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Women in ophthalmology – An upsurge!

2022; Medknow; Volume: 70; Issue: 3 Linguagem: Inglês

10.4103/ijo.ijo_387_22

1998-3689

Santosh G Honavar, Rolika Bansal, BruceE Spivey,

Diversity and Career in Medicine

"For most of history, anonymous was a woman" – Virginia Woolf The 19th century was the period wherein women all over the world made a remarkable impact by overcoming the barriers of gender inequality, political issues, and racial differences. Despite the strife trickling down to the medical field, our women left no stone unturned in attempting to participate equally as their male counterparts. Indeed, the number was less, but the impact was strong and significant. The struggles of these women shall not be forgotten for eons to come as they have paved the way for generations of women in ophthalmology, inspiring them to be astute clinicians, skillful surgeons, methodical researchers, and leaders, and most important of all, to stand up for themselves with determination and brook no refusal. We herein highlight important women who were the first to light the torch of equality in the 19th century and made their mark in ophthalmology. Amy Stokes Barton (1841–1900) Born on October 1, 1841 in Camden Country, New Jersey to a farmer Joseph Barton and Rachel B. Evans, Amy Barton was high on principles and values. Her dedication made her rise and she graduated in 1874 from the Woman's Medical College of Pennsylvania (WMCP) and evolved to be the first woman physician in Pennsylvania.[1] Her zest, brilliance, and interest in ophthalmology made her overcome the encumbrance of gender inequality and she was successfully assigned to assist George Strawbridge at Wills Eye Hospital. She worked under his guidance for over a decade till his resignation in 1890. She got promoted as professor in 1891 and returned to the WMCP. Her wish was to establish a dispensary associated with Woman's College in Philadelphia with multispecialty care. She raised funds and founded such a system on October 31, 1895 at 1212 South Third Street, Philadelphia as the Hospital and Dispensary of the Alumnae of the WMCP, which got later shifted to 333 and 335 Washington Avenue, known as Amy S. Barton Dispensary and Health Clinic [Fig. 1].[234] She passed away in Philadelphia on March 19, 1900 from stroke; however, her indefatigable hard work and assiduity shall be praised over centuries to come.Figure 1: (a and b) The patients waiting at the Amy S. Barton Dispensary and Health Clinic[4]Olga Arkadeovna Mashkotseva (1851–1933) One of the most renowned women ophthalmologists that Russia gifted to the world was Olga Arkadeovna Mashkotseva. She was an ardent student of Dobrovolskij's in Petersburg, who graduated in 1878 from the Nicholas Army Hospital. She contributed significantly by actively participating in new eye societies and educating others via several of her presentations in regional and national meetings. Her interests ranged from primary care to research, and she practiced from 1887 to 1933 in Simeropol.[5] Charloette Louisa Ellaby (1854–1909) Born in 1854 at Clifton, Somerset, England to James Watts Ellaby and Emma Field of Woodston, Peterborough, UK, Charloette Louisa Ellaby was the youngest daughter of the family. Dr. Ellaby graduated in 1884 from Paris and in her thesis, she presented her research work in ophthalmology. She happened to be one of the first few staunch supporters of ophthalmology at that time. Garrett Anderson recommended her to work in coordination with Edith Pechey in Bombay, India and in November 1884, she was recruited as Dr. Pechey's junior medical officer by George Kittredge.[6] She established the first of its kind ophthalmic department for women at Bombay's Khetwadi dispensary.[7] She later established the Department of Ophthalmology at the Cama Hospital (currently affiliated to Grant Medical College) [Fig. 2], a hospital for women and children constructed by Pestonjee Horsumjee Cama, a Parsi philanthropist,[8] and markedly increased the outpatient department, giving a boost to the practice of ophthalmology in India.[9]Figure 2: Cama hospital (source – Wikipedia)After few years of dedicated work in India, she returned to England where she passed the examination of the society of apothecaries to obtain a registrable British qualification. The recent opening of women in this society enabled her to fulfill her dreams. The graph of her success was steep, as she was appointed as the first ophthalmic surgeon by the committee of the New Hospital for Women in 1890. In her tenure, she proved to be a passionate life force of ophthalmology. She was requested to travel back to India in 1894 by William McClelland to use her surgical skills and expertise to perform a cataract surgery upon the Maharani of Jamnagar. She went on take leading positions as a member of the Faculty of Medicine of the University of London and lecturer in ophthalmic surgery at the London School of Medicine for Women. She worked extensively on the amplitude of convergence, strychnine, and a report on a case series of retinitis patients. She passed away at the age of 55 on May 14, 1909 at her house in Harley Street.[9] Elizabeth Sargent (1857–1900) A political leader, Aaron A. Sargent (senator from California, later United States Minister to Germany), and a prominent women's suffragette, Ellen Clark Sargent, were blessed with a daughter in 1857 – Elizabeth Sargent. Since the early years, she was encouraged to participate actively as a suffragist and work in sync with her parents for women's rights. A large sum of money was also contributed to the cause of women's rights by the Sargent family.[10] Following the footsteps of Isabel Hayes Chapin Barrows,[1112] Ms Sargent attended the Howard University Medical College and earned her medical degree from Cooper Medical College (formerly known as Medical College of the Pacific and currently, the Stanford University's School of Medicine).[13] Pertaining to her father's political journey in Germany, she got the opportunity of getting trained by Professor Johann Friedrich Horner. Dr. Sargent stayed unmarried and was acknowledged for her dedication toward children's health care and eventually turned out to be one of the leading eye specialists at San Francisco. She donated selflessly at the Pacific Dispensary for Women and Children's hospital, San Francisco,[14] where she later practiced as a pediatric ophthalmologist. She believed strongly in women empowerment and encouraged her peers to work with enthusiasm, while breaking all boundaries keeping gender equality as her ideology.