Eighteen year-old Nellie Mattie MacKnight stepped confidently into the spacious dissecting room at San Francisco’s Toland Hall Medical School. Thirty-five male students stationed around cadavers spread out on rough board tables, turned to watch the bold young women enter. The smell of decomposing corpses mixed with tobacco smoke wafting out of the pipes some of the students were puffing on assaulted Helen’s senses. Her knees weakened a bit as she strode over to her appointed area, carrying a stack of books and a soft, rawhide case filled with operating tools. To her fellow students Nellie was a delicate female with no business studying medicine. Determined to prove them wrong she stood up straight, opened her copy of Gray’s Anatomy and removed the medical instruments from the case.It was the spring of 1891. She nodded politely at the future doctors glowering at her. A tall, dapper, be speckled professor stood at the front of the classroom watching Nellie’s every move. The sour look on his face showed his distain for a woman’s invasion into this masculine territory. “Do you expect to graduate in medicine or are you just playing around,” he snarled? The blood rushed to Nellie’s face and she clinched her fists at her side. She had expected this kind of hostile reception when she dared to enroll, but was taken aback just the same. “I hope to graduate,” she replied firmly. Disgusted and seeing that Nellie could not be intimidated, the professor turned around and began writing on a massive chalk board behind him. The students quickly switched their attention from Nellie to their studies. Nellie grinned and whispered to herself, “I will graduate…and that’s a promise.” Nellie got her resolute spirit from her mother. Olive Peck MacKnight raised her daughter virtually alone, enduring many trials while providing for her only child. Nellie was born to Olive and Smith MacKnight on December 15, 1873 in Petrolia, Pennsylvania. She was one of three children for the MacKnights. Their son and first daughter died shortly after they were born. Olive was very protective of her surviving child and Smith, a land surveyor by trade, constantly showered his “only little girl” with attention. According to her autobiography Nellie’s early years were happy ones. She was surrounded by the love and affection of her parents and numerous extended family members. In 1878, Smith MacKnight contracted a contagious case of gold fever that drove him to leave his wife and child and head West. Before he left he sent Olive and Nellie to live with his mother and father in New York. He promised to send for the pair once he had found gold. Olive was distraught about having to move from their home and the prospect of being without her husband. It was a heartbreaking experience from which Olive never fully recovered. By the time Smith’s first letter from California arrived, five year-old Nellie and her mother had settled into life on the MacKnight farm. The absence of Smith made Olive quiet, withdrawn and despondent. Outside of her daughter she seemed content to be left alone. Nellie on the other hand was outgoing and cheerful. She was particularly close to her grandmother whose character was much like her own. Grandmother MacKnight taught Nellie how to cook and quilt and how to prepare homemade remedies for certain illnesses. Her grandfather and uncle taught her how to ride a horse and care for animals. As Olive slipped further into depression, Nellie became more attached to her grandparents. A letter from Smith announcing that he had purchased a mine with “great potential” momentarily lifted Olive’s spirits and gave her hope that they might be together soon. Several days later news that Olive and Nellie would have to wait for the mine to pay off before Smith sent for them left devastated all over. The dispirited woman nightly cried herself to sleep. The stability Nellie had come to know at her grandparent’s home ended abruptly one evening in October of 1880. Her grandmother contracted typhoid fever and died after a month of suffering with the illness. Helen watched pallbearers carry her grandmother’s wooden coffin into the cemetery. She wept bitterly wishing there had been something she could have done to save her. The subsequent death of her favorite Uncle, suffering from the same ailment, served as a catalyst for her interest in healing. Fearing for the physical well being of her daughter, Olive moved Nellie to her father’s home in Madrid, Pennsylvania. Any hopes the two had that their circumstances would improve at their new location were dashed when Olive became sick and collapsed. The high temperature from the typhoid fever mad Olive delirious. She didn’t recognize her surroundings, her family or her child and cried out constantly for her husband. Olive