In the Hands of Women, page 1
Jane Loeb Rubin
IN THE HANDS OF WOMEN
A Gilded City Series
First published by Level Best Books/Historia 2023
Copyright © 2023 by Jane Loeb Rubin
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise without written permission from the publisher. It is illegal to copy this book, post it to a website, or distribute it by any other means without permission.
This novel is entirely a work of fiction. The names, characters and incidents portrayed in it are the work of the author's imagination. Any resemblance to actual persons, living or dead, events or localities is entirely coincidental.
Jane Loeb Rubin asserts the moral right to be identified as the author of this work.
Author Photo Credit: Jai Catalano
First edition
ISBN: 978-1-68512-347-5
Cover art by Level Best Designs
This book was professionally typeset on Reedsy
Find out more at reedsy.com
To my family, writing partners, and all those who inspire hope.
Praise for In the Hands of Women
“Rubin has written a fascinating novel, well-paced and brimming with historical detail. It’s 1905 in New York City, a time and place of dramatic social changes. Hannah Isaacson has graduated from a major university with an MD in obstetrics but faces widespread discrimination as a professional woman. She encounters chronic antisemitism, realistically depicted. One can’t help cheering her on as she fights for decent health care for women, for equality within the medical profession, and for respect in her own personal relationships. Ultimately, In the Hands of Women is a compelling and heartwarming historical novel.”—Libby H. O’Connell, Chief Historian Emeritus, History Channel, and author, The American Plate
“Vividly written and meticulously researched, In the Hands of Women is a gripping story of female friendship, the challenges women doctors faced in the early 1900s, and the noxious impact of antisemitism. Young obstetrician Hannah Isaacson returns home to her beloved sister and to a job at New York City’s Mount Sinai Hospital in 1905 after becoming one of the first female graduates of the Johns Hopkins Medical School. But Hannah’s passion for helping pregnant women–at a time when birth control and abortion were illegal–puts her life at risk and leads to high-stake confrontations with her fiancé and some of New York’s most powerful men. I lost myself in this novel as I followed Hannah from high-society restaurants and lower East Side tenements to New York City’s hospitals and jails … And I cheered for her every step of the way. I’m crossing my fingers Jane Rubin is working on her next tale starring Hannah, her family, and friends.”—Mally Becker, Agatha Award-nominated author of The Turncoat’s Widow and The Counterfeit Wife
“Jane Rubin’s stunning debut, In The Hands Of Women, is historical fiction at its best. Hannah Isaacson, a young doctor at Mount Sinai Hospital is a force, fighting for women’s healthcare in the early 1900’s. She confronts antisemitism and demands equal treatment in her professional and personal life. With empathy, Rubin takes us through the travails of the medical system when poor women had little access to good maternity care. Her impeccable research weaves the subjects of midwifery and abortion within the intricacies of the twentieth century class system in New York. Rubin’s characters stay with me. They’re compassionate, smart, and strong. Reading this page-turner gave me more than a thrilling read. It gave me a lesson on history and how we can do better. I couldn’t put it down.”—Julie Maloney, author and director of Women Reading Aloud, an international writing organization
“A rallying cry from the past to women of today to defend our rights, especially our medical ones—and a reminder of the horrors that can occur when we don’t. An immaculately researched and immersive debut novel.”—Michelle Cameron, award-winning author of Beyond the Ghetto Gates, https://michelle-cameron.com
I
Part 1
1900 – Baltimore
Chapter One
“Push! Stop the damn screaming!” Dr. Adams shouted at Mrs. Everly. He twisted his head to me. “My Pa’s dairy cow birthed quieter than her!”
My ears stung from his insult, but I kept my composure. “She’s doing her best. It’s her first.” Clean towels in hand, I waited to receive the newborn. Why did he feel it necessary to degrade her? What did Dr. Adams know about a woman’s pain?
Another anguished shriek. “I can’t take it any longer.”
The nurse mopped her forehead. “You’re doing fine, Mrs. Everly. Keep up the good work.”
