentiality of maternity. They lay upon women the weighty responsibility of becoming more and more the moral guides in life’s journey. Women are called upon very specially to judge all practical action as right or wrong, and to exercise influence for this high morality in whatever direction it can be most powerfully exerted.

We see the indication of this providential inherited impulse to moral action, in the great and increasing devotion of women to the relief of social suffering and their sturdy opposition to wrong-doing, which form a distinguishing characteristic of our age. These spiritual mothers of the race are often more truly incarnations of the grand maternal life, than those who are technically mothers in the lower physical sense.

With sound intellectual growth the range of moral influence increases. But such sound growth can only take place under the guidance of moral principle; for moral perception becomes reason as the intellectual faculties grow, and reason is the true light for all. It is in this high moral life, enlarged by intelligence, that the ideal of womanhood lies. It is through the moral, guiding the intellectual, that the beneficial influence of woman in any new sphere of activity will be felt.