Monday, March 11, 2019

Women's History Month 2019: Celebrating the Achievements of Women in Healthcare and Medicine

Women's History Month affords us the chance to reflect on and honor the ways in which women have helped shape, not only the United States but also the rest of the world.

This year, the Louisiana Department of Health will be highlighting women pioneers in medicine and healthcare who have not only advanced and advocated for the health of all Americans but also advanced the cause of women and gender equality around the world.

Elizabeth Blackwell - the first woman in the United States to receive a medical degree

The first woman in America to receive a medical degree, Elizabeth Blackwell championed the participation of women in the medical profession and ultimately opened her own medical college for women.
Born near Bristol, England on February 3, 1821, Blackwell was the third of nine children of Hannah Lane and Samuel Blackwell, a sugar refiner, Quaker, and anti-slavery activist. Blackwell’s famous relatives included brother Henry, a well-known abolitionist and women’s suffrage supporter who married women’s rights activist Lucy Stone; Emily Blackwell, who followed her sister into medicine; and sister-in-law Antoinette Brown Blackwell, the first ordained female minister in a mainstream Protestant denomination.
In 1832, the Blackwell family moved to America, settling in Cincinnati, Ohio. In 1838, Samuel Blackwell died, leaving the family penniless during a national financial crisis. Elizabeth, her mother, and two older sisters worked in the predominantly female profession of teaching.
Blackwell was inspired to pursue medicine by a dying friend who said her ordeal would have been better had she had a female physician. Most male physicians trained as apprentices to experienced doctors; there were few medical colleges and none that accepted women, though a few women also apprenticed and became unlicensed physicians.
While teaching, Blackwell boarded with the families of two southern physicians who mentored her. In 1847, she returned to Philadelphia, hoping that Quaker friends could assist her entrance into medical school. Rejected everywhere she applied, she was ultimately admitted to Geneva College in rural New York, however, her acceptance letter was intended as a practical joke.
Blackwell faced discrimination and obstacles in college: professors forced her to sit separately at lectures and often excluded her from labs; local townspeople shunned her as a “bad” woman for defying her gender role. Blackwell eventually earned the respect of professors and classmates, graduating first in her class in 1849. She continued her training at London and Paris hospitals, though doctors there relegated her to midwifery or nursing.  She began to emphasize preventative care and personal hygiene, recognizing that male doctors often caused epidemics by failing to wash their hands between patients.
In 1851, Dr. Blackwell returned to New York City, where discrimination against female physicians meant few patients and difficulty practicing in hospitals and clinics. With help from Quaker friends, Blackwell opened a small clinic to treat poor women; in 1857, she opened the New York Infirmary for Women and Children with her sister Dr. Emily Blackwell and colleague Dr. Marie Zakrzewska. Its mission included providing positions for women physicians. During the Civil War, the Blackwell sisters trained nurses for Union hospitals.
In 1868, Blackwell opened a medical college in New York City. A year later, she placed her sister in charge and returned permanently to London, where in 1875, she became a professor of gynecology at the new London School of Medicine for Women. She also helped found the National Health Society and published several books, including an autobiography, Pioneer Work in Opening the Medical Profession to Women (1895).
Michals, Debra.  "Elizabeth Blackwell."  National Women's History Museum.  National Women's History Museum, 2015.  Date accessed. March 11, 2019.

Marie Curie - Nobel Peace Prize recipient in chemistry

Marie Curie, née Maria Sklodowska, was born in Warsaw on November 7, 1867, the daughter of a secondary-school teacher. She received a general education in local schools and some scientific training from her father. She became involved in a students’ revolutionary organization and found it prudent to leave Warsaw, then in the part of Poland dominated by Russia, for Cracow, which at that time was under Austrian rule. In 1891, she went to Paris to continue her studies at the Sorbonne where she obtained Licenciateships in Physics and the Mathematical Sciences. She met Pierre Curie, Professor in the School of Physics in 1894 and in the following year they were married. She succeeded her husband as Head of the Physics Laboratory at the Sorbonne, gained her Doctor of Science degree in 1903, and following the tragic death of Pierre Curie in 1906, she took his place as Professor of General Physics in the Faculty of Sciences, the first time a woman had held this position. She was also appointed Director of the Curie Laboratory in the Radium Institute of the University of Paris, founded in 1914.

