Dorothy Case Blechschmidt

Dorothy Case BlechschmidtShe was last of nine and among first of those who would forge their way into the annals of women's medical history. On the day of her birth, her father raced to McKinney's grist mill and blasted the noon whistle for a full ten minutes - thus, loudly proclaiming that a healthy daughter had been born to Marcus and Harriet Case. "We'll call her "Dott," he had announced, "for she is a remarkable period; the end of the line of children for us." And so it was that Dott Case launched her distinguished career, a career that would take her on a journey throughout Europe, would lead her to the heart of Palestine as a medical missioner, and would later thrust her into the center of Philadelphia, Pennsylvania's high-profile medical community.

Born in Ithaca, Michigan on April 9, 1885, Dott (later "Dorothy") displayed from infancy a quick wit and keen aptitude for learning. Urged on by eight older siblings and coached by her mother who had taught school in Maple Rapids, she soon excelled in music as well as in her other lessons. By the time the family moved to Loch Haven, Pennsylvania in 1889, she was singularly well versed for her age in reading and elementary mathematical concepts.

The decision to move to Loch Haven, Pennsylvania had far-reaching consequences for Dott and her family. Their household goods arrived in Johnstown the day the South Fork Dam gave way, and everything they owned was swept away in the raging tides of the Conemaugh River. With only the clothes on their backs and their hand-held luggage, the Case family began again to reestablish themselves. Without a doubt, this undaunted resiliency in the face of hardship became part and parcel of Dott's make-up; a characteristic that would follow her throughout her life.

By the age of eighteen Dott had determined that she would pursue a medical career. Encouraged by Dr. George King, an old family friend from Battle Creek, Michigan, she applied to and was accepted at Women's Medical College in Philadelphia. For the next four years she battled the rigors of a demanding schedule, the difficulty of her academic pursuits, and the prejudices of a non-accepting society of male colleagues.

The Philadelphia Academy of Music was a dignified setting for the annual commencement of the Women's Medical College of Pennsylvania. Dott proudly took her place among the forty women who were to receive degrees in the class of 1907. Years of study in a field traditionally available only to men had been an up-hill struggle: working vacations aimed at alleviating the financial burden of her education; the opposition of family and friends to women in a non-traditional role; the painful memory of open hostility steeped on female medical students by their male counterparts. All these circumstances dimmed in light of her hard-earned accomplishment as Dott accepted her coveted diploma from the hand of the distinguished Dr. Earl Barnes.

It was soon after graduation that Dott met and fell in love with Jules Blechschmidt, a German physician who had studied at Jefferson University in Philadelphia. When Harriet, with her flashlight discernment, saw them together for the first time, she turned to her daughter and remarked, "I am afraid you have looked too deeply into a pair of dark eyes." And in truth Dott had found a soul-mate, for it was Jules, twelve years her senior, who provided the stability and stimulation that Dott needed to rise above everyday obstacles to heights seldom reached by other women of her time.

After their marriage, at the request of Jules' uncle, the Reverend Martin Schneider, Dott and Jules volunteered to go Haifa, Palestine to establish a medical clinic at the Mount Carmel Mission. By the time they arrived at their destination, however, the route from Philadelphia to the Far East had been a circuitous one.

Dott had visited palaces in London, stood awestruck beneath the cathedrals of Paris, and celebrated the birthday of Emperor Wilhelm II in Berlin; she had toured Cuxhave and Hamburg prior to staying with Jules' family in Leipzig, had viewed Mont Blanc from the parapet of the Castle de Neon, and had finally settled into a four-month period of study and travel on the shore of Lake Geneva. Though she felt she had "ridden over the high places of the earth," she could barely touch in her wildest imaginings the experiences that lay before her.

Early in April, Dott and Jules finally embarked for Egypt where they changed ships at Port Said and continued on to Haifa. As they neared their ultimate destination, the work that lay before them assumed overwhelming proportions, proportions that in Dott's words "Seemed like jumping off the face of the earth." In a strange land, worlds apart from the life she hand known, she now determined to fulfil unreservedly the commitment she had made to the mission at Mount Carmel.

It would not be long until she would face an unexpected challenge to that commitment. Within hours after her arrival, an entourage led by a heavily-armed Turk made its way into the mission compound. After dismounting his stallion, he thrust before him a heavily veiled figure, her jaw swollen to grotesque proportions. The local dentist had turned her away; now her husband demanded that Dott treat her abscessed tooth. Fearing that refusal would heap reprisals upon the Mission, Dott took forceps in hand and extracted the tooth. Thus it was that, after her long journeying and preparation, Dott's first patient was one for which she had neither training nor previous experience.

Soon after, Dott was confronted with a crisis that would earn her a reputation as "the wise woman" (Hackeema in Arabic), a name that would follow her throughout her time in Palestine. Early one morning she was called to the side of a young stable boy who had been bitten by a deadly whip snake. Seeing that he was unconscious and barely breathing, Dott immediately applied a tourniquet above the bite, made an incision to extract the venom, and stayed with him for the next eight hours to administer whatever medical attention was necessary. News of this single act spread throughout the area and earned her the unqualified respect and admiration of the Mount Carmel community.

