Dr Elizabeth Gould Bell (1862 – 1934) - The First Woman to Graduate In Medicine And Practice In Ulster

SUMMARY

On 11 October 2016, the Ulster History Circle unveiled a blue plaque in commemoration of Dr Elizabeth Gould Bell MB BCh BAO (Royal University of Ireland) at the entrance of Daisyhill Hospital, Newry, Co Down, Northern Ireland. As one of the first female doctors to qualify in medicine in Ulster in 1893, against all the odds, she entered general practice in Belfast. She became a leading member of the suffrage movement in Ulster and then went on to answer a call for women doctors to volunteer service in the Royal Army Medical Corps in 1916. She was in the first group of such women to be sent to Malta during the First World War. In 1896, she married Dr Hugh Fisher, my great uncle, who was also a general practitioner. He died in 1901 of typhoid fever. Her only son, Lieutenant Hugh Bell Fisher, who had enrolled at Queen’s University, Belfast, as a medical student, joined the 2nd Royal Munster Fusiliers and died from wounds he received at the Battle of Passchendaele on 23 November 1917. Dr Bell lived at 4 College Gardens, Belfast from 1925 and died there in 1934.

Dr Bell was a member of the Ulster Medical Society from 1893; Dr Fisher was a member from 1895.

FAMILY BACKGROUND

Dr Elizabeth Gould Bell¹ was born on 24 December 1862 at Spring Hill House, close to the Newry Workhouse. She was the daughter of Joseph Bell, Clerk of the Newry Poor Law Union, whose family were from Killeavy Castle and Spring Hill, Newry, Co Armagh. Her mother, Margaret Bell, was the daughter of a farmer from the nearby townland of Carnegat. There were three daughters and two sons of the marriage: her sister, Margaret^1,2 became one of the first female general practitioners in Manchester. One of her brothers followed in his father’s footsteps and was also Clerk of the Newry Poor Law Union.

EDUCATION

There is no record of where Dr Bell went to school. However, there is a record that in 1889 she and her sister, Margaret, completed one year’s study in the Arts Faculty of Queen’s College, Belfast. This was possible due to the movement to allow women in Ulster to enter university education which began in 1867 with the establishment of the Belfast Ladies Institute. Its objective was “to provide advanced classes for ladies of a higher class than hitherto attempted”. In 1870 the question of women attending the College came before the Council of Queen’s College, Belfast. Thomas Andrews, Vice-President, proposed that they should be permitted to attend particular courses of lectures, “if the Professors considered it expedient and were satisfied the discipline and instruction of the classes would not suffer”. They would not be eligible for scholarships or prizes or enjoy the same privileges as the male students. Professor Redfern, President of the Biology Section, objected to these restrictions and wanted women to be admitted on equal terms with men, if the charter permitted. However, the matter was deferred indefinitely³.

The Belfast Ladies Institute approached the Senate of Queen’s University of Ireland in 1873 and again in 1882. The Royal University of Ireland (RUI), which had now replaced the Queen’s University of Ireland, was open to women and the President of Queen’s College, Belfast, J L Porter, supported the women’s application to Queen’s College. It was perhaps relevant that he had three clever daughters. So it transpired that in 1882-83 women were admitted to Arts Classes only but it was not until 1889 that women were admitted to the Medical Faculty of Queen’s College, Belfast for the first time³.

Elizabeth and Margaret Bell entered the Faculty of Medicine along with 3 other female medical students for the 1889-90 session. They attended the Belfast Royal Hospital, in Frederick Street, which became the Royal Victoria Hospital and the Belfast Union Hospital which became the Belfast City Hospital for clinical sessions. There was no opposition from the staff of these hospitals to the attendance of these female medical students³. Of the five female medical students, only Elizabeth Bell and Henrietta Rosetta Neill proceeded to the more prestigious university degree, the rest were satisfied with diplomas from licensing bodies. Dr Bell graduated MB BCh BAO from the Queen’s College, Royal University of Ireland on 27 October 1893. Her name was included in the Medical Directory of Ireland on 25 November, 1893. Figure 1 shows a photograph of Dr Bell.

