Monday, 10 June 2019

Tales of Gender and Medical Life

A few Notes and comments on Conan Doyle's Tales of Adventure and Medical Life.

The collection was first published in 1922, this paperback edition in 1963.

Dates for the individual stories are not given, but Internal evidence  suggests a setting in the 1880s, that is around the time when the author was trying unsuccessfully to establish himself as a general practitoner. The 'Medical Life' section provides a wealth of authentic detail relevant to several aspects of the history of medicine.

The second story of the 'Adventure' set also has a medical theme, as may be guessed from the title, 'The Surgeon of Gaster Fell'. The inclusion of a young female character, not essential to the plot, rounds out the narrative and incidentally provides a kind of baseline for considerations of gender in the 'Medical' set. Noting that this duaghter and sister of medical men does a lot of reading, the narrator encourages her: "Women have opportunites now such as their mothers never knew. Have you ever thought of going further - or seeking a course of college [sic] or even a learned profession?"  When she denies having any ambition and expresses anxiety about her future, he reassures her that she seems "... destined to fulfil the lot of women - to make some good man happy..." The year is 1885.

Women are present in strength in the medical stories, admittedly viewed primarily in relation to medical men, as patients, relatives, or occasionally fellow health professionals. Although they are often the subject of patronising generalisations, even misogynistic insult from the less sympathetic male characters, the latter are likely to be shown the error of their ways or are let in for some sort of comeuppance, The author displays nuances and subtlety of understanding; while still clinging to assumptions about supposedly universal 'male' and 'female' attributes, gender-based expectations may be confounded and stereotypes undermined.

No.1, 'A Physiologist's Wife', illustrates the unthinking dependence of medical high-flyers on the help and support of well-disposed women - wives or unmarried sisters - whose grateful acquiescence is blandly assumed (some at least of the speaker's  taking-for-granted turns out to be misplaced):
 "... I cannot imagine any higher mission for a woman of culture than to go through life in the company of a man who is capable of such a research..." (p.107)
 "You... have a worthy mission before you in aiding the life-work of a man who has shown himself capable of the highest order of scientific research..." (p.121)

No.5, 'The Curse of Eve', tackles the reality of a difficult chidlbirth in a modest home, not so much as experienced by the mother, but partly from the points of view of doctor and consultant, and first and foremost through the increasingly desperate anxiety of the expectant father (so often the subject of feeble jokes and clichés) about what was happening to his wife:
"Where was the justice of it?.. Why was Nature so cruel?.."

Childbirth as agonising, dangerous and unfair is a recurring theme, There is a link here with Dr Joseph Bell of Edinburgh, famously associated with the character of Sherlock Holmes, who is credited with having been among the first senior doctors to insist on hand-washing before examination of pregnant and puerperal women, thus saving many from potentially fatal infection. (He may also, of course, have inspired the creation of aome of the medical characters in these stories.)

The husband mentioned above does not get off scot free, but his night of emotional torment is outdone by the ordeal by which another father, in No.6, 'A Medical Document', chooses or is made to 'share' his wife's experience. This story is in fact a portmanteau in which doctors from various specialisms, and a generalist, frankly exchange views, discuss cases and swop anecdotes after one of the quarterly dinners of the Midland Branch of the British Medical Association. A contribution on chidlbirth stands out, and could almost stand alone as a striking short-short:
The post-prandial medics go on to agree that obstetrics and gynaecology (not so called) is 'a very wearing branch of the profession' and discuss what is apparently the main reason for this:
"I was a very shy fellow myself as a student, and I know what it means...
"Take some poor, raw young fellow who has just put up his plate in a strange town. He has found it a trial all his life, perhaps, to talk to a woman about lawn tennis and church services. When a young ma in shy he is shyer than any girl. Then down comes an anxious mother and consults him upon the most intimate family matters. "'I shall never go to that doctor again,' says she afterwards. 'His manner is so stiff and unsympathetic.' Unsympathetic! Why, the poor lad was struck dumb and paralysed..."

A logical conclusion from such a state of affairs might be the recruitment of more women to the profession, and some similar atttiude may lie behind Conan Doyle's more than comparative openness to the idea of women as doctors. Perhaps a part was played too by his sense of justice, or vicarious guilt over the vicious behaviour of Edinburgh medical students in this connection, not very long before his time there - not to mention a fine sense of the irony and absurdity of male attitudes.

