How Dr. Marie Zakrzewska Created Boston’s First Hospital By Women, For Women

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In 1863, about a year before twenty-one-year-old Mary Putnam joined the New England Hospital as an intern, Dr. Marie Zakrzewska was making her rounds when she received word that a gentleman had arrived and was insisting on seeing her. Full of curiosity, Zakrzewska quickly finished her rounds and went to her office. Her visitor stood at once, shook her hand, and gave her his card, which read H.R. Storer, M.D. Zakrzewska blinked with surprise because she recognized the name. She was even more astounded when he told her that he wanted to apply for the attending surgeon position she had only just posted.

Horatio Storer had an exceptional reputation. His father was the dean of the faculty of medicine at Harvard Medical School. Horatio graduated from Harvard Medical School in 1853 and then, like Emily Blackwell, studied surgery with James Young Simpson in Edinburgh. He returned to Boston in 1855 and began practicing medicine, with an emphasis on obstetrics and gynecology, and lecturing at Harvard. He had also worked as an attending physician at the Boston Lying-In Hospital until it was forced to close because too many women were dying from postpartum infections. Although he was in private practice and taught a gynecology class at Harvard, Storer wanted to make use of his surgical talents. Zakrzewska hired him on the spot.

Even though she welcomed prominent physicians as consultants, Zakrzewska had not intended to hire a man to work with the women physicians at her hospital.

In addition to working as a physician, Storer had spent years building a reputation as a moral crusader. In 1857 (the same year Elizabeth Blackwell opened the New York Infirmary for Women and Children), he uncovered statistics revealing that abortion was more prevalent among married Protestant white women in Boston than unmarried single and poor women. These findings shocked him to his core. At the time, women could obtain abortions legally until quickening, the stage when fetal motion was felt, usually sixteen to twenty weeks into a pregnancy; most religions believed that this was when a fetus was ensouled. Quickening was a subjective marker that could be judged only by the pregnant woman herself. Even so, no one worried about a woman ending her pregnancy before the fourth or fifth month. Many physicians performed surgeries to “restore stopped menstruation,” while the scandalous women abortionists plied their trade in bigger cities.

Storer was so outraged by his findings—that married white women were avoiding the duties of childbirth—he persuaded the American Medical Association to research the number of abortions performed in the United States.

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Since its founding in 1847, the AMA had struggled to be taken seriously. The editor of the Cincinnati Medical Observer described the medical association as “a body of jealous, quarrelsome men whose chief delight [was] in the annoyance and ridicule of each other.” The organization was desperate to improve its reputation. Stirring up moral outrage against abortion seemed ideal, so the AMA appointed Storer to chair the Committee on Criminal Abortion, a group made up of strident antiabortion activists.

Broadening his campaign, Storer wrote to physicians throughout the country arguing (without any scientific proof) that human life began at conception rather than at quickening and pushing for legal restrictions on abortion. He proposed incarcerating the women who sought abortions as well as their doctors or abortionists and recommended even harsher sentences for married women. It was the first time a doctor had publicly elevated the fetus above the mother’s well-being.

Storer’s moral argument was drawn from racial fears that eventually inspired what was known as the “science” of eugenics: a social movement aimed at perfecting the human species by increasing the population with “desirable” genetic traits and reducing those with “undesirable” traits by forced sterilization. In their attempts to control the birth rate, safeguard the racial health of white people, and purge society’s defectives, eugenicists primarily targeted women. Storer asked whether the United States would “be filled by our own children or by those of aliens? This is a question that our own women must answer; upon their loins depends the future destiny of the nation.” Criminalizing abortion would put control of women’s reproduction in the hands of male doctors and politicians and tip the racial balance in the white man’s favor.

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Physicians from across the country sent letters to Storer thanking him for alerting them to the dangers and the need for action. In 1859, Storer authored the committee’s report, which recommended a strong antiabortion position. The AMA adopted this position as its official stance at its national convention that year, and the physicians’ crusade against abortion was born. In 1860, J.B. Lippincott published the report under the title On Criminal Abortion in America. The doctors’ crusade against abortion would finally knock out what the AMA considered its competition: amateurs, midwives, and female abortionists. And the AMA’s poor reputation would begin to improve.

