Chapter 3 - Twice as Hard - PDF

Given the numerous structural barriers that choked the rate of new black women physicians at the turn of the twentieth century, the black women who were able to thrive in these barren conditions likely came from families whose support helped to make up for the societal oppression they faced. For man...

Given the numerous structural barriers that choked the rate of new black women physicians at the turn of the twentieth century, the black women who were able to thrive in these barren conditions likely came from families whose support helped to make up for the societal oppression they faced. For many, this support was likely coupled with privilege—the familial privilege to help daughters dream of a future that entailed more than being a nanny or house cleaner for a white family, and the financial resources to help daughters make that dream a reality. Dorothy Celeste Boulding Ferebee was blessed to be raised in a family like this. Born in Norfolk, Virginia, in 1898, two years after May Chinn, Dorothy was not afforded the dignity of knowing her birth date. She was born in a hospital that upheld racist practices. The doctors refused to issue a birth certificate for African American babies. This practice was commonplace throughout Norfolk. It’s as if these medical institutions detested black life so much that they didn’t want to recognize the beginning of new life. Dorothy’s family tried to work against this dehumanizing practice by making note of when Dorothy entered the world. Their best guess for her birthday was October 10, 1898. While Dorothy was brought up in a society that reinforced the idea that her life held little value due to her race and gender, she had a family who countered this false narrative. They were highly educated and accomplished black professionals. This was proof that Dorothy could find professional success too. Her family included lawyers and writers, and a judge. Their upward social mobility outpaced that of most African Americans at the time. Still, their start in America was the same as May’s family’s and every other African American: through slavery. Dorothy’s parents were Benjamin Richard Boulding and Florence “Flossie” Cornelia Paige Boulding. The family wealth came from hermother’s side. Dorothy’s maternal grandfather, Richard Gault Leslie Paige, was born into slavery. He escaped when he was ten via the Underground Railroad. A local antislavery society in Boston aided in his escape. It helped him reunite with his aunt, who had escaped from slavery before him. As he grew into his freedom, Richard earned a living as a craftsman. Eventually, he became a Massachusetts state legislator. Dorothy’s great-uncle, George L. Ruffin, carried on the family’s tradition of black excellence when he became the first black person to graduate from Harvard Law School and went on to serve as first black judge in Massachusetts.1 Imagine being born into such a family legacy. She was a black girl in the early 1900s with so much stacked against her. She was also a black girl born into a family of extremely accomplished black people with strong connections in the community. I grew up as a black girl with successful parents, so I can understand the paradoxical situation she was in. She was engulfed in a society that tried to convince her that she wasn’t smart or talented enough to make an impact. Yet, her family served as an inspirational cocoon that shielded her from these discouraging messages. This is the space where she developed her own dreams. Whenever someone told me that I wouldn’t be successful in college or in a STEM career, I would just think of my parents. I believed that if they could succeed, I could too. It didn’t matter that most of the African Americans on TV were depicted negatively, or that I knew only a handful of black people who were leaders in their fields. My parents’ example as college-educated professionals was enough to encourage me to try. Maybe this was how Dorothy felt. Dorothy developed an interest in medicine at a young age. Her ambitions, coupled with her mother falling ill, probably motivated her parents to move Dorothy to Boston to live with her great-aunt, Emma Ruffin. At this time, the intense levels of discrimination in southern states like Virginia likely stifled many black girls from achieving their dreams. While northeastern states like Massachusetts still had their problems, they offered many more opportunities for African Americans. By the time Dorothy moved to Boston, more than a hundred black women had trained at northeastern medical schools, while none had been allowed to study at predominantly white southern medical schools.2 Dorothy completed most of her formal education in Boston. Privilege countered prejudice, giving Dorothy access to opportunities that most black children in her generationdid not have. Without the opportunity to leave the South, another promising and ambitious black girl born at the same time in the same city likely wouldn’t have become a physician. Following a successful high school career, Dorothy started at Simmons College in the fall of 1916. Remaining focused on her medical aspirations, she bravely expressed this interest to a few of her professors. While it was common during this time for women to be discouraged from pursuing this path, the Simmons professors encouraged Dorothy to pursue her goal. They also connected her with various physicians at nearby Tufts University School of Medicine. Their support kept Dorothy motivated as she plowed through numerous challenging science courses. Toward the end of her time at Simmons, she applied to