Story No.8, 'The Doctors of Hoyland', opens with a description of a 30-plus male doctor whose position in the locality, "a clear run of six miles in every direction", seems secure: "He was particularly happy in his management of ladies. He had caught the tone of bland sternness and decisive suavity which dominates without offending."
Then a well-qualified rival sets up, and shock-horror, Doctor Verrinder Smith turns out to be a woman - "'What?' he gasped. 'The Lee Hopkins prizeman! You!'
"He had never seen a woman doctor before, and his whole conservative soul rose up in revolt at the idea. He could not recall any Biblical injunction that the man should remain ever the doctor and the woman the nurse, and yet he felt as if a blasphemy had been committed..."
Later: "Not that he feared competition, but he objected to this lowering of his ideal of womanhood... It revolted him the more to recall the details of her education. A man, of course, could come through such an ordeal with all his purity, but it was nothing short of shameless in a woman."

Dr, Smith comes off best in the immediate argument:
He: "Ladies are in danger of losing their privileges when they usurp the place of the other sex. They cannot have both."
She: 'Why should a woman not earn her bread by her brains?" [...]
He: "'... I must say that I do not think medicine a suitable profession for women and that I have a personal objection to masculine ladies." [...]
She: "... Of course, if it makes women masculine that would be a considerable deterioration."

She also comes off better professionally. "In a month, Doctor Verrinder Smith was known, and in two she was famous." She takes on cases and performs operations that would have defeated him: "For all his knowledge he lacked nerve as an operator, and usually sent his worst cases up to London. The lady, however, had no weakness of this sort, and took everything that came in her way."
When he has become her patient after an accident he finds himself defending her to his assistant-surgeon brother, visiting from London: "She knows her work as well as you or I"; "... [W]e may have been a little narrow in our views". Eventually he confesses himself to have been "quite in the wrong" over this woman question.

"And yet under all her learning and firmness ran a sweet, womanly nature..." The reader may by now, if not from the start, be inclined to suspect a traditional battle-of-the-sexes plot to be resolved in romance, and a proposal does indeed ensue, but (spoiler) without the conventional 'happy ending'. Happy enough for Dr Smith, who has only intended her stay in the area to be temporary, and had already decided to devote her life entirely to science: "There are many women with a capacity for marriage, but few with a taste for biology. I will remain true to my own line, then."
"And so it came about that in a very few weeks there was only one [now sadder and wiser] doctor in Hoyland...'

Further discussion of the medical stories can be found in some of the biographies of Conan Doyle, e.g.:

Rodin, Alvin E. & Key, Jack D. The Medical Casebook of Doctor Arthur Conan Doyle: From Practitioner to Sherlock Holmes and Beyond..(Robert E. Krieger 1984)  

Booth, Martin. The Doctor, the Detective and Arthur Conan Doyle: A Biography. (Coronet Books)

Sunday, 9 June 2019

Two Female Physicians of the early 20th Century

(This post was sparked off by a recent similarly-themed one from 'lenathehyena')

A Flett from Findochty and a MacCallum of Muckairn Manse

By the 1920s the occurrence of women's names in the Medical Register (and Medical Directory) had become less of a rarity than it had been, although they were still very much in the minority and would remain so for many decades. As it happens, two such names in particular leapt to the eye in the course of previous research for this blog, those of Nelly Flett (no relation, as far as is known, to other Fletts looked at here) and Margaret MacCallum, sister of Dr John Cameron MacCallum.

Nelly Flett is not the only woman with that surname listed in the 1927 Medical Register (MR) - the others were Jessie from Uddington and Isabelle from Bathgate - but her address, 5 Seafield Street in the Flett stronghold, Findochty - links her geographically at least with the family background of Joe Flett and of two First World War Conscientious Objectors. She gained her registration on 10th May 1924, having qualified MB ChB (Bachelor of Medicine and Bachelor of Surgery) at Aberdeen. (Joe's elder brother Alexander was a doctor: MB ChB Aberdeen 1904; MD 1906).

