Martha Wollstein: A pioneer American female clinician-scientist

Martha Wollstein (Figure 1), born in New York City in 1868, was not only a notable pioneer pediatric pathologist, but she was also a rare female in the field of pathology in an era when just a relatively small number of women became doctors in any medical specialty.^1,2 In 1880, there were only about 2000 women physicians in the United States; by 1900, the number had grown to around a still modest 7000. Wollstein graduated during that period from The Women’s Medical College in 1889, ³ and her path to medicine was influenced by her family support and ethnic and religious background. Although during her time, she was recognized internationally for her research and was respected for her medical and scientific skills, today her important career has been largely forgotten.

We recently published a paper in a specialty journal positing that Martha Wollstein was the first fully specialized pediatric perinatal pathologist practicing exclusively in a North American children’s hospital. ⁴ She was the pathologist of record at Babies Hospital in New York City, where she worked from 1891 until her retirement in 1935. Her full scope of pathology practice at Babies Hospital included anatomical pathology, microbiology, hematology, and some chemistry, and she also worked for a number of years at the prestigious Rockefeller Institute for Medical Research. In addition to her career in pathology and pediatrics, she was also named the head of the Pediatric Section of the New York Academy of Medicine, and in 1930, she became the first woman ever to be elected a member of the American Pediatric Society. Martha was also a prolific clinician-scientist who published over 65 papers during her career on a wide range of topics, including her research on pediatric and infectious diseases. ⁴ While our prior paper describes some of Wollstein’s professional accomplishments as a pediatric pathologist and established her priority in the field, the current essay explores the personal life, upbringing, and beliefs that allowed her to succeed as an early academic woman clinician-scientist. Her lifelong commitment to medicine and science was facilitated, in part, by her Jewish religious and ethnic background, which fostered great respect for education and the field of medicine, in particular, and her parents’ elevated financial and social status, which allowed her to devote herself to her career instead of having to worry about economic self-sufficiency.

Martha Wollstein was born in New York City on 21 November 1868 to German Jewish immigrant parents, Louis and Minna Cohn Wollstein. Martha’s father, Louis, was born in Breslau, Germany on 5 March 1838, and her mother, Minna Cohn Wollstein, was born in Crossen, Germany in February 1839. Genealogical sources indicate that Louis graduated from the Elizabeth Gymnasium School in Breslau, and that the couple married in Germany in 1863 and immigrated to the United States in 1865. ⁵ Significant numbers of German Jews began to immigrate to American shores in the 1820s in search of greater economic and social opportunity and to escape poverty, persecution, and restrictive laws aimed at Jews back in Europe,^6,7 and the Wollsteins reflected this pattern. OPEN IN VIEWER

Early federal census records indicate that after the Wollstein family arrived, they first lived in the 11th Ward of New York City in Manhattan, what became known as the Lower East Side. At the time, the area was an enclave for German immigrants of all faiths. Most of those immigrants were involved in agricultural farming endeavors in New York City, but German-born Jews generally worked as peddlers, small merchants, or in skilled or semi-skilled occupations after they arrived. The 1870 census lists Louis’s occupation as a printer, ⁸ but he quickly became an upwardly mobile successful businessman. When he died at the age of 78 in 1914, he was the retired head of the United States Refining and Smelting Works, which had a main factory operation located in Newark, NJ, owned a house in Manhattan as well as an apartment in another fashionable neighborhood on Central Park West, and he was known for his charitable philanthropy. ⁵

The Wollsteins became the parents of six children, three boys and three girls. Martha had two older sisters, Helene born in Germany in 1864, who later married Elias Raum, and Rose, born in 1866, who was married to Robert Lichtenfels in 1893 but died in 1895, when she was in her late 20s. It appears that Rose had a daughter, Rosalie, who lived with her grandparents after her mother’s death. Martha’s other two brothers, Adolph and Edward, became estranged from the family, but she was close with her younger brother, Isaac, born in New York City on 29 August 1871. Isaac apparently worked with his father as a partner in his smelting and refinery business. Isaac married Louise Heylbut on 27 January 1897, and the couple lived in Manhattan. ⁹ A 1921 passport application for Isaac listed his occupation as a smelter but a census record around the same time listed his occupation as “refinery.” Isaac’s passport also indicated that he and his wife planned to visit France, Italy, Switzerland, and other European countries, which suggests the family members were quite affluent. ¹⁰