medical school. Dorothy started medical school at Tufts in the fall of 1920, only weeks after the Nineteenth Amendment to the US Constitution was ratified, granting women the right to vote, but almost five decades before black women were able to exercise this right throughout the US.3 Although Simmons and Tufts were only three miles apart, their cultures were vastly different. While the professors at Simmons were excited to see a black woman become a physician, many of the professors at Tufts had no interest in training women for careers in medicine. The attitude toward women in medicine at Tufts was evident in class makeup. In Dorothy’s medical class of 143, only 5 students were women. Dorothy stood out as the only black woman in her class. These women accounted for only 3.5 percent of the class, but the percentage of female medical students was actually higher than normal. Dorothy believed that the school had an unofficial quota limiting enrollment to three women per class, similar to Dr. Chinn’s suspicions about NYU.4 The increased diversity of Dorothy’s class was attributable to wealth and institutional connections: one female student was the daughter of a very wealthy banker, and another female student had family connections to the medical school. Dorothy’s experience mirrored that of Dr. Chinn; it took extreme privilege and wealth to convince the white male faculty at Tufts to admit a few more women into the medical school. While Dorothy and her white female classmates had different ethnic and socioeconomic backgrounds, they found solace in one another as they navigated sexism at an overwhelmingly male medical school. This was not always the case for black women pursuing medicine.When Dorothy started medical school, she held the logical expectation that her professors would give her medical training in exchange for the high tuition payments. Instead, the Tufts medical professors neglected Dorothy and the other female students. For the first three years, the instructors acted as if they didn’t exist. Whether in a large auditorium with all their classmates or in smaller learning groups, the women were always passed over when opportunities for individual learning arose. When a woman raised her hand in class, lecturers pretended they couldn’t see her. Anytime there was an opportunity for a student to give a presentation, male students were the only ones selected. This gender-based exclusion persisted in the clinics. When students began to practice delivering diagnoses at the bedside, a necessary skill to be a competent physician, none of the five women were permitted to give the diagnosis. They were even relegated to clinical experiences that aligned more with a nursing curriculum, such as the bandage clinic or the foot- soaking clinic. In comparison, the male students had extensive exposure to the clinics most applicable to physicians, such as the surgery and medical clinics. Despite all of these obstacles, the women refused to allow bigotry to impede their dreams. In a 1979 interview, Dorothy reflected on how they persisted in those times: “The five of us decided that we would stick together, and we would study together, and we would outrun some of these difficulties surrounding us.”5 The mutual support and encouragement were necessary when they wanted to cry tears of sorrow or scream out in frustration over their situation. But once these women reached their third year of medical school, they deemed the disadvantages in medical training too great to endure in silence. That year, their medical class had the opportunity to receive clinical training at Massachusetts General Hospital, a world-class teaching hospital associated with Harvard Medical School. Every Friday afternoon, from one to five, the students would crowd into the hospital’s amphitheater and watch as a well-regarded physician presented complex clinical cases. After providing key details about a case, the physician would choose a few lucky medical students to work through the case systematically. What is your differential diagnosis? How would you go about elucidating the true cause of the patient’s chief complaint? What is the proper treatment plan for this patient? Practice working up a clinical case in this fashion is vital for any budding physician.But in this room filled with promising physicians in training, the five women were treated differently. Dorothy described how her professor made her feel: “We could’ve really been dust on the wall or a spot on the floor as far as he was concerned because he never even looked at us.”6 Imagine how difficult it must have been for these women to be treated as if they were worthless, by an accomplished physician and possible role model. It would’ve been easy for them to internalize this man’s prejudice and believe that they didn’t belong in the space, wondering if maybe the admissions committee made a mistake when it had admitted them. But Dorothy and her friends knew the truth. They had earned their spots in medical school just as fully as their male classmates had. In the fall of their third year, the women marched into the office of the dean of students for Tufts Medical School. While reporting the Harvard- affiliated physician put students in a very vulnerable position, they mustered up enough courage to speak truth to power. The women were upfront with the dean about the professor’s discriminatory treatment, and they emphatically explained how the professor’s behavior was impacting their medical educations. The dean listened attentively. He appeared sympathetic to their plight. After learning more details about the situation, he