recovered after several weeks, but the fever and the sadness of being separated from Smith, had taken its toll. Her dark hair had turned gray and the dark hollows under her eyes were a permanent fixture. Smith’s mine in Bodie, California had still not yielded any gold and he was unable to send any money home to support his family. In order to keep herself and Nellie fed and clothed, Olive took a job at the Warner Brothers’ Corset Factory. Nellie attended school and excelled in all her subjects, showing an early aptitude in medicine. She poured over books on health and the human body. When Nellie wasn’t studying she spent time trying to lift her mother’s melancholy spirit. Letters from Smith made Olive all the more anxious to see her husband again and even more broken hearted about having to wait for that day to come. She began using laudanum, a tincture of opium used as a drug, to ease the pains she had in her hands and neck. The pains in her joints was a lingering effect of the typhoid fever. Olive developed a dependence on the drug and one night overdosed. She left behind a note for her daughter that read, “Be a brave girl. Do not cry for Mamma.” Smith was informed of his wife’s death, and although he was sad about the loss, he opted to continued working his claim. The day after Olive was laid to rest, ten year old Nellie was sent back to New York to live with her father’s brother and his wife. Nellie’s uncle was kind and agreeable, but her aunt was not. She was resentful of Nellie being in the home and treated her badly. Nellie endured her aunt’s verbal and physical abuse for two years until her mother’s sister invited Nellie to live with her at her farm four miles away. Nellie adapted nicely to the congenial atmosphere and learned a great deal from her aunt about primitive medicine. After a short time with her aunt, Nellie finally received word from her father. Smith was now living in Inyo County, California and working as an assayer and surveyor. Nine years of searching for gold had turned up nothing. Smith decided to return to his original line of work and he wanted his daughter by his side. Fourteen year-old Nellie met her father on the train in Winnemucca, Nevada. Smith agreed to meet with her there and escort her the rest of the way to his home. Although his face was covered with a beard and his eyes looked older, Nellie knew her father when she saw him. Smith, however, did not instantly recognize his child. He wept tears of joy as she approached him. “You’re so grown up!” he told her. Little time was spent before the pair were made to take their seats to continue their journey. Father and daughter had a long way to travel before they reached Smith’s cabin in Inyo County. As the train sped along the tracks, Nellie was in awe of the purple blossoming alfalfa that grew along the route and of the grandeur of the Sierra Mountains. Nellie continued to be impressed with the sights and people she encountered during their two day trip to the homestead in Bishop. Smith promised his daughter a happy life among the beauty and splendor of the California foothills. Nellie recorded in her journal how exciting, gay, and carefree she found her new home to be. “The streets of the town were like a country road, lined with tall poplars and spreading cottonwoods – quick growing trees marked boundary lines and gave shelter to man and beast. Their leaves were pieces of gold in the sunshine.”Nellie MacKnight – 1887After a brief stay at her father’s ranch, Smith enrolled Nellie at the Inyo Academy. Not only would she be studying at the school, but living there as well. Smith spent a great deal of time on surveying trips and wanted Nellie to be in a safe place while he was gone. The Inyo Academy was home to many young men and women whose parents were ranchers and cattlemen from all over the country. Nellie thrived at the school, and once again excelled in ever subject. She was valedictorian of her class when she graduated from the Academy. Smith insisted the now seventeen year-old Nellie should go to college and continue her education. She was in favor of the idea and decided to pursue studies in literature. Smith promised to pay for her schooling only if she chose law or medicine as her point of interest. “If I wished an education I must abide by his decision. My only knowledge of the law was “the quality of mercy.” My only picture of a woman doctor was that of Doctor Mary Walker, dressed in men’s clothes and endeavoring in every way to disguise the fact that she had been born a woman. That I should choose neither was unthinkable.”Nellie MacKnight – 1887As Nellie contemplated her decision her thoughts settled on her grandmother’s struggle with typhoid fever and her mother’s fatal attempt to ease the physical pain she