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Doctoring and nursing arose as complementary functions, and the society which defined nursing as feminine could readily see doctoring as intrinsically “masculine.” If the nurse was idealized Woman, the doctor was idealized Man—combining intellect and action, abstract theory, and hard-headed pragmatism. The very qualities which fitted Woman for nursing barred her from doctoring, and vice versa. Her tenderness and innate spirituality were out of place in the harsh, linear world of science. His decisiveness and curiosity made him unfit for long hours of patient nurturing.
These stereotypes have proved to be almost unbreakable. Today’s leaders of the American Nursing Association may insist that nursing is no longer a feminine vocation but a neuter “profession.” They may call for more male nurses to change the “image,” insist that nursing requires almost as much academic preparation as medicine, and so on. But the drive to “professionalize” nursing is, at best, a flight from the reality of sexism in the health system. At worst, it is sexist itself, deepening the division among women health workers and bolstering a hierarchy controlled by men.
Conclusion
WE HAVE OUR OWN MOMENT OF HISTORY TO WORK out, our own struggles. What can we learn from the past that will help us—in a Women’s Health Movement—today?
These are some of our conclusions:• We have not been passive bystanders in the history of medicine. The present system was born in and shaped by the competition between male and female healers. The medical profession in particular is not just another institution which happens to discriminate against us: it is a fortress designed and erected to exclude us. This means to us that the sexism of the health system is not incidental, not just the reflection of the sexism of society in general or the sexism of individual doctors. It is historically older than medical science itself; it is deep-rooted, institutional sexism.
• Our enemy is not just “men” or their individual male chauvinism: it is the whole class system which enabled male, upper-class healers to win out and which forced us into subservience. Institutional sexism is sustained by a class system which supports male power.
• There is no historically consistent justification for the exclusion of women from healing roles. Witches were attacked for being pragmatic, empirical, and immoral. But in the nineteenth century the rhetoric reversed: women became too unscientific, delicate, and sentimental. The stereotypes change to suit male convenience—we don’t, and there is nothing in our “innate feminine nature” to justify our present subservience.
• Men maintain their power in the health system through their monopoly of scientific knowledge. We are mystified by science, taught to believe that it is hopelessly beyond our grasp. In our frustration, we are sometimes tempted to reject science, rather than to challenge the men who hoard it. But medical science could be a liberating force, giving us real control over our own bodies and power in our lives as health workers. At this point in our history, every effort to take hold of and share medical knowledge is a critical part of the struggle—know-your-body courses and literature, self-help projects, counseling, and women’s free clinics.
• Professionalism in medicine is nothing more than the institutionalization of male upper-class monopoly. We must never confuse professionalism with expertise. Expertise is something to work for and to share; professionalism is—by definition—elitist and exclusive, sexist, racist, and classist. In the American past, women who sought formal medical training were too ready to accept the professionalism that went with it. They made their gains in status—but only on the backs of their less privileged sisters—midwives, nurses, and lay healers. Our goal today should never be to open up the exclusive medical profession to women, but to open up medicine—to all women.
• This means that we must begin to break down the distinctions and barriers between women health workers and women consumers. We should build shared concerns: consumers aware of women’s needs as workers, workers in touch with women’s needs as consumers. Women workers can play a leadership role in collective self-help and self-teaching projects, and in attacks on health institutions. But they need support and solidarity from a strong women’s consumer movement.
• Our oppression as women health workers today is inextricably linked to our oppression as women. Nursing, our predominate role in the health system, is simply a workplace extension of our roles as wife and mother. The nurse is socialized to believe that rebellion violates not only her “professionalism,” but her very femininity. This means that the male medical elite has a very special stake in the maintenance of sexism in the society at large: doctors are the bosses in an industry where the workers are primarily women. Sexism in the society at large insures that the female majority of the health workforce are “good” workers—docile and passive. Take away sexism and you take away one of the mainstays of the health hierarchy.
What this means to us in practice is that in the health system there is no way to separate worker organizing from feminist organizing. To reach out to women health workers as workers is to reach out to them as women.
Bibliography
[As appeared in the original 1973 printing.]
The Manufacture of Madness, by Thomas Szasz, MD, Delta Books, 1971. Szasz asserts that institutional psychiatry is the modern version of the witch-hunts, with the patient in the role of the witch. We are indebted to him for first presenting witchcraft in the context of the struggle between professionals and lay healers. See especially the chapter on “The Witch as Healer.”