promised to do something to fix the problem. The women waited eagerly to see how the dynamic in the hospital would change. As weeks passed by, it became clear that either the dean had done nothing to remedy the situation or his actions were not persuasive enough to convince the Mass General physician to actually acknowledge the women in his class. The women may have felt discouraged when they realized that the dean of students would not protect them from a professor’s discriminatory behavior, but they knew they had power within themselves. They resolved to work together to fill the gaps in their clinical knowledge and skills. They agreed to meet every Friday and Saturday to discuss cases from five foreign medical journals that they deemed important: from Vienna, Paris, Berlin, England, and Scotland. They would explain the different clinical cases and the medical teams’ therapeutic approaches. By sampling such a large array of cases, the women were more than prepared for the sessions at Mass General Hospital, as well as those in their clinics. Solidarity was vital in keeping the study group together. One of the students was Polly, a Jewish woman. She had difficulty attending the Friday sessions because she was expected to observe her faith’s Sabbath fromsundown on Friday to sundown on Saturday. During that period, she was expected to rest—not engage in work, like studying. After reflecting on how she practiced her faith, she decided that she wanted to join the study group, but she needed permission from her rabbi. She explained her plight to her friends. The other four women offered to accompany Polly to a discussion with the rabbi. The five women met with the rabbi and described the unique challenges they were up against in medical school, and how their study group had been formed to ensure that all five of them completed their medical educations. The rabbi saw the importance of their efforts, so he allowed Polly to participate in the weekend study sessions. Mary, a daughter of Italian immigrants, and Marguerite Kelly, a member of a staunch Irish Catholic family, also faced cultural obstacles in their communities. Just as they had banded together to speak with Polly’s rabbi, the women joined forces to convince Mary’s and Marguerite Kelly’s families of the importance of the work they were doing. Following these conversations, both women were allowed to participate in the study group. Luckily, Dorothy didn’t have any issues gaining family support to participate in the group. Dorothy’s great-aunt Emma, along with the rest of Dorothy’s family, were extremely enthusiastic about Dorothy’s pursuit of a medical degree. Her great-aunt Emma encouraged Dorothy and her friends to study any day they needed. She even offered her home as a study spot. On a brisk winter afternoon in early February, the students finally had a chance to correct their professor’s false perceptions of them. As on many Friday afternoons before, an orderly rolled a patient into the auditorium. The professor instructed the orderly to undrape the patient and carefully place him on the clinic table. Then, without looking at any of the women, he called all five of them by their last names and announced that he wanted them to take charge of the case. Hearing the sound of her name made Dorothy feel breathless. She was ecstatic to finally be acknowledged by her professor. The professor may have seen this as an opportunity to embarrass the female medical students, but they weren’t afraid. They had studied for countless hours. They were ready to put their hard work to the test. The professor instructed an intern to read a clinical vignette about the patient to the medical students. Dorothy listened to the description of the patient’s primary illness and information on how long he had been afflicted by it, and a host of other details. As the intern laid out the case, a light went off in Dorothy’s head. The case bore astrong resemblance to a case from the Vienna journal article that the five women had reviewed a couple of weeks earlier. The other four women were in sync with Dorothy about the connection between the cases. It was a complicated case, but the women understood it well. Still, they remained calm and didn’t reveal the added confidence that now surged through them. Once the history had been read, the professor asked the women to speak. With so much time spent reviewing cases, the women knew one another’s strengths. While the first woman reviewed the patient’s chief complaint and obtained a family medical history, the next woman followed up with a physical exam. Dorothy remembered noting that none of the men in the room were paying attention to their extremely thorough work, but she remained focused. The next woman presented her differential diagnosis. To narrow down the list of potential diagnoses, she requested various labs. After the group of women had reviewed the lab results, physical exam outcome, and history, Dorothy was elected to give the final diagnosis. Dorothy stood tall, as the only black woman in a room full of white men who refused to treat her as an equal. Then she gave a case summary that was impossible to ignore. She went through each diagnosis that was high on her team’s differential, laid out the clinical findings that supported a given diagnosis, and pointed out any evidence that would persuade her against a particular diagnosis. After providing thorough arguments against various diagnoses, Dorothy delivered her final diagnosis. The professor—who was not expecting the women to figure out the correct diagnosis—stood with his mouth opened, in shock. He became angered