“It is not easy to be a pioneer — but oh, it is fascinating! I would not trade one moment, even the worst moment, for all the riches in the world.”

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

The Photograph that Started It All

Every now and again, something from a remote corner of the Internet emerges from obscurity and commands a global audience. Such was the case when blogger Jaipreet Virdi-Dhesi posted a photograph of three graduates from the Woman’s Medical College of Pennsylvania, and the photo went viral within the medical community.

“It was a lucky find,” Virdi-Dhesi said of the iconic portrait. She had been researching her thesis on medical experiences of the deaf community in the late 19th century, when she chanced upon the photograph in the Legacy Center, Archives and Special Collections of the Drexel University College of Medicine. The image piqued her interest, so she shared it on her blog about the history of medicine. Although the photograph had made its rounds through the Internet before, Virdi-Dhesi’s post sparked a renewed interest in the story behind the three graduates.

There’s something powerful about the photograph, a certain “je ne sais quoi” that captivated millions of viewers around the world.

Underneath the yellowed countenance of the photograph, the three elaborate gowns — each representative of a distinct Asian heritage — suggest a perplexing scenario; given the apparent age of the photo, what could produce this rare confluence of cultures? A closer look at the photograph reveals that each of the women in the portrait wears an expression as distinct as her gown. Overshadowed by the mystifying garments and stares, the unassuming caption almost seems like an afterthought, and yet it’s the caption that confesses the true significance of the image.

The women in the portrait braved incredible physical and societal adversity to study at the Woman’s Medical College and pioneer Western medicine for their countries.

Meet the Graduates


Tabat Islambouli is the most mysterious of the three graduates. She was known to wear her dark, silk kaftans while attending the Woman’s Medical College, and after graduation she returned home to Syria as the first female physician in her nation, but the rest of her life went mostly undocumented. Besides these meager details, little is known about Islambouli.

Keiko Okami’s life, on the other hand, is slightly more well known. She was the second female physician in Japan, but historians say that she was probably the first to have studied overseas. Following her graduation, she returned to her home in Japan and became the head of the gynecology department at Jikei Hospital in Tokyo. Though her appointment was a milestone for Japanese women, she resigned after Japanese Emperor Meiji visited her hospital and refused to receive her because she was a woman.

She went on to start her own private practice and opened the Eisei-En sanitarium to care for patients suffering from tuberculosis. Unfortunately, the sanitarium closed down from lack of funds and patients. Okami eventually gave up practicing medicine in deference to her husband, who did not approve of the profession. Nevertheless, Okami led a long, happily married life and was a stewardess in the medical profession.

Though Okami and Islambouli were both remarkable in their own light, Anandibai Joshi has always been the most iconic of the three graduates. Her epic life of triumph and tragedy inspired biographies, a novel, and even a play. With these resources and the letters she left behind, we can get a glimpse of her experiences as a woman in medicine.

Joshi started life in the highest echelons of Hindu society. As a member of the Brahmin caste, she enjoyed great social privilege. As a girl, however, she could not exercise the right to choose her own fate. At only nine years old, she was married off to a man 20 years her senior. The match was both unfortunate and fortunate. Gopalrao Joshi, Anandibai’s new husband, simultaneously exhibited the domineering attitude of the surrounding patriarchal society and progressive ideologies that were far ahead of his time. While other husbands beat their wives for not cooking, for example, Gopalrao beat his young wife for not focusing on her studies. He was keenly interested in her education and wanted to see her go to medical school.

As for Joshi, she had her own reasons for wanting to attend medical school. At the age of 14, she gave birth to a son. Within 10 days, her son died, leaving behind a bereft young mother. Most women were cut off from proper healthcare in those days because they were more afraid of seeing a male physician and breaking modest social customs than they were of dying. Joshi sought to fulfill this urgent need in her community and aspired to become a physician. In applying to the Woman’s Medical College, she wrote:

“[The] determination which has brought me to your country against the combined opposition of my friends and caste ought to go a long way towards helping me carry out the purpose for which I came, i.e. is to render to my poor suffering country women the true medical aid they so sadly stand in need of and which they would rather die than accept at the hands of a male physician. The voice of humanity is with me and I must not fail. My soul is moved to help the many who cannot help themselves.”

Attending medical school would take more than an earnest appeal to the dean of the Woman’s Medical College. Joshi and her husband could not pay the tuition fee themselves so they sought help from American missionaries. The missionaries agreed to pay her school fees but on the condition that she convert to Christianity. Although not an immensely spiritual woman, Joshi held fast to her Hindu religion and rejected the offer.

She found a sponsor instead in Theodicia Carpenter. In a rare meeting of worlds, the wealthy New Jersey woman and the ambitious Indian girl developed a relationship so affectionate that Joshi often called Carpenter her “dear aunt.” As Joshi prepared for the treacherous journey to America, she wrote to Carpenter.

