Editing ones own work is always difficult, but even more so whether there are decisions to be made and things to look up, rather than just errors to fix, in the final pass. For example, in one recent three-hour session, even though I’d already had two professional edits of the novel, I spent time:
finding out how I spelled “moustache” in the first book
looking up greetings appropriate for an afternoon tea party / art exhibit
learning how to force an em-dash to stay with a quotation mark on the same line in Word (you can’t)
deciding whether it should be M.P. or MP
removing the word “so” everywhere because I use it too much
looking up whether they would have called it a comforter in 1863 (yes)
changing colloquial phrases (“gone up” to “been increased”)
realizing the appalling necessity of a thesaurus
All of which make for a better book. It’s a little different than grabbing a red pen and making some marks, and really shouldn’t be done by someone else. And I admit to some frustration that I missed things, as in “how could I not have caught that on the first four reads?” But it’s all part of the journey.
Whenever historians discuss the “first” of anything, they use qualifiers. In the case of the first female doctor in the UK, there might be several candidates, depending on how one qualifies the word “doctor.” The innumerable wise women and healers who made diagnoses and prescribed treatment for centuries may be unknown to history. So we define “doctor” in terms of official qualification and credentials.
The honor of being the first female doctor in the UK thus goes to an extraordinary person, Elizabeth Garrett Anderson. Although she had been refused admissions to the College of Surgeons and Physicians because of her sex, she was admitted to the Worshipful Society of Apothecaries because their rules stated nothing forbidding women (an oversight they remedied shortly afterward). The University of Paris then admitted her to the examination necessary to certify her as a medical doctor in the 1860s.
Before her, one might argue, was Elizabeth Blackwell, the first woman on the UK Medical Register as a practicing physician. She would not have been able to obtain a medical degree but was grandfathered into the Medical Act of 1858.
But there is an even more startling possibility. Dr. James Barry was a famous figure in nineteenth-century military circles. He obtained his medical degree from the University of Edinburgh and might have been prevented from sitting his exams due to his youthful appearance but for the intervention of the Earl of Buchan, who was friends with his tutor.
Portrait of James Barry, Wellcome Collection
Dr. Barry was a good physician, known for an excellent bedside manner, and he became a talented surgeon in the army. He served in South Africa and the Caribbean and performed the first successful European caesarean section in Africa. He became Inspector General in 1857 and traveled the British Empire enforcing sanitation in hospitals.
There is much evidence of Dr. Barry’s personality. He was known for his squeaky voice and violent temper. Florence Nightingale, whom he met in the Crimea, hated him, even though his emphasis on hygiene was as energetic as her own. Others reported that he was quarrelsome in the extreme.
He also never undressed in front of other people. This, and his clean-shaven face, curly hair, and short stature do not appear to have caused much comment among most of his colleagues. Later, however, there were rumors of duels caused by insults about his appearance and the expected posthumous claims that “I always suspected” or “I always knew.”
When he died in 1865 of dysentery, a charwoman named Sophia Bishop laid out his body. This action was against Barry’s known wishes that under no circumstances should his body be disrobed in death. The woman claimed that his body had full female genitalia and stretch marks, indicating a possible pregnancy. Barry’s own doctor, Major D.R. McKinnon, simply refused to care about his patient’s sex, having been called upon to identify the body and sign the death certificate. He had written the sex as male on the certificate. When Bishop told him her observations and tried to get him to pay for her silence, McKinnon famously reported to George Graham of the General Register Office:
The woman seems to think that she had become acquainted with a great secret and wished to be paid for keeping it. I informed her that all Dr Barry’s relatives were dead, and that it was no secret of mine, and that my own impression was that Dr Barry was a Hermaphrodite. But whether Dr Barry was a male, female, or hermaphrodite I do not know, nor had I any purpose in making the discovery as I could positively swear to the identity of the body as being that of a person whom I had been acquainted with as Inspector-General of Hospitals for a period of years.
The army sealed the records, supposedly for a hundred years. Isobel Rae’s 1958 book The Strange Story of Dr. James Barry, based on access to those papers, broke the story in the subtitle: Army Surgeon, Inspector General of Hospitals, discovered on death to be a woman. The only evidence, despite the new batch of papers, was the word of the woman preparing the body.
James Barry qualified as a doctor in 1812, so if one says he was female, then he would be the first woman doctor by several decades. The story has fascinated many, and more documents have since been uncovered demonstrating that Barry was Margaret Ann Bulkley in his earlier life. (This includes items like a letter from young Barry to a family solicitor where the recipient wrote “Miss Bulkley” on the outside of the envelope.*) The current wisdom that James Barry was, in fact, a woman, is happily disseminated in more recent books, both for adults and children.
It is natural that current discussions of gender would play into how we interpret James Barry today. Did he simply dress as a man to have a career not open to women? Is it right to call him the “first female medical doctor” if we believe he identified as male? Should we call him a transgender man? Or is it best to respect his own view of himself?
Even if we accept the report of the avaricious charwoman and the handwriting analysis of Margaret Bulkley, we have no way of knowing whether Dr. Barry actually identified as male or would simply be labeled a cross-dresser hiding his female identity. His last wish that he not be undressed for burial seems to speak to something deeper. But here, we are certainly engaging in supposition unsupported by the sources. Instead, it might be best to celebrate an extraordinary career, acknowledge the good he did with his medical skills, and enjoy critiques of his explosive personality from a safe distance.
*see Pain, Stephanie. “The Extraordinary Dr. James Barry.” New Scientist, vol. 197, no. 2646, Mar. 2008, pp. 46–47.
