August 20, 1872

Dr. Susan Dimock Begins Medical Residency

PRIMARY SOURCE: Letter, 1868
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On this day in 1872, Dr. Susan Dimock became the resident physician at the New England Hospital for Women and Children in Boston. Only a month earlier, she had returned from medical school in Europe, where there was less hostility to women becoming doctors. In her three years at the New England Hospital, she handled day-to-day management, cared for patients, and performed surgery. Her most lasting contribution, however, was her work to improve the training of nurses. In Dimock's program, students not only worked on the wards, they also attended lectures and studied anatomy. Tragedy struck before Susan Dimock could see how much the professionalization of nursing did to transform American health care. She died in a shipwreck at the age of 28.

Well into the nineteenth century, nursing was considered undesirable and menial work, suitable only for women whose circumstances left them no better options for supporting themselves.

Well into the nineteenth century, nursing was considered undesirable and menial work, suitable only for women whose circumstances left them no better options for supporting themselves. It took Florence Nightingale many years to convince her family to allow her to study nursing. She trained in Germany before returning to London to take up her profession. Britain's involvement in the Crimean War (1854-1856) gave her the chance to demonstrate the benefits of having nurses in military hospitals, but first she had to overcome doctors' opposition to the presence of women in the wards. Once she did, she quickly earned the respect and gratitude of the soldiers and in time their families. After the war, contributions from a grateful public enabled Nightingale to start the first nurses' training school at a London hospital.

Meanwhile, in Washington, North Carolina, a young Susan Dimock was borrowing anatomy books from the family doctor and accompanying him on his calls. The Civil War disrupted her education — the local academy she was attending closed — and her family life. Her father died, and most of the family property was lost. In 1864 17-year-old Susan and her widowed mother joined relatives in Sterling, Massachusetts. A year later, Susan took a job teaching school in Hopkinton. She spent her evenings poring over medical books recommended by Dr. Marie Zakrzewska, the founder and head physician at the New England Hospital for Women and Children.

Although Harvard, like almost every other American medical school, refused to admit women, it did allow women "under certain restrictions" to follow doctors on their rounds.

Zakrewska had helped to establish the New York Infirmary for Women and Children, the first institution in the world devoted to the care of women and children. Female doctors and surgeons directed the hospital and tended all the patients. In 1862 "Dr. Zak," as she was known, moved to Boston and founded the New England Hospital for Women and Children.

In 1865 Susan Dimock finally persuaded her mother to allow her to study medicine. In January of 1866, a few months shy of her 19th birthday, she arrived at the New England Hospital as a medical student. Although Harvard, like almost every other American medical school, refused to admit women, it did allow women "under certain restrictions" to follow doctors on their rounds. This increased Susan Dimock's determination to obtain a medical degree. She decided to go to Europe, where medical schools were more welcoming of women students than those in the U.S. In 1868, with help from her mother, Dr. Zak, and several Boston philanthropists, she began studying medicine at the University of Zurich in Switzerland.

In between her studies, she traveled. She visited Florence Nightingale in London and observed her nursing education program. She spent time at Kaiserswerth, Germany, where Nightingale had been trained. She returned to Boston in the summer of 1872 eager to put her knowledge and newly acquired medical degree to use.

"No man, not even a doctor," Nightingale once observed, "ever gives any other definition of what a nurse should be than this – devoted and obedient."

Dimock accepted a three-year appointment at the New England Hospital for Women and Children, where she set out to reorganize the training program for nurses. Hospitals traditionally viewed student nurses as a source of cheap labor. They took no classes but learned on the job, by following instructions they received on the ward. After the Civil War, doctors began exercising more oversight of nurses' training. All but a handful of American doctors were men, and they had no expectation (or wish) that nurses would make independent judgments or carry out tasks on their own.

Thanks to Florence Nightingale, however, Susan Dimock saw things differently. "No man, not even a doctor," Nightingale once observed, "ever gives any other definition of what a nurse should be than this – devoted and obedient. This definition would do just as well for a porter. It might even do for a horse. It will not do for a nurse." Nightingale believed that the nurse had a special role as a health care provider and hospital administrator, and that her education should prepare her for that role.

Florence Nightingale saw nurses in training as students, not workers; Susan Dimock believed they could be both.

Dimock agreed with Nightingale's vision of nursing — up to a point. She understood and was eager to lower the obstacles nurses faced to gaining knowledge, credentials, and respect; but as a doctor herself, she also understood the value of the nurse's traditional role. Florence Nightingale saw nurses in training as students, not workers; Susan Dimock believed they could be both.

She started a one-year training program for student nurses at the New England Hospital and soon added a second year. Students began their day before sunrise and finished at 9 pm. Dimock and other women doctors lectured on a variety of topics, including nutrition, bandaging, inflammation, and surgery. A number of the graduates of the program were instrumental in helping nursing become a respectable profession, one that a middle-class woman could pursue without seeming "unwomanly." After Susan Dimock's sudden death at sea in 1875, friends and admirers endowed a "free bed" for indigent patients in her name at the New England Hospital for Women and Children. Today the hospital is home to the Dimock Community Health Center.

Location

This Mass Moment occurred in the Greater Boston region of Massachusetts.

Sources

Prologue to Professionalism, ed. by M. Louise Fitzpatrick (Bowie, 1983).

Ordered to Care: The Dilemma of American Nursing 1850-1945, by Susan Reverby (Cambridge University Press, 1987).

Notable American Women, Vol. 1 (Harvard University Press, 1971).

Memoir of Susan Dimock, Resident Physician of the New England Hospital for Women and Children. (n.p., 1875.)

Enduring Issues in American Nursing, ed. by Ellen Baer, et al. (Springer Publishers, 2001).

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