that his attempt to humiliate the five women with a difficult case was unsuccessful. His blood began to boil and he went red behind the ears. He decided to target his rage at Dorothy. After avoiding eye contact throughout the entire presentation, he chose this moment to finally look Dorothy in the eye. But instead of showing respect or pride at her adept handling of the case, he had fire in his eyes. In front of the entire class, he thundered: “So you think you’re pretty good, don’t you?”7 She knew that he expected her to acquiesce. He wanted her to say something indicating that she did not believe that she was smart or impressive. Dorothy was not a person who would typically challenge a professor, but she had reached her breaking point. This man had ignored her and her friends for months, and now attempted to challenge their intelligence with a case he deemed impossible for them to solve. So insteadof submitting to his bigotry, Dorothy confidently rebutted: “Sir, I don’t think I’m pretty good. I think I’m very good.”8 To this response, the whole amphitheater went wild in support of her. The men clapped vigorously. Some stamped their feet. They had been converted from seriously doubting the five women’s capabilities to being completely impressed with their intellects and dedication to medicine. The doctor was outraged by the positive response to the women. He abruptly turned away from the crowd and charged out the door. Dorothy marked the day as the moment the five women were finally considered part of the class of 1924. Their male classmates finally respected them. The men began consulting the women on various clinical cases. The men recognized that not only were these women their equals, but they had insights that the men could learn from. After three years of trekking through the trenches of medical school as students who were alienated from much of their class, the five women were finally accepted as members of the community. At the end of their medical schooling, all five women graduated with honors and were ranked among the top 9 of 143 in the class. After graduating from medical school, Dr. Dorothy Boulding was asked by various organizations to speak at events throughout the country. Sometimes her friends from medical school would attend the events. In an interview, she reflected on the experience: “[When] they ask me to speak to public groups, I’ll always say that the five women were among the first nine. And then one of them will jump up. Polly will jump up and say, ‘Well I want to correct something that Dorothy Boulding had said. She isn’t telling the truth.... Yes, the five women were in the top nine, but she never tells anybody that she was number one.’ So, in a class of 143 people, I was first. But I never bragged about it. I let my colleagues tell the story.”9 When Tufts medical students were still in their final year of medical school, they began preparing for the next steps, sending their residency applications to various programs around the country. Unfortunately, the bigotry that the women faced at Tufts played out on a national scale. Dr. Dorothy Boulding faced the brunt of it. The entire medical class submitted residency applications around the same time, but the residency programs delivered responses in phases. Early into the students’ final year, all the men had been accepted into residency programs. The women likely felt anxious while the men received their placements because the women still hadn’t even been acknowledged by the programs they applied to.Finally, in May, months after the men were sure of their next steps, responses for the women began to filter in. Sadly, the letters brought disappointment. They made excuses: “I’m sorry, the application list has been filled,” or “I’m sorry, we are not taking women this year.”10 One residency program even told Dr. Boulding that her academic record was not strong enough for its program. If a woman ranked number one in her medical class at a well-regarded medical school isn’t good enough, what is? Unsurprisingly, the men ranked below her were considered strong enough applicants to qualify for residency programs. Residency programs likely sent similar letters to other female applicants across the country. These applicants had to find ways to attain postgraduate clinical training, or they wouldn’t be able to become licensed physicians. The white women in Dr. Boulding’s class used their family connections and wealth to gain admission to residency programs. Dr. Boulding’s family didn’t have that kind of social capital, but they refused to let her career aspirations vanish. Her brother found a way to help. Dorothy’s oldest brother, Ruffin Paige Boulding, had gained admission to Howard University School of Law. Located in Washington, DC, Howard is a historically black university committed to training black people from the university level to professional school. Unfortunately, the cost of attendance was more than Ruffin could afford. But he was determined, like his sister. He delayed his own education and took a job in Boston to raise enough money for his tuition. After many years, he had saved enough money to finally go to school. Around this time, he learned of Dorothy’s struggles to find a residency placement. Ruffin was familiar with the opportunities in DC. He gave Dorothy insight on how to navigate the system. She would need to travel to DC and take an exam, which would make her eligible for a spot at a government hospital. Ruffin knew that Dorothy had her own financial constraints due to the costs of medical school and living in Boston. He didn’t want lack of money to impede