Her early researches, together with her husband, were often performed under difficult conditions, laboratory arrangements were poor and both had to undertake much teaching to earn a livelihood. The discovery of radioactivity by Henri Becquerel in 1896 inspired the Curies in their brilliant researches and analyses which led to the isolation of polonium, named after the country of Marie’s birth, and radium. Mme. Curie developed methods for the separation of radium from radioactive residues in sufficient quantities to allow for its characterization and the careful study of its properties, therapeutic properties in particular.

Mme. Curie throughout her life actively promoted the use of radium to alleviate suffering and during World War I, assisted by her daughter, Irene, she personally devoted herself to this remedial work. She retained her enthusiasm for science throughout her life and did much to establish a radioactivity laboratory in her native city – in 1929 President Hoover of the United States presented her with a gift of $ 50,000, donated by American friends of science, to purchase radium for use in the laboratory in Warsaw.

Mme. Curie, quiet, dignified and unassuming, was held in high esteem and admiration by scientists throughout the world. She was a member of the Conseil du Physique Solvay from 1911 until her death and since 1922 she had been a member of the Committee of Intellectual Co-operation of the League of Nations. Her work is recorded in numerous papers in scientific journals and she is the author of Recherches sur les Substances Radioactives (1904), L’Isotopie et les Éléments Isotopes and the classic Traité’ de Radioactivité (1910).

The importance of Mme. Curie’s work is reflected in the numerous awards bestowed on her. She received many honorary science, medicine and law degrees and honorary memberships of learned societies throughout the world. Together with her husband, she was awarded half of the Nobel Prize for Physics in 1903, for their study into the spontaneous radiation discovered by Becquerel, who was awarded the other half of the Prize. In 1911 she received a second Nobel Prize, this time in Chemistry, in recognition of her work in radioactivity. She also received, jointly with her husband, the Davy Medal of the Royal Society in 1903 and, in 1921, President Harding of the United States, on behalf of the women of America, presented her with one gram of radium in recognition of her service to science.

Marie Curie – Biographical. Nobel Media AB 2019. Fri. 15 Mar 2019. <>

Clara Barton
An educator and humanitarian, Clarissa “Clara” Harlowe Barton helped distribute needed supplies to the Union Army during the Civil War and later founded the disaster relief organization, the American Red Cross.
Born on December 25, 1821 in Oxford, Massachusetts, Barton was the youngest of Stephen and Sarah Barton’s five children. Her father was a prosperous farmer. As a teenager, Barton helped care for her seriously ill brother David—her first experience as a nurse.
Barton’s family directed their painfully shy daughter to become a teacher upon the recommendation of renowned phrenologist L.N. Fowler, who examined her as a girl. She began teaching at age 18, founded a school for workers’ children at her brother’s mill when she was 24, and after moving to Bordentown, New Jersey, established the first free school there in 1852. She resigned when she discovered that the school had hired a man at twice her salary, saying she would never work for less than a man.
In 1854 she was hired as a recording clerk at the US Patent Office in Washington, DC, the first woman appointed to such a post. She was paid $1,400 annually, the same as her male colleagues. However, the following year, Secretary of the Interior Robert McClelland, who opposed women working in government, reduced her to copyist with a lower salary. In 1857, the Buchanan Administration eliminated her position entirely, but in 1860, she returned as copyist after the election of President Abraham Lincoln.
When the Civil War began in 1861, Barton quit her job and made it her mission to bring supplies to Union soldiers in need—among them, men of the 6th Massachusetts Infantry. This started a life-long career of aiding people in times of conflict and disaster. In 1862, she received official permission to transport supplies to battlefields and was at every major battle in Maryland, Virginia, and South Carolina, where she also tended to the wounded and became known as the “angel of the battlefield.” She was officially named head nurse for one of General Benjamin Butler’s units in 1864, even though she had no formal medical training. She joined Frances Gage in helping to prepare slaves for their lives in freedom. After the war, Barton helped locate missing soldiers, mark thousands of graves, and testified in Congress about her wartime experiences.
In 1869, Barton traveled through Europe to regain her health. While in Switzerland, she learned about the International Red Cross, established in Geneva in 1864. Returning to the US, Barton built support for the creation of American society of the Red Cross by writing pamphlets, lecturing, and meeting with President Rutherford B. Hayes. On May 21, 1881, the American Association of the Red Cross was formed; Barton was elected president in June. In 1882, the US joined the International Red Cross.
Barton remained with the Red Cross until 1904, attending national and international meetings, aiding with disasters, helping the homeless and poor, and writing about her life and the Red Cross. She was also an ardent supporter of women’s suffrage. In 1904, she established the National First Aid Association of America, an organization that emphasized emergency preparedness and developed first aid kits. Her Glen Echo, Maryland home became a National Historic Site in 1975, the first dedicated to the achievements of a woman.
Michals, Debra.  "Clara Barton."  National Women's History Museum. National Women's History Museum, 2015. Date Accessed. March 20, 2019