In the late-nineteenth and early-twentieth century, the field of medicine was popular with a small but prominent group of female Jewish physicians, although the road for women of all faiths and from all ethnic groups in the medical profession was often long and filled with frustrations. Women, as a whole, in America in the late-nineteenth century faced a significant challenge in gaining acceptance in the medical field, which was transitioning into a more institutionalized professional as significant advances in education, technology, and bacteriology helped transform medicine into a science. ¹¹ As Frances Emily White, an early Philadelphia women doctor and medical education reformer, put it in 1895, women physicians were “in the position of emigrants to a new territory, or as might have been said, in the advance-guard of an advancing army, compelled to build their own roads and create their own facilities in advance.” ¹² Even in the early-twentieth century, most women doctors struggled to be regarded as respected professionals and found that “medicine was a man’s world.” ¹³

Like so many of her contemporaries, Martha Wollstein also faced many challenges in her medical career, including overt discrimination against female physicians by their male counterparts, but her parents appear to have been supportive of her educational and professional path. Although German Jewish households tended to be paternalistic, it was the male sons who often followed their fathers into the family business. Perhaps because Isaac Wollstein joined his father Louis’s smelting company, Martha was allowed more leeway. Immigrant Jewish parents appear to have been especially appreciative of the benefits of higher education, and at times this extended, albeit in a more limited fashion, to daughters as well as sons. This apparently was the case in regard to Martha Wollstein, an unusually gifted student. The traditional Jewish emphasis on health and healing as well as the quest for social justice also likely influenced a number of Jewish women, including Martha, in their choice of a medical career.

Concentrating on the needs of women and children was common for women physicians at the time, and most of them focused on areas of “feminine specialties,” including obstetrics, gynecology, and pediatrics. This targeted avenue of research and practice also reflected their own self-image. As one medical historian observed, “If there was a dominant point of view among female doctors in the nineteenth and early-twentieth centuries, it was that women belonged in the medical profession by virtue of their natural gifts as healers and nurturers.” ³ Although these women doctors were pursuing a career that during the era was predominantly considered the domain of men, many still focused on aspects of medicine that fell within the traditional women’s sphere of the care of women and children. Even those Jewish female doctors who did not work exclusively with women and children tended to incorporate traditional Jewish emphasis on caregiving and responsibility for the poor and disadvantaged in their practices.

This was certainly true for Martha Wollstein, whose main research would later focus primarily on diseases that affected infants and children. The vast majority of her early scientific/experimental papers were connected to her affiliation with the Rockefeller Institute for Medical Research, and appeared in three highly prestigious journals: Journal of Experimental Medicine, Proceedings of the National Academy of Sciences, and Journal of Clinical Investigation. Later in her career, her focus became more clinically oriented and her pediatric pathology papers were highly cited. ⁴

The Wollsteins were very active in the German Jewish Reform community of their day. Louis served as a trustee of Temple Beth El, an upper class German Reform synagogue at Fifth Avenue and 76th Street in Manhattan, and he moved in rather exalted circles. When Louis was on the Temple Beth El board, he was also joined by a number of prominent Jewish New Yorkers such as businessman Solomon Sulzberger, related to members of the New York Times family dynasty, as well as leading department store magnate Lazarus Strauss, who started a thriving import business and took over Macy’s, and Lyman Bloomingdale, co-founder of the eponymous department store. Louis was also a member of the Montefiore Home, the Mount Nebo Lodge of the Masons, and served as a president of the local B’nai B’rith, a national Jewish philanthropic organization. ⁵ Rabbi Kaufman Kohler, a leading American liberal Reform rabbi at the time, was the head of Temple Beth El during the period the Wollsteins were members, and he was noted for his strong views on women’s equality, ¹⁴ which may have influenced the Wollsteins to support Martha’s career path. Although one of Martha’s fellow female physician colleague at Babies Hospital seemed to think Wollstein’s career was somewhat hampered by circumscribed roles prescribed for women by her “Orthodox Jewish heritage,” ¹³ this is not borne out by the family affiliation with the liberal Reform Congregation Beth El. However, the family may have been Orthodox in Germany and moved away from traditional practice in the United States.