In the days that followed, Dott's caseload grew by leaps and bounds. Natives gathered before sunup to await the opening of the clinic and the arrival of the Hackeema. Long and grueling hours were filled with a variety of medical situations that Dott had not previously encountered. Cataracts, diseases of the eye, infectious fevers, abscesses, nutritional deficiencies, nervous and emotional disorders, snake bite - such afflictions became part and parcel of everyday life on Mount Carmel. Ultimately, however, it was the sheer poverty that Dott encountered which touched her deepest sensitivities and would irrevocably shape her ideals and attitudes in the years to come.

Many things in addition to her medical work contributed to Dott's happiness while at Mount Carmel. She reveled in the tales told by travelers from England, France, and the United States who had included Haifa in their tour of the Holy Land. She and Jules had attended social functions hosted by the leading citizens of Haifa. With the help of an Arabic teacher, she had conquered many simple patient instructions and colloquialisms in the Arabic language. She had been the honored guest at a three-day wedding of a Syrian princess and had visited all the cities from Acre to Damascus. But it was always her work with the poor and disadvantaged that she found most rewarding.

By the time Dott left Haifa, she had lived to see the Mount Carmel Mission prosper far beyond the dreams of the Reverend Martin Schneider. But climate and long arduous days at the clinic had taken their toll. In May of 1913, on the advice of Doctor Herman Graham, medical professor at the Syrian College, Dott reluctantly left this missionary land for the more equitable climate of the United States.

Their return voyage was punctuated by an additional week in Alexandra and nearby Cairo. As they continued to travel homeward, Jules' concern for Dott's health prompted him to arrange stopovers wherever Dott was comfortable or took particular interest in an area. They went by train following the River Rhone to Geneva, from there to Interlaken, then to Leipzig where they once again visited Jules' family. Gradually the extra rest and change of pace had Dott eager to explore and study once again.

A sensitive and astute physician, Jules recognized in Dott qualities that stood out in the medical field. Having observed her clinical work on Mount Carmel he was convinced she could be a gifted surgeon. At his suggestion, Dott decided to go to London for additional post-graduate work before returning to America.

Thus, it wasn't until the winter of 1914 that Dott and Jules sailed for New York on the S.S. Crown Prinz Wilhelm, a ship that later became a raider during World War I. The United States at the time of their return was a thriving nation, a country on the move under the Democratic administration of Woodrow Wilson and his carefully selected cabinet. Dott was filled with a sense of excitement and pride as she re-entered a nation full of unparalleled power, roaring optimism, and universal hope.

With great care, Dott and Jules selected a location suitable for their future plans. Jules received a teaching position at Jefferson Medical College and Dott eagerly accepted an appointment as Instructor of Clinical Gynecology at the Women's Medical College of Pennsylvania. Seizing this valuable opportunity under the Professorship of Dr. Ella B. Everett, Dott taught and supervised Junior medical students at the College Hospital Out-Patient Clinic. At this time she also volunteered in the Amy Barton Surgical Clinic situated in Philadelphia's Southwark District, an area heavily settled by Italian and Irish immigrants. Although her beloved work at the Carmel Mission was now thousands of miles distant, Dott soon found herself immersed in the heart of Philadelphia's poor.

Two years after her return to Women's Medical, Dott was appointed Associate Professor of Gynecology with the additional responsibility of examining Senior medical students prior to graduation. This position was cut short, however, by the sudden death of Dr. Ella Everett. Following the funeral of this friend and supportive colleague, Dott was asked to carry on all operative work at the College Hospital.

As always Jules gave invaluable help and encouragement. To save Dott from excessive medical and surgical reading, he would scan articles in the journals, especially those of Gynecology, Obstetrics, and Surgery. These Dott would find underscored in red ink and lying on her office desk for her perusal.

Not long after receiving her appointment at the College Hospital, Dr. Harry Deaver, now President of the Faculty of Women's Medical, chose Dott as his first assistant. This opened wide the door to General Surgery and provided a research avenue for the reception of her Fellowship in the American College of Surgeons. Within months after attaining this prestigious position, Dott became Chief of General Surgery for the Women's Hospital of Philadelphia.

Dott sky-rocketed to prominence. The relentless demands of her work, however, took their toll. Writing papers, preparing reports for referring physicians, delivering papers for selected scientific meetings: continuing work at the Barton clinic, teaching operative surgery, building a private practice, and trying to maintain a normal family life. All this constituted an astronomical workload, the full responsibility for which was shouldered by the young surgeon.

Dott was never a feminist in the militant sense, although she preferred to confine her work primarily to women patients. She liked to demonstrate a fact which she felt had long been ignored in the masculine world: that "Science knows no gender;" that talent, skill, and dependability are matters of general importance equally shared by both sexes.

"Archduke of Austria Assassinated." The headline blazing across the Philadelphia Public Ledger chilled the world that August morning of 1914. Jules paced the floor in their home on Rittenhouse Square. "This will mean War. A terrible war!" he lamented. "How will we ever meet our expenses?" His stress was compounded by the knowledge that any income he received from Germany would assuredly be cut off. But Dott herself refused to be disheartened. "The real test of Faith is to live with hope on the brink of ruin," she declared and from that moment, she successfully redoubled her efforts to increase her private practice.

