Author Janice Nimura details the lives of Emily and Elizabeth Blackwell, who paved the way for women to study and practice medicine in 1800s America, during this Pulsar podcast brought to you by #MOSatHome. We ask questions submitted by listeners, so if you have a question you'd like us to ask an expert, send it to us at sciencequestions@mos.org.

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ERIC: In November, we celebrated women in science and engineering at the Museum of Science. We got a great question about the history of women in science that we're going to explore today on Pulsar. I'm your host, Eric. And my guest today is author Janice Nimura, author of the new book, The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine. Janice, thanks for joining me.

JANICE: I'm honored to be here.

ERIC: So your new book explores the careers of Elizabeth and Emily Blackwell.

JANICE: Well, if you've heard those names at all you've probably heard Elizabeth Blackwell's name as the first woman doctor in America. She was the first woman to receive a medical degree in this country in 1849. And out of her many siblings, she picked her younger sister, Emily, who was five years younger, to follow in her footsteps and join her on this lonely path of being the first woman in medicine. Emily received her medical degree five years later in 1854.

ERIC: So to start with, what is it like to research the lives of two figures who lived more than 100 years ago? I mean, you can't interview them or ask anyone who knew them. So what kind of sources and materials did you use to get to know the Blackwell sisters?

JANICE: Well, luckily for me, the Blackwells were two among nine very tight-knit siblings who sort of had a sense of, "our tribe against the world," and at the same time, all drove each other a little nuts. So they were constantly leaving and writing back to each other, which meant there are thousands and thousands of letters among these siblings. A lot of them also kept journals, which was always a great gift to an archival researcher.

And I quite love doing research in the 19th century. It's just a thrill to hold old pieces of paper that someone poured their heart out onto and read that again so that the voice is fresh. Seeking treasure in archives is one of the biggest thrills of doing this work. Sometimes it's hard to stop and actually start writing because wandering around in libraries is too much fun.

ERIC: In your research of these two doctors, were you able to find anything in their youth that triggered a desire to get into science and, specifically, medicine?

JANICE: Well, interestingly, no - well, yes and no. They came from a family that was very interested in natural science. They were all botanists. They liked to go out collecting things, like many 19th century families at a certain intellectual level.

But as far as being explicitly drawn to science or biology or caregiving, decidedly no. And that was sort of interesting about their origin story is that Elizabeth chose medicine consciously as a way to prove a point about what women were capable of. She actually thought that bodily functions were fairly disgusting and that sickness was really just a form of weakness when it came to herself.

She was not drawn to the mysteries of physiology and anatomy and disease and healing. This was a way to prove a point, which is a little bit surprising, I think, to people who imagine that if you're going to be the first female doctor, you must have felt a vocation for it. What she felt a vocation for was being an example to other women as to what a woman could do and be.

ERIC: And the 1800s were a completely different time. Can you talk about the challenges that the Blackwell sisters faced when they set out on this career path?

JANICE: The very idea that a woman would seek a medical degree was completely outrageous, if not scandalous. It wasn't something women did despite the fact that women had traditionally been midwives and healers. The idea of a woman getting a professional degree, which was increasingly what you needed to do to be a doctor, doctoring was moving into the professional sphere with the growth of more and more medical schools in America. But the idea of a woman interacting with the gross realities of the body was horrifying and impossible.

Elizabeth Blackwell's idea of getting a medical degree at all was outrageous. But she really saw this as a way of proving the idea that women could be what they wanted to be and that humanity would rise and become more enlightened if women unleashed their own power. So she decided on medicine as a way to prove this and really struggled to find a place in medical school.

The place that she did win herself at a tiny provincial medical school in Geneva, New York, the descendant institution is Hobart and William Smith College. She achieved that seat in that tiny medical school almost by accident and kind of as a practical joke. But to learn the joke, I guess you're going to have to read the book.

ERIC: Here's a question we got on our social media, how was the sisters' relationship with each other? You mentioned that Elizabeth sort of selected Emily to join her in her pursuits?

JANICE: Right, I mean, in a way, she sort of anointed Emily. Emily, you shall follow me into medicine. And Emily, as the fourth of five girls - and there were also four brothers - was very used to obeying her rather domineering older sisters' words. But in this case, it was a good match. She actually took to medicine and to science more naturally than Elizabeth did and quite embraced the role of being a doctor as a practitioner.

But their relationship to each other was always a little bit fraught. They supported each other. They were each other's staunchest allies in some ways. But at the same time, Elizabeth Blackwell really saw women in medicine as being more about public health, about being teachers armed with science. Whereas Emily was more of a practitioner, her goal was to be a physician and a surgeon and a medical professor, the equal of any man. And they sort of agreed to disagree about that, and, in fact, spent the last 40 years of their lives on separate continents.

ERIC: So speaking of that, what was it like in the United States compared to other countries at this time? Would it have been different if they were looking to start a medical career in a different part of the world in the 19th century?

JANICE: Well, funnily enough, actually getting the degree was probably easiest in America than in the UK or in Europe even though there were women, especially in Europe like in Berlin and Vienna, who were pursuing medical pathways, there were no schools in those areas that were conferring degrees. America was a little bit more of a brash, young place, more willing to break rules. And there were more loopholes, I think. The layers, the strata of society were slightly less rigid. And Elizabeth and Emily were able to sort of slip through before their sisters in Europe and the UK were able to.

