Literature and Medicine I

Rules and Roles in the Piedmont

11 Annie Alexander was undoubtedly capable of, and suited for, a career in medicine. The first assessment was by Dr. Anita E. Tyng, a native of Providence, Rhode Island, the second vice-president and recording secretary of the Woman’s Medical College of Pennsylvania when Alexander entered in 1881, and the Physician-in-Charge and Alexander’s mentor at the Woman’s Hospital of Philadelphia in 1884-85. Tyng commented in March 1885: “[I] anticipate an honorable & brilliant one [a medical career] for her, because besides her mental accomplishment & good observing faculty, she has three other qualities of the good physician, dignity, gentleness, firmness, & a calmness & coolness in emergency which inspires confidence in others.”[42]Alexander Papers, Box 1, Folder 1, Tyng to John Alexander, Mar. 19, 1885. This is the only known assessment of Alexander which could have been applied equally to a good male physician. All others were highly praiseworthy, and all interpreted her as a woman physician. Susie Van Landingham in 1896 portrayed the practitioner’s success in Charlotte within the context of “a modesty that is impressive and womanliness that is emphatic” (qtd. in Henderson-Smathers 41). Alexander’s niece, who provided the main obituary notice for the North Carolina Medical Society, initiated (in print) the well established family tradition of “Dr. Annie’s” exceptional, heroic, struggle against prejudice: “Her invasion of the field of medicine, so long held by men, and with the laity slow to accept the woman doctor, required very considerable courage” (Stowe 164). Compare her assessment with that earlier by Tyng: “Love and kindliness radiated from her presence in the sick-room, inspiring confidence.” The result was the same; the construction was highly gendered. Both her niece and the Mecklenburg County Medical Society considered her an “unusual woman” (Stowe 164).[43]“Death of Dr. Alexander Subject of Resolutions” (Alexander Papers, Box 1, Folder 11). It is as well that Dr. Alexander was not alive to read this last comment, for her self-assessment would never have placed these two words together. The editorial in The Charlotte News which marked her demise is worthy of quotation in full, as the considered judgment of an influential male commentator: More than the mere novelty of having been the first woman South of the Potomac River to enter the ranks of medicine for a professional career attached to the life and achievements of Dr. Anne [sic] Alexander whose passing here is so widely mourned. She brought into that profession such high resolutions and nobility of character, such proficiency in maintaining that warmth of relationship between practitioner and patient, that she became outstanding. There was a demureness about her and a humility, a seeking of not her own that glorified her in the esteem of her people. Long has she wrought her good works. For more than 40 years she has practiced her profession in the homes of the people here, moving among them with a majestic dignity and a proficient touch which enthroned her not only as a medical expert of superb order, but as a woman doing a great work in a womanly way – with tenderness, with soulfulness, and with love for her work no more dominant than love for those she served.[44]Alexander Papers, Box 1, Folder 11, “Dr. Anne [sic] Alexander” (Oct. 1929).

12 Dr. Alexander would have agreed with the interpretation that she, and all women in medicine, were responsible for performing “a great work in a womanly way.” The character Dr. Katherine feared that contemporaries would view her as transformed “from a gentle girl into a masculine woman.” Alexander consciously worked to avoid such an epithet. This appears to have been both a personal preference, and a public policy. She viewed herself as a white, elite southern woman, whose profession was medicine. Modesty was essential: women of her class and race were modest, and demonstrated this through personality, actions, and dress. This theme lay at the center of Alexander’s actions in the public sphere, and in her private practice, for the moral reform of girls and young women.[45]The theme runs through many of her public addresses and essays. Note, “Fifty Years Ago” and “Dress” (Box 1, Folder 2), “Indigestion Is the Pandoras’ Box of Human Ills” (Box 1, Folder 3). Parents were instructed to restrain, not cultivate, their children’s imaginative and artistic faculties: “Cultivate & insist upon orderliness in all things. Fitness, self control, & orderliness are the most important.”[46]Alexander, Untitled 19-page address to the Charlotte Woman’s Club, beginning “Our Woman’s Club.” Alexander Papers, Box 1, Folder 5. Her unmarried pregnant teenage patients were wrongdoers and sinners.[47]For example, casebook 1924-29, 171, 180 (Alexander Papers, Box 1, Folder 15). A firm Presbyterian piety was a frequently commented upon, life-long, attribute (cf. Stowe 165).[48]Expenditures in her financial records, 1920-24: Alexander Papers, Box1, Folder 7 (unpaginited); “Funeral to Be Held Today For Dr. Alexander”: Alexander Papers, Box 1, Folder 11. Alexander’s value system was traditional at its core. She wrote, “I believe no womans [sic] life is complete until she is a wife and mother. Some of us never attain to that completeness […].”[49]Alexander, “Our Woman’s Club” (Alexander Papers, Box 1, Folder 5). Motherhood was a sensitive personal topic for Alexander. She once observed that the Charlotte Woman’s Club was originally named the Mother’s Club, and she and Miss Lily long, a nurse, were the only unmarried members: “I was asked what we two were doing as members of a mothers [sic] club. I answered that we had helped rear more children than any other member. […] In heart and soul we [women] are all mothers.”[50]Alexander, “Our Woman’s Club” (Alexander Papers, Box 1, Folder 5). She asserted that health and morality concerned women more than men, and their civic involvement was therefore indispensible: “Women should be on all Boards that have to do with women and children [in addition to working through women’s clubs and civic leagues]. […] Women’s work is essential with children.”[51]Alexander, “Womans [sic] Aid in Civics” (Alexander Papers, Box 1, Folder 5). And, in medical practice, even in the South, a woman doctor was accepted “where she conducts herself as a true woman and physician should.”[52]One detached page of an address by Alexander on women in medicine, delivered to a South Carolina audience, circa 1890s. Alexander Papers, Box 1, Folder 5.