Fig 1.

MARGARET SMITH BELL

Margaret^1,2 who was the second daughter in the family, was not as academically gifted or strong-willed as her elder sister. She opted to take the Licence of the Royal College of Physicians of Ireland (LRCPI) and of the Royal College of Surgeons of Ireland (LRCSI), along with the Licence in Midwifery (LM) in 1894. After attending the Ulster Hospital for Children and that for Eye, Ear and Throat conditions, Margaret entered general practice in Manchester and built up a considerable practice mainly among women. She was appointed medical officer of the influential Ancoats Day Industrial School of the Grove Retreat, Fallowfield and other cognate organisations. On 9 October 1901, she married Dr Joseph Douglas Boyd, also a general practitioner. In the summer of 1906 they had been staying at sister Elizabeth’s home in 4 College Gardens and for spells in Portrush seeking benefit for a refractory throat problem. After two surgical operations Margaret died in nearby Claremont Street Hospital. She had one son who became a distinguished radiologist, Dr Douglas Priestly Bill Boyd (MB, QUB, 1931).

MARRIAGE

On 2 March 1896 Dr Elizabeth Bell married Dr Hugh Fisher¹ in Fitzroy Presbyterian Church, Belfast. The son of Hugh Cumming Fisher, bank clerk, of Lennoxvale Street, he was born on 9 April 1870. He was educated at Methodist College, Belfast from 1885. He studied medicine at Queen’s College, Belfast from 1887, qualifying in 1893 with MB BCh (RUI). He became a general practitioner and was based at 75 Great Victoria Street. They had one son, Hugh Bell Fisher, known as Hugo by his family and friends. Sadly, Dr Hugh Fisher died on 18 October 1901 from typhoid fever after only five years of marriage.

GENERAL PRACTICE IN BELFAST

Dr Bell became a general practitioner and worked from 41 and later 83 Great Victoria Street, Belfast. Her patients were mostly women and young children. She was Honorary Physician⁴ to the Women’s Maternity Home in Belfast, the Belfast Babies Home and Training School at The Grove, Belfast. She was also medical officer⁵ to the Malone Place Hospital. This establishment was set up by some “Belfast ladies” who were concerned about women and girls who frequented public houses in Belfast. The ladies went out at midnight and invited the women to spend the night at the “Belfast Midnight Mission” at the Malone Place Hospital. The homeless and strangers were helped to find homes and jobs. Later, around the turn of the century, the plight of unmarried mothers and their babies was met by setting aside a room for confinements and a trained nurse and mid-wife were appointed.

In February 1919 Dr Bell was appointed as Medical Officer to Riddel Hall⁶ which was founded and endowed by The Misses Eliza (1831 – 1924) and Isabella (1836 – 1918) Riddel. They donated a substantial sum of money (£35,000.00) to build Riddel Hall as an independent hall of residence for female protestant students and teachers of Queen’s University in 1913. Miss Duffin, first Warden of Riddel Hall said of Dr Bell, “she proved a firm friend and a rock of common-sense in her frank and friendly dealings with students’ ailments and I much appreciated the way in which she told me what to note in various illnesses or note a student’s general “type” or constitution”. Later, Dr Bell became a Governor of the permanent committee of Riddel Hall. It is now home to Queen’s University Management School, the William J Clinton Leadership Institute, the Institute of Directors (IOD) and the Northern Ireland Centre for Pharmacy, Learning and Development (NICPLD).

From 1922 to 1926 she assisted the Babies’ Clubs welfare scheme, run by the Belfast Corporation, which provided subsidised milk for impoverished mothers.

OTHER INTERESTS

Dr Bell was medical advisor for the Slainte Health Insurance Scheme. She taught students in the Presbyterian Deaconesses’ Home. She was also interested in temperance and supported the Ulster Women’s Christian Temperance Association.

