Framing a Professional, Medical Identity in Fighting for Life

I’m starting a new research project, one that I hope will lead to a published paper on Fighting for Life, a 1939 autobiography by physician and vanguard public health official Sara Josephine Baker. My first step in this process is presenting my work at a conference. Moving toward that goal, I will, as usual, be blogging my research.

Fighting for Life chronicles Baker’s early childhood, decision to attend medical school, and her transition from private practice to public health work in early-twentieth century New York City. Baker’s public health interventions are legion. In addition to establishing and directing the city’s Bureau of Child Hygiene, she was a champion of preventative medicine, instituting “free milk centers” and placing nurses in public schools. 100 years later, American society still benefits from her path-breaking strides.

This post is about the tensions in Fighting for Life within Baker’s characterization of medicine, or tending to the well-being of others: is it a career choice or a moral call of duty? 

In an earlier post on Fighting for Life, I introduced Baker the writer, provided an overview of her career, and considered two widely published reviews of the autobiography, including one written in 1939 on the occasion of the text’s first publication.

“Mrs. Larocca making willow plumes in an unlicenced [sic] tenement. Found nine families at work making feathers. When our investigator made her first call there she found the whole tenement in much worse condition. Children had bad skin trouble and fever, etc. New York City.”
Public domain photograph by Lewis Hine. Courtesy of Wikimedia and NARA.

Among Baker’s many accomplishments, she often is credited with “saving 90,000 babies,” and contemporary and historical reviews of Fighting for Life as well as the back cover of the paperback’s 2013 re-release all note this specific feat.

When Baker herself invokes this statistic in chapter two of Fighting for Life (26), she clarifies her chief purpose in the text as well as an issue to which she returns over and over: explaining how “saving 90,0000 babies” came to pass. That is, why did she study medicine? And what led her away from private practice towards public health and preventative social medicine?

Baker’s pursuit of answers to these questions demonstrates her awareness of specific autobiographical conventions. She admits that her memory is not perfect but she has endeavored to tell the truth. Moreover, any factual mistakes she may have reproduced do not detract from the significance of her story or any other truth-claims she may have made in the course of telling it. This is especially true of her narration of her earliest days to age 17 when she decided to study medicine.

In explaining her medical school matriculation and all that came after, builds a professional identity that legitimizes and subverts fin de siècle expectations of gender. At the heart of this persona lies a tension between two prevailing conceptions of physicians, which Regina Morantz-Sanchez labels in Sympathy and Science as poles of a spectrum (200). At one end, caring for the well-being of others was seen as a moral call of duty governed by specific sentimental obligations. At the other end, medicine was viewed as a career path leading to financial success and personal renown.

Baker is aware of these narrative frames and their attendant gendering, and she places her professional persona in Fighting for Life within both. In doing so, she rejects other, conventional narrative frames commonly ascribed to female doctors, such as the notion that she pursued medicine as the result of her own or family members’ illnesses.

Resisting a simplistic account of her professional persona, Baker creates a complex identity in Fighting for Life that combines characteristics traditionally viewed as “masculine” and “feminine.” In some respects, her professional identity is resoundingly masculine. She chose medical school over Vassar to achieve long-term financial stability, and she implies that her ambition, choices, and alliances all positively shaped the movement of her career.

Still, Baker does not discount the import of inborn, altruistic traits—seen as the province of women—to this trajectory. It is telling, after all, that Baker’s opening anecdote in Fighting for Life describes her stripping naked as a six year-old to offer her Sunday best to a “little colored girl…wearing only a ragged old dress the color of ashes” (1). Baker’s only explanation for this act that she felt compelled, presumably by some internal force, to do it.

Although Baker attributes her success to relying on masculine and feminine traits, she also sees it as a product of ingenuity, a somewhat gender-neutral trait in Fighting for Life. Importantly, ingenuity in the text becomes a tool that reaps greater individual and social gains, all at once.

Ultimately, Baker’s Fighting for Life prompts contemporary readers to reflect on historical conceptions of gender as they relate to the study and practice of medicine. The text also encourages students who are entering health-related fields to consider the extent to which these beliefs govern medicine and public health today as well as how they affect practitioners, patients, and society.

Works Cited

Baker, S. Josephine. Fighting for Life. 1939. New York: New York Review of Books, 2014. Print.

Morantz-Sanchez, Regina. Sympathy and Science: Women Physicians in American Medicine.  1985. Chapel Hill, NC: U of North Carolina P, 2000. Print.

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Curious about the image used in this post? I found the Lewis Hine photograph in the Wikimedia repository. It had been added to Wikimedia by the National Archives and Records Administration. Since 2012, NARA has uploaded hundreds of thousands of images to Wikimedia and has plans to digitize more creative-commons licensed material.