her success, so he used money from his savings to buy her a train ticket. He told her that if she had challenges affording housing in Washington, he would take the next year off to ensure that she could complete her residency training. She took her older brother’s advice and traveled to Washington to complete the exam. Given its more objective nature, the written exam was easy for Dr. Boulding to pass. Things grew more complicated during theoral exam, which was conducted by a panel of white men with their own agenda. They wanted their sons to receive the medical internship placement, and Dr. Boulding was a threat to their nepotistic practices. They also told Dr. Dorothy Boulding that they didn’t see why any woman should be selected for the internship position, regardless of her credentials. This constant rejection must have been extremely frustrating for Dr. Boulding. It didn’t matter how hard she worked. If the gatekeepers of medicine didn’t want her in the field, she couldn’t join. Despite this committee’s persistent corruption, one of the physicians took pity on Dr. Boulding because of her situation. He was familiar with Howard University and its teaching hospital, Freedmen’s Hospital. He encouraged Dr. Boulding to investigate opportunities at the predominantly black hospital, rather than seek a place at a predominantly white government hospital. She was referred to Dr. William A. Warfield Jr., the superintendent of the hospital. Dr. Warfield was impressed by Dr. Boulding’s credentials and interview, so he offered her a residency position at Freedmen’s Hospital. Dr. Dorothy Boulding began her residency training in the summer of 1924. Dr. Boulding was so grateful for the opportunity to further her clinical education that she prioritized it over many things in her personal life. Her home was the hospital. Her black male co-residents enjoyed their weekends at baseball games or dances, but Dr. Boulding didn’t indulge in such luxuries. She oftentimes found herself in the hospital on Saturdays and Sundays, accompanied only by one or two other interns of the eleven in her class. By the time she completed her internship year, she had experience in every ward, even though she hadn’t been assigned to them all. One aspect of her clinical training involved serving with the crews of Freedmen’s ambulances in the late 1920s. Her ambulance was frequently called to care for people who had been wounded in street fights or domestic disturbances in southeast Washington. Due to redlining, many of the African Americans from low-income backgrounds were segregated to this area. During this time, Dr. Boulding saw more than just broken bones. She saw the challenges that the community faced, which improved her understanding of the people’s social needs. One issue that really struck her was the lack of opportunities for children. Many of the schools were rundown. The city government deprived the predominantly black school district of funds that it freely distributed tothe nearby white school districts. As a result, black school-age children’s academic progress was blunted, compared to that of their peers. Younger children were in an even more precarious position. They were left at home when their mothers went to work (sometimes as early as five in the morning). Mothers tried to enlist caretakers to watch over their children, but the mothers’ finances were strained. Caretakers were usually a grandmother or older sibling. Dr. Boulding recalled a similar dynamic in the neighborhood where she lived. One woman would take care of multiple children on her block while their mothers and fathers went to work. Even with all hands on deck, the families struggled to make ends meet. As Dr. Boulding’s nights on the ambulance wore on, she continued to see the challenges in the community. She became convinced that something needed to be done to help the people. She just wasn’t sure what. One day she was working in her office at a Freedmen’s clinic when her phone rang. Expecting a call from a patient or colleague, Dr. Boulding was surprised to hear a police officer on the other end. This event was so memorable, she recalled details from it in an interview fifty years later: “This is the police department. This is Precinct Five over on Fifth Street and Southeast. We have a little boy here that we’ve arrested, and he says that you know him.” Startled, Dr. Boulding tried to elicit more information from the police officer. Instead of giving her more details, the officer insisted that she come over to the department. Dr. Boulding hurriedly closed out what she was working on and headed out the door. She jumped into her sleek two-seater, which her uncle had gifted her for graduating from medical school, and drove with her heart in her stomach until she finally arrived at the precinct. Once she reached the front desk, she implored: “What is this? What is this?” Behind the desk, there was a little black boy with a runny nose and tears streaming down his face. He cried out to her: “Dr. Boulding, they’re going to put me in jail!” When she questioned the white policeman, who was hovering above the child, the policeman retorted, “Well he’s been stealing!” The little boy wailed in defense, “I wasn’t stealing. I was getting some milk for my baby brother. He was crying and had no food. And momma had gone to work.”Dr. Boulding then asked the boy, “Does momma usually go to work and leave the baby?”11 The boy explained that his mother had to leave at six in the morning to go to work, leaving him to care for his two-year-old brother. At some point, the child began to cry. The little boy must have felt