In December, I read a review in the New York Times about Fighting for Life, a 1939 autobiography by Sara Josephine Baker that recently was re-released. A medical doctor and New York City public health official, Baker is said to have saved “90,000 babies.”
I was intrigued. I’m a scholar and teacher of the medical humanities; I have a keen interest in memoir and autobiography in which illness and contagious disease are at the forefront; and I was weeks away from having my first child.
I finished Fighting for Life and I’m working out my critical interpretation of the text. I hope to share that work soon in a more formal setting, such as a conference. For now, I’ll begin to untangle my thoughts here. I often “blog my research” because it helps me organize ideas during the beginning of a project. This post is the first of a multi-part series on Fighting for Life. You can read subsequent posts here.
In this post, I introduce Baker the writer, provide an overview of her career, and consider two widely published reviews of Fighting for Life, including one written in 1939.
In the second post, I discuss the tension between two conceptions of medical and public health work in her text: “careerism” and “moral calls of duty.”
Baker the Writer?
In addition to Baker’s autobiographical writing, she was an accomplished scientific and lay writer, having authored “50 journal articles and more than 200 pieces for the popular press about issues in preventive medicine, [including] five books” (Parry).
That Baker left a large and genre-spanning textual legacy is interesting. I’d venture to say that people know more about her contributions to public health policy and practices than her writing. At least, this is true of me. I was aware of her public health work, largely because of my dissertation. Chapter one in part focused on Jacob Riis’s How the Other Half and Claude McKay’s Home to Harlem and required substantial research on late-nineteenth and early-twentieth century public health initiatives in New York City. I also regularly teach a module in my advanced composition course that centers on Mary “Typhoid Mary” Mallon; Baker was infamously involved Mallon’s case. Despite all of this work, I had never come across references to her books, including Fighting for Life.
Baker published Fighting for Life in 1939, six years before her death in 1945. I wonder what prompted Baker to turn from writing about public health to writing about herself within the context of medicine and preventative care. We may never know, at least in Baker’s own words. Helen Epstein in her illuminating introduction to the 2013 reissue of the autobiography notes that Baker destroyed all of her personal papers (xviii).
Without the aid of Baker’s personal papers, Epstein nevertheless offers an interesting theory about the authorship of Fighting for Life. It’s possible that Baker collaboratively wrote at least part of the autobiography with her partner Ida Wylie. Wylie was a prolific Hollywood scriptwriter who herself wrote an autobiography. While Baker and Wylie’s books necessarily differed in subject matter, similar turns of phrase appear in both, including the eponymous “fighting for life” (Epstein xvii).
Baker’s Medical and Public Health Career
Baker earned her medical degree in 1898 and opened a private practice with a friend in 1899 but eventually abandoned it to pursue a position in New York City’s public health division. In 1907 she became the Assistant Commissioner of Public Health and in 1909 was appointed as the Director of the Bureau of Child Hygiene.
According the National Library of Medicine’s site devoted to Baker and other notable women in the medical field, Baker
developed programs for midwife training, basic hygiene, and preventive care. She also pioneered city-funded well baby stations, and the Little Mothers Leagues (beginning in 1910), to train girls age 12 and older in basic infant care…[She also] promoted health education in the city’s immigrant communities, distributed milk to children, and created a school health program that was copied in thirty-five states across America. By the time Baker retired in 1923, New York City had the lowest infant mortality rate of any major American city. (“Changing the Face of Medicine”)
Press for Fighting for Life, Then and Now
Fighting for Life in fact has been reviewed twice in the New York Times: by Rose Feld on May 14, 1939 when the book initially was published, and as I mentioned earlier, last December, when the New York Review of Books reissued the text with Epstein’s introduction.
The most recent review perhaps marginally qualifies as such, at least when the conventions of the genre are considered; Baker’s autobiography is referred to once in the review–and even then, never directly by title (Zuger). In comparison to the latest review, Feld’s gloss is anchored more firmly to Fighting for Life, as she often paraphrases and quotes from the text.
Such differences aside, the reviews do share some thematic similarities. In discussing Fighting for Life, both pieces emphasize two dimensions of Baker’s legacy. In one respect, the reviews marvel that many policy enactments Baker instituted, like the licensing of midwives, are still in place today. Also consider that at the time of Feld’s review, doctors and midwives around the world were still using equipment Baker invented to keep silver nitrate drops sterile. (The drops had been used to prevent eye infections in newborns since the late 1880s, but it was difficult to preserve their purity.)
The reviews of Fighting for Life in the Times also draw attention to Baker’s larger contribution to public health: preventative care. Baker believed helping well people stay healthy was as important to public health as treating those who were sick. That historical and contemporary reviews of Fighting for Life underscore Baker’s essential founding of preventative medicine within public health is revealing. This suggests that “treating the well” has been and continues to be controversial (and thus underfunded), despite it being a sound social practice.
In addition to focusing on Baker’s legacy, reviews of Fighting for Life also touch on how and why she came to medicine. Perhaps because Feld’s piece is more textually focused, it preserves the complexity of Baker’s decision to pursue a medical degree, as this event emerges in Fighting for Life. Feld explains that, according to the autobiography, Baker “became a physician because it seemed a good idea to her and because it didn’t seem a good idea to relatives.” Accordingly, Feld asserts that Baker “overturns the sentimental concept of a woman dedicating herself with mystic devotion to a vocation of saving human lives.”
For the most part, I agree with Feld’s assessment of Fighting for Life. Baker rejects sentimental and gender-norming characterizations of her career and women’s careers in medicine, more generally. At the same time, and as I’ll discuss in a follow-up post, Baker in Fighting for Life does not wholly abandon conceiving of her work a moral call of duty.
Baker, S. Josephine. Fighting for Life. 1939. New York: New York Review of Books, 2014. Print.
“Changing the Face of Medicine.” U.S National Library of Medicine. U.S. National Library of Medicine, 2005. Web. 27 June 2014. http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_19.html.
Epstein, Helen. “Introduction.” Fighting for Life. New York: New York: New York Review of Books, 2014. Print.
Feld, Rose. Feld, Rose. “Pioneering for Public Health.” New York Times 14 May 1939: n. pag. Print.
Parry, Manon. “Sara Josephine Baker (1873–1945).” Am J Pub Health 96.4 (2006): 620-21. National Library of Medicine. Web. 27 June 2014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470556.
Zuger, Abigail, MD. “A Life in Pursuit of Health.” New York Times. N.p., 28 Oct. 2013. Web. 27 June 2014. http://www.nytimes.com/2013/10/29/health/josephine-bakers-fighting-for-life-still-thought-provoking-decades-later.html?_r=0.