Laura D. Hirshbein, MD, PhD
University of Michigan, Ann Arbor, United States
Galen of Pergamon, the most famous medical researcher of classical antiquity
In 1914, a group of fraternity men from the University of Michigan Medical School in Ann Arbor, Michigan, decided they needed more influence at the school. One of the students had an uncle on the faculty, and with his connections these men founded the Galens Honorary Medical Society, an elite organization intended to represent the best and brightest of the students. One of the group's first activities in 1916 was to successfully lobby the University's hospital for a smoking lounge, since the men objected to standing on the steps behind the hospital in order to smoke.1 Over subsequent decades, the Galens organization became an important mechanism for medical student networking with faculty. The group had remarkable input on medical school policies and curriculum. The society was the motivating force behind the institution of an honor code, and their opinions were frequently solicited on various changes proposed by the faculty.2
According to its constitution and by-laws, the Galens Society was "to promote the interests of the Department of Medicine and Surgery of the University of Michigan; to bring together for mental and social enjoyment the public-spirited men of the faculty and upper classes; to diminish any feelings between the members of the medical fraternities and the independents; to invite leading men to speak before the club or before the medical classes on topics related to medicine; to stand for the honor system." The group would be selected by personal recommendation of the student leadership, and faculty would be chosen as honorary members. Under the group's charter, the only explicit limitation was that "no women shall be members."3
Although all-male medical organizations were not remarkable in the early twentieth century, the Galens Society was not single sex by default—the University of Michigan (U of M) had admitted women to its medical school beginning in 1870 and was well known as one of the most significant places for women's training as physicians.4 Further, Galens policy of recruiting from among the medical fraternities deliberately excluded members from the alpha chapter of the women's medical sorority, Alpha Epsilon Iota (founded in 1890).5 But the Galens group embraced the male atmosphere of camaraderie in which medical students and faculty smoked together, discussed scientific papers, planned changes to the medical student program, and exchanged bawdy jokes. In 1918, the Galens Society organized an event they called the "Smoker," which became an annual raucous theater performance based on the foibles and idiosyncrasies of the medical school faculty. Not to leave this kind of fun to a once-a-year venue, beginning in 1931 the Galens Society also published an underground newspaper that was so ribald that even the senior administration did not know what was in it.6
But the Galens Society was not all fun and games. Within the exuberant atmosphere, Galens men were intent on nurturing their faculty contacts. Through the decades, the Galens officers utilized different mechanisms to make sure that faculty attended their meetings. They cultivated a close relation with the medical school dean, and provided entertainment for medical school alumni events.7 They gathered information on internships and Galens faculty advisors helped members look for appropriate training positions after medical school. Galens men also looked into ways to solidify faculty-student relationships through social contacts such as golf or cocktails.8
But like many men's service organizations of the time, the group also perceived an obligation to help those less fortunate.9 And the medical students at the University of Michigan were under pressure—as were students in teaching settings everywhere—to prove to the community that they were not taking advantage of patients' misfortunes to learn how to practice medicine.10 The Galens men started off by giving a gift every year to a disadvantaged child during a Christmas party at a medical fraternity house. In 1927, though, the chosen boy was somewhat disparaging of his gift—it turned out that his father was the fraternity bootlegger. In their embarrassment over this incident, the officers of Galens turned to Miss Dorothy Ketcham, the formidable head of the hospital's Social Service program. Ketcham suggested that the group use the Christmas holiday to raise money for child's activities in the hospital. The men initiated a tag drive—they would walk around with buckets to collect donations, giving paper tags to anyone who participated. They gave the funds to Miss Ketcham, and the result was the "Galens Workshop," a room where children recovering from illness could go and participate in a variety of handicraft activities.11
By the 1930s and 1940s, the Galens Society charitable activities became more extensive, formalized, and publicized. The "Tag Day" became an annual fundraising event in which Galens men went out to the streets of Ann Arbor with buckets collecting money for children at the hospital. The Galens Workshop was highlighted in hospital publications about children's activities. And the society created a store in the hospital to sell items to visitors; the proceeds would support the children's programs. By creating a shop within the new children's hospital in 1969, the Galens Society became one of the major benefactors to children's activities. And the Galens Workshop stood next to a playroom constructed by another all-male service organization, the Kiwanis Club.12
Although the Galens Society received admirable publicity for their philanthropic efforts, the men's behind-the-doors activities became more boisterous. In 1948, a copy of the society's humorous newspaper made it to the desk of the University of Michigan’s Dean of Students. He was not amused. He wanted to disband the society and expel the students, but was convinced by the medical school dean (who had been a founding member of Galens) to simply suspend the society for a year with a promise of future more respectful behavior. But the annual theatrical roast of faculty, the Smoker, continued to be so inappropriate that it was considered a "stag event." When medical sorority women sneaked into the theater in 1964 to watch (and paid for their tickets after the fact), the men responded in (mock?) horror that women should have witnessed their revels.13