“One last push! Head’s out. And for heaven’s sake, stop screaming,” Dr. Adams admonished, wiping the sweat from his brow. “How am I supposed to concentrate?”
The nurse helped Mrs. Everly lean forward. “Bear down again. Almost there.”
“I can’t,” she cried.
Ignoring her words, Dr. Adams commanded back, “Now! Push harder…shoulders are out…damn it, nurse, keep her legs in the stirrups! Here it comes, and… it’s a boy.” His face relaxed, visibly relieved the ordeal was over.
The nurse helped our patient lay back in the disheveled bedding, adjusting the damp pillows behind her head. “Very good, dear.”
“Isaacson, get over here!” Dr. Adams ordered.
“I’m right next to you,” I answered calmly, grasping the squealing, slippery baby from his filmy hands. I wrapped the child in a warm white towel, gently clearing the mucous and blood from his tiny face as his crying quelled.
Stepping to the mother’s side, I carefully set the newborn in her eager arms. “Here you go, Mrs. Everly. Meet your little boy.” I watched the anxious lines on her forehead melt as she cuddled her infant. “Such a brave job, both of you.”
Dr. Adams snorted. Barely taller than my short frame but twice the width, he had a fiery disposition. Balding, with deeply rutted acne scars, his poor looks matched his personality. I was assigned to work with him for the next few weeks; every day was a challenge. I’d yet to encounter him in a pleasant mood.
“Finish up here, Isaacson. Patient will pass the afterbirth. Catch it, no tugging.” Dr. Adams stepped to the sink to scrub his hands and arms. “Nurse, take the baby and wipe him clean. I’ll tell the father he’s got a son. Lucky devil.”
Heat rose to my cheeks. Like so many men, Adams was ready to congratulate the father rather than recognize the painful work of the mother. I moved to his chair at the foot of the table and glanced up at Mrs. Everly. She looked from the baby into my eyes, and an exhausted smile crossed her face. She mouthed, thank you.
Now in my third year of medical school, I was fully prepared to deliver babies. I’d assisted on dozens of births both with midwives and doctors. And I’d observed that, in more cases than not, a good deal of the screaming came from male physicians made irritable and impatient by the mothers’ labors.
Once the delivery room door closed behind Dr. Adams, I was the senior clinician in charge. “Nurse, hold off a few minutes. First, help baby latch onto Mama’s breast. That’ll make the afterbirth easier to pass.”
The nurse nodded and guided the baby onto his mother’s nipple. Within moments, the placenta and remaining pregnancy tissue slid from her body, filling the pan propped on the stool in front of me. My dear mentor back home in New York, Dr. Boro, had always cautioned, “Don’t tamper with Mother Nature. That’s when most trouble begins.” One of his earliest lessons had been how effective nursing right after birth helped coax out the afterbirth.
“Good job, Mrs. Everly. I’ll clean you up, and you can watch the nurse give your son his first bath.”
* * *
Hours later, in the Women’s Ward, I checked each of my patients. There were twenty-four iron-framed beds, arranged evenly around the perimeter of the large room. Each was separated by a thin curtain and contained a small table and chair for visitors. New mothers were placed together on the left side of the room, where Mrs. Everly rested in Bed Four, while other ailments were bedded on the right.
“How are you feeling?” I asked the newest of our mothers.
Still fighting her way through the residual anesthesia, she shifted her doe-like eyes my way. “I think I’m fine. Don’t remember too much.”
“Any pain, discharge? Have you gotten out of bed?” I lifted her chart hanging from the metal frame at the foot of the bed.
“Not yet, but I’d like to use the commode, Nurse.”
“I’m a doctor in training, but I’ll need a nurse to help me support you, just in case you feel light-headed.” I signaled to Nurse Hammond, who sat at the end of the ward, a stout, middle-aged woman with a tight bun scarcely harnessing her grey frizzy hair. I pulled the privacy drapes around the bed and wheeled in a commode.