Martha graduated from the New York Normal School in 1886. Normal schools existed primarily to train teachers, one of the few acceptable occupations for women at the time. Martha, who had higher aspirations, then enrolled in the Women’s Medical College of the New York Infirmary in 1886; she received her medical degree in 1889. Like Martha Wollstein, most female doctors stemmed from the middle and upper middle class. ³

The Women’s Medical College of the New York Infirmary was founded by Dr Elizabeth Blackwell, who in 1849 became the first woman in the United States to receive a medical degree, and her sister, Dr Emily Blackwell. The Blackwells’ goal in founding the Women’s Medical College was to allow women to become doctors following the highest standards of practice so that they would not be considered inferior to male physicians. After Martha graduated, she completed a two-year internship at the Babies Hospital in New York City. She was then hired as the pathologist at the hospital, where she worked for 44 years. Most of her research focused on diseases that affected infants and children, including infant diarrhea, malaria, tuberculosis, and typhoid fever. She also later became active in fundraising activities on behalf of the New York Infirmary for Women and Children. In 1918, she served as its treasurer as it launched a campaign for a new infirmary, and in 1935, she was listed as one of the members of its Board of Trustees.^15,16

Dr Wollstein certainly was cognizant of the many barriers that existed for women in the medical field in her era. In 1908, she published a robust essay about “The History of Women in Medicine” in The Woman’s Medical Journal. With great pride and appreciation, Martha traced the role of female involvement in the area of medicine back to Greek and Roman eras and through various European countries during the middle ages, but she did not overlook the many setbacks. She noted that the history of medical women in the American colonies began “deplorably,” but that significant strides had been made by the mid-nineteenth century due to the perseverance and courage of a number of women doctors like Dr Elizabeth Blackwell in the face of what had appeared to be insurmountable roadblocks. Referring to her own day, Wollstein particularly lamented the fact that “It is from the lack of hospital appointments and opportunities that women suffers most, so few large, general hospitals being open to them as interns and attending physicians.” Still, she was encouraged by the trend that “In the last 60 years, however, since a wider field and more general recognition has been accorded them… woman’s work in general medicine, in gynecological surgery, in anatomy, pathology, and bacteriology has made itself felt.” ¹⁷

Medicine as a career often involved tremendous personal sacrifices. Life for a woman doctor in the late-nineteenth and early-twentieth century was especially intense, and juggling a family and career was highly challenging. Wollstein never married, and at that time many women had to choose between marriage and a career. Like so many of Martha’s female contemporaries in medicine, she appears to have been wedded to her work. It appears that Martha was especially focused on her research and profession, and her work did garner widespread contemporary attention. In a 1912 article in The Washington Post about a high-profile medical conference, Martha was signaled out for a paper she presented related to her work: “Much interest was evoked in the afternoon session by a paper on the experiments conducted with influenza meningitis in the Rockefeller Institute by Dr Martha Wollstein,” who announced that the disease “May soon be brought within control of medical science…” through the discovery of anti-influenza meningitis serum she made in goats. ¹⁸

According to an entry about her life in American National Biography, she apparently formed few, if any, close bonds with men or women, developed few active friendships, and was sometimes perceived as difficult to work with by her colleagues. ¹⁹ However, Dr Dorothy Reed (later Reed-Mendenhall), a female colleague of Martha’s at the Babies Hospital, knew Martha well and offered a first-hand description. Mendenhall found that Wollstein was friendly toward her and Reed, in turn, sometimes covered for Martha when she was out of town. According to Reed-Mendenhall’s biographer, who studied her papers extensively, Dorothy Reed found that Martha was “a rather timid, unassertive woman,” who in Dorothy’s mind, “typified the early female professional woman—single, very bright and extremely hardworking but embittered by years of discrimination from male members of the profession.” ¹³ Reed Mendenhall’s own medical career reflected overt discrimination, but she is remembered for her path-breaking research on Hodgkin’s disease, which included the careful description of the Reed-Sternberg cell which is diagnostic for the illness. Later in her career, Mendenhall was also a pioneer in child health education.