suffered. It didn’t take Nellie long to come to the conclusion that her “calling” was in medicine.Just prior to Nellie graduating from the Academy her father remarried. Nellie’s initial reaction to her step-mother was one of indifference, but as she got to know her she had a change of heart. She was an extremely kind woman and never failed to show Nellie love and compassion. She encouraged her step-daughter in her future endeavors and cried for days when Nellie moved to San Francisco to attend medical school.Smith accompanied his only child to the Bay area and on to Toland Hall Medical College. He paid her tuition, helped her find a place to live, wished her well, and returned to Bishop. Their parting was difficult. Nellie was grateful for the opportunity he was giving her and vowed to be home soon with a diploma in hand. Neither fully realized how difficult it would be to fulfill that promise. The attitude of many of the Toland Hall professors and students towards women in medicine was vicious. Most felt a female’s presence in the medical profession was a joke. Nellie was aware of the prevailing attitude and was determined to prove them wrong. She devoted herself to her studies, arriving at school at dawn to work in the lab. She kept late hours, pouring over Gray’s Anatomy and memorizing the definitions of various medical terms. The harder she worked the more resentful her male counterparts became. Classmates exchanged vulgar jokes with one another whenever the women were around in hopes of breaking their spirits. Professors were cold and distant to Nellie and the two other women at the school – often times refusing to answer their questions. Doctor R. Beverly Cole, Toland Hall’s Professor of Obstetrics and Gynecology, delighted in insulting female students during his lectures. He maintained publicly that “female doctors were failures.” “It is a fact,” he told students, “that there are six to eight ounces less brain matter in the female. Which shows how handicapped she is.” Nellie quietly tolerated Doctor Cole’s remarks and allowed them only to spur her on towards the goal of acquiring a degree. While in her third year of medical school, Nellie took an intern position at a children’s hospital. Many of the patients that allowed her to care for them were Chinese. She assisted in many minor operations and births and helped introduce modern forms of cures that countered the Far East’s approach to handling illnesses.Months before Nellie was to graduate she was granted permission to assist in a major surgery. Two physicians were required to perform an emergency mastoid operation on a deathly ill docks worker. Nellie was one of two interns on duty and the only woman. The male intern fainted at the site of the first incision. Nellie was a bit uneasy as well, but assured the doctor she could do the job when he ordered her at his side. “The surgeon talked as he worked. He described the blood supply, the nerve supply, the vessels that must be avoided, the paralysis that would follow if he invaded the sacred precinct of the facial nerve. Chip by chip he removed the bone cells, but the gruesome spectacle had been magically transformed into a thrilling adventure. I forgot that I had a stomach; forgot everything but the miracle that was being performed before my eyes, until the last stitches were placed, the last dressings applied.” Nellie MacKnight – 1893Nellie eagerly looked forward to graduation day. In spite of the fact that her grades were good and her talent for medicine was evident, the male faculty and students remained unimpressed with her efforts. She was confident that when she and the two other female students accepted their diploma the men would be forced to recognize that a woman’s place in the emerging profession is a definite. Shortly after passing her final examination Nellie was summoned to the Dean’s office. He was a man who did not share Nellie’s vision for a woman’s role in medicine and because of that she feared he was going to keep her from graduating. The matter he wanted to discuss was how she wanted her name to appear on the diploma. She told the Dean that her christened name would be fine. The man was furious. “Nellie Mattie MacKnight?” He asked her annoyed? “Nellie Mattie?” Nellie did not know how to respond. “How do women ever expect to get any place in medicine when they are labeled with pet names,” he added?The Dean persuaded Nellie to select a more suitable name. She searched her mind for names in which her name had been derived. “I had an Aunt Ellen…and there was Helen of Troy…,” she thought aloud. “You may write Helen M. MacKnight,” she said after a moment of contemplation. The Dean informed her that he would make the necessary arrangements. Before she left his office he added, “See that it is