Dr. Elizabeth is highly readable and is a valuable biography for young people. It portrays the struggle to open the medical profession to women and exposes the many lines of defense devised to prevent women from expanding their role once they entered the field of medicine. Clapp delves into some of the reasons women wanted to become doctors; she also provides insights into the state of medicine in the United States in the mid-nineteenth century, especially the lack of concern for sanitation and hygiene among practitioners who saw no value in cleanliness and dismissed sanitation as a waste of time.

Clapp emphasizes Blackwell’s concern for sanitation and her desire to raise the standards of medical education. She reveals the poor quality of medical education in the nineteenth century. Blackwell’s two years at Geneva Medical College consisted of short, superficial courses with easy oral examinations and no practical experience. A typical medical college had no laboratories, clinics, or hospital affiliation, and the faculty consisted of part-time teachers who were physicians in private practice seeking to increase their income. Blackwell’s New York Women’s Medical Col-lege was well in advance of such schools as the Harvard Medical School, which still utilized short lecture courses and required no practical experience.

The book is a captivating one. The conversational tone and use of the first person provide immediacy and intimacy, and Clapp’s use of these methods is effective. The story is never overburdened with the details of illnesses or treatments, yet there is enough detail to enable the reader to appreciate the major illnesses and prevailing treatments of the time and to see how Blackwell reacted to her patients. She was warned before beginning a medical career that medicine could be ghastly, and indeed she encountered suffering and disfiguring ailments that shocked her. Clapp effectively deals with this and describes how traumatic some cases could be.

The biography is about both Blackwell the doctor and Blackwell the person. Clapp probes her subject’s fears, loneliness, frustrations, and joys and creates a compelling, three-dimensional character. Both medical experiences and personal concerns are seen from Blackwell’s own viewpoint, which enhances the depiction of what it might have been like to face discrimination, disapproval, and rejection.

Clapp also attempts to relate the world of medicine to the status of women in society. For example, in the 1840’s, the only women in medicine were midwives, as nursing was not then a profession but a form of domestic service provided by lower-class women. Clapp could, however, have provided more context for the entrance of women into medicine. She does discuss the desire of women to be treated by women as a matter of modesty, but the larger context is missing. In the 1840’s there was a women’s rights movement that promoted both higher education for women and entrance into the professions. There was also a health reform movement stressing concern for personal health, knowledge of the body and its functions, diet, and hygiene. This movement, with its lectures and publications, was directed at women, since they were in charge of family health. These two movements are missing from this treatment, however, despite the fact that they had a major role in creating women’s desire to become physicians.

Dr. Elizabeth is understandable, well written, inspirational, and timely. Many women today can enter occupations in which women were once rarely found; one of these is medicine. Blackwell serves as a model of a woman who won entrance into medical school, succeeded in her practice, and rose to become a leader in the profession. She was a pioneer in both medicine and women’s rights. The first-person narrative offers an opportunity to empathize with this complex and determined woman.