PUBLICATION

Dr Bell published³ A Curious Condition of Placenta and Membranes in the annual report of the Northern Ireland branch of the British Medical Association, for 1895-1896.

POLITICAL ACTIVIST

Dr Bell was noted for her involvement in the suffrage movement in the years before the First World War. Although the first suffrage society to be established in Belfast was in 1870 it was not until the early years of the 20^th Century that it gained momentum in Ulster. In 1909, the North of Ireland Women’s Suffrage Society changed its name to the Irish Women’s Suffrage Society (IWSS) which was based in Belfast but had branches outside the city. It was the educated, middle class women who formed the kernel of the suffrage movement. “These women saw their campaign within the context of democracy, claiming that the absence of women from the governing institutions of the state were responsible for a dearth of thoughtful attention directed to matters which concern women more intimately than they can possibly concern men. In essence, the vote came to symbolise women’s emancipation from social drudgery, virtuous convention and economical and political subservience. Suffragists aimed to make women feel responsible for their own destinies and those of their children and for their sex as a whole”⁷.

The suffragists and suffragettes⁸ were members of two very different movements. Suffragist was the broader term referring to the supporters of suffrage for women, more specifically the members of the National Union of Women’s Suffrage Societies (NUWSS), formed in 1897 and led for over twenty years by Millicent Garrett Fawcett. NUWSS aimed to achieve enfranchisement for women by peaceful and legal means, such as bringing petitions and Bills to parliament, and distributing literature for their Cause.

In 1903 Emmeline Pankhurst, frustrated at the lack of progress towards getting women the vote, along with her daughters Sylvia, Christabel and Adela, established the Women’s Social and Political Union (WSPU), the members of which became known as the suffragettes (around 1906, after a Daily Mail article coined the phrase). Dora Montefiore noted that the WSPU⁷ “revolted against the inertia and conventionalism which seemed to have fastened upon… the NUWSS”, and certainly its aims were to employ more militant, public, and illegal tactics, although more so after 1905 when it was clear media interest in the fight for suffrage was waning. Their motto was ‘Deeds not Words’, and, unlike the majority of other groups in support of women’s suffrage, they refused to join NUWSS⁸.

Dr Bell became a friend and ally of Mrs Emmeline Pankhurst and Lady Balfour, who was also a prominent feminist figure of the time. In 1911, Dr Bell and Miss Margaret Robinson took part in WSPU activities in London⁹. On 21 November 1911¹⁰ they were participating in a demonstration and were arrested for throwing stones through Swan and Edgar’s London Department⁹ store windows. Dr Bell was subsequently imprisoned in Holloway Women’s Prison for this behaviour. There is no evidence that she engaged in any more violent or illegal acts which characterised the tactics of some suffragettes.

The suffragists in Belfast, when imprisoned, refused food in protest at the lack of recognition of their political status. The authorities were worried that if the suffragists died in prison public support for them would gain ground and so they began to release the women prisoners when their health deteriorated. Soon all suffragists took up hunger strikes in prison and the prison authorities started to force feed the women instead of releasing them. This involved inserting a feeding tube down the throat or nose of the prisoner and then introducing liquid into the tube. The procedure was very violent and often caused extreme pain and violent sickness. This practice of force feeding brought about public outcry and in 1913 the Cat and Mouse Act was introduced by the British Government to try and prevent suffragists from getting public support for their hunger strikes. The act allowed the prison authorities to release suffragettes on hunger strike who became ill, and then re-imprison them once they had recovered. The Cat and Mouse Act (officially, the Prisoners Temporary Discharge for Ill Health Act) was supposed to break the spirit of the suffragettes but it failed on every level. Suffragettes released under the Act often went into hiding to recuperate and then carried out more militant acts, but the support from the general public increased fourfold⁹.

Dr Bell acted as doctor for the suffragette prisoners in the Crumlin Road Jail. In recognition of her service to the suffrage movement she received this certificate in or around 1912.