Mary-Claire King 

Mary-Claire King was born on February 27, 1946, in Evanston, Illinois, a suburb of Chicago, to Harvey W. and Clarice King. The family included a brother Paul, who later became a mathematician and business consultant, as well as a stepbrother and stepsister. King's father worked at Standard Oil of Indiana managing the personnel department. King studied mathematics at Carleton College in Northfield, Minnesota, graduating Phi Beta Kappa in 1966. Eager for a challenge, she enrolled in graduate school studying biostatistics at the University of California at Berkeley, where she planned to use her math background in the field of medicine. After a course with geneticist Curt Stern, King found she enjoyed the concrete applications of genetics and changed her major. She was granted a National Science Foundation fellowship from 1968 to 1972 for her graduate studies.

During the turbulent Vietnam War era, King organized a letter-writing campaign and petition drive at the University of California, protesting the American invasion of Cambodia. After then-governor Ronald Reagan sent the National Guard to the campus to remove students from the buildings, King became dismayed and dropped out. For a while, she worked with consumer watchdog, Ralph Nader, investigating the effects of pesticides on farm workers. He offered her a job in Washington, D.C., and she weighed the option heavily. She told her friend Allan Wilson, a professor of biochemistry and molecular biology at Berkeley, that she was disappointed with her academic research. "'I can never get my experiments to work,' I said," recalled King in Omni. "'I'm a complete disaster in the lab.' And Allan said, 'If everyone whose experiments failed stopped doing science, there wouldn't be any science.' So I went to work in his lab."

At the time, Wilson was looking into the genetic differences between chimpanzees and humans. King worked with him, despite doubts, and finished her dissertation outlining the fact that the DNA of humans and chimps is 99 percent identical. This indicated that the two species possibly had a common ancestor about five million years ago, a time estimate about ten million years sooner than previously thought, based on fossil evidence. The researchers were pictured on the cover of Science magazine in April 1975 for their discovery. Meanwhile, King received her doctorate from the University of California in 1973 and married Robert Colwell, a zoologist. They later had a daughter, Emily, but divorced when she was five. The couple went to the Universidad de Chile to teach. In September, after the assassination of Socialist government leader Salvador Allende, many left-wing supporters were killed, went into hiding, or left Chile. These included some of King's friends and students.

Returning to the United States, King worked for a year in epidemiology at the University of California in San Francisco, then was hired as an assistant professor in that discipline at the Berkeley campus in 1976. She was promoted to associate professor in 1980 and professor in 1984. King spent her time studying 1,579 women, trying to prove that some breast cancer cases could be traced to a single gene. Aware of the fact that breast cancer sometimes runs in families, she studied chromosomes of related women who had the disease. After tedious work dating from 1974, a new technology breakthrough in the early 1980s made it possible to search for pieces of DNA from blood samples. In 1990, she presented her findings at the American Society of Human Genetics annual meeting in Cincinnati. King had narrowed the possibilities to a gene located on chromosome 17.
Following this remarkable news, a kind of "holy grail" search ensued in the scientific community, with about a dozen teams of researchers fervently trying to isolate the gene, dubbed BRCA1. In September 1994, Mark Skolnick and his colleagues at the University of Utah Medical Center won the race. King and her group, however, did not fail in their mission. Her original research, coupled with ongoing studies of BRCA1 and BRCA2 (another gene that was found a year later), had succeeded in raising awareness of breast cancer and the need for further study. King noted at a 1996 conference in Paris that immense achievements had been made in figuring out how the gene worked. She and some researchers at Vanderbilt University discovered that healthy genes may be able to halt, or even reverse, the effects of the mutant gene. This opened up the possibility of using gene therapy-correcting or replacing the gene-as a future method of treatment. Well into the 1990s, however, scientists still had few clues as to why breast cancer rates were increasing in developed nations such as the United States, Canada, and across Europe.

