November 15, 1873 – Sara Josephine Baker:
“It is six times safer to be a soldier in the trenches than a baby in the United States.”
Baker was an American physician whose contributions to public health, especially in the immigrant communities of New York City deserve our remembering her. She fought against the damage that widespread urban poverty and ignorance caused to children.
She was born in Poughkeepsie to a wealthy Quaker family. After her father and brother died of typhoid, Baker needed to support her mother and sister financially, and at 16 years old, Baker decided on a career in medicine.
She studied chemistry and biology at home, and then enrolled in the New York Infirmary Medical College, a medical school for women. She graduated second in her class in 1898, and then began a year-long internship at the New England Hospital for Women and Children in Boston.
Baker began practicing as a private physician in New York City following her internship. In 1901, Baker passed the civil service exam and qualified to be a medical inspector at the Department of Health and began working as a health inspector in 1902. She was called “Dr. Joe”. Wearing men’s tailored suits, her colleagues seemed to have forgot that she was a woman.
In February 2020, “Patient A1.1”, as he was referred by the Center for Disease Control, attended the funeral of a family friend after returning home from an out-of-state trip. Three days later he went to a family member’s birthday party. Three weeks later, at least 15 people who had been in contact with Patient A1.1 had COVID-19. Three of them died.
This man, like our charming president, is what we now call a “super-spreader “. 103 years before he unknowingly passed along a deadly virus, “Typhoid Mary” did the same. The doctor who stopped Mary was Baker.
3000 citizens of New Yorker City were infected with Typhi bacteria in 1907, a disease that had a 10% mortality rate at the time. Mary Mallon, an Irish immigrant who worked as a cook for families in the city, was the main spreader of the outbreak.
Baker went to a house where Mallon worked to test her. Along with the police who escorted her there, she was met by an uncooperative Mallon, who eluded them for five hours. Mallon tried to stab Baker with a fork. As Baker:
“I tried to explain to her that I only wanted the specimens and that then she could go back home. She again refused and I told the policemen to pick her up and put her in the ambulance.”
Mallon tested positive and was forced to quarantine after refusing to start handwashing, self-isolating, or taking any steps to prevent the spread of typhoid. Discovery of treatment was over forty years away, so Mallon remained actively infectious the rest of her life. Despite being contagious, Mallon only wanted to get back to work, and the NYC Department of Health kept her isolated against her will.
After over two years on an island in the East River near Rikers Island, Mallon convinced the new health commissioner to release her in 1910. She was the cause of another outbreak after going back to work as a cook who refused to wash her hands, directly infecting at least 25 people in three months but eluding health officials for five years, spreading typhoid all over the city. When they apprehended her again, they put her back in isolation where remained for the next 23 years.
Baker focused most of her career on lowering infant mortality rates in the poorest parts of New York City. She was the first director of New York’s Bureau of Child Hygiene, founded in 1908. Over the next ten years, infant mortality rate in the city went from 144 to 88 deaths per 1000 live births thanks to Baker’s teaching and implementing sanitation efforts like handwashing.
Baker promised herself she would retire when every state in the union had a child hygiene service, and that is what did in 1923 when she was 50 years old.
Baker had modeled herself on the fiercely independent, boyish ”Jo” in Louisa May Alcott‘s Little Women (1868), and she cultivated an image of being tough when it was required to get the job done, handling drunken husbands in tenements and forcing vaccinations on men in Bowery flophouses.
That she achieved so much professionally as a woman in the medical field is even more impressive by the fact that in 1900, only six percent of physicians were women. When Baker graduated in 1898, female doctors were still prohibited from working in hospitals, which led to her job as a medical inspector for New York City. When she witnessed 1500 babies dying each week of preventable diseases in that work, she committed her career to the uncommon idea of preventative care. She went on to become the first woman to earn a doctorate degree of Public Health.
Baker trained mothers on how to care for their babies: how to clothe infants to keep them from getting too hot, how to feed them a good diet, how to keep them from suffocating in their sleep, and how to keep them clean. She set up a milk station where clean milk was given out. Baker also invented an infant formula, enabling mothers to go to work so they could support their families.
Baker aided in the prevention of infant blindness caused by gonorrhea bacteria transmitted during birth. Baker’s efforts meant infants were much safer; blindness decreased from 300 babies per year to 3 per year. But there was still one area where infancy was dangerous: at birth. Babies were often delivered by midwives, who were excluded from the formal training available to doctors. Baker convinced New York City to license midwives to ensure a degree of quality and expertise.
While Baker was campaigning to license midwives, treating blindness, and encouraging breastfeeding, older kids were still getting sick and malnourished. Baker worked to make sure each school had its own doctor and nurse, and that the children were routinely checked for infestations. This system worked so well that head lice and the eye infections, once rampant in schools, became almost non-existent.
”The way to keep people from dying from disease, it struck me suddenly, was to keep them from falling ill. Healthy people don’t die. It sounds like a completely witless remark, but at that time it was a startling idea. Preventative medicine had hardly been born yet and had no promotion in public health work.”
Baker was also a suffragette and a feminist who was with her life partner, writer Ida Wylie, from 1920 until her passing in 1945. Wylie was an Australian-born novelist, screenwriter, short story writer, who was honored by the literary circles of her era and she was famous around the world. Between 1915 and 1953, more than 30 of her novels and stories were adapted into films, including Keeper Of The Flame (1942), directed by George Cukor and starring Spencer Tracy and Katharine Hepburn; Torch Song (1953) with Joan Crawford and Phone Call From A Stranger (1952) with Bette Davis. Her story Grandmother Bernle Learns Her Letters, published in the Saturday Evening Post in 1926, was filmed twice: by John Ford in 1928 as Four Sons (1928), and in 1940, also as Four Sons.
In her autobiography My Life With George (1940), Wylie writes:
“I have always liked women better than men. I am more at ease with them and more amused by them. I too am rather bored by a conventional relationship which seems to involve either my playing up to someone or playing down to someone. Here and there and especially in my latter years when there should be no further danger of my trying to ensnare one of them I have established some real friendships with men in which we meet and like each other on equal terms as human beings.”
Wylie wrote that her women friends refer to her as “Uncle” and her choice of being credited as “I.A.R. Wylie” instead of Ida Wylie was an attempt to downplay her gender in publications.
Baker and Wylie were two of the approximately 100 women in the Heterodoxy Club, a radical discussion group. The club met biweekly for a luncheon discussing the issues of free-thinking women. The couple bought a farm in New Jersey along with a third lesbian, Dr. Louise Pearce, after Baker retired, and the three lived together until each one took their leave from this world. Pearce helped develop a treatment for the African Sleeping Sickness that cured 80 percent of the cases during an epidemic in Africa. Wylie wrote that they lived “amicably and even gaily together even if it was an odd phenomenon“.
At a time when the world was dealing with another public health crisis, Baker made a commitment to serving the most vulnerable, an important reminder for our own era. Her advocacy and her focus on public education are what we need to encourage. Baker brought medical training together with a Progressive spirit of social reform.
As an unconventional public figure, she showed the possibility of standing up to discrimination and living a fulfilling personal life, even in a time of prejudice.
Baker may have retired in 1923, but she did not stop working. She became the president of the American Medical Women’s Association, wrote four books and 250 articles.
The three queer women lived there together on their farm until Baker died in 1945, followed by Pearce, and then Wylie, who checked out in 1959 at 74 years old . They are buried together at their farm.