“To Elizabeth Bell

On behalf of all women who will win freedom by the bondage which you have endured for their sake, and dignity by the humiliation which you have gladly suffered for the uplifting of our sex, We, the members of the Women’s Social and Political Union, herewith express our deep sense of admiration for your courage in enduring a long period of privation and solitary confinement in prison for the Votes for Women Cause, also our thanks to you for the great service that you have thereby rendered to the Woman’s Movement. Inspired by your passion for freedom and right may we and the women who come after us be ever ready to follow your example of self-forgetfulness and self-conquest, ever ready to obey the call of duty and to answer to the appeal of the oppressed.

Signed on behalf of the Women’s Social and Political Union,

E. Pankhurst E.Pethick Lawrence”

The public controversy surrounding the suffrage campaign ensured that no more than a minority of women were prepared to breach the social taboos. It is claimed that approximately one thousand women were actively involved in the Ulster movement by 1914⁷. However, most suffrage activity ceased with the outbreak of the First World War and it was not until 1928 that the Equal Franchise Act was passed giving women in Ulster equal voting rights with men, allowing all women aged over 21 to vote in elections⁹.

SERVICE IN THE ROYAL ARMY MEDICAL CORPS

In May 1916, Dr Louisa Aldrich-Blake, Surgeon at the Elizabeth Garrett Anderson Hospital and Dean of the London School of Medicine for Women, approached all the women on the Medical Register at the time asking them to say if they would be willing to serve with the Royal Army Medical Corps (RAMC). In July of that year Dr Bell was in the first group of women to join the Women’s Medical Unit of the RAMC and on 2 August she embarked for Malta along with twenty-one others¹⁰.

The Director General Army Medical Services, Sir Alfred Keogh, was responsible for employing medical doctors. They were referred to as “lady doctors” and were classed as civilian surgeons attached to the RAMC. Women serving as full time doctors in the Army and doing precisely the same work as their male colleagues had neither military rank nor status, but did receive the same pay, rations, travelling allowances and gratuity as temporary commissioned male officers of the RAMC. Dr Bell, according to her service record¹¹, was contracted to work for twelve months as a Civilian Surgeon in the RAMC. Her salary was 24 shillings a day, including allowances, but excluding duty transport. A gratuity of £60 was awarded at the end of the contract. Dr Bell requested to work in Irish Command but as no vacancies were available she was assigned to St Andrew’s Military Hospital.

In August 1915, Malta hospitals had accommodation for 7044 patients. In March 1916, when the needs of the Gallipoli campaign had been met the number of beds had risen to 13,500. In July 1916, an outbreak of malaria among the troops in Macedonia brought weekly convoys of ships carrying the sick increasing from 718 to 2,587 in successive weeks. To accommodate them the beds in the hospitals and convalescent depot were increased to 25,570. The highest figures were reached in October 1916 when the demands of the Salonica Force made it necessary to increase the number of beds. To the end of August 1917, the total number of men treated in Malta was 125,000¹².

In 1915, it was decided to convert St Andrew’s Barracks into a hospital. It was taken over by the RAMC on 4 May 1915 and provided 845 beds expanding to 1,158 beds using verandahs and tentage. Dr Bell was one of five lady doctors to work there. The type of cases managed in Malta depended on the phase of the war. During the time that she served in St Andrew’s Hospital there were a large number of medical casualties mostly suffering from malaria, predominantly Plasmodium vivax type with a few Plasmodium falciparum. In addition to the malaria cases there were dysentery cases, some of which required drainage of liver amoebic abscesses. In April 1917, German submarine attacks on hospital ships made it unsafe to continue evacuating casualties to Malta from Salonica and five General Hospitals were mobilised at Malta for duty in Salonica. Thereafter, casualties arriving in Malta were greatly reduced¹². Dr Bell left Malta in July 1917 and returned to Ireland.

