Regina Morantz-Sanchez. Conduct Unbecoming a Woman: Medicine on Trial in Turn-of-the-Century Brooklyn. Oxford and New York: Oxford University Press, 1999. 292 pp. $30.00 (cloth), ISBN 978-0-19-512624-2.
Reviewed by Janet Golden (Department of History, Rutgers University-Camden)
Published on H-SHGAPE (January, 2000)
Take This Case, Gentlemen...Try to Decide It Justly
In 1889 Brooklyn surgeon Mary Dixon Jones sued the local paper, the Daily Eagle, for libel after it ran a series of articles portraying her, in the words of Regina Morantz-Sanchez, as "an ambitious and unscrupulous social climber, a knife-happy, over-eager and irresponsible practitioner who forced unnecessary operations on unsuspecting women and used the specimens gleaned from their bodies to advance her reputation..."(p. 2). There were, as well, claims that the Women's Hospital run by Dixon Jones had engaged in financial wrongdoing. The case came to trial in 1892, after Dixon Jones had been found not guilty in a manslaughter case following the death of one of her surgical patients. When the testimony ended, the judge instructed the jurors: "take this case gentlemen...try to decide it justly."
Conduct Unbecoming a Woman: Medicine on Trial in Turn-of-the Century Brooklyn explores the libel trial and the professional life of Dixon Jones. Setting aside questions of guilt and innocence, the book instead explores the uncertainties about gynecological surgery, medical professionalization, patient-directed medicine, gender, and urban rivalry that permeated the courtroom.
Morantz-Sanchez opens with a detailed account of the Brooklyn Eagle's allegations against Dixon Jones and her defense by a rival paper, the Citizen. The former presented her as manipulating the local elite to gain support for her hospital which she ran privately but with the aid of public funds; the latter defended her with stories of how she ministered to the poor who sought her services, sometimes foregoing payment. When the Eagle detailed surgical cases that ended with the deaths of patients whose bodies were removed from the hospital under the cover of darkness, the Citizen responded by printing letters from satisfied patients.
In subsequent chapters Morantz-Sanchez steps back from the sensational details to interpret the context in which the case unfolded. She begins with the city of Brooklyn where, she argues, a sense of rivalry with New York helped to shape local politics, the identity of the elite, and the self-perception of Dixon Jones' lay and professional supporters and opponents. At the trial, Dixon Jones' medical defenders came from Philadelphia and New York; those who testified against her were her fellow Brooklyn physicians--the same ones who had rejected her membership in the local medical society, even as it welcomed her son, a surgeon who worked in her hospital.
Such a rejection, Morantz-Sanchez suggests, must have been a bitter blow. Dixon Jones looked for approval from her male colleagues. Unlike many women physicians who practiced a conservative form of medicine, she sought to prove herself in the manly world of the operating theater and to gain the acknowledgement of male peers through extensive publications on cellular pathology. She embraced the ideals of a new generation of gynecological surgeons who sought to relieve their patients' sufferings through aggressive surgical interventions and over the course of her career performed hundreds of ovariotomies.
The key questions at Dixon Jones' manslaughter trial and in her subsequent libel case were whether she adequately informed her patients of the risks of such surgery (or whether, as the Eagle suggested, she coerced them into undergoing operations) and whether such surgeries were appropriate treatment. In suggesting some possible answers, Morantz-Sanchez combed the medical literature, interpreting the writings of Dixon Jones, her allies, and her rivals.
Eschewing the simplistic portrayal of women subjected to disfiguring and dangerous surgeries at the hands of vicious physicians -- a theme once common to studies of women and medicine --Morantz-Sanchez asks, in the newer historiographic tradition, how patients helped shape emerging medical practices. In a brilliant chapter "'The Lured, the Illiterate, the Credulous and the Self-Defenseless': Mary Dixon Jones and Her Patients," she provides copious evidence gleaned from the newspaper reports of the libel trial testimony that women sought relief for their complaints by consulting with an informal network of fellow sufferers who in turn referred them to local practitioners. They visited doctors until they found one who cured them, sometimes demanding radical surgical interventions when physicians demurred from such an approach. Morantz-Sanchez dissects the illness narratives patients presented to Dixon Jones and argues that a mutually validating relationship arose: "though Dixon Jones corroborated her patients' experiences, they underscored and legitimated her therapeutics as well"(p. 145).
Dixon Jones' troubles, the author asserts, derived in part from the ongoing debate between the radical surgeons who invaded the female body to remove diseased organs and especially ovaries, and their conservative opponents who sought to preserve fertility at all costs. Yet, having established the conflicting ideas of the two medical camps, Morantz-Sanchez seems hesitant to assess the relative merits of their approaches. She might have examined such things as the mortality rates of the two groups or explored Dixon Jones' mortality rates as compared to others who embraced radical surgery and even defended her at her trial. We are left to wonder whether Dixon Jones was a dedicated but flawed surgeon and whether, indeed, her detractors were right about her therapeutic mischief, despite the gratitude of many of her patients.
I will not reveal the outcome of the trial. Instead, I suggest reading the book, not simply to find out what happened, but to understand why the Dixon Jones case and the issues it represented, were so compelling at the turn of the century and why they remain so. This is a finely crafted medical, gender, and social history that investigates the ways in which patients shaped medical practice, the press influenced medical judgements, and local and professional rivalries recast the scientific underpinnings of medicine as representations of gender and class ideals.
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