In 1907, after having completed some work there as a fellow, Martha Wollstein was appointed as researcher to the prestigious Rockefeller Institute in the field of pathology. As one of five women to receive various research appointments, the news was important enough to make the front page of the New York Tribune, which titled the short article “Women Germ Experts, Five Research Workers Go to the Rockefeller Institute.” The article noted that the goal of the institution was to “advance medical science,” and that it was the “ambition of every researcher to be identified with the institute.” Certainly, it was a testament to both Martha’s competence and growing reputation as well as a boost to her visibility and career. It was, as the newspaper put it, an honor which “attracted attention in medical circles.” ²⁰

By the 1910 census, Martha was listed as residing at 2070 Fifth Avenue, an upscale address, in Manhattan, apparently still living with her parents. Since the Wollstein family was comfortably off, earning a living did not seem to be a primary concern for Martha. When her father died on 5 October 1914, having been predeceased by his wife, Minna, in 1911, Martha, her sister Helene Wollstein Raum, and her brother, Isaac, each received an equal share in the family house and lot at 2 West 128th Street. Martha also received all the furniture, paintings, and jewelry at her late father’s apartment on Central Park West. In addition, Helene Raum received a $1000 life insurance policy, and other policies of unknown value were left solely to Martha. The residue of the estate was divided equally between Helene, Martha, Isaac, and Louis’s granddaughter, Rosalie Wollstein Lichtenfels. Martha and a family friend, Samuel Fleischman, served as executors of Louis Wollstein’s estate, and the will stipulated that if they wished, the two of them could carry on the work of the smelting and refinery works. ⁹ That Martha received perhaps an even larger share of her father’s estate than her siblings and was named as co-executor appears a testament to the close relationship she retained with her parents and the fact that she was unmarried and had to support herself.

Despite her hardships, Wollstein worked closely and productively with acclaimed pathologist and researcher Dr Simon Flexner at the Rockefeller Institute. And although family wealth may have cushioned her from some of the challenges other women doctors faced, her career was far from being without roadblocks. Although she earned a well-deserved reputation, published over 65 articles in medical journals, and made a number of important discoveries that led to treatment of meningitis and other serious illnesses, unlike her male Jewish colleagues at the Rockefeller Institute, she never received a formal appointment. ²¹ When that honor failed to materialize due to institutional discrimination, Martha dropped her affiliation with the Rockefeller Institute, but she continued her full-time position at the Babies Hospital.

Little is known about Martha’s personal life, but she did travel for leisure from time to time, including visits to Puerto Rico and Europe, and in a 1899 passport application, she described herself as 5′ 3″ tall, having black eyes and brown hair, and she noted her occupation as a physician. She apparently remained close to her niece Rosalie Lichtenfels, and when Rosalie, a graduate of Oberlin College, married Arthur Kaufman in 1917, according to a report in the society pages of The American Hebrew, “The bride was given away by her aunt [Martha Wollstein.]” ²² It appears, then, that higher education for women was encouraged in the Wollstein household.

During her career at the Babies Hospital, Martha was a paid up member of the prestigious and richest New York Jewish Reform congregation, Temple Emanu-El. She also did some volunteer work for the local Jewish orphanage starting in 1890 as “at a meeting of the Board of Governors of the “Home” at Yonkers on Tuesday evening last, Miss Dr Martha Wollstein was unanimously elected as a member of the visiting and consulting staff of the “Home.” ²³ Although the exact dates she first joined and how long she remained a member of Temple Emanu-El are unclear, it does suggest she retained at least some of her Jewish religious connection, and her residence when she first became affiliated with Temple Emanu-El was 340 West 87th Street, not too far from the synagogue.