overwhelmed with the responsibility of taking care of a baby when he was still a child himself. He thought food might ease his little brother’s distress. But when he went to the icebox for some food, he saw there was none. No milk. Not even any ice. Suddenly, the little boy felt hungry too. This hopeless situation filled him with sorrow, so he began to weep alongside the searing cries of his baby brother. He looked out his front door and saw that the milkman had just delivered a quart of milk to the family across the street. As soon as the milkman turned the corner, the little boy ran across the street and took the quart of milk. Before he could reach his house, a police officer appeared and dragged him to the police station. When Dr. Boulding heard the full story, she was infuriated by how the child had been treated. She pleaded his case to the officers. One of the officers was very hostile. He didn’t care what situation had led the child to take the milk. Thankfully, another officer was more sympathetic, so Dr. Boulding worked with him. They agreed that she could take the child and the milk to feed both children. In exchange, she paid for the milk, which at the time was about seventeen cents per quart. When they arrived at the boy’s home, they found the baby extremely distraught. He was still crying and had torn up his bed. Since the officer had brought the boy to the precinct without allowing him to go home first, the two-year-old had been left alone for hours. This traumatic experience may have had a long-term psychological impact on the child. Dr. Boulding fed both children and tried to soothe them. The disturbing situation left her uneasy. She waited with the kids until their mother returned home that evening. The mother had no idea what had happened to her children that day. She had brought leftover food from her job to stock the icebox. Dr. Boulding turned the children over to their mother and walked home. As she passed one block after another, she tried to process what had happened that day. She recognized the societal dynamics that forced mothers to leave their children when they went to work. She also saw that children were at risk without a structured day care system. They could be neglected, or even facejail time for doing what they could to survive. Reflecting on the situation compounded the young doctor’s initial yearning to help the community. She set her heart on helping to support the mothers and children struggling within this system. She knew there were day care centers in the area, but they refused to care for black children. So Dr. Boulding began work to create a day care that would care for black children in the area. Through this upsetting experience, the Southeast Settlement House was born. Dr. Boulding applied for and received approximately nine thousand dollars from the local United Way foundation and other philanthropic organizations. She used the money to rent a six-room house, which became the day care center, and to hire people to help with the endeavor. Following extensive planning and organization, Dr. Boulding opened the Southeast Settlement House. At the time, it was the only day care serving black children in that part of DC. It slowly expanded to support more children. After-school programs were developed to get older children off the streets. By the late 1970s, the Southeast House served children, teenagers, and senior citizens. In addition to its initial services, it provided youth counseling, youth employment training, juvenile restitution, tutoring services, geriatric day care, and more. It served people living between South Capitol Street and the Anacostia River. Dr. Boulding noted the center was serving more than twelve thousand people in 1979. Its proposed budget for 1980 was $2.1 million.12 Dr. Boulding built this incredible institution while she was completing her residency training. It continued to have a positive impact in the community through the early 1990s, more than sixty years after its founding. Dr. Boulding’s hard work in and out of the hospital caught the eye of Freedmen’s Hospital superintendent, Dr. Warfield. When Dr. Boulding completed her residency, Dr. Warfield offered her a job as a professor in obstetrics at Howard University College of Medicine, with the option to also maintain her own private medical practice. In 1929, she was hired as a physician to women at the Howard University Health Service. During her time at the health service, she met a handsome man named Dr. Claude Ferebee, who taught at Howard’s College of Dentistry. Claude was initially impressed by Dorothy’s work at the university and the Southeast House. The two first became friends, thanks to their mutual respect for each other’s work. Later, a strong attraction caused their friendship to blossom into something more romantic. They eventuallymarried in 1930, prompting Dr. Boulding to change her name to Dr. Dorothy Boulding Ferebee. They opened a joint medical and dental private practice a year after they tied the knot. At the same time, they started a family. By the end of 1931, Dorothy was pregnant with twins. Suddenly Dr. Ferebee had to balance the responsibilities of her job and the Southeast House plus the obligations that came with having a husband and two kids. While she loved all of these pursuits, her children held a special place in her heart, and she prioritized quality time with them over her work. She would typically read bedtime stories to her children when they were young. If story time conflicted with patients wanting to be seen, she would have her patients wait a bit. Being a mother had its challenges, but