“A doctor, you say? How unusual.” Mrs. Everly twisted into a sitting position, draping her legs over the side of the bed.
Nurse Hammond slipped through the curtain, repositioning her nursing cap, its design unique to Johns Hopkins. “I couldn’t help but hear. Dr. Isaacson is heaven-sent. In a million years, men could never understand what women go through. You’re lucky she was assigned to you.”
I was surprised by Nurse Hammond’s support. “Why, thank you.” I’d often observed her watching me critically while I worked and assumed she was waiting for me to make a mistake. Jumping to conclusions again, Hannah.
Moments later, we helped Mrs. Everly back into bed and sponge-bathed her lower body, replacing her cotton pads.
“Feeling refreshed?” Nurse Hammond asked.
“Much better. I had no idea I’d be so sore afterwards.”
So many new mothers were dismally ill-prepared for childbirth. It was a constant challenge, particularly for first-time mothers. Almost without fail, they hadn’t been seen by a midwife or doctor until the last weeks of their pregnancies.
“Every day, you’ll feel a little more like yourself. Be patient. Have you nursed your baby again?” I asked.
She looked at her chest. “I shouldn’t have before. I’ll need binding. My husband’s forbidden it. He’s hiring a wet nurse. Doesn’t want my figure ruined.”
Was it shame or disappointment on her face?
I stiffened, recalling memories of my older sister, Tillie, singing nursery rhymes to my niece, Miriam, as she nursed her.
Medical students were told, in no uncertain terms, not to interfere or attempt to influence our patients about nursing their infants. Nurse Hammond, who knew my feelings, changed the topic. “Miss Isaacson is one of twenty or so women training to be doctors here at Johns Hopkins. We’re proud our medical school joined this modern effort.”
“I wasn’t aware,” the patient said.
Nurse Hammond continued. “It must be getting close to seven or eight years since the program started. I don’t recall exactly. What a difference it’s made.” She pulled the covers up to Mrs. Everly’s shoulders, smoothing the top. “They’re quite smart doctors, all of them.”
“Thank you, Nurse. It’s good to hear you say that.” I answered gratefully. I knew the decision to accept women had been controversial. For centuries, medicine had been an exclusive men’s club. In most places, it still was. For the first time, I noticed warmth in the nurse’s grey eyes as she smiled at me.
Nurse Hammond filled the pitcher with fresh water and set it by Mrs. Everly’s bed. “Try to relax now. You worked hard today and earned a rest. And don’t forget to drink your water.”
We left the patient’s bay and walked to the end of the ward, where I sat behind a large, worn oak table, laid out my patients’ charts, and began writing notes with the ballpoint pen my sister, Tillie, had sent to me as a gift. She had a passion for new inventions, especially those that reduced mess and staining.
Nurse Hammond cleared her throat. “Can I ask why you chose to study medicine?”
I looked at her curious face, framed with creases around her eyes, belying her youthful appearance. Having worked as a nurse for decades, she was the most experienced nurse on the unit. “There were so many reasons. My sister pushed me to study hard and continue my education. And my local doctor, Dr. Boro, held our community together through thick and thin with his fine care. In high school, he took me under his wing and let me follow him on house calls.” I silently reflected, recalling how upset I was at my first deathbed, but pulled myself together when I saw Dr. Boro’s composure. And the joy of seeing women deliver babies was exhilarating. “He showed me many ways to help patients heal. The entire community depended on him.”
Nurse Hammond’s smile deepened. “He sounds like a fine inspiration. You have many of those same gifts despite your youth. I’m certain big things are in store for you.” She gazed toward the patients’ beds. “Time for me to get back to work.” Nurse Hammond circled back to her patients, methodically attending to them one by one.
Her encouraging words were energizing, giving me the lift I needed to finish my notes. I carried the stack of completed charts into the patient ward, hanging each on its corresponding bedframe. Waving good night to Nurse Hammond, I gathered my cloak and left the ward. As I descended the steps to the lobby, a nearby church bell chimed nine in the evening. At long last, time to go home.