Murder at Old St. Thomas’s is set in 1862, so I did quite a bit of research. For me, this was stepping back 25 years from my usual research area, so I found a lot of surprises, in addition to this novel technique for social distancing:
The first thing to do after putting on my crinoline was to find good maps of London, big maps where you can see street names and even buildings:
Guide to the what? The International Exhibition of 1862. Although the Great Exhibition of 1851, with its Crystal Palace, is more famous, this one was supposed to be even bigger. You can see the catalogue here. It took place in South Kensington, on Cromwell Road, where the Natural History Museum would be later.
The Victorianist blog has some good information, and points out that the death of Prince Albert in December 1861 put a damper on the whole proceedings from the start. And it says the building, above, cost £300,000 but the cost was covered by the profits from the Great Exhibition of 1851. My studies of Victorian science education claim that the entire system of British science education was basically financed by the same pool. Which makes me think that the money from the Great Exhibition of 1851 is like pieces of the cross. There is no possible way that they made enough profit in 1851 to fund everything that’s been claimed.
The Exhibition caused a lot of traffic snarls, especially in west London. And it really was international, with exhibitors and visitors coming from all over the globe. More in my next post…
While she was not writing about people quarantined in their homes, Florence Nightingale’s Notes on Nursing (1859) were about caring for people in their homes, and doing it well.
Nightingale is known, of course, for her service during the Crimean War and her active reform of nursing and hospital hygiene in the mid-Victorian era. She’s the one who realized that many deaths in military hospitals were unnecessary, caused by unhygenic conditions rather than wounds or injury. And she came to this conclusion when aneasthetics were in early days, and antiseptics as yet unknown (Joseph Lister would start his famous work after the war).
Contrary to her “lady with the lamp” image, Nightingale was a no-nonsense, if not actually abrasive, person. She was once even cussed out by a doctor who might have been the first woman to get a medical degree in Britain, except that s/he identified as a man (more on this person in a future post).
I have had a copy of Nightingale’s Notes on Nursing for awhile. I don’t even recall why I bought it. I assumed it was a book for teaching nurses, since Nightingale founded her school of nursing at St. Thomas’s Hospital. But it’s a book about nursing, not just in hospitals, but in the home. And her emphasis, not surprisingly, in on creating healthy conditions.
It is also not surprising that this was considered a job for women, and in my opinion this book should reside on a shelf alongside Mrs. Beeton’s Book of Household Management, published in series at the same time, and printed as a book only two years later. Most people know that Ms. Nightingale was a big advocate of fresh air. In fact, the odd configuration of the new St. Thomas’s Hospital, opened in 1867, was the result of her promotion of cross-ventilation.
Have you ever opened a window for fresh air, and it became so chilly you wished you could leave the heat on? Nightingale recommends this, or at least keeping the fire going with a window open, so that an ill person can have fresh air. She points out that you can keep the patient warm with blankets, and safely allow fresh cold air into the room.
Her book also notes that opening doors and windows is to no avail if the air that comes in isn’t fresh. If your room opens onto a utility closet, or you leave your chamber pot open under the bed (oh those master bathrooms!), or your window overlooks a refuse heap, you are not doing any good with air. Ill people really should be taken out into the garden to get a little sun and air, which I see done all too seldom. I’ve been in elder nursing homes where the windows don’t open and the only outside is a little paving of cement in a courtyard. Nightingale was not a fan of courtyards — the air isn’t fresh enough, going round and round.
Too much bedding, too many visitors
All of her advice was based not only on her experience, but on research and statistics. Her faith in scientific endeavor was firm. In the early 1860s, when the plot was being hatched for passing the Contagious Diseases Act, she argued against it based on statistics. The idea was that preliminary arrest and examination of prostitutes would prevent venereal disease in the military. The act would give the police power to arrest any woman they suspected of being a prostitute. Many who were against the idea argued on the basis of feminine modesty, or the inappropriateness of making a private disease a public issue, or the likely abuses by the police. Nightingale argued on facts: everywhere that harsh measures arresting and examining prostitutes had been enforced by a state, the V.D. numbers had actually increased rather than decreased.
Her household nursing advice seems so common-sense, and yet is often ignored, then and now. She had to recommend that damp towels be spread out to dry, that one not chit-chat inanely with someone who wasn’t feeling well, and that one should always sit beside the sickbed rather than hovering over it, forcing the ill person to crane their neck. And here’s more:
Reading the patient the funny bits of a book you’re reading (update: bits and memes off the internet) is extremely annoying to the ill person.
Quiet is important, because when someone is ill certain sounds can be distressing or even intolerable.
A bedroom, where one sleeps, is not the same as a sickroom. A person in bed because they are ill needs not only air but light, and should be able to see out an open window.
The bed needs to be aired daily — in fact Nightingale suggests two different beds so the sheets of one can always be aired. Not doing this, or using too much bedding and thick mattresses, leaves the patient essentially in their own waste of sweat and their own breathed air. (The current metal hospital bed is likely based on the iron ones she recommended.)
Cleaning must be thorough. Damp cloths, not dusters that just raise the dust into the air. Carpets are horrible even if lifted and beaten 3 times a year (I can just imagine what she’d think of wall-to-wall carpeting). Bad smells indicate organic matter is stuck to things, and it shouldn’t be.
See why I want this filed next to Mrs. Beeton? It’s far less about medical nursing than about good housekeeping. The medical advice reminded me of Hippocrates, especially when it came to diet (“The diet which will keep the well man healthy may kill the sick one”). But at this time, when there is more than the usual concern about people being ill at home, it’s still good advice.