Satanism and Witchcraft, by Jules Michelet. The Citadel Press, 1939. A mid-nineteenth century work by a famous French historian. A vivid book on the Middle Ages, superstition and the Church, with a discussion of “satan as physician.”
The Malleus Maleficarum, by Heinrich Kramer and James Sprenger, translated by Rev. Montague Summers. The Pushkin Press, London, 1928. Difficult medieval writing, but by far the best source for the day-to-day operations of the witch-hunts, and for insights into the mentality of the witch-hunter.
The History of Witchcraft and Demonology, by Rev. Montague Summers. University Books, New York, 1956. Written in the 1920s by a Catholic priest and defender—really!—of the witch-hunts. Attacks the witch as “heretic,” “anarchist,” and “bawd.”
Witchcraft, by Pennethrone Hughes. Penguin Books, 1952. A general introduction and survey.
Women Healers in Medieval Life and Literature, by Muriel Joy Hughes. Books for Libraries Press,
Freeport, New York, 1943. A conservatively written book, with good information on the state of academic medicine and on women lay doctors and midwives. Unfortunately, it dismisses the whole question of witchcraft.
The Witch Cult in Western Europe, by Margaret Alice Murray. Oxford University Press, 1921. Dr. Murray was the first person to present the anthropological view, now widely accepted, that witchcraft represented, in part, the survival among the people of a pre-Christian religion.
A Mirror of Witchcraft, by Christina Hole. Catto and Windus, London, 1957. A source-book of extracts from trial reports and other writings, mostly from English witch trials of the sixteenth and seventeenth centuries.
The Formation of the American Medical Profession: The Role of Institutions, 1780-1860, by Joseph Kett. Yale University Press, 1968. Conservative point of view, but full of scattered information on lay healers. He discusses the politically radical nature of the Popular Health Movement in Chapter Four.
Medicine in America: Historical Essays, by Richard H. Shryock. Johns Hopkins Press, 1966. A readable, wide-ranging and fairly liberal book. See especially the chapters on “Women in American Medicine” and “The Popular Health Movement.”
American Medicine and the Public Interest, by Rosemary Stevens. Yale University Press 1971. Long and dry, but useful for the early chapters on the formation of the American medical profession and the role of the foundations.
Medical Education in the US and Canada, by Abraham Flexner, Carnegie Foundation, 1910. (Available from University Microfilms, Ltd., Ann Arbor.) The
famous “Flexner Report” that changed the face of American medical education. Some reasonable proposals, but amazing elitism, racism, and sexism.
The History of Nursing, by RIchard Shryock. N.B. Saunders, 1959. Better than most nursing histories—which are usually glorifications of nursing by nursing educators—but must worse than Shryock’s medical histories.
Lonely Crusader: The Life of Florence Nightingale, by Cecil Woodham-Smith. McGraw Hill, 1951. A richly detailed biography which puts nursing in the context of the oppression of upper-class Victorian women.
Glances and Glimpses, by Harriet K. Hunt. Source Book Press, 1970. Rambling autobiography of a feminist and “irregular” woman doctor of the mid-nineteenth century. It’s useful for its descriptions of the state of medical practice at the time.
“The American Midwife Controversy: A Crisis of Professionalization,” by Frances E. Kobrin. Bulletin of the History of Medicine, July-August 1966, p.350. Restrained and scholarly account of the outlawing of American midwives. Very worthwhile reading.
NOTES
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a We are omitting from this discussion any mention of the New England witch trials in the 1600s. These trials occurred on a relatively small scale, very late in the history of witch hunts, and in an entirely different social context than the earlier European witch craze.
Published in 2010 by the Feminist Press
at the City University of New York
The Graduate Center
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Text copyright © 1973 by Barbara Ehrenreich and Deirdre English
All rights reserved
No part of this book may be reproduced or used, stored in any information retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the Feminist Press at the City University of New York, except in the case of brief quotations embodied in critical articles and reviews.
Library of Congress Cataloging-in-Publication Data
Ehrenreich, Barbara.
eISBN : 978-1-558-61690-5
1. Women in medicine--History. 2. Medicine--United States--History. 3. Women healers--United States--History. I. English, Deirdre. II. Title. [DNLM: 1. History of Nursing--United States. 2. Nurses--United States. 3. Midwifery--history--United States. 4. Witchcraft--history--United States. 5. Women’s Health--history--United States. WQ 11 AA1 E33w 2010]
R692.E35 2010
610.82--dc22
2010009446