The more likely of two Nelly Fletts in the 1901 Census was living at 18 Blantyre Place, Rathven (the parish/registration district, often used interchangeably with Findochty in the records). Her father John was a fisherman. (Joe's family were in the fishing and fish-curing business).
Findochty Harbour
In 1930 Nelly is still appearing (Registration being for life, unless struck off) but her address has changed to 'c/o National Bank of India, Bombay' - no clue as to her reason for emigrating, whether off her own bat or in order to join her future husband. 'Nelly Flett' disappears from subsequent MR volumes, to be replaced by (Mrs.) Nelly Tarlton:
British India Office Marriages - on 2-2-1929 at Calcutta, Bengal:
Nelly Flett (30) and Edward Smedley Tarlton (43).

The Bombay address continues through MR 1933 and 1936 (volumes in the National Archives library) but by 1939 Nelly is evidently back in Britain, at Cherington Park, Avening, Stroud.

The Tarltons duly appear in the 1939 Register of Electors online, although it doesn't give Nelly her due. Her 'MB ChB' is transcribed erroneously as if middle intials, 'Ma Mb C?' and her occupation as the default for married women,'Unpaid Domestic Duties'.  Her 26-12-1898. Edward is described as 'Engineer (Mechanic) Retired', d.o.b.19-1-1884.

It is not clear without further research whether or for how long Nelly practised medicine in Gloucestershire, where she evidently continued to live. She appears in the Medical Directory for 1942 and 1944 as 'Tarleton, Nelly, née Flett', and (consistently as Tartlton) at the same Avening address in the MR until 1966, when she would have been in her 68th year.

Incidentally, Alec Flett's daughter and Joe's niece Elizabeth Horne Flett joins her father on the MR listing in 1942, with the qualification MRCS Eng (Member of the Royal College of Surgeons of England) LRCP London (Licentiate of the Royal College of Physicians of London) 1941. Her home address was 34 The Avenue, Bedford Park, Chiswick.

Margaret Nathaniel MacCallum, apart from being female, was a more likely candidate for the medical profession, being the daughter of a Church of Scotland minister and younger sister of a doctor. What's more, her family showed signs of holding progressive views. Her brother's stand as a 'conchie' is well documented, along with his concern for workers' health and rights, while her father Malcolm stood as a Labour and Land League candidate in the 1920 Argyll by-election.

Margaret, born in 1892, studied medicine at Edinburgh - scene of notorious rioting against women in the medical faculty a few decades earlier - and qualified MB ChB in July 1913, so that she appears in the Medical Register and Medical Directory from 1914. In 1916 she added a Diploma in Public Hea;th (DPH) from Birmngham, suggesting an inclination towards social involvement rather than an elitist career. Her address until 1921 is given as the family home, Muckairn Manse, Taynuilt in Argyllshire (now a Category B listed building).
Muckairn Manse, designed by Thomas Telford (1828)
Changes in the listings from 1922 are explained, like Nelly's at the end of the decade, by the fact that she married. This record too is slightly inexact, but clear enough in meaning:
McCallum, Margaret Nathan married Dunst[a]n, Robert at Newington in 1922.
Robert Dunstan was also a doctor, registered from 9-11-1900 (MRCS Eng, LRCP  London).

Margaret continues to appear under her married name, Dunstan (Mrs.) Margaret Nathaniel (formerly/née MacCallum), coincidentally also until 1966 like Nelly, when she would have been about 75. But for a time in the MR, at least until 1933, she had remained as MacCallum. Her address and Robert Dunstan's are the same: 84 Boyson Road, London SE17 during most of that time. In MD 1929 Robert has the additional address 'Paper Ridge, Temple'; this and other volumes show his additional attainments: Barrister-at-Law, Gray's Inn; Mem Med Leg (Medico-Legal) Soc; late Lt.RAMC (Royal Army Medical Corps - one wonders how he got on with his brother-in-law John).

The Dunstans do not seem to show up on the 1939 Register of Electors (frustratingly England and Wales only) online, although the MD for that year lists them both as living at South Green Cottage, Fingringhoe, Essex. Twenty years later (MR 1959) they were at Ivy Lodge, Martock, Somerset, and from 1964 Margaret was at Shipley Avenue, Torquay.


Neither of these is a noted pioneer among women in the medical profession nor celebrated for having practised medicine in a particularly adventurous or dangerous environment, but they like many others are part of the story of what the pioneers enabled women to achieve, even if the process was slow.* It took even longer in some specialisms, as indicated by the moderately well-known 'riddle' about the surgeon who turns out (spoiler alert) to be a woman  - who would have thought of that?!