King's breast cancer research paved the way to determining whether other diseases could be inherited. "Before BRCA1, there was a widespread view that diseases like breast cancer were caused by multiple genes that interact with environmental factors. This didn't provide geneticists with a clear road ahead," noted Maynard Olson, a professor with the University of Washington, in Columns, the university's alumni magazine. "In the midst of that, Mary-Claire's initial report was a jolt. She told a different story: that in carefully selected families she could find a fairly simple genetic link for breast cancer. It provided us with a powerful path forward. We now know that many important diseases can be attacked in the same way."

King combined her activist zeal and her education in genetics to assist grandmothers in Argentina who had lost their grandchildren during the civil war of the 1970s. After a coup in 1975, the military began kidnapping huge numbers of people in order to instill terror. Many of the "disappeared," as they came to be known, were pregnant women or women with children. Older children were killed, and pregnant women were tortured. Their babies were sold or adopted by military members, after which the mothers were killed. The new parents would claim the children as their own, despite no sign of pregnancy by the military wives. Through subversive contacts, such as midwives and obstetricians who were coerced to deliver the babies, family members tried to keep track of the relatives they had lost. By 1977, families began forming human rights groups to find the missing children.

In 1983, members of Abuelos de Plaza de Mayo asked the American Association for the Advancement of Science to provide a geneticist who could help determine if certain youngsters were their grandchildren. King went to Argentina in June 1984 to identify remains as well as perform HLA (human leukocyte antigens) typing on living children, a test that analyzes blood proteins. Thanks to King's help, dozens of children were reunited with their biological families. She also assisted with performing DNA tests on exhumed remains in order to initiate criminal cases against the murderers. In similar projects, King has helped the U.S. government and the United Nations identify the remains of soldiers who had been missing in action.

In the mid-1990s, King began doing AIDS research, trying to determine whether genetics plays a part in why some people quickly develop full-blown AIDS, while others live for years with the disease. At this time, she accepted a position at the University of Washington, where she teaches in the departments of medicine and genetics. King has worked with the Human Genome Project, a government-sponsored program to map and analyze all 100,000 human genes. In addition, she has served on the Special Commission on Breast Cancer of the President's Cancer Panel; the advisory board of the National Institutes of Health Office of Research on Women's Health; and on committees of the National Academy of Sciences and the National Institute of Medicine.

"Mary-Claire King.Encyclopedia of World Biography. . 22 Mar. 2019 <>.

Virginia Apgar 

Virginia Apgar contributed to many areas of medicine during her career, including anesthesiology, infant care, and the study and prevention of birth defects. It was her work with new babies and mothers, however, that has left the greatest mark in the health sciences. She was the creator of the Apgar Newborn Scoring System, a method of evaluating the health of infants minutes after birth in order to ensure the delivery of proper care. Apgar also contributed to infant health through her discovery that some anesthetics given to women during childbirth had a negative effect on babies. Her findings led doctors across the country to revise their use of painkillers during labor. Later in her career, Apgar was a vital force in the March of Dimes organization, where she directed research efforts, raised money, and educated the public about birth defects. Her lifetime of energetic work resulted in standard medical procedures for mothers and babies that have prevented thousands of infant deaths.

Apgar was born on June 7, 1909, in Westfield, New Jersey. Her childhood home contained a basement laboratory, where her father pursued scientific experiments with electricity and radio waves and built a telescope. Perhaps due to this atmosphere of curiosity and inquiry, Apgar set her sights on a scientific career in the field of medicine. After graduating from high school, she entered Mount Holyoke College with the intention of becoming a doctor. Although she received scholarships that helped to pay for her tuition, she still had to take a number of jobs to support herself through college. Despite the extra work, she graduated with a bachelor's degree in 1929.