LIEUTENANT HUGO BELL FISHER

Dr Bell and Dr Fisher’s son, Hugh Bell Fisher, was born on 5 April 1898 and educated at the Newry Intermediate School and the Royal Belfast Academical Institution, Belfast. In 1914 at the age of sixteen years he entered Queen’s University, Belfast, Medical Faculty and had passed his first medical examination when he joined the Officer Training Corps of the University¹³. In November 1915, he was appointed to the 7^th Battalion of the Royal Munster Fusiliers and served in various battalions of the regiment including the 1^st Battalion. In July 1916, he was appointed to the 2^nd Battalion and served overseas (Figure 2).

Fig 2.

It is known that Lieutenant Hugh Fisher fought in the Battle of Passchendaele, officially known as the Third Battle of Ypres, which was a major campaign of the First World War. The battle took place on the Western Front, from July to November 1917, for control of the ridges south and east of Ypres as part of a strategy decided by the Allies at Conferences in November 1916 and May 1917. Sir Douglas Haig ordered nine British divisions, led by Sir Hubert Gough’s army, to advance on the German lines near the village of Passchendaele on 31 July. Passchendaele lay on the last ridge east of Ypres. By 6 November, Canadian and British troops had captured the village. The final battle came on 10 November. At 06.45 the 1st Canadian Division set off to push the Germans a little further north of the ridge.

Meanwhile the British II Corps was attacking the crest at Goudberg with two battalions leading. The battalion on the right lost direction and veered to the right causing a gap to appear. The Germans promptly counter-attacked and penetrated into this gap cutting off most of the battalion on the left, the 2^nd Royal Munster Fusiliers. Of seventeen officers in the action only four returned and four hundred other ranks were killed, missing or wounded¹⁴.

A collection of biographical details¹⁵ of old boys of Royal Belfast Academical Institution who served in the First World War and did not return compiled by Alan Curragh records the following:

“Hugo was reported as being missing on 10^th November 1917, the last day of the Passchendaele campaign, and later discovered to have been taken prisoner. The 2^nd Royal Muster Fusiliers were taking part in the 1^st Division attack on the Goudberg Ridge. They lost over 400 men that day, in which, for a time, they withheld a German counterattack on a position called Void Farm by throwing mudballs at them. The Germans mistook them for bombs and fell back.

Private Kennedy of the 2^nd Royal Munster Fusiliers reported -

“I am in “C” Company, No 11 Platoon. Soon after passing the first German lines of trenches right down in the valley, I saw 2^nd Lt Fisher lying on the ground on his face with his hands spread out. I passed him and went on.”

Lance Corporal Milos wrote -

“I saw Lt Fisher being hit in the stomach. He fell in his face in the mud and did not stir again.”

Hugo’s mother received a letter from her son on 21^st November, sent from Limburg, a clearing station for the wounded. She reported that “he writes very badly that he is feverish and wounded in the left foot.”

Hugo died on 23^rd November 1917, at the age of 20, in a German field hospital in Beveren, Belgium, from a shell splinter wound to his left thigh. He was originally buried in the Military Cemetery at Beveren, but was re-interred at Harlebeke New British Cemetery (ref. XI A 8), Flanders, Belgium”.

On 20 November Sir Douglas Haig decided to close down the Flanders campaign and claimed victory. However, the Passchendaele ridge was never used as a springboard for attacks on Bruges or Ghent nor had it exhausted the German Forces. The losses on both sides were enormous but never exactly known: it is estimated that British, French, Canadian, Australian and New Zealand forces suffered approximately 310,000 casualties¹⁵, as opposed to 260,000 on the German side during the battle for Passchendaele. On the Allies side 90,000¹⁶ soldiers were reported as “missing” and thousands upon thousands were never identified¹⁴.

RESIDENCES

Dr Bell’s address in the Medical Register of 1910 was recorded as 83 Great Victoria Street, Belfast. From 1925 she lived at 4 College Gardens, which became the site of the Queen’s Common Room³. She died at home on 9 July 1934, at the age of 71. Her obituary⁴ is recorded in the British Medical Journal.