Beth El and Emanu-El actually merged and consolidated in 1927, so her membership may have been taken simply out of a sense of loyalty for her family’s longtime affiliation with the former. ²⁴ However, given her intense commitment to her profession, it is likely that medicine became her “religion.” Nevertheless, the Jewish community was certainly proud of her accomplishments. In an essay titled “Woman in Industry,” which was published in The American Hebrew newspaper in 1918, Wollstein was lauded as one the leading Jewish woman in “intellectual occupations” as the main pathologist at the Rockefeller Institute, who “heads our list of Jewesses in medicine,” and in another article later that year about “Jewish Women in War Work,” Martha was noted for her war efforts of “infinite value.”^25,26

It is interesting to compare Wollstein’s experiences as a woman physician and a researcher with other women in her field. Her encounters with her successful contemporary, Dr Reed-Mendenhall, who made a major contribution to the treatment of Hodgkin’s disease, was noted above, but there were many other women who followed similar paths. Since tuberculosis was the leading cause of illness and death in the late-nineteenth and early-twentieth century, it is not surprising that Wollstein as well as other women in medicine devoted some of their studies to finding out more about the illness in hopes of a cure. For example, Esther Rosencrantz, one of the most accomplished of the early Jewish female physicians in the country at the time, was a contemporary of Martha Wollstein. Rosencrantz, who was born in San Francisco in 1876, was less than a decade younger than Martha. After Esther graduated from Stanford in 1899, she entered the prestigious Johns Hopkins University, studied under leading William Osler, and received her medical degree in 1904, in an era when even few Jewish males were admitted to Johns Hopkins. After graduation from medical school, Esther Rosencrantz focused on tuberculosis research and treatment in New York City and Europe for nearly a decade. In 1913, she returned to California and was appointed an assistant and later associate clinical professor of medicine at the University of California. She also served overseas during World War I, including two years with the Red Cross Tuberculosis Commission in Italy, and was decorated by both the American and Italian governments for her contributions. Back in San Francisco, Esther continued her tuberculosis work, personally assisting poor patients with food and medicine and supervising the San Francisco Hospital Tuberculosis Clinic as the attending physician under the auspices of the University of California. Rosencrantz authored a number of tuberculosis studies before her retirement in 1943.^27,28

When Wollstein retired in 1935, the 47th Annual Report for Babies Hospital that year noted that Martha “had been a member of the staff longer than anyone now living, having been appointed the first resident physician of the hospital in 1889, shortly after its founding, and having been its pathologist since 1898 (NB all other sources state 1891). Through her investigations of the anatomy of disease in early life, many of which have appeared in the literature of the field, she has become internationally known as a scholar and has brought renown to the name of the hospital.” ²⁹ In her later years after her retirement, Martha Wollstein relocated to Grand Rapids, Michigan (possibly to join her niece) but returned to New York for medical treatment at Mount Sinai hospital, where she died in 1939. Wollstein’s funeral notice was listed in the New York Tribune, which described her as “the beloved daughter of the late Louis and Minna Wollstein, and sister of Isaac,” who presumably submitted the information. Her private service was held at the Universal Funeral Chapel in Manhattan on 1 October rather than the synagogue she and her family had been affiliated with. However, like her mother and father before her, she was also buried at the Jewish Beth-El Cemetery in Queens, New York. ³⁰

In December of 1939, the Journal of the American Medical Association (JAMA) included a brief notice of her death, and reported that she had “at one time [been] a demonstrator in histology and in pathology at her alma mater [Woman’s Medical College of the New York Infirmary for Women and Children]” and had also served as an assistant professor of diseases of children and pathology at the Columbia University College of Physicians and Surgeons, and as an associate at the Rockefeller Institute from 1906 to 1921. ³¹ However, an obituary in the American Journal of Diseases of Children was more flattering noting that “at the time of her retirement she probably had a more extensive experience in the morphology of disease in infants and children than any other American living.” ³²

Despite Martha Wollstein’s many influential contributions, the New York Times ran only 9 brief obituary. It noted only that Wollstein was a retired New York physician, who had graduated from the Women’s Medical College, was a member of the New York Academy of Medicine and the Pathological Society, and had worked at the Babies Hospital, and “was also known as a pathologist.” ³³ Nothing was mentioned of her groundbreaking research and impressive publications, or that she was the first female pediatric pathologist and one of the earliest female clinician-scientists in North America, certainly impressive accomplishments that we should acknowledge today.