Emily Blackwell Did More Than Just Operate Against the Odds, She Built a Legacy of Inclusion

By: Aeryn Kangas-Dick, MD

This is a special edition blog post presented in partnership with the Association of Out Surgeons & Allies (AOSA) in celebration of Pride Month.

In 1854, a pioneer in surgery, Emily Blackwell was the second woman in the United States to receive an MD degree at what is now Case Western Reserve University.. She practiced surgery in lower Manhattan where, along with fellow surgeon Marie Zakrzewska, and her sister Elizabeth Blackwell, she was instrumental in founding a women’s hospital, the New York Infirmary for Women and Children. The hospital added a medical school, which trained 364 women surgeons before closing in 1899. Dr. Blackwell first met Elizabeth Cushier when she was a student at the medical school. The pair lived together for the rest of their lives, and they raised a daughter together. Dr. Blackwell was instrumental in advocating for state funding for the hospital, which expanded to serve 7000 patients a year. The hospital survives today as New York-Presbyterian Lower Manhattan Hospital. 

Marie Zakrzewska first came to the United States after emigrating from Poland, where she had studied as a midwife at the Royal Charite Hospital in Berlin. Her persistence and performance in school impressed her professor, Dr. Joseph Schmidt to such a degree that she was appointed Chief midwife after her graduation in 1851. Unfortunately, there was significant opposition from her colleagues as no woman had ever held this position. After Dr. Schmidt died, she was dismissed after only six months. Seeking better opportunities, Dr. Zakrewska emigrated to the United States, where she met Elizabeth Blackwell who eventually helped her to successfully enroll at Case Western, which at the time was one of the only medical schools in the US that would grant medical degrees to women. After graduation, she began work in New York City where she practiced surgery as well as both obstetrics and gynecology, initially in a private group with the Blackwells. The trio was profoundly affected by the lack of access to medical care amongst the city’s poor women. Their collaboration led to the foundation of the New York Infirmary, as a way to not only provide care to patients but to educate the next generation of women surgeons and physicians. 

After her work with the Blackwells, she traveled to Boston where she became a professor of Obstetrics and Gynecology at the New England Female Medical College. While initially she found Boston to be more friendly to the idea of a woman surgeon, she resigned from the hospital in 1861 after the founder of the school insisted that female physicians be referred to as “doctress.” In response to the rampant misogyny of the time she founded the New England Hospital for Women and Children in July, 1862, as an institution where women physicians could practice medicine, and established the first nursing school in the United States. She met her partner, Julia Sprague during her time in Boston, where the pair lived together for forty years. While many contemporary historians characterize their relationship as platonic, letters from Dr. Zakrzewska to her friend Caroline Severance suggested a romantic relationship.

The lives and work of Emily Blackwell and her sister Elizabeth Blackwell, Marie Zakrzewska, Elizabeth Cushier, and Julia Sprague remind us that the history of surgery has never been separate from the history of gender, sexuality, power, and belonging. These women were giants who built hospitals, medical schools, and training pathways at a time when the profession actively attempted to exclude them and question their legitimacy as surgeons and educators. Their stories remind us to recognize that LGBTQIA+ people, including women, nonbinary people, transgender people, and gender-nonconforming people, have always been present in medicine, even when history has obscured or softened that truth. The barriers they faced were about access to education and to operating rooms but also about the right to live openly, to love, to lead, and to be recognized as fully human within this profession. 

As we celebrate Pride, we honor not only visibility, but also generations of physicians, surgeons, nurses, and trainees whose courage created spaces for others to follow. Organizations such as the Association of Women Surgeons (AWS) and the Association of Out Surgeons and Allies (AOSA) play a crucial role in continuing this work by advocating for equity, amplifying historically marginalized voices, and creating safer professional communities for anyone whose identities have been excluded from traditional narratives of surgical excellence. Pride is both a celebration and a call to action. We must remember history honestly so that we can continue to protect people who are still facing discrimination and build a surgical culture where everyone can belong and lead.

Aeryn Kangas-Dick, MD, is a surgical oncologist at the West Michigan Cancer Center and assistant professor of surgery at the Homer Stryker MD School of Medicine at Western Michigan University where she also serves as associate clerkship director for the surgical core rotation. She completed a General Surgery residency at Maimonides Medical Center in Brooklyn, NY, and fellowship in Complex General Surgical Oncology at Roswell Park Comprehensive Cancer Center in Buffalo, NY. She specializes in esophageal, gastric, and pancreatic cancers, and is passionate about her research into both cancer outcomes and creating inclusive learning environments for general surgical trainees. She is a proud member of both AWS and AOSA. Outside of the operating room, she enjoys spending time with her partner and their dog and cat. She is a long time rugby player and stays active with her local club team.