Medical Women and Victorian Fiction (review)

Kristine Swenson's Medical Women and Victorian Fiction diverges from the Foucault- inspired thesis, espoused by books such as Lawrence Rothfield's Vital Signs: Medical Realism in Nineteenth-Century Fiction (1994), that nineteenth-century medicine was a discursive discipline that elevated doctors' diagnostic practices into a principle of panoptic authority. Swenson argues that this viewpoint represents women "almost exclusively as the objects upon which medical men and their constructions operate" (3). Using a methodology more empirical and flexible, if perhaps necessarily less systemic, than Rothfield's, she seeks to bridge this dichotomy between power and passivity by showing how prominent the medical woman was in Victorian culture.

Swenson begins with a discussion of Florence Nightingale. As part of her independent stance vis-à-vis the (once) New Historicism, she emphasizes Nightingale's individuality more than other recent commentators, who have downplayed the significance of the heroic Crimean War nurse. But on the other hand, Swenson claims the figure of Ruth, the wayward nurse in Elizabeth Gaskell's 1853 novel of that name, as a figure whose representation was influenced by the Nightingale prototype.

Though she still has to die at the novel's end to maintain social standards, Ruth's status as a medical woman counterbalances her representation as a fallen woman: Swenson posits the medical woman as the Victorian antidote to the prostitute. The medical woman accepted a salary for services rendered, yet she did so on behalf of the public good and performed actions that improved society in a practical way. Nightingale was not just a medical figure, but also a cultural one. Her momentous popularity helped keep alive the British public's support for a war that was not going especially well. The medical aspects of the Crimean War also constitute the subject of Charles Kingsley's Two Years Ago (1857). Swenson provides a superb reading of this work, which is often overlooked in favor of Kingsley's earlier condition-of-England fiction. Grace Harvey is a post- Nightingale heroine who is, as a nurse, the ancillary of the doctor Tom Thurnall, even as she also serves as his better angel, the agent of his moral elevation.

But the nurse did not remain on this Victorian pedestal. Nurses earned wages, possessed power over life-and-death situations (including access to poison), and came into contact with men in a professional capacity where they could serve as "the other woman"; thus, they soon were seen as possessing the capacity to disrupt the Victorian domestic sphere that Nightingale epitomized, even though she herself remained unmarried and did her most famous work abroad. Drawing from a series of examples including Nurse Rubelle in The Woman In White (1860), Swenson charts the decline of the nurse from angel to potential demon.

Thus, even though the woman doctor theoretically posed a greater threat to patriarchal control than did the nurse, when the woman doctor became more culturally visible in the 1870s, she possessed a greater aura of respectability than the now-suspect nurse. There is not an obvious canon of nineteenth-century British woman-doctor novels as there is in American literature, which features a cluster of works by Elizabeth Stuart Phelps, Sarah Orne Jewett, and William Dean Howells. But Swenson argues that this does not mean that the British medical woman was not as significant; rather, because of the greater size and social mobility of the United States, women doctors merely were more in demand there. Similarly, we seldom think of any British woman physician being as iconic as Mary Putnam Jacobi was in the United States. But Swenson discusses Sophia Jex-Blake, a rambunctious and unconventional doctor who shook up the British medical establishment. Swenson also analyzes two women physicians who actually wrote fiction, Margaret Todd and Arabella Kenealy, and traces their contribution to the New Woman literature of the 1890s.

Swenson's most unexpected chapter examines women physicians abroad. Women physicians simply had more opportunities to practice in the colonies than in England. Swenson shows that despite women...