Leading ladies: Pioneering women in anaesthesia
Most of us are familiar with the same few famous names celebrated in the history of women in medicine. Elizabeth Garrett Anderson and Elizabeth Blackwell, for example, are rightly lauded for their tireless efforts to enable women to study at university and gain recognition as doctors. But their stories are not the only ones worth telling. Some lesser-known trailblazers recognised the importance of proper training in anaesthesia before it was officially acknowledged as its own specialty or supported by formal qualifications. They completed higher education or anaesthetic training when medicine was male-dominated and became highly skilled at delivering safe anaesthesia.
Dr Rupa Bai Furdoonji
Considered to be the first female anaesthetist, Dr Rupa Bai Furdoonji had an impressive education and was involved in the chloroform commissions of 1888 to 1891. She studied Hakeem (medicine) under Surgeon Major E Lawrie at Hyderabad Medical School, India, where she trained in delivering chloroform before graduating in 1889. Lawrie noticed that Dr Rupa was skilled in safely administering the drug and even opened his Clinical Lecture in the Hyderabad Chloroform Commission (1891) praising her abilities:
“In the case of operation for the removal of the uterus and its appendages for sarcoma, which you witnessed yesterday, chloroform was administered, and the patient was kept fully anaesthetised for one hour and a half by Miss R. Furdonji [...] without assistance or interference from anybody.” [1]
After graduating, Dr Rupa gave anaesthetics in numerous hospitals across the Hyderabad region. She also travelled to America to complete a medical degree. Despite resistance to women completing higher education in America at the time, Dr Rupa was accepted at John Hopkins University in Baltimore. But two medical qualifications weren’t enough. Dr Rupa sought a deeper understanding of the science of medicine, so in 1909 she also earned a diploma in physics and chemistry from the University of Edinburgh.
Three qualifications later and having worked in Chaderghat Hospital (the British residency hospital), Afzalgunz Hospital and Zenana Hospital, Dr Rupa retired around 1920. The finer details of Dr Rupa’s career are hazy, but her determination to get as close as she could to specialising in anaesthetics in the absence of an official diploma is clear. She earned three different qualifications in three different continents, in a world where women still weren’t universally accepted to universities. Dr Rupa didn’t want to simply deliver anaesthesia, she wanted to learn and develop her craft and study topics which were considered “useful for the doctors who handled anaesthetics.” [2]
Lady Helen D’Abernon
You may recognise Lady Helen D’Abernon as the fashionable socialite gracing the canvas of artist John Singer Sargent’s famous painting, but Lady D’Abernon was far from just a passive portrait sitter. She was a forward-thinking nurse during the First World War who identified a need for better pain management in military hospitals and took matters into her own hands.
As vice-president of the Surrey Red Cross, in 1915 D’Abernon spent some months working as a war-time nurse in Dieppe, France. [3] She quickly noticed that patients often weren’t given chloroform or ether to ease their pain and “skilled anaesthetists were entirely absent” from military hospitals. As she wrote in her diary, “clumsily administered” general anaesthetics would only add to the distress of an injured patient. [4] Military hospitals in Dieppe had significant room for improvement, and D'Abernon took it upon herself to make these improvements.
Self-assured in her ability to become the skilled anaesthetist Dieppe was lacking, D’Abernon returned to England to find training. Between 1915-16, she shadowed anaesthetist Dr W Page Ward at Guy’s Hospital until she had learnt enough to give an anaesthetic herself and earned written recommendations from her colleagues. Several surgeons and anaesthetists wrote testimonies praising D’Abernon’s “careful and conscientious” work and “technical knowledge.” [3, 4]
Trained in anaesthesia, D'Abernon returned to France in 1916, where she delivered 1,137 successful anaesthetics between 1916 and 1918 under challenging conditions. She describes her experiences working through the night to anaesthetise wounded soldiers vividly in her diary:
“The system, so far as one can see is to have two equipes. This means two sets of surgeons with their respective assistants for operations and dressings. Under normal conditions these equipes are on duty alternately for a fortnight, but in times of stress like the present an equipe stays at its post uninterruptedly for twenty-four hours and then rests for twenty-four hours before coming on duty again. Motor-ambulances bring in the wounded mostly at night.An anaesthetist is attached to each equipe, and it was to give anaesthetics that I came out...Forty-five beds have been squeezed into its narrow space, and we are four women to divide night and day shifts as best we can” [4]
Despite the pressures of a cramped environment and limited (wo)man power, D’Abernon “did not lose a single patient.”
Before the Diploma of Anaesthesia was introduced in 1935, general practitioners commonly delivered anaesthetics. They may have had instruction in anaesthesia early in their medical training, but there were no formal courses or qualifications. So, D’Abernon was also ahead of her time in seeing that experience, practice, and special training were vital when administering anaesthetics and untrained “ordinary practitioners” delivering them could be dangerous. She recognised the dangers of ill-trained doctors delivering pain medicine 16 years before Sir Ivan Magill proposed a diploma of anaesthesia at the1931 Royal Society of Medicine meeting. [5] D'Abernon's foresight and dedication to proper training and expertise in anaesthesia not only helped wounded soldiers but reveals herself as a pioneer in the development of safer anaesthesia.
Erin Taylor
Editorial and Heritage Co-Ordinator, Association of Anaesthetists