Some time later, the Dean of Women's Medical College sent for Dott to commend her work in the Barton clinic. Suddenly, in a tone of great confidence, she remarked "I do not approve of women doctors mixing their professions with home-making and child-bearing. I hope you will not have children to hamper your career." Dott, who was four month's pregnant, froze on the spot. "I am a loving wife, a successful surgeon, and soon-to-be a mother. Men surgeons prosper and have families. Why should I be different if I chose medicine rather than the life of a club women, a bridge friend, or a butterfly?" So saying Dott quickly exited the dean's office.

That same year marked another turning point in Dott's career. Early in July she was summoned to treat a woman who was suffering from severe pain and vomiting. Although Dott suspected a ruptured appendix, she asked Dr. Harry Deaver, Professor of Surgery at Women's Medical College, to confirm her diagnosis. He recommended an immediate operation. Hearing this, the afflicted widow, a wealthy Quaker lady, lifted her head and addressed Dr. Deaver: "Give me thy bill for thy consultation. I want the woman doctor to operate." Dott's hopes plummeted. Any aspirations she had had of becoming assistant to this professor-idol seemed lost. Dr. Deaver, however, nodded thoughtfully. "There you are," he replied as he handed the woman a bill for his services. "I always respect the wishes of my patients. You are definitely in safe hands." A miracle had happened! Dott had received affirmation from one of the most eminent surgeons in his field -- and had launched another phase of her own prestigious career.

The money from this significant operation financed all the expenses surrounding the birth of Dott's daughter. Now it seemed that her life had come full-circle; motherhood opened unexplored vistas and broadened her entire outlook on her world. Financial necessities, although important, were of minor concern when viewed in light of the new life that added joy to the Case-Blechschmidt home.

When the Market crashed in 1929, financial concerns of necessity assumed the utmost importance. Dott and Jules lost their home on Rittenhouse Square, though they still had a farm which they had purchased during the flood-tide of prosperity. People bewailed on every side that the "bottom had dropped out of everything." Dott, on the contrary, reasoned that the top had sky-rocketed to unreasonable heights and that now the bottom had resumed a more normal position. Although most of her patients had been wiped out financially, Dott made it clear that she would cancel any outstanding debts until the patient was able to pay. "Despite the misfortune that surrounds us," she explained, "I still have faith in the present and hope in the future." With characteristic optimism and courage, she and Jules set out to recoup their losses.

During this difficult period Dott became Director of Public Health for the Philadelphia Federation of Women's Clubs and allied organizations. Teaching public health was her priority and great interest and she felt that cancer control and the work of the Field Army and cancer program at Lankenau Hospital was vital. She herself spoke or provided guest speakers for various women's health programs now emerging in Philadelphia and around the country. She became a driving force in the Business and Professional Women's Club and filled numerous speaking engagements, the main topics focusing on cancer of the breast and uterus and women after forty.

In 1940 Dott joined the staff of Doctor's Hospital in Philadelphia where she received a Chiefship in Surgery, the only woman member on the major staff. It was at this time, with the aid of a board of civic-minded women that she established the Dorothy Case-Blechschmidt Cancer Health Clinic of Doctor's Hospital, a cause to which she donated her services one day a week for over ten years. Under Dott's leadership the Board not only raised money for running the clinic, but paid for the repair and renovation of a large lecture hall in the clinic building, built a kitchen and serving area, and established a rotating fund from which money for the needy was available to be paid back when the patient was able to do so.

In 1945 after a full and active life, Jules had a cerebral hemorrhage from which he never fully recovered. On September 6, 1947 he died peacefully at home outside Philadelphia. For thirty-seven years he and Dott had maintained a deep understanding and warm affection. Dott shouldered this sorrow as she had faced all others in her lifetime - with courage, faith, and an indomitable spirit. But now she felt it was time to consider retirement. "I plan to go before anyone can call me `that doddering Dr. Dorothy," she quipped.

And so it was that in 1953 Dott moved to "Sunshaft," a lovely home nestled in the orange groves outside Riverside, California. Her life had come full circle, and she looked back with deep appreciation for the opportunities that had graced her and enabled her to accomplish her greatest dreams and ambitions. From the back hills of Michigan to the desert expanse of Palestine to the lime-light of Philadelphia society - Dott truly had "ridden over the high places of the earth." By the time of her death in 1970, she had accomplished what few women of her day had dared to dream about. And for all of us she leaves a legacy of undaunted courage and the desire to make a difference. Her life is testimony that our only limitations are the limitations that we find within ourselves; that if we dare to dream, dare to trust in a power greater than we --then, as women on the threshold of the twenty-first century, we can reach beyond the boundaries of today to new and exciting tomorrows.

The above biography was originally published as "A Legacy of Dreams: Dorothy Case Blechschmidt, M.D., F.A.C.S" by Julia Case Gabell in Notable Women Ancestors: The Journal of Women's Genealogy & History, Vol. I, No. 1, October, 1998 and is reprinted here with permission of the author and editor.

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