In 1970, Frances Bull, one of the few women on the medical school faculty, wrote to the honorary faculty members of the Galens Society to suggest that perhaps it was time to reassess the status of the group and admit women. As she dryly observed, "1970 is the centennial of the admission of the first woman to the University of Michigan … so I would not view this concern as hastily contrived."14 One of the faculty men responded with irritation to Bull's letter, and waspishly suggested that, "If there are female medical students who feel the need for membership in an all-male society, I would suggest they contact the male members of that society to raise their grievance."15 Another faculty member waited a year to respond, then wrote to Bull to let her know that the organization changed its constitution and that they "nominated one girl to the new group of initiates" that year.16 The same year, the Smoker officially invited women faculty and medical students to attend.17
At the time when the Galens Society finally admitted women, the organization began to distance itself from naughty or forbidden behaviors. The Galens Shop stopped selling cigarettes in the hospital. The society stopped restricting membership to a few invited initiates, and they stopped meeting at fraternity houses. The Smoker became a community amateur theater event, and the annual Tag Day fundraising drive got state-wide publicity.18 By the 1990s, histories of the organization skated lightly over Galens initial closed admission to women, and emphasized the group's service to children's activities.19 And while the organization helped some with faculty student relationships, the mentoring and networking system set up by the original Galens members and their male faculty disappeared.
The history of the Galens Medical Society at the University of Michigan illustrates that gender in medical education was (and is) much more complicated than just the sex of the students in the class. Although the University of Michigan was the first fully coeducational medical school, separate social organizations characterized student life. And despite the presence of women in the student body—or perhaps because of them—elite men within the medical school felt the need for a more exclusive club in which men could bond with each other over smoking and crude jokes.20
The timing of the transformation of Galens from an elite male club to an open, co-ed service organization in the 1970s was consistent with other changes in social and professional medical organizations nationwide. In 1970, the venerable Women's Medical College of Pennsylvania, in existence since 1850 to train women physicians, began to admit men. By the 1970s, most medical schools saw a significant increase in the number of women applying to (and accepted in) medical school. And most women in medicine strove to be included in previously male organizations rather than in separate women's groups.21
In many ways, it is curious that the Galens Society, which was resolutely against admitting women through the first six decades of its existence, became best known as an organization that benefitted sick children. Indeed, women gained entrance into medicine in the nineteenth century partly by arguing that they were needed to care for the health of women and children.22 Further, children's welfare had been a well-established area for women reformers—including women physicians—in the first half of the twentieth century.23 Perhaps because this area was so frequently associated with women reformers it highlighted the philanthropic nature of the Galens group. This men's organization gained nobility for their caring for children in the hospital. In this context, it is not surprising that the prestige of the society would diminish when women joined. Women medical students and physicians, after all, have been unremarkable when they displayed interest in sick children.
When the Galens organization remained all male, it functioned as a mechanism to lower boundaries between male students and faculty. Its small size and elite entrance pathway ensured that its alumni went on to prosperous professional positions, including many on the faculty at the University of Michigan. Although the boys' club clearly needed to be open to women, some of the club's benefits did not carry over to the group in its reincarnation as a service organization. When women were admitted to Galens, the organization became less exclusive and less honorary. It also became a much less effective mentoring organization. By 1981, a press release for the annual Tag Day identified the Galens Medical Society as "a group of University of Michigan medical students devoted to contributing to the quality of children's health care in the Ann Arbor area."24 Medical students participating in the Galens Society got kudos for being service-oriented, but it did not necessarily help them get ahead in the competition for residency programs or jobs.
In this day and age, it is hard to imagine a justification for an exclusive professional organization in which women were not allowed solely because of gender. It seems self evident that both men and women should have access to mentorship opportunities and advancement. But as historian Estelle Freedman pointed out more than two decades ago, it has not been enough for women's advancement to merely gain access to men's organizations.25 Mentoring within academic medicine continues to privilege an unspoken network of men.26 An organization such as Galens operated in an earlier time to promote the (self-selected) elite within the profession in a way that is impossible in our more inclusive time. But as the historical example of Galens demonstrates, it is hard to break into the boys' club.