Apgar's financial situation did not improve when she enrolled at the College of Physicians and Surgeons at Columbia University in New York City the following September. A month later, the stock market crashed, signaling the beginning of the decade of economic turmoil known as the Great Depression. Determined to stay in school, Apgar borrowed money in order to complete her course work. She emerged in 1933 with a medical degree and a fourth-place rank in her graduating class, but also with the burden of a large financial debt. Her high marks earned her a much sought-after internship in surgery at Columbia, but during this period of training Apgar began to consider how she could best support herself in the medical profession. She saw that even male surgeons had trouble finding work in New York City, and as a woman in what was then a male-dominated profession, she realized that her chances of success were even slimmer. She felt that she was more likely to be successful in the field of anesthesia.

Traditionally, nurses had been responsible for administering anesthesia, but at that time greater emphasis was being to be placed on the importance of anesthetics; doctors had begun entering the field in the hopes of making breakthroughs that would allow for improved surgery techniques. Women physicians, in particular, were encouraged to pursue medical anesthesiology, perhaps because it was still considered a female realm. So after finishing her internship at Columbia in 1935, Apgar began a two-year residency program in anesthesiology, during which time she studied not only at Columbia, but also at the University of Wisconsin in Madison and Bellevue Hospital in New York.

Apgar's choice of career did allow her to realize her goal of securing a job. She was hired as director of the anesthesia division at Columbia University in 1938. Her new position, however, proved to be a challenging one. She was the only person in the anesthesia area, leaving her with a heavy workload. In addition, she struggled to get surgeons to recognize the anesthesiologist as a fellow doctor, not a subordinate, and she fought against the policy that prevented anesthesiologists from being allowed to charge standard doctor's fees. Eventually, Apgar and her department began to receive more support and respect—she gradually increased the number of physicians in the division and won sufficient funding for the area and its employees in 1941, after threatening to quit her post if the school refused her requests. After World War II, anesthesiology began gaining more attention across the nation as an area of specialty and research, and Columbia University created a separate department of anesthesia for training physicians and conducting research. When the chair of the new department was selected in 1949, however, Apgar was passed over in favor of a male anesthesiologist. Instead, she was named a full professor in the department, making her the first woman to reach such a level at Columbia.

It was in this position as a teacher and researcher that Apgar would make her greatest contributions to medicine over the next decade. She began to focus her work in the area of anesthesia used during childbirth. Apgar realized that the period immediately following birth was a critical time for many infants; however, babies were usually not evaluated carefully by doctors, who were often more concerned with the welfare of the mother. Because of this lack of an organized examination, many life-threatening conditions were not identified in infants. To provide a quick and efficient means of determining which babies required special care, she devised a five-part test that scored a child's heart rate, respiration, muscle tone, color, and reflexes. The test, known as the Apgar Newborn Scoring System, was to be scored one minute after birth; the recommended timing of the test was later expanded to five and ten minutes as well. Although developed in 1949, a description of the system was not published until 1953. It eventually became a world-wide standard among physicians. A study by Apgar involving a dozen hospitals and more than 17,000 infants evaluated by the Apgar score proved that the testing method was a predictable indicator of a child's survival and rate of development.

Another victory for infant health was won with Apgar's research into the effects of anesthesia given to mothers during childbirth. Collaborating with pediatrician L. Stanley James and anesthesiologist Duncan Holaday, Apgar monitored the blood levels, blood gases, and pH levels of newborns whose mother received anesthesia during labor. These measurements, combined with the application of the Apgar score system, were designed to indicate to doctors what kinds of problems—such as a low oxygen level or a pH imbalance in the blood—needed to be addressed if a baby was doing poorly. To take such measurements and facilitate treatments, Apgar became the first person to place a catheter in the umbilical artery, now a standard practice in neonatal care. In the course of her research, Apgar found that the anesthesia cyclopropane had a noticeable negative effect on a baby's overall condition. Immediately ceasing her use of the gas for mothers in labor, other doctors across the country quickly followed suit after Apgar published her findings.