[15] Her paper published in 1892 on ocular complications in pernicious anemia in Herman Knapp's Archives of Ophthalmology was very well appreciated and her writings on women suffrage have been considered of very high value and impact.[11] She represented the American Medical Association (AMA) section on ophthalmology in an international meeting in Germany, following which she succumbed to endocarditis in 1900 [Fig. 3].Figure 3: Elizabeth Sargent (1857–1900)[11]Trinidad Arroyo Villaverde de Márquez (1872–1959) Born in Palencia, Spain, to a liberal family of industrial dyers on May 26, 1872, Trinidad Arroyo Villaverde rose beyond the limitations that were set for women in the times of yore. Her academic excellence was her strength; however, she was highly looked down upon by her male peers. On March 16, 1882, the University of Valladoid had eliminated the admission of women as per the royal order. However, with the constant encouragement and support of her father, Don Laureano Arroyo, she pulled out all the stops and on December 31, 1888, she was permitted to register to study medicine. She earned her degree in 1895, following which she became Spain's first female ophthalmologist in 1896.[16] Her dedication toward ophthalmology helped several individuals all over the region, as she opened a practice alongside her brother in Spain in 1898. After her brother's demise, she donated his legacy, his library, to the Palencia College of Physicians. In the world of gender bias, there existed men with strong belief in women and their potential, and Manuel Márquez became her lifelong encourager as they got married on February 6, 1902. Inspired by his wife, Dr. Manuel Márquez also chose ophthalmology as his specialty and together with his loving wife, made several historical contributions. Dr. Trinidad Arroyo Villaverde de Márquez participated in various conferences and spoke on the use of atropine in corneal ulcers, ocular analgesia of codeine hydrochloride, adrenaline in ophthalmology, retinal detachment, astigmatism and diagnosis and therapy of ocular tuberculosis.[16] Dr. Manuel Márquez was appointed as Dean of Faculty of Medicine at San Carlos in October 1934, and Dr. Trinidad Arroyo Villaverde de Márquez worked incessantly to cut down on the struggles faced by women in that era by collaborating with political and social organizations and established a cultural exchange between Spain and the Union of Soviet Socialist Republics. She was considered an epitome of energy and inspiration in Spain, as she worked tirelessly to provide for the women rights. Her leadership qualities and persistence enabled her to become a member of the Lyceum Club Femenino, Vice President of the Comité Femenino de Higiene Popular in Madrid, and cofounder and honorary president of the Spanish Association of Women Physicians. She added a controversial section, "Feminist notes. From woman to woman," in the Spanish Social Medicine journal.[17] She exiled in Mexico during the civil war. After her death on September 28, 1959 in Mexico, a statue was built in her honor at the Instituto Jorge Manrique in Madrid [Fig. 4][18] and a school was built in Palencia to commemorate her contributions.[17]Figure 4: Statue of Dr. Trinidad Arroyo Villaverde de Márquez (1872–1959) in Palencia[18]Lizzie Maud Carvill (1873–1934) The year 1873 brought forth one of the earliest women researchers, Lizzie Maud Carvill. Little is known about her childhood. However, while growing up, she faced several instances of gender discrimination. She was an epitome of determination and persistence. In 1898, Maud Carvill, early in her career, happily took the job as an instructor in physical training for women at the Tufts College.[19] In 1899, she graduated from Tufts College and as Dr. Carvill from Tufts College Medical School in 1905. She happened to be the first woman ophthalmologist at the Massachusetts Eye and Ear Infirmary [Fig. 5] and is known for her perpetual happy-go-lucky nature and positive joyous vibe that she brought to the work environment and for her patients. She joined as ophthalmic staff at the New England Hospital for Women and Children and also worked there as a consultant.Figure 5: Maud Carvill examining patients in 1923 at her clinic (Source – Massachusetts eye and ear social portals)She embraced the struggles faced by women in that era and was welcomed to be a part of professional societies – AMA, New England Women's Medical Society, American College of Surgeons, American Academy of Ophthalmology and Otolaryngology, the New England Ophthalmological Society, and the American Ophthalmological Society. The list of her remarkable research work included[20] congenital fistulae of the lacrimal canaliculi, persistent hyaloid artery, tubercular iritis, occurrence of pregnancy-induced bitemporal contraction of the visual field,[21] and treatment of interstitial keratitis with antisyphilitic treatment.[22] Her excellent handpicked team, including late Dr. George S. Derby, extolled her scientific contributions and services. Her death in 1934 was considered a severe loss for the medical profession and for the community.[20] Her vivacity was kept alive in the memories of her colleagues, and her positive spirit was carried forward by her successors. Conclusion The courage, grace, determination, strength, dedication, and perseverance of women in the 19th century were beyond comparison. The struggles faced by them were unfathomable, and yet, they never gave up and the barriers of gender inequality, social liabilities, and racial discrimination were set ablaze by this upsurge of women in ophthalmology, leaving a fresh ground for the future generations. The ingenuity of these women has inspired us to be go-getters and leaders in our respective fields, with our heads held high. These women of substance have made us believe that nothing is impossible and we must go that extra mile to be able to create opportunities for self and several generations to come. "History has shown us that courage can be contagious and hope can take on a life of its own." – Michelle Obama