Zakrzewska, Marie Elizabeth b. September 6, 1829; Berlin, Prussia d. May 12, 1902; Jamaica Plain, Massachusetts

In 1852 Marie Elizabeth Zakrzewska was the most thoroughly trained medical woman in Berlin. At the age of twenty- two, she was installed as chief Accoucheuse (obstetrician or midwife) of the Royal Hos­pital Charite and as professor in the affili­ated School for Midwives.

Zakrzewska’s early formal education was somewhat unusual in that she attended classes with boys in primary school. She re­called that teachers called her “unruly.” Her temperament did not lend itself easily to the three most important virtues taught in the Prussian Restoration era—namely, piety, patriotism, and submissiveness. In the meantime, her practical introduction to medical care began. Her grandfather, in organizing a charitable institution for war veterans, included living quarters for the sick and insane. There, she learned from nurses how close observation of patients could teach the causes and courses of dis­eases. When she supervised maternity wards in Berlin, her strict attention to cleanliness virtually eliminated deaths there from puerperal fever.

During the time Zakrzewska was visit­ing Berlin medical institutions for charita­ble and familial reasons; her family was forced by financial reverses to enter paid medical service. Influential friends secured the mother’s admission to midwifery train­ing so that she could support her family. After one and one-half years of practical study, student midwives moved into resi­dence in the maternity hospital for six months. Zakrzewska’s mother boarded out her five younger children during this in­ternship, but gained permission for eleven­year-old Marie to stay in the hospital be­cause she needed eye treatments. During this time, Marie was treated by a Dr. Muller who allowed her the run of the hospital, in­cluding the morgue, where she satisfied her curiosity about corpses and dissection appa­ratus. He gave her books to read during school vacations, including the History of Midwifery and the History of Surgery. Thus, Zakrzewska began her first apprenticeship phase in learning medicine at the age of eleven by reading with a doctor.

In 1843 when she was fourteen years old, she began assisting with her mother’s midwifery practice. Marie also provided private medical care for relatives, as did other women of her time. Through an aunt, Zakrzewska met a homeopath who taught her about the theories of Samuel Hahnemann and about then-prevalent Spiritualist beliefs, including mesmerism and magnetism. She studied scientific books on her own, while at the same time going through the usual discipline of Ger­man girls, learning plain sewing, dressmak­ing, and the management of the house­hold.

After attending the midwives school at the Charite Hospital in Berlin, Zakrzewska became—to the astonishment of many male colleagues—the assistant of Joseph Hermann Schmidt, the director of the royal hospital. When Schmidt announced that Zakrzewska was to be his future assis­tant, younger male members of the medical profession who coveted the post of mid­wifery professor began to organize in op­position to Schmidt’s plans. However, Schmidt considered educating women as an experiment in scientific possibilities. He made a point of inviting prominent med­ical men to witness his protege’s final ex­amination, saying he wanted to convince colleagues that she could do better than half of the young men at their examina­tions. Once she was admitted to the mid­wifery school, Schmidt trained her to take over his lectures. Zakrzewska constantly ac­companied him on his hospital rounds, completing the second phase of an appren­ticeship in medical practice, that of riding (visiting patients) with the doctor.

When her mentor died on the very af­ternoon of her appointment to be superin­tendent of the Midwifery Department, Za- krzewska faced an uphill battle against her male colleagues. Without Schmidt’s influ­ential support, Zakrzewska continued in her academic duties for only six months be­fore bureaucratic pressures and professional intrigues drove her to resign her positions at the state hospital. Sympathetic sponsors then offered to raise funds to build a private maternity or surgical hospital for her to manage. As influential figures in the Berlin medical establishment rallied to her sup­port, a window of opportunity for advanc­

ing the work of women as practitioners and teachers of modern medicine seemed to be opening. However, Zakrzewska remem­bered her mentor’s excitement when he re­ceived the first report of the Pennsylvania Female Medical College.

She left Berlin and potential opportu­nities for her unusual career as a woman in German medical practice and education against the protests of family, friends, and professional colleagues. She later reported that she had idealized the freedom of the United States and especially the degree of reform in the position of women. After having been several years in the United States, very probably she would have thought twice before undertaking again to emigrate, for even the idealized freedom had lost a great deal of its charm when she considered how much better it could be. Upon arrival in New York, German ac­quaintances informed Zakrzewska that fe­male physicians in America were only doc- toresses or abortionists who advertised their services in the newspapers. Dr. Reisig, an emigre physician who had been em­ployed by Zakrzewska’s mother for difficult deliveries in Berlin, offered Marie a nursing position in his office, saying that female physicians ranked lower than good nurses in the United States. Finally, a charity or­ganization introduced Marie to Elizabeth Blackwell, who recognized the value of Za- krzewska’s German medical training and her potential worth to reform women’s ed­ucation. Marie Zakrzewska earned her medical degree at the same college as Dr.

Emily Blackwell; namely, Cleveland Med­ical College in 1856.

In the United States, too, recognition of women’s abilities was rare among med­ical men. Zakrzewska recalled proudly that Dr. Cabot, a consulting physician for her Boston hospital, said in 1862 that it was not necessary to call him for forceps cases, as was the usual practice when women de­livered babies, since she was so skilled with forceps and instruments. In fact, Za- krzewska was probably far better trained both in obstetrics and in basic physiology and anatomy, at that time, than most of her American colleagues, male and female.

By the 1890s women interns at Za- krzewska’s New England Hospital for Women and Children who already pos­sessed university degrees sometimes re­sented her insistence that they learn practi­cal patient care from the ground up through attending to conditions of cleanli­ness in the wards, while learning about nu­tritive cooking for the sick, and from not­ing the basic social needs of patients for housing, clothing, and employment. This intensive practical training was patterned after Zakrzewska’s own broad experiences with the sick and invalided in Germany. At the turn of the century, however, an ap­prenticeship system of learning medicine through working long years under the su­pervision of a master practitioner was no longer acceptable to modern generations of medical students. In the end, from Marie Zakrzewska’s perspective, what the new fe­male medical college graduates gained in book learning might well have been offset by their loss of practical hands-on experi­ence at all levels of patient care.

Paulette Meyer

See also Kindergartners

References and Further Reading

Drachman, Virginia. Hospital with a Heart: Women Doctors and the Paradox of Separatism at the New England Hospital, 1862—1969. Ithaca, NY: Cornell University, 1984.

Meyer, Paulette. “From ‘Uncertifiable’ Medical Practice to the Berlin Clinic of Women Doctors: The Medical Career of Franziska Tiburtius (M.D. Zurich, 1876).” Dynamis: Acta Hispanica ad Medicinae Scientiarumque Historiam Illustrandam 19 (1999): 279-303.

Tiburtius, Franziska. “The Development of the Study of Medicine for Women in Germany, and Present Status.” Canadian Practitioner and Review 34 (1909): 492-500.

Vietor, Agnes, ed. A Woman’s Quest: The Life of Marie E. Zakrzewska, M.D. New York: Appleton, 1924.

Zakrzewska, Marie E. “Report of One Hundred and Eighty-seven Cases of Midwifery in Private Practice.” Boston Medical and Surgical Journal 121, no. 23 (December 5, 1889): 557-560.