“You have reason to think that this very distant voyage will be hazardous for a girl of 18 because the world is full of frauds and dangers, but dear Aunt, wherever I cast my glance, I see nothing but a straight and smooth way. I fear no miseries. I shrink not at the recollection of dangers, nor do I fear them.”

To fully appreciate Joshi’s courage, one must understand what she sacrificed to pursue a medical degree. Brahmin custom at the time prohibited travel across the ocean and eating food prepared by people of a different caste. Therefore, in order to travel to and live in America, Joshi would have to break with the rigid religious and social system that defined her upbringing. Defying cultural expectations in a society so rigidly bound by its traditions meant that she faced rejection from her community, friends and family. Gopalrao was the only person from her home that would accept her, but she had to move away from him and across the world. In abandoning her home and her customs, Joshi placed all her hopes and dreams on an American education.

America had just emerged from the Civil War and was still divided by racial tensions. When the Irish and Italians were treated as second-class citizens, this Indian woman with a thick accent faced the prospect of even greater discrimination. Despite the difficulties of her circumstances, Joshi made the journey to America with the following resolve:

“Though I cannot teach courage, I must not learn cowardice, nor at least leave undone what I so long since determined to do. I am not discouraged.”

— Anandibai Joshi

Joshi’s bravery and determination attracted attention from the moment she stepped foot in America. Reporters gathered for her arrival so that they could see the exotic “Hindoo” woman who would be the first foreign student at the Woman’s Medical College. Her stardom only increased as she worked toward her medical degree. When Joshi graduated as a physician, Queen Victoria, the Empress of India, sent a letter to the Woman’s Medical College expressing her interest in the accomplishment of her young subject.

Just as Joshi’s life had taken a turn for the better, she fell ill with tuberculosis. Her illness rapidly consumed her; the woman who had once crossed oceans spent her last moments unable to leave her house. It is said that Joshi was bright and cheerful to the end. When she finally succumbed to the tuberculosis, her words were, “I have done all that I could.” The young doctor died at the age of 21, without ever practicing medicine.

Though Joshi’s promising life was cut short, her legend lives on. In addition to the researchers looking to learn more about this brave soul, Indian men and women visit the Drexel archives just to see her files. “In some ways, it’s like a pilgrimage,” Drexel archivist Matt Herbison explained. “She did things that even men in India didn’t do at that time.”

A Time of Troubles

Joshi, Okami and Islambouli entered the Woman’s Medical College at a time of great crisis in the medical field. The traditional Western school of medical thought focused on literally removing a disease from the body. In order to relieve a fever, for example, a physician would employ bloodletting, using a flawed logic that fever resides in the blood and, therefore, a dosed loss of blood could remove the fever from the body. Similarly, purgatives and radical surgeries aimed to remove the source of the illness with little regard for the patient’s wellbeing following the procedure.

This misguided approach became known as “heroic” medicine for its severe and questionably effective techniques. The public sentiment turned on it in the 1800s because heroic medicine often did more harm than it did good. Moliere, the famous French playwright, even commented, “Nearly all men die of their medicines, not of their diseases.”

While doctors struggled to preserve the traditional approach in an increasingly skeptical medical landscape, alternative ideologies cropped up and offered a more gentle, though often ineffective, approach to healing. Hydropathy, for example, rejected drugs and surgery and instead emphasized the healing power of water. Botanics, on the other hand, emphasized the use of plant-based remedies instead of pharmaceuticals. Homeopathy advocated a “like cures like” approach to medicine and gained popularity simply because, unlike mainstream medicine, its practices did not kill the patient. These sectarian approaches fragmented the medical industry such that the very definition of “medicine” was in question.

In the midst of this theoretical debate, medical practitioners were of dubious caliber. Physicians considered themselves superior to other professional classes, but the standards of medical education had been lowered over the years, and many physicians had poor medical training before entering the field. Others claimed to be doctors and “treated” patients without ever having received admission to a medical school, let alone graduating with a medical degree. The rising practice of quackery and sectarian medicine fractured the reputation of medicine so greatly that women like Okami, Islambouli and Joshi could slip through the cracks.

The Fall of Man, the Rise of Woman

Women had long been excluded from practicing medicine on the grounds that medicine was a “man’s job.” Many claimed that women couldn’t stomach the gruesome practices of medicine, such as amputating a limb while the patient was fully conscious. When the advent of anesthesia made medical practices more humane, opponents of women’s education claimed that higher education would compromise a woman’s domestic and reproductive capabilities. Some said that a woman would neglect her responsibility to her children and husband while studying for a medical degree, while others argued that a woman’s very physiology precluded her ability to survive the academic gauntlet of medical school.