HEIRLOOMS

When I qualified in medicine from Queen’s University, Belfast, in 1974, my uncle, James Taylor Rea CMG MA gave me the chair that Dr Bell occupied in her surgery in Great Victoria Street. My father, Dr Martin Alexander Rea, MB RAMC OBE bequeathed to me her certificate denoting her support of the suffrage movement (Figure 3) and her (Figure 4) and her husband’s graduation certificates.

Fig 3.

Fig 4.

I also possess a copy of a letter dated 15 November 1917 and headed “BEF, France and signed by 2^nd Lieutenant John Doorley, 2^nd Royal Munster Fusiliers informing Dr Bell unofficially, as a friend of Hugo, that he was wounded and a prisoner. According to his enquiry from the men he led into action, he was last seen lying in a shell-hole with a wound in the head. Expressing his deepest sympathy of all in the battalion, he stated that Hugo was “very popular in the battalion”.

The official letter confirming that Hugo was “missing believed to be killed” was dated 13 November 1917 and signed by Herbert P.K. Ireland, Lieutenant Colonel, Commander, 2^nd Royal Munster Fusiliers. It states, “He led his men into action on the morning of the 10^th November with great gallantry and arrived at his objective. While there he was seen to fall believed instantaneously killed. At that time we were subjected to intense shelling at that point and some counter-attacks and we lost some of our ground including that where your son was and therefore I cannot definitely assure you of his fate. But no doubt whatsoever remains in my mind after sifting the accounts that he was shot dead and suffered no pain. I enclose a slip showing the disposition made of his personal effects. If I can be of any use to you in the matter please command me”. I do not have the letter Hugo gave to Lieutenant Doorly to give to his mother just before he went into action, should anything happen to him.

A letter written by Hugo in reply to a letter written by my father, was postmarked 1 October 1917. My father was aged fourteen at the time. It is obvious from the letter that Hugo was unable to say much about his whereabouts or the conditions of warfare. He refers to moving every three days. However, Hugo’s sense of humour is reflected in his writing: about the battlefield he writes “there are little bits of lead flying about and they don’t seem particular as to what they run into. But there is always some nasty medicine in every spoonful of jam n’estce pas?” His letter ends with the words, “Thanks for your good wishes. I’ll do my best to avoid running into one of those things. See and have a good time yourself. Cheery O, Your cousin, Hugo”.

Dr Bell was known in the family as “Aunt Betty”. It is noted in family records that she was quite a formidable lady but very hard-working and kind. Living close to the University, she was visited often by her nephews and nieces and at times provided them with accommodation while they were studying at University.

THE ULSTER HISTORY CIRCLE BLUE PLAQUE

The Ulster History Circle is a small voluntary, non-profit, organisation that places commemorative plaques in public places in towns and villages all over the Province in commemoration of men and women who have contributed to its culture, industry and history. When Dr Bell was awarded the Blue Plaque (Figure 5) it was decided to place it at Daisyhill Hospital because it occupies the site of the Newry Workhouse close to where Dr Bell was brought up and where her father worked. The Workhouse was built in 1841 and functioned until 1948. It is quite possible that Dr Bell and her sister were inspired by the plight of the destitute inmates of the workhouse to devote their lives to the service of others.

Fig 5.

It was my privilege to be present at the unveiling of the Blue Plaque and to speak, as a relative, about Dr Bell’s life history and achievements. Her husband, Dr Hugh Fisher, was a brother of my paternal grandmother. Dr Bell was a truly remarkable woman, intelligent and courageous, whose life was marred by immense tragedy with the death of her husband and the loss of her son. She succeeded in medicine despite discrimination on the grounds of gender. Joining the profession in the first place was a major challenge and she, along with other women doctors during the First World War, were found to be competent, effective and resourceful. She was also a pioneer of the feminist movement in Ireland.

Dame Beulah Bewley¹⁶, in her article about the careers of early women doctors, concluded; “In the early twentieth century a successful woman doctor described her position in the profession as being ‘on the inside sitting alone’. One hundred years later, women are prominent in all branches of medicine in Ireland, as elsewhere, and owe their success in large part to these early pioneers”.