After a more than twenty-year career at Columbia, Apgar left her post as professor to earn a master of public health degree at Johns Hopkins University. Her new career took her to the March of Dimes organization in 1959, where she was hired as the head of the division on congenital birth defects. In 1969, she became the head of the March of Dimes research program; during her three-year stint in this role she changed the foundation's emphasis from the prevention of the crippling disease polio to a concentrated effort to prevent birth defects. In an effort to educate the public about the topic, she gave many lectures and cowrote a book titled Is My Baby All Right? in 1972. Apgar left her research position in 1973 to become vice president for medical affairs and a fund-raiser. She was a great success in both roles, increasing donations to the charity and channeling the new money into research on birth defects, resulting in better prevention and treatment of many conditions. At the same time, she held a research fellowship at Johns Hopkins University and a position as clinical professor at Cornell University, where she became the first U.S. medical professor to specialize in birth defects.

During her lifetime, Apgar made significant contributions to science not only in the laboratory, but also in the classroom. She instructed hundreds of doctors and left a lasting mark on the field of neonatal care. Apgar received a number of awards recognizing her role in medicine. She was honored with the Ralph Waters Medal from the American Society of Anesthesiologists and the Gold Medal of Columbia University, was named Woman of the Year for 1973 by Ladies' Home Journal, and was the recipient of four honorary degrees. In addition, a prize in her name was founded by the American Academy of Pediatrics and an academic chair was created in her honor at Mount Holyoke College.

Apgar, who never married, was unrelenting in her pursuit of knowledge. In her sixties, she began a course of study in genetics at Johns Hopkins University. She also found time, however, for a number of personal interests, including music, gardening, photography, and stamp collecting. On August 7, 1974, Apgar died in New York City at the age of 65. She was remembered as an honest and encouraging teacher who inspired numerous doctors in their medical practice and research. The modern fields of anesthesiology and neonatal care are greatly indebted to her pioneering work.

Gertrude B. Elion

Gertrude B. Elion, in full Gertrude Belle Elion, (born Jan. 23, 1918, New York, N.Y., U.S.—died Feb. 21, 1999, Chapel Hill, N.C.), American pharmacologist who, along with George H. Hitchings and Sir James W. Black, received the Nobel Prize for Physiology or Medicine in 1988 for their development of drugs used to treat several major diseases.

Elion was the daughter of immigrants. She graduated from Hunter College in New York City with a degree in biochemistry in 1937. Unable to obtain a graduate research position because she was a woman, she found work as a lab assistant at the New York Hospital School of Nursing (1937), an assistant organic chemist at the Denver Chemical Manufacturing Company (1938–39), a chemistry and physics teacher in New York City high schools (1940–42), and a research chemist at Johnson & Johnson (1943–44). During this time she also took classes at New York University (M.S., 1941). Unable to devote herself to full-time studies, Elion never received a Ph.D.

In 1944 Elion joined the Burroughs Wellcome Laboratories (later part of Glaxo Wellcome; today known as GlaxoSmithKline). There she was first the assistant and then the colleague of Hitchings, with whom she worked for the next four decades. Elion and Hitchings developed an array of new drugs that were effective against leukemia, autoimmune disorders, urinary-tract infections, gout, malaria, and viral herpes. Their success was due primarily to their innovative research methods, which marked a radical departure from the trial-and-error approach taken by previous pharmacologists. Elion and Hitchings pointedly examined the difference between the biochemistry of normal human cells and those of cancer cells, bacteria, viruses, and other pathogens (disease-causing agents). They then used this information to formulate drugs that could kill or inhibit the reproduction of a particular pathogen, leaving the human host’s normal cells undamaged. The two researchers’ new emphasis on understanding basic biochemical and physiological processes enabled them to eliminate much guesswork and wasted effort typical previously in developing new therapeutic drugs.

Though Elion officially retired in 1983, she helped oversee the development of azidothymidine (AZT), the first drug used in the treatment of AIDS. In 1991 she was awarded a National Medal of Science and was inducted into the National Women’s Hall of Fame.

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