ERIC: So a medical degree was difficult enough to obtain. But I can't imagine that once they had that they were instantly respected among their peers. Can you talk about some of the challenges they had next when they were trying to practice medicine?

JANICE: Yes, no, recognition did not come instantly or, in some cases, ever. The degree was only the very first step. Elizabeth Blackwell, after receiving her diploma and then finishing her practical training in London and Paris, returned to New York triumphantly ready to hang out her shingle and no one came. The idea of seeing a female physician was just impossible for most genteel women, largely because the very phrase female physician was generally used to refer to a "back alley abortionist," in quotes. So that was an obstacle.

However, she did find that indigent women, poor women who really didn't have the luxury of choice when it came to medical care were not so picky. So the path that she found her way toward was opening institutions that served poor women as charity institutions where wealthy donors could patronize the idea of women in medicine without necessarily seeing a female doctor. And female doctors could practice on poor women who were grateful for good care regardless of who was administering it.

ERIC: And that leads into the next thing I'd like to talk about, which is the accomplishments of the Blackwell sisters, particularly in helping other women be able to practice medicine.

JANICE: Right, so it started humbly. Elizabeth first founded a one-room dispensary on the Lower East side of Manhattan, which grew first in 1857 into the New York Infirmary for Indigent Women and Children. That was the first hospital staffed entirely by women. And it also had as one of its goals to be a place where the slowly growing numbers of female medical graduates could go to receive some practical training.

Because, of course, most hospitals didn't want women, even if they had medical degrees, wandering around the wards unless they were nurses. That was their first institution that Elizabeth and Emily founded together in 1857. By 1869, they had added a women's medical college to that institution. Even though they didn't really believe that women should study medicine separately from men, there were still very, very limited options for women to sneak into men's medical schools. And the women's medical schools were kind of mediocre.

So they founded their own women's medical school, but made it at least as rigorous as the men's schools. And that was sort of their crowning achievement as a team. Once that college was founded in 1869, Elizabeth moved on and moved back to England where she had been born and where she preferred to be, leaving Emily really at the helm of both the infirmary and the women's medical college until the end of her life.

ERIC: So it was almost by necessity that they were helping other women get into medicine because it was still so difficult years after they got started?

JANICE: Right, and the ways in which they facilitated women's medical education shifted in response to the barriers that they faced. They assumed that men's medical schools would see their success and soften up when it came to admitting female students. But that didn't happen, which shifted their own goals as far as how to be a woman doctor. Clearly, they were going to have to create a place for women doctors to become excellent. Because excellence was really part of the project. It wasn't enough just to be one in name. You had to be one worthy of the name.

ERIC: And without giving too much of the book away, can you tell us something surprising or intriguing that you found out during your research?

JANICE: One of the interesting things about the Blackwells is that if you've ever heard of them you've probably heard of them because you had a book about Elizabeth Blackwell when you were little. She's much easier to find on the children's bio shelf than in the adult part of the library. I was really intrigued and interested by the space between that sort of slim, pretty, inspiring woman in the children's books and who Elizabeth and Emily Blackwell really were. They were opinionated, prickly sometimes, often funny, but often frustrated. They were out of step with a lot of the other members of the women's rights movement in the 19th century.

The way all of those things complicated the children's story were really what intrigued me most. And so my goal was really to tell the story of both of them, Elizabeth and Emily, and to tell it in a way that left all of their complexity intact. Because I think we all know complicated, powerful women. And we should honor them because of, and in spite of, those complexities.

ERIC: So 150 years after they got their start, how do you hope they'll be remembered?

JANICE: Well, I mean, of course, as people who shifted the paradigm of who could be what. After the Blackwells, no one could say, a woman can't be a doctor. They were doctors at a very high level with sterling careers and really made impacts, both in the fields of public health and in medical practice. After the Blackwells, no one could say women didn't belong in the medical field. But at the same time, I would say - I am not a physician, but I can point you to any number of female physicians who will explain to you in vivid detail about how a lot of the problems that the Blackwells faced are still problems today, despite a lot of progress.

ERIC: Well, let's hope society can keep eliminating those barriers and prejudices. Next, I wanted to ask, what made you interested in the story and drew you in enough to write an entire book about it?

JANICE: Well, I'm a many generations New Yorker. And growing up, I attended a very proudly feminist girls school. And I was definitely the math science kid at that school. And I graduated intending to study medicine in college. I swerved, clearly.

But that was who I was growing up. And I had never heard of either Blackwell sister until five years ago. And when I did first "meet them," quote, unquote, I was astounded that I had never heard of them given my own background and that I'd grown up in the city where they practiced. So that seemed crazy to me.

But it also seemed like maybe an opportunity, that if I hadn't heard of them given what my interests were, that maybe I wasn't the only person who hadn't heard of them. And given what their accomplishments were, there was absolutely no reason that anyone should be in any doubt as to who they were. It seemed like a story that was ripe for retelling and two women who were ripe for reintroduction to the present. And I do hope that's true, especially in this moment of electing our first female vice president and, really, a little bit of a paradigm shift in what paths we acknowledge women can take and what roles they can fill.

ERIC: All right, well, Janice, thank you so much for coming on Pulsar and telling us all about the Blackwell sisters and how you got to know them well enough to tell their story.

JANICE: It was a great pleasure. Thank you so much for having me.

ERIC: The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine is now available wherever books are sold. Until next time, keep asking questions.

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