Dr Sara Josephine Baker

Dr Sara Josephine Baker (1873-1945)

This LGBTQ+ History Month’s theme is #UnderTheScope celebrating LGBTQ+ in medicine, so in honour of that, lets learn about the lesbian woman who not was not only “instrumental” in identifying Typhoid Mary as the source of the 1907 typhoid outbreak which infected almost 3000 people in New York, but who also broke many other barriers to make the world a healthier and safer place, Dr Sara Josephine Baker, aka Dr Joe.

Dr Baker was already remarkable in the very fact that she was a woman doctor. In 1900, only 6% of doctors were women. In 1894, Baker had enrolled from a medical school founded by Elizabeth Blackwell who just a generation earlier had become the first American woman to earn a medical degree. When Baker graduated in 1898, female doctors were still prohibited from working in hospitals, so she instead found work as a medical inspector in NYC. She was horrified to learn that over 1500 babies died each week of preventable diseases and thus took on the crusade of what was then a radical idea: preventative care. She went on to become the first woman to earn a doctorate of Public Health. Baker was easily identified by her masculine attire, dressing primarily in tailor suits and neckties. However, this may have been an attempt to downplay her conspicuousness as one of the only women in the profession and not only a representation of her sexuality or gender identity.

As Assistant Commissioner of Health, Baker was the one to trace the typhoid outbreak of 1907 back to “Typhoid Mary”. However, when she and the police tried to put this theory to the test, Typhoid Mary evaded them for five hours before she was apprehended – but not before Mary had attempted to stab Dr Baker with a fork!  In the end, Mary tested positive and was sent to forced quarantine after refusing to take steps to prevent the spread of typhoid. The Department of Health controversially kept her isolated against her will for decades to come. 

Aside from this drama, Dr Baker worked primarily on lowering infant mortality rates in the poorest parts of New York. In 1908, she was made the first director of New York’s Bureau of Child Hygiene, founded in 1908. During the following decades, NYC’s infant mortality rate plummeted from 144 to 88 deaths per 1000 live births thanks in part to Dr. Baker’s efforts in teaching and implementing sanitation efforts like handwashing. She ardently believed that urban poverty and ignorance caused the most damage to public health, and she drew attention to the cause by publicly decrying the fact that in 1917, babies born in the US faced a higher mortality rate than frontline soldiers in WW1.  Most of the infant deaths were caused by dysentery, but ignorance and poor hygiene of the parents were also significant factors in the deaths. Accordingly, Baker and a group of nurses started to train mothers in how to care for, clothe, clean, and feed their babies. She also established a milk station where mothers could get clean milk rather than the contaminated stuff that was commercially available. She even invented her own nutritious baby formula.

Baker also helped to address the widespread blindness of babies caused gonorrhoea bacteria transmitted during birth. She revolutionised the bottles from which babies were given drops of silver nitrate in their eyes which previously had been more dangerous than healing. Baker designed and implemented small containers made out of antibiotic beeswax that each held a single dose of silver nitrate, so the medication would stay at a known level of concentration and could not be contaminated. Thanks to these efforts, blindness decreased from 300 babies per year to 3 per year. Another crucial step to reducing child mortality was taken when Baker convinced NYC to license midwives who had previously been excluded from formal medical training resulting in a huge variety of skill and expertise.

While Baker was campaigning to license midwives, treat blindness, encourage breastfeeding, provide safe pasteurized milk, and educate mothers, older children were ailing. To combat this, Baker worked to ensure that every school had a doctor and nurse, and that children were frequently checked for headlice and trachoma – infestations which became virtually extinct thanks to Baker’s new regulations. 

In 1923, at the age of 50, Baker retired – having fulfilled her promise that she would work until every state in the union had a child hygiene service, a vision that had come true largely thanks to Baker’s own ideas and interventions. Despite having officially retired, Baker became the first woman to be a professional representative to the League of Nations when she served on the Health Committee for the United States from 1922 to 1924. She also continued to write and serve on medical boards.
Baker prided herself on her tough approach, often regaling her friends with tales of how she manhandled drunken husbands who interfered with her work and forcing men in the poor immigrant areas to be vaccinated. She was also a passionate suffragette and feminist. She met her partner, author Ida Wylie in 1920, and they lived together until Baker died in 1945. The couple were two of around women who joined the Heterodoxy Club, “a radical discussion group” made up of ‘free-thinking and free-spirited women’ (almost a quarter of whom identified as lesbian or bisexual). In later life, Baker and Wylie bought a farm in New Jersey along with a third woman, Dr. Louise Pearce, staying together until all were dead. Wylie wrote in her autobiography, that the three lived “amicably and even gaily together” even if it was an “odd phenomenon.”

While some of her more forceful methods might be questionable today, Dr Baker’s work leaves a legacy of lessons in public health – the importance of which became abundantly clear during the covid-19 epidemic. Her pioneering work on the impact of preventative measures in avoiding the spread of contagious diseases and on the role that environmental factors have on public health continue to save lives to this day.

Source: https://www.them.us/story/dr-sara-josephine-baker-typhoid-lesbian-doctor-history