The hospital was quiet, its daytime commotion evaporating as visitors, doctors, and staff left. Patients settled in for the night. Any overnight emergencies would be handled by medical students and residents.
Walking through the quiet corridor, my footsteps echoing, rat tap, rat tap, I thought of the heart-wrenching reasons I chose medicine that I hadn’t shared with Nurse Hammond. I’d lost too many members of my family to disease. My mother died while I was still in diapers, and within the year, Papa married my stepmother, Rebecca. But ever since I could remember, I lived with my sister, Tillie, and her husband, in the Lower East Side of New York City.
Months before I moved in with Tillie, she had given birth to twins, and the smaller, Sarah, perished during a flu epidemic. Although I barely recalled baby Sarah, who shared Mama’s name, I absorbed Tillie’s grief. As Tillie recovered from her loss, I depended on our neighbors, whose daughter, Eva, quickly became my playmate and dearest friend.
In high school, Eva died from consumption before my eyes, and I slid into a sea of grief. But Dr. Boro helped me channel that anguish into the study of medicine. A giant in my small world, he was brilliant and compassionate. In his customary big-hearted way, he coached me through the most grueling courses in both high school and at Barnard College.
But choosing obstetrics came later, after the delivery of my sister’s daughter, Miriam. After a childhood of loss, Miriam’s birth restored my belief in the miracle of life. Tillie allowed me to assist, helping our local midwife. When I wrapped the infant in her first blanket and met those searching eyes, I knew my destiny was in obstetrics.
I was one of a handful of women attending Johns Hopkins Medical School in Baltimore, and always under scrutiny. Those of us who made it through the rigorous admissions process were treated as an experiment. Most men doctors expected us to fail, viewing us with doubt, believing we lacked their sturdy disposition. Sadly, some of the nursing staff agreed. I spent every minute of every day in the hospital, proving them wrong. Determined to rise above their expectations, my dream was to return home and find an obstetrical post at Mount Sinai Hospital in New York City.
Chapter Two
The gas lamps glowed, casting their light through the mist, dimly illuminating the sidewalk. Within a few blocks, I arrived at my rooming house on Madison Street. The home, an older three-story Victorian, was a replica of others on the block. Stacked like doll houses, they had gabled roofs, rounded towers, and large windows—charming, but eerie for anyone with an active imagination. The brick and wood exterior were in dire need of repair, while the trim was shattered to pieces, a haven for nesting squirrels.
Mine was the only women’s boarding house I could locate close to the medical school that had streetlamps nearby. Tillie had insisted on a house with outdoor lighting, knowing I’d be walking home from the hospital alone at night.
Rotten floorboards creaked as I stepped onto the once ornate wrap-around porch, the gingerbread latticework absent slats here and there. I slid my key in the rusty knob, knowing Mrs. Collins would call to me any moment. My landlady had the ears of a hound.
I removed my shoes on the threadbare runner by the door and carried them, dripping, to the fireplace to dry. The hand-knotted carpets and interior were a vestige of the original European furnishings from the home’s early days of splendor. Hanging my blue wool cloak on the mahogany rack above my shoes, I walked through the parlor into the dining room. A long oak table with ten chairs filled the space. Seven other boarders, not counting Mrs. Collins, lived and ate breakfast and dinner in the house. It was a snug fit when we were all at home, but the dining room, designed for a large family seemed to inhale, making room for everyone at mealtime.
Stained damask fleur-de-lis wallpaper in light blues and greens covered the parlor and dining room walls, adding a hit of past refinement. Sadly, the furniture suggested the opposite. The torn and lumpy chairs and sofa were in sore need of reupholstering, and the dining room table was deeply scratched from years of serving as both a meal and sewing table.
Mrs. Collins swept into the dining room from the kitchen. “’Tis you, Hannah? Have you had your supper?” she asked in her heavy brogue.
“Not yet, but shouldn’t you be asleep? It’s almost ten.”