13 In 1889, Alexander argued the case for women in medicine in terms of separate spheres. They were required because “[a] suffering woman naturally turns to [a] woman for sympathy.” And, there were diseases peculiar to women which both should be, and better could be, treated by doctors of their own sex (“Women Physicians”). Moreover, women physicians had demonstrated great success in treating childhood diseases because “There is an instinct in women that gives them an insight into the sufferings of the little ones” (“Women Physicians” 1-2). The sentiments within “Doctor Katherine”, expressed more briefly, adhere to these beliefs. A quarter century later, in a similar exhortation to young women, Alexander no longer cited the importance of providing women physicians for women patients. Now, the emphasis was upon medicine as a wise career choice for talented young women. Abundant well-paid jobs existed in public health, medical laboratories, hospitals, and medical colleges, in contrast to the overcrowded fields for women teaching in the humanities. Moreover, “[w]hile the work in any field of medicine is exacting, lack of monotony […] lends a charm and inspiration which means joy to the worker, and without which the real zest of living must be lost.”[53]Alexander, “Woman in the Medical Profession” (Alexander Papers, Box 1, Folder 5). At present, she noted, twenty-five women were practicing medicine in North Carolina, without novelty and free from professional or lay prejudice.

14 Race and class figure subtly in Alexander’s lectures on civics and social improvement. Although a supporter of women’s suffrage and their advanced education as general principles (cf. Alexander, “Women Physicians”),[54]Alexander Papers, Box 1, Folder 11. her focus was always directed towards women not dissimilar to herself. For example, when advocating for women to take up civic involvement, she wrote: “Women have more to do with the health and morals of our race than the other [male] half.”[55]Alexander, “Fifty Years Ago” (Alexander Papers, Box 1, Folder 2). In a lecture to the Charlotte Woman’s Club in 1912 on the importance of public tuberculosis education, she condemned the city’s African-American population for inculcating and spreading the disease: “Their ignorance in regard to the disease is dense. They crowd together, sleep in the room with the sick one, who knows nothing of personal hygiene […].”[56]Alexander, “What Can We Do to Prevent Tuberculosis?” (Alexander Papers, Box 1, Folder 3). After many negative assertions along the same lines, Alexander then briefly added, “I have seen [the same] occur among the ignorant whites of the city,” and she called upon the Club to devise a practical method of educating “these two classes.” The structure of the speech allotted blame disproportionately upon the African-American population, but clearly neither they nor the poor whites were within the pale. Alexander was a supporter of eugenics who believed that “The death dealing hand of nature [rightly] destroys the life of most of her offspring” as “the sick and the weak succumb to their insufficiency.” However, “[a]s we conquer disease we preserve the unfit, in saving infant lives we save many inefficient ones to grow to maturity to propagate their kind and become a burden on society.”[57]Alexander, “Eugenics Comparably a New Word” (Alexander Papers, Folder 3). Frequent references to Mecklenburg County’s “poor, ignorant and dirty” demonstrate a womanly, an elitist, and a professional requirement to assist, but no affinity.[58]For example, Alexander, “Womans Aid in Civics” (Alexander Papers, Box 1, Folder 5).

15 Alexander, thus, was very much a part of her time and place. Women were to be educated not least because the educated mother was the best mother.[59]Alexander, “Womans Aid in Civics” (Alexander Papers, Box 1, Folder 5); Alexander, “A New Born Infant” (Alexander Papers, Box 1, Folder 3); Alexander, “Menstrual Disorders” (John Alexander Papers, Box 1, Folder 7). Their intellect was superior to males (“Women Physicians”), but excessive study during adolescence undermined health and made them prone to emotional, nervous disorders.[60]Alexander, two lectures on nervous prostration (Alexander Papers, Box 1, Folder 3), “Our Womans Club” 12-16 (Alexander Papers, Box 1, Folder 5), and “Fifty Years Ago” (Alexander Papers, Box 1, Folder 2). The woman in medicine possessed a special calling (in addition to the one shared with male colleagues) because she was a woman and because, from necessity, she came from society’s well-to-do. If we accept the second-hand evidence that John Alexander was responsible for selecting in 1878 a medical career for a dutiful young daughter, aged fourteen (Pendleton 42; Thompson 14; Kent 94-96), it is worth speculating whether he could, or would, have done so in the absence of his aggressive self-assuredness at the top of the county’s hereditary elite. For Alexander, herself, she encountered no exact role models: an analysis of career choices by elite women in North Carolina, 1865-95, could produce for medicine only Alexander (cf. Censer).[61]The vocational and educational context also worked against the development of directly applicable role models (cf. McCandless; Turner). She, in “Doctor Katherine” and in her first publication of 1889, would look to the American North and West for models of women physicians (“Women Physicians”). However, she never considered a life for herself outside the South. In the South, perhaps especially for her in Mecklenburg County, Alexander possessed a role. She broke some rules. She entered medicine, and family tradition states that a portion of the family never again spoke to her or uttered her name (Kratt 12). She did not marry. The family tradition would have us believe John Alexander forbade marriage, for then the expense of a medical education would have been wasted (Pendleton 42, 62, 64; Thompson 14-15). In 1919 she adopted a three-year old orphaned boy, and she raised in her home the seven children of her deceased brother, Robert (Blythe; Thompson 15; Pendleton 64). Interestingly, Annie Alexander is assigned no credit (or no blame) for either of the transgressions – both were attributed to a strong-willed, long deceased, father. Alexander, herself, is for us today wholly silent on both career and marriage decisions, except within the pages of “Doctor Katherine.”