Dr. Ferebee found it extremely rewarding. When the Great Depression hit in the 1930s, Dr. Ferebee felt a new drive to serve her community. The economic downturn devastated many communities in America, particularly the most vulnerable. She knew that many African Americans throughout the country were hit hard, and she wanted to do something to help them. Alpha Kappa Alpha Sorority became her avenue for having an impact. Founded in 1908, it was the first sorority for black college-educated women. Previously, there were white sororities throughout colleges in the US, but they did not allow black women to join. Alpha Kappa Alpha became an essential community for innumerable black women in the US and abroad. It boasts countless notable members, including Rosa Parks, Coretta Scott King, Toni Morrison, Mae Jemison, and Vice President Kamala Harris. Dorothy became a member of Alpha Kappa Alpha in the mid-1920s, while she was completing her medical degree. I also had the privilege of joining this wonderful organization, in 2016, following in my mother’s footsteps. I have found sisters through the organization who have given me great joy and have inspired me to be my best self. Since starting medical school, I’ve been pleasantly surprised by the fact that many of my black female mentors in medicine are also members of my sorority. Service has always been a central tenet of Alpha Kappa Alpha. We implement community outreach projects on the local, national, and international levels. Most of our projects aim to uplift the black community. Dr. Ferebee led one of these projects: Alpha Kappa Alpha’s Mississippi Health Project. She served as the program’s director from 1935 to 1941. The program focused on Bolivar County, a predominantly AfricanAmerican community that was struggling during the Great Depression. Like numerous other African American communities in the Jim Crow South, the people of Bolivar County suffered from dismal health facilities. A significant portion of Bolivar County’s black men suffered from syphilis. This is one reason why the US Public Health Service selected Bolivar County, in addition to five other rural counties in the South, for the infamous Tuskegee experiment from 1932 to 1972.13 Some of the same black men who were forced to live with untreated syphilis for decades may have also been Dr. Ferebee’s patients. Residents of Bolivar County also frequently suffered from dysentery, and many died of tuberculosis. Starting in the summer of 1935, Dr. Ferebee went to Mississippi with a team of African American women doctors, nurses, and teachers, many of whom were likely members of the sorority. From the start of their journey, these black women faced discrimination. They were volunteers from around the country who met in DC with the intention of taking a train down to Mississippi together. African Americans were allowed to ride only at the back of the train, in the Jim Crow car. The area was extremely hot and dirty. When Dr. Ferebee told the salesperson at the railway station that she wanted to buy seventeen tickets for herself and the other volunteers, he refused her request. There were only twenty-four seats open to black passengers, and the salesperson didn’t want one group to take up so many of the seats. As a result, members of Dr. Ferebee’s team were forced to drive their cars more than fifteen hours from DC to Bolivar County. Once the women arrived in Mississippi, they faced hostility from the white plantation owners. These men didn’t like the idea of black women coming to their area to provide healthcare. They initially denied the women’s requests to access their workers. But eventually one plantation owner cosigned the sorority’s efforts. With his encouragement, the other white men grudgingly allowed the black women to open a clinic. Dr. Ferebee and her team set up five clinics around the county. They had their medical instruments, medications, and a large supply of diphtheria and smallpox vaccines ready to care for the community. 14 On the day they opened, the clinics were eerily empty. They had notified the African Americans living in the community, but no one came. After further investigation, the women found out that many people wanted to come, but the plantation owners would not let the African Americans take a break from picking cotton in order to tend to their health. Unwilling to give up,the women declared, “Well, if they can’t come to us, we’ll go to them.”15 This is how the first mobile health clinic in the country was born. These black women went to each plantation, carrying their medical supplies in their cars. Like Dr. Crumpler, who went to Richmond, Virginia, to provide medical care for recently freed African Americans, these black women were committed to serving a people whose health was generally ignored by American society. Alpha Kappa Alpha’s Mississippi Health Project provided immunizations against diphtheria and smallpox to more than 14,000 children. It also treated thousands of adults for diseases that plagued the Bolivar community, such as malaria and syphilis. The black sharecroppers in the county also suffered from extreme malnutrition, so the team spent extensive time teaching families how to use their limited food supplies to correct malnutrition.16 Dr. Ferebee’s contribution to the health project garnered her support within the sorority, and in 1940, she became the Supreme Basileus (a.k.a. the national president) of Alpha Kappa Alpha Sorority, a role she held until 1951. She was the organization’s first and only Supreme Basileus to date who was a physician. Unfortunately, as Dr. Dorothy Ferebee saw