Helen M. MacKnight on you shingle too!”Nellie graduated with honors from Tolland Hall Medical School. Her father and step-mother were on hand to witness the momentous occasion. As her name was read and the parchment roll was placed in her hands she thought of her mother and grandmother and pledged to help cure the sick. Chances for women to serve the public in that capacity were limited, however. Widely circulated medical journals stating how “doubtful it was that women could accomplish any good in medicine,” kept women doctors from being hired. They criticized women for wanting to “leave their position as a wife and mother,” and warned the public of the physical problems that would keep women from being professionals. “Obviously there are many vocations in life which women cannot follow; more than this there are many psychological phenomena connected with ovulation, menstruation and parturition which preclude service in various directions. One of those directions is medicine.”The Pacific Medical Journal – 1895In San Francisco in 1983, there was only one hospital for women physicians to practice medicine. The Pacific Dispensary for Women and Children was founded by three female doctors in 1875. The facility was designed to provide internship for women graduates in medicine and training for women in nursing and like professions. Nellie joined the Pacific Dispensary staff, adding her name to the extensive list of women doctors already working there from all over the world. In the beginning, Doctor MacKnight’s duties were to make patient rounds and keep up the medical charts by recording temperatures, pulses and respiration. After a short time she went on to deal primarily with children suffering from tuberculosis. She also assisted in surgeries, obstetrics, and was involved in diphtheria research. In 1895, Nellie left the hospital and returned home to help take care of her ill stepmother. Within a month after arriving at her parent’s her stepmother was on her way to a full recovery. Nellie decided to stay on in Bishop and set up her own practice. The response she received from the community and the two other male physicians in town was all too familiar to her. She persevered, however. She set up an office in the front room of the house where she lived, stocked a medicine cabinet with the necessary supplies, and proudly hung out a shingle that read Helen M. MacKnight, M.D., Physician and Surgeon. Doctor MacKnight traveled by cart to the homes of the handful of patients who sought her services. She stitched up knife wounds, dressed severe burns, and helped deliver babies. As news of her healing talents spread her clientele increased. Soon she was summoned to mining camps around the area to treat typhoid patients. Although her diploma and shingle read Helen M. MacKnight, friends and neighbors who had known her for years called her “Doctor Nellie.” It became a name the whole countryside knew and trusted. While tending to a patient in Silver Peak, Nevada, Nellie met a fellow doctor named Guy Doyle. The physicians conferred on a case involving a young expectant teenager. Doctor Doyle treated Doctor MacKnight with respect and kindness. Nellie was surprised by his behavior.“I had worked so long, fighting my way against the criticism and scorn of the other physicians of the town, that it seemed a wonderful thing to find a man who believed in me and was willing to work with me to the common end of the greatest good to the patient.”Nellie MacKnight – 1898What began as a professional relationship grew quickly into romance. The couple decided to pool their resources and go into business together. They opened an office inside a drugstore on the main street of Bishop. In June of 1898, Helen and Guy exchanged vows in a ceremony that was attended by a select few in Inyo County. “My wedding dress was a crisp, white organdy, with a ruffled, gored skirt that touched the floor all the way around. The waist had a high collar and long sleeves. The wedding bouquet was a bunch of fragrant jasmine…. A small group of friends came to witness the ceremony, and the gold band that plighted our troth was slipped over my finger.”Nellie MacKnight – 1898Doctor Nellie MacKnight Doyle and Doctor Guy Doyle provided the county with quality medical care for more than twenty years. The couple grew their practice and took care of generations of Bishop residents. Nellie and Guy had two children – a girl and a boy. When their daughter grew up she decided to follow in her mother’s footsteps and pursue a medical degree. Upon her graduation from college she was given a foreign fellowship in bacteriology.Doctor Nellie M. MacKnight spent the last thirty years of her life studying and practicing anesthesiology. She died in San Francisco in 1957 at the age of 84.