Finally, in the fall of 1847, Elizabeth’s persistence was rewarded when Geneva Medical College, in upstate New York, punted the decision on her application to its students, who voted to admit her. It was only the first of many doors she had to beat down — to be allowed in the dissecting room, to observe hospital treatments, to gain hands-on experience. When Emily attempted to follow her sister’s blazed trail, it had been scuffed over: Geneva did not make the same mistake twice, and Emily finally graduated from Cleveland Medical College in 1854.
While Emily was pursuing her diploma, Elizabeth was desperate to put hers to use. But returning to New York City to open her own practice, she found herself sitting and waiting for patients who did not appear. Dr. Blackwell was shadowed by the lurid specter of another female “physician,” known as Madame Restell, who peddled herbal remedies and surgical intervention for the oldest problem women faced. To escape the taint of association with the brazen abortionist, Elizabeth soon replaced her private practice with a clinic licensed by the state.
Power in medicine was shifting from individuals toward institutions, and there was only so much the Blackwell sisters could do alone. In 1857, they opened a larger infirmary, joining forces with a confident, highly qualified German midwife named Marie Zakrzewska, whom they called “Dr. Zak.” Over time, it evolved into a college for female doctors known for its rigorous standards — a symbol of progress, and an important legacy. When its doors closed at the end of the century, the advances of women in medicine were unstoppable.
None of the five Blackwell sisters married, prizing careers, one another and their independence too highly, yet their family circle nevertheless expanded. Henry Blackwell, most notably, married the prominent women’s rights activist Lucy Stone, fully supporting her decision to keep her own name, strike the word “obey” from her vows and use their wedding as a platform to denounce the institution of marriage. Elizabeth, under a cloud of depression in 1854, adopted an orphan named Kitty, who called her “Dr. Elizabeth” and grew up with an in-between status, “half ward, half servant.” Emily, too, adopted a baby and named her after Hannah, the beloved Blackwell matriarch. For the last 30 years of her life, she lived and worked with another Elizabeth, 10 years her junior, who arrived at the college in 1870 and never left.
Apart from a few early hints of romance, Elizabeth remained single, with Kitty as her constant companion. Always happier in England than America, she returned there for good after the infirmary opened, becoming more prominent as a writer and public figure than a practicing physician. In her extraordinary self-belief (“I know that I am one of the Elect”), her hardness and her idealism, Elizabeth is a striking figure, and Emily, self-doubting and hardworking, never quite gets clear of her shadow. To her credit, Nimura, who is also the author of “Daughters of the Samurai” (2015), about three Japanese girls who traveled to America to study in 1871, doesn’t strain to fit the sisters into the narrow shape allowed to feminist pioneers, as either virtuous role models or “badass” rebels against society. Instead, they emerge as spiky, complicated human beings, who strove and stumbled toward an extraordinary achievement, and then had to learn what to do with it.