Despite Storer’s reputation as a moralizer, Zakrzewska was grateful that a man of his prominence, connections, and ability was interested in working as an attending surgeon at her hospital. She had labored endlessly to gain the support of Boston’s leading male physicians. Her favorite colleague and champion, Henry Bowditch, had introduced inductive reasoning to American medical science and pushed for public health by chairing the Massachusetts State Board of Health. He also encouraged the education of women as physicians, even at Harvard. In a letter to Zakrzewska, he wrote that women physicians and surgeons should be allowed to work in all hospitals and that hospitals should open their clinical instruction to both men and women.

Even though she welcomed prominent physicians as consultants, Zakrzewska had not intended to hire a man to work with the women physicians at her hospital. But she needed an attending surgeon and had scoured the region in vain for a qualified woman—a shortage she blamed on Harvard and the other regular medical schools that continued to exclude women—so she was willing to make an exception in Storer’s case. It was a decision she would come to regret.

Within a year of moving from New York to Boston, Dr. Marie Zakrzewska bought a large home at 139 Cedar Street in Roxbury, a respectable middle-class neighborhood. Although at first she lived alone, her household grew into a communal refuge for like-minded companions. The family she attracted, however, had little to do with the idealized household of husband, wife, and children. Like the Blackwell sisters, she never considered marriage. In fact, she often compared it to prostitution.

Zakrzewska’s sisters Minna and Rosalia lived with her for a few years before moving out, and shortly thereafter Karl Heinzen; his wife, Louise; and their sixteen-year-old son, Karl Friedrich, moved in. Heinzen was a German radical, an author, journalist, and lecturer who immigrated to America with other German Forty-Eighters to escape oppression after the democratic revolutions of 1848 that they supported failed. Through Heinzen, Zakrzewska became a member of the local German radical community devoted to social justice.

Heinzen, who paid for his family’s room and board with proceeds from his newspaper Pionier, helped Zakrzewska care for the property’s towering elms, woody shrubs, and flowers. So many rocks dotted the area that Zakrzewska and her family began calling their home “Rock Garden.” Groups of hospital directors, doctors, and interns, as well as other friends, often gathered there. Zakrzewska would sit in the garden and write hundreds of letters to keep in touch with all the doctors and students who had been connected to her hospital. Christmas at Rock Garden became the trendiest party in Boston.

Two years after the Heinzens moved in, Julia Sprague, a women’s rights activist and founding member of the New England Women’s Club, also joined the household. Sprague and Zakrzewska established an immediate friendship and eventually became lovers, sharing a long-term romantic relationship.

From a young age, Marie Zakrzewska felt uncharacteristically shy around girls and spent more time roughhousing with boys. At age eleven, she met twelve-year-old Elizabeth Hohenhorst, a sweet Catholic schoolgirl who told vivid adventure stories that won young Marie’s heart. “My love for her was unbounded,” Zakrzewska wrote in her memoir. Even though she was Protestant, young Marie accompanied Elizabeth to her Catholic church and even received religious instruction to become a nun. This lasted until Elizabeth went to confession for the first time. After hearing about Elizabeth’s adoration for her Protestant friend, the priest forbade her to continue the relationship. The separation broke young Marie’s heart.

Now she surrounded herself with interesting women. Her circle of friends included Caroline Severance, Harriot Hunt, Anna Freeman Clarke, Lucia Peabody, Ednah Dow Cheney, and Lucy Goddard. Julia Ward Howe, Boston socialite and renowned lyricist of the “Battle Hymn of the Republic,” often attended Zakrzewska’s parties to read her most recent poems. Some of these women also invested in Zakrzewska’s hospital and joined its board of directors. They weren’t just her friends and business partners; they were her protectors too.

Zakrzewska’s first job after moving to Boston was as a professor of obstetrics and diseases of women at the New England Female Medical College. The institution had been founded as a school of midwifery in 1848 by Samuel Gregory, an eccentric health reformer with no formal medical training. Gregory was able to secure the funding for his medical school by asserting that, for morality’s sake, only women should assist other women during childbirth. Its board of lady managers consisted of some of the most prominent women reformers: Lucy Goddard, Harriet Beecher Stowe, and Ednah Dow Cheney. These women, not Gregory, had enticed Zakrzewska from New York to Boston, and the young doctor entered her new position full of energy and hope.