increasing success in her career, her husband encountered challenges in his. This put a strain on their marriage. Around 1935, Dr. Claude Ferebee lost his faculty position at Howard, while she maintained her strong standing there. Dr. Dorothy Ferebee recounted the difficulties this caused with her husband. “He was becoming more and more resentful of everything that I was doing as a woman, because what I attempted seemed to turn to gold, and his effort was turning to mud.... That didn’t set too well with him. And for that reason, he became very, shall I say, not disgruntled, but unhappy and uncooperative, and insisted that I give up my work. Of course, I wasn’t going to do that.”17 Dr. Dorothy Ferebee faced countless obstacles set by men who sought to hinder her success. She was finally reaching the peak of her career, but her husband wanted her to give it all up just to stroke his ego. To make matters worse, Claude betrayed their marital union by taking on multiple mistresses. Dorothy was left to cope with her husband’s actions while caring for young twins and working a demanding job. Dorothy knew that if she refused her husband’s demand to give up her job, more marital distress would ensue. Still, she held on to the unwavering determination that had helped her reach such high levels of success in the face of staunch sexismand racism. She told her husband no. She would not be hindered professionally, not even by her husband. Claude was too stuck on wanting a woman who would submit to his whims, so he allowed his resentment toward Dorothy’s success to fester. He moved to New York, leaving his wife and kids behind. Although this must have been painful for Dorothy, she found respite in her children and her professional life. The widespread impact that she had in the community caught the eye of Dr. Mordecai Wyatt Johnson, the first African American president of Howard University. He took her on as a mentee and encouraged her to strive for more. With his support and encouragement, Dr. Ferebee was named medical director of Howard University Health Services in 1949. This was noteworthy because it was almost unheard of for a woman to hold a high-level leadership position over men. Even at Howard University, a school that worked against racism, Dr. Ferebee saw sexism persist.18 Many of the male physicians and directors at Howard resented Dr. Ferebee for her appointment as medical director. It is likely that she experienced further ostracization when the health division of the State Department selected her as a US representative for various global initiatives. It sponsored her for numerous medical service trips in Africa, Asia, and Europe. While engaged in these global initiatives, Dr. Ferebee continued to expand her impact on the national stage. She became a visiting professor in preventive medicine at her alma mater, Tufts University School of Medicine. From 1949 to 1953, she was the president of the National Council of Negro Women. In 1950, she was appointed to the executive committee for the White House Conference on Children and Youth. She was also on the board of directors for various organizations, such as the Young Women’s Christian Association and the Girl Scouts of the USA. Amid all this success, tragedy struck. One of Dr. Ferebee’s twins, Dorothy Ferebee Jr., fell ill. She had an infection that quickly overtook her body. She died suddenly in 1950, when she was only eighteen years old. The elder Dorothy struggled with the loss of her only daughter; her heart was broken. Leading up to this point, Dr. Dorothy Ferebee had been traveling between Washington, DC, and New York to maintain a relationship with her husband, despite their separation. Sadly, the loss of their daughter was the final crack in their marriage. Claude asked for a divorce, and Dorothy acceded to his request. Although she never fullyrecovered from the loss of her daughter, she buried herself in her work to cope. In the 1960s, Dr. Ferebee was appointed to President Kennedy’s American Food for Peace Council. She also became a medical consultant to the Peace Corps and to the State Department. She even spoke before the World Health Assembly in Geneva, Switzerland. Throughout all of this, she continued to build Howard’s Health Services as its medical director, a position she held until 1968. That year, she was appointed medical associate to the dean of the College of Medicine at Howard University. In 1972, she retired from her private practice and her post at Howard. L ike Drs. Crumpler and Chinn, Dr. Dorothy Ferebee entered the medical field at a time when multiple structural barriers had been put in place to limit the number of black women in the profession. She prevailed in these hostile conditions by relying on her determination and grit, as well as the support of her family and a small group of peers and advisors who saw past her race and gender. In the 1920s, all women experienced intense sexism, so they developed tight-knit groups, irrespective of racial differences. Experiences from current medical students suggest that the level of solidarity that Dr. Ferebee enjoyed may not have persisted to the present, which is a loss to all of us. Once Dr. Ferebee secured her place within medicine, she turned her focus to serving communities in need. Her involvement in Alpha Kappa Alpha Sorority helped her find other black women in medicine, many of them sharing her commitment to giving back. She worked with the sorority and multiple other service organizations to care for the underserved. Through her efforts, she positively impacted hundreds of thousands of lives and even had a global reach.