Dr. Florence Rena Sabin (1871–1953): Remaking the Face of Medicine

Prior to 1849, women were forbidden from attending American medical schools. ¹ Elizabeth Blackwell (1821–1910) became the first to break this barrier, but female graduates still faced exclusion from postgraduate training and certification. ² Throughout her long career of firsts, Florence R. Sabin built on the legacy of Elizabeth Blackwell to reshape the face of American medicine.

Born on 9 November 1871 in Central City, Colorado, Sabin attended Smith College, graduating in 1893 with a Bachelor of Science. ³ Lacking the necessary funds to attend medical school, Sabin taught mathematics at Wolfe Hall in Denver. ⁴ After three years, Sabin matriculated to Johns Hopkins Medical School in October 1896, one of 14 women in her class. ⁵ One of her peers was Dorothy M. Reed (1874–1964) for which Reed-Sternberg cells of Hodgkin lymphoma are eponymously associated. ⁶ Sabin and Reed graduated in 1900, placing fourth and fifth in their cohort, respectively, and were the first female interns at Johns Hopkins Hospital under the tutelage of Sir William Osler (1849–1919).^5,7

Osler influenced the careers of Sabin, Reed, and Maude E.S. Abbott (1868–1940). Abbott was a Canadian physician who petitioned the Faculty of Medicine at McGill University in February 1889 so that women could pursue medical degrees. ⁸ She was promptly refused because no one wanted to teach “mixed classes.” ⁸ Nevertheless, Abbott became an expert in heart murmurs and contributed to Osler's System of Medicine in 1908. He later said that Abbott's chapter on congenital heart diseases was “by far and away the very best thing ever written on the subject in English — possibly any language." ⁸

It was during her time at Johns Hopkins under Osler and Dr. William H. Welch (1850–1934) that Reed discovered the blood cell disorder linked to Hodgkin disease. ⁹ In the following years, she devoted her efforts to child and maternal health, despite criticism from male physicians for her attempts to balance motherhood with her career in medicine. ¹⁰ Motivated by the loss of her firstborn, she spearheaded research investigating infant and maternal mortality. The hallmark study stemming from her work in 1926 ultimately determined that American mortality rates were higher because of unnecessary medical interference during childbirth. ⁹

Sabin spent a decade working with Osler as a medical student (1896–1900), house officer (1900–1901), and junior faculty member (1902–1905). ⁵ As an intern, she was responsible for one of Osler's tuberculosis patients in which she discovered the benefit of repeated pericardiocentesis for serous effusions. ¹¹ She also isolated tubercle bacilli and mononuclear cells from pericardial exudates, prompting thoughts on host defenses to infection.^3,11

After completing her internship, Sabin remained at Johns Hopkins as an embryology and histology researcher from 1902 to 1925. ⁵ During this time, she also identified the origins of blood cells and the lymphatic system.^12–15 In 1917, Sabin was promoted to Professor of Histology, the first female to acquire this rank at an American medical school, and was next in line for academic succession. ⁵ However, when her mentor — Franklin P. Mall (1862–1917), the first Professor of Anatomy at Johns Hopkins — died, Sabin was not promoted.^16,17 Instead, Lewis H. Weed (1886–1952), one of her former students, became Professor of Anatomy, convincing Sabin to relocate to the Rockefeller Institute in New York City in 1925. ⁴ She embraced this change, remarking that “it is not being but becoming we must understand.” ¹⁸

Recruited by Dr. Simon Flexner (1863–1964), Sabin became the first woman to chair a department at the Rockefeller Institute. Her research concentrated on hematology and the basic immunology of tuberculosis. Sabin and her colleagues stained leukocytes to appreciate their differentiation during hematopoiesis. ¹⁹ They also investigated red blood cell maturation and the cell wall of Mycobacterium tuberculosis.^20,21 After thirteen years at the Rockefeller Institute, Sabin retired in 1938 and returned to Colorado. ⁵

The last part of Sabin's career began in 1946 when Colorado Governor John C. Vivian (1887–1964) appointed her to chair a subcommittee that resuscitated the state's public health system. ⁵ Known as the “little lady with the big hats,” ²² Sabin courted public support by campaigning in each of the state's 63 counties. ⁵ Her persistent effort resulted in four bills — the “Sabin Health Bills” — being signed into law in 1947.^3,4

On 3 October 1953, Dr. Florence R. Sabin died while watching her beloved Brooklyn Dodgers in the World Series. ⁵ Sabin's life was one of many firsts — the first woman appointed full professor at Johns Hopkins Medical School, the first woman to chair a department at the Rockefeller Institute, and the first woman elected to the National Academy of Sciences. ⁴ Furthermore, she is the only female physician represented in the National Statuary Hall Collection in the U.S. Capitol Building in Washington, D.C. (Figure 1).

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Figure 1.

Dr. Florence R. Sabin's bronze statue in the Hall of Columns in Washington, D.C. It was created by Joy Buba and donated to the National Statuary Hall Collection by Colorado on 26 February 1959. The inscription in part reads “Teacher - Scientist - Humanitarian.” Courtesy of the Architect of the Capitol.

Similar to Elizabeth Blackwell, Sabin was a trailblazer who paved the way for the next generation of female physicians, scientists, and public health officers.