Harvard professor E. H. Clarke used this biological angle to argue against co-education when he wrote, “In the education of our girls, the attempt to hide or overcome nature by training them as boys has almost extinguished them as girls. Let the fact be accepted that there is nothing to be ashamed of in a woman’s organization, and let her whole education and life be guided by the divine requirements of her [reproductive] system.”

He based his prescriptions on the idea that a woman’s body could not manage two processes — such as thought and the development of the ovaries — and one process would lose out to the other. The old guard of medicine also turned to economic arguments: they lamented that an industry already flooded with sectarians and quacks could not support an influx of female physicians as well.

Historian Regina Morantz highlighted the fear underlying all of these arguments when she wrote, “More subtle and more insidious was the fear that the influx of women would alter the image of the profession, by feminizing it in unacceptable ways.” Most physicians were reluctant to surrender the masculine reputation they had earned through centuries of hacking limbs and bleeding patients.

Paradoxically, the same Victorian sensibilities that kept women in the domestic sphere also propelled a daring few into medicine. The cultural expectations demanded that women hold delicacy and modesty paramount. Visiting a male physician for feminine issues, therefore, threatened this exaggerated idea of womanhood, so most women, as articulated by Joshi, deferred medical treatment until it was too late. The famous 19th century obstetrics professor Charles Meigs commented.

“I confess I am proud to say that…there are women who prefer to suffer the extremity of danger and pain rather than waive those scruples of delicacy which prevent their maladies from being fully explored. I say it is an evidence of the dominion of a fine morality in our society.”

Despite his personal convictions, even Meigs admitted that women could not maintain their Victorian delicacy and health at the same time.

The medical field needed female physicians to treat female patients.

Though there was an emergent need for female physicians, the existing medical schools provided no means to educate aspiring female physicians. A few enterprising women, including the tenacious Elizabeth Blackwell, managed to earn admission into medical colleges, but they did so through loopholes and under great duress. Blackwell, for example, was admitted to Geneva Medical College after the all-male student body jokingly voted for her admission. Most schools were quick to avoid the same error. For example, Emily Blackwell, Elizabeth’s sister, was denied readmission after successfully completing her first year at Rush Medical School.

Those who managed to survive the admissions and readmissions process faced ridicule from their peers and faculty, and rejection from their families and friends.

The world’s first medical college for women arose unsurprisingly in Philadelphia, otherwise known as “Quaker City.” Philadelphia had long been home to the Quakers, whose progressive ideas were far ahead of their time. “At this time in history,” Herbison explained, “if you saw anything progressive going on, there was a pretty good chance that the Quakers were behind it.” Indeed, the Quakers fought for abolition, temperance and a woman’s right to education.

Establishing the Woman’s Medical College proved to be a difficult task, since few would fund the enterprise and even fewer would teach women medicine. With limited means, the Woman’s Medical College put out its first graduating class of eight students. As the years went on, however, the school matured into a bustling hub of diversity. Dr. Kate Campbell Hurd-Mead described the ambience, calling the old halls of the college “gay with foreign costumes.”

Aspiring female physicians from all over the world flocked to Philadelphia seeking the warm, accepting atmosphere of the Woman’s Medical College. At a time when racism and sexism were rampant, the Woman’s Medical College trained the first female African American, Omaha Native American, Indian and Syrian female physicians.

As women started practicing medicine, the all-male schools capitulated. One by one, the medical schools across the nation and across the world opened their doors to female students. The Woman’s Medical College eventually went co-ed and became the Medical College of Pennsylvania in 1970.

A few decades later, MCP joined forces with Hahnemann University, making MCP Hahnemann School of Medicine the largest private medical school in the country. Five years after the merger, however, the parent corporation of MCP Hahnemann declared bankruptcy. As the medical college and its associated hospital had become an integral part of the surrounding community by that point, Drexel University decided to intervene to save the school and hospital from collapse.

Today, the Drexel University College of Medicine remembers its roots in the Woman’s College of Medicine. The dedicated staff at the Legacy Center work to preserve the history of the medical school, its graduates and its founding ideologies. The traditions of the Woman’s Medical College live on through programs such as the Executive Leadership in Academic Medicine fellowship program, which helps prepare women in medicine for a medical administrative position.

All of this tracks back to the three graduates from Woman’s Medical College, our story’s three heroes. They overcame overwhelming odds. They faced discrimination not only for their ethnicity but also for their gender. They endured the perilous journey to America, the rigorous medical training and the condemnation of society to learn the medical skills their countrywomen so desperately needed. As the first of their kind to conquer these difficulties, the intrepid three paved the way for women at the time, today, and for the endless future.