Zakrzewska required all of her employees to exhibit empathy toward patients and follow the Golden Rule: treat others as one wants to be treated.

However, it soon became apparent that Gregory’s unstable temperament and old-fashioned ideas about treating disease conflicted with Zakrzewska’s scientific approach to medicine. She believed he had driven the school into quackery. The college offered only four months of study and without a standardized, graded curriculum. Zakrzewska received no support when trying to raise the school’s standards. Worst of all, Zakrzewska later wrote, Gregory consistently antagonized Boston’s elite physicians by accusing them of “the grossest indelicacy, yes, even criminality, in their relations with their [female] patients.” In turn, Boston physicians refused to support the school, and women physicians who trained at other medical schools kept their distance. Zakrzewska realized that working for Gregory could result in the death of her own career. The final blow came when he denied her requests for thermometers, microscopes, and test tubes on the grounds that these were “new-fangled European notions.” After that, the eminently scientific Zakrzewska resigned. She left with several top students and trustees, including Cheney and Goddard.

Zakrzewska envisioned building her own medical school, one that would be guided by the highest standards of excellence. To achieve her vision, she scoured Boston for funding. But even the charismatic Zakrzewska, who had attracted seemingly unlimited funds for the Blackwells’ infirmary, could raise only pennies for a women’s medical school. Refusing to admit defeat, she decided to open a hospital for women and children operated by women only. That endeavor proved to be extremely popular.

Women provided the backbone of Zakrzewska’s support, but she also depended on the goodwill, encouragement, and active participation of men in Boston’s inner circle of male reformers, including William Lloyd Garrison, the abolitionist Frederick W. G. May, and the wealthy state senator and judge Samuel Sewall. In addition, a number of physicians were willing to stake their reputations on a separate institution for women doctors. Drs. Henry Bowditch, Samuel Cabot, and Benjamin Jeffries were among twenty-six men who served as consulting physicians to the new hospital.

With the blessing of prominent Boston men and the help of Harriot Hunt’s network of activists, Zakrzewska purchased used hospital equipment and rented a “sunny, airy house with a large yard at No. 60, Pleasant Street.” On July 2, 1862, in the midst of the Civil War, she was ready to open the New England Hospital for Women and Children. She widely advertised that the institution would provide medical aid for women by competent physicians of their own sex, assist educated women in the practical study of medicine, and train nurses for the care of the sick. Lucy Sewall, Senator Sewall’s daughter and a protégée of Zakrzewska’s who had studied medicine in Europe, became the hospital’s first attending physician. Lucy and Zakrzewska were close friends and often rounded together in the morning and evening, greeting patients, answering questions, calming worries, and establishing a nurturing environment. Women patients wanted to be cared for by other women. Some had complained to Zakrzewska that at the other Boston hospitals, the male practitioners treated them with open hostility, calling them names and blaming them for their own botched procedures.

By contrast, Zakrzewska required all of her employees to exhibit empathy toward patients and follow the Golden Rule: treat others as one wants to be treated. At the New England hospital, the doctors and nurses were less hurried and less interventionist in deliveries, and they performed practical charitable functions, such as finding housing and employment for their indigent patients.

Zakrzewska’s hospital was very clean and well organized. Each room contained a sink with a bar of soap so doctors and nurses could wash their hands. Freshly laundered and vividly white hospital gowns, sheets, and towels were stored for easy access. Even the nurses’ laced boots were perfectly white. Zakrzewska required her practitioners to keep written records on all patients, an extraordinary request back then. At the time, no other hospital in Boston kept any patient records at all. Commenting on this fact, Zakrzewska mocked the male doctors by saying that perhaps important patient details remained permanently inscribed in men’s large brains.

The lying-in center at the hospital provided care for impoverished women and women experiencing complications that prevented them from safely giving birth at home. Zakrzewska cared for the patient population that she deemed most vulnerable, including prostitutes. While most hospitals required proof of marriage from pregnant women, Zakrzewska never turned away a woman in need. “Let he who is without sin throw the first stone,” she told her staff.

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