- Minutes, Meeting Summaries, 1914-1920, Box 1, and Undated History, Histories and Constitutions, Annual Histories, 1914-1930, Box 4, Galens Medical Society Records, Bentley Historical Library, University of Michigan, Ann Arbor, MI.
- Histories and Constitutions, Annual Histories, 1914-1930, Box 4, Galens Records.
- Marvin J. Lubeck, "History of the Galens Honorary Medical Society," University of Michigan Medical Bulletin 21 (1955): 41-50. Copy in Box 4, Galens Records.
- Regina Markell Morantz-Sanchez, Sympathy and Science: Women Physicians in American Medicine (New York: Oxford University Press, 1985).
- Alpha Epsilon Iota Records, Bentley Historical Library.
- Donald M. Black, "Galens Honorary Medical Society," unpublished history, 1984, Box 4, Galens Records.
- Activities and Funds, Triennial Medical Alumni Banquet, 1953-1964, Box 4, Galens Records.
- Activities and Funds, Box 3, Galens Records.
- Clifford Putney, "Service Over Secrecy: How Lodge-Style Fraternalism Yielded Popularity to Men's Service Clubs," Journal of Popular Culture 27(1993): 179-190.
- On the social contract in teaching hospitals, see Kenneth M. Ludmerer, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care (New York: Oxford University Press, 1999), 21-25.
- Black, "Galens Honorary Medical Society."
- Frances E. Bull to Roland Hiss, 28 April 1970, Box 2, Officers' Records and Reports, President, 1970-1971, Galens Records.
- Letter from Dr. Earl R. Feringa, Chief of the Neurology Service, to Dr. Bull, 8 May 1970, Officers' Records and Reports, President, 1969-1970, Box 2, Galens Records.
- Hiss to Bull, 1 March 1971, Officers' Records and Reports, President, 1970-1971, Galens Records.
- Notice, 11 February 1971, Officers' Records and Reports, President, 1970-1971, Box 2, Galens Records.
- Black, "Galens Honorary Medical Society."
- Megan Schimpf, "Tags and ponchos, Scripts and Shows: Galens Medical Society Members Give of Themselves in Return for Intangible, Priceless Benefits," reprint from Medicine at Michigan, Fall 1999, Histories and Constitutions, Miscellaneous Histories, Box 4, Galens Records.
- For more on perceived crises in masculinity during the time period in which Galens was founded, see Michael S. Kimmel, Manhood in America: A Cultural History (New York: Free Press, 1996), 171-175.
- Mary Roth Walsh, Doctors Wanted: No Women Need Apply: Sexual Barriers in the Medical Profession, 1835-1975 (New Haven: Yale University Press, 1977).
- Morantz-Sanchez, Sympathy and Science.
- Linda Gordon, "Putting Children First: Women, Maternalism, and Welfare in the Early Twentieth Century," in U.S. History as Women's History: New Feminist Essays, ed. Linda K. Kerber, Alice Kessler-Harris, and Kathryn Kish Sklar (Chapel Hill: University of North Carolina Press, 1995), 63-86; Ellen S. More, Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995 (Cambridge: Harvard University Press, 1999), 161-168.
- Announcement for Tag Day 1981, Activities and Funds, Tag Days, Box 4, Galens Records.
- Estelle Freedman, "Separatism as Strategy: Female Institution Building and American Feminism, 1870-1930," Feminist Studies 5(1979): 512-529.
- See for example, Bonnie J. Tesch et al., "Promotion of Women Physicians in Academic Medicine. Glass Ceiling or Sticky Floor?," JAMA 273(1995): 1022-1025; Rachel B. Levine et al., "Stories From Early-Career Women Physicians Who Have Left Academic Medicine: A Qualitative Study at a Single Institution," Academic Medicine 86(2011): 752-758.
LAURA HIRSHBEIN, MD, PhD is a psychiatrist and medical historian at the University of Michigan. Her first book, American Melancholy (Rutgers University Press, 2009), explored the emergence of depression as a gendered diagnosis in the second half of the twentieth century. Her second book, Smoking Privileges (Rutgers University Press, forthcoming), is about the history of the relationship between the mentally ill and cigarette smoking in the context of changes in psychiatry and the tobacco industry.