Heavy air settled over Olive Street in St. Louis in 1885, smelling of yeast from nearby breweries, and thickened with coal and lead dust from factories. Newly erected electric poles leaned like skeletons over the wooden sidewalks, while trolley cars clanged past on regular schedules. 

On a narrow, dim section of Olive Street known as Scab Row, Mary Hancock McLean (M.D. 1883) and Bertha Van Hoosen (M.D. 1888) rented a room in a home where the landlady's children used the front entrance as a toilet. This was their last resort. They'd been banished everywhere else, deemed unfit by 46 other landlords across the city who worried they'd adversely affect property values or ruin a home's reputation. They were, after all, women in the medical field. Van Hoosen was working to pay for her medical education, and McLean was a doctor trying to set up private practice. 

"In my initiation into medicine, Dr. McLean opened my eyes to the prejudice, the discrimination, the lack of confidence, and paucity of opportunities that had to be reckoned with before success could be secured," wrote Van Hoosen years later in her memoir, Petticoat Surgeon. 

McLean and Van Hoosen had met at U-M when McLean was a medical student and Van Hoosen was an undergraduate. "I had never heard of a woman physician," Van Hoosen marveled in her memoir, adding that McLean's enthusiasm for her work "fired my imagination." 

McLean would be an influence on and inspiration to Van Hoosen and countless other women. At a time when women doctors were largely relegated to "practical help" for other women, children, and the poor (they were often called "hen medics"), McLean focused on obstetrics and gynecology while refusing to shy away from the surgical demands of the job. She would become the first woman admitted into the St. Louis Medical Society, one of only a handful of women admitted to the American College of Surgeons at the time, and a fellow of the American Medical Association. 

McLean's First Patient 

McLean was born to a well-to-do family in Washington, Missouri, in 1861. Her father, a physician, was determined to give his daughter the best education available at the time. After attending Vassar College for two years, McLean came to the University of Michigan Medical School, where she graduated in 1883. 

McLean headed back to her home state after graduation, landing a job as an assistant physician at the St. Louis Female Hospital — the first woman to hold such a position. She cared for the poorest of patients, as well as prostitutes with venereal diseases. "Her privileged upbringing and genteel family background could not have prepared her for the experience of treating poor and diseased women," observes the author of an article about McLean published by the Missouri Historical Society. 

In the summer of 1885, McLean used what little influence she had to help Van Hoosen find a job at the nearby Mary Institute teaching calisthenics and physiology to young girls. And McLean herself was desperate to hang her shingle and begin her own surgical practice, never mind that it made her a social pariah. 

After three long weeks of no appointments, she finally landed her first patient. An impoverished former servant named Tillie had a uterine fibroid, and McLean performed the operation at her own expense, sterilizing her own equipment and employing two nurses to assist. It was a success and, afterward, McLean's practice flourished. "She had the unique experience of being the fad," wrote Van Hoosen. People of all social ranks now flocked to this one-of-a-kind female surgeon. 

The Missouri Missionary 

In spite of her newfound success, McLean's heart was never far from the poor and needy. By 1893, McLean and another St. Louis physician, Ella Marx, M.D., had opened the Evening Dispensary for Women to help working women get treatment after their shifts had ended. Most services were free, or nearly so. 

The 1904 World's Fair brought a new crop of young, inexperienced women to St. Louis hoping for jobs and opportunities in the city. When they arrived, they were often over-worked, underpaid, and generally exploited. Desperate to help, McLean established the Emmaus House, a residence where these young women could be cared for and protected until they could find a better way forward. Within a few years, Emmaus House had evolved into the St. Louis YWCA, where McLean served on the board and continued to offer her medical services to women. She even pioneered sex hygiene and sex education courses — a much-needed innovation at the time. 

By 1909, she'd opened an advanced clinic for working women, roping more of her female medical colleagues into the work. The clinic stayed open two or three evenings each week and ran until 1928. 

McLean also was involved in missionary work in China and Japan in the early 1900s, with a focus on health and humanitarian efforts. She supported education for numerous students, and one of them, Li Yuin Tsao, M.D., became an intern for Van Hoosen in her Chicago practice. 

In 1928, McLean broke her wrist and was forced to step away from surgery, though she continued to see patients in her private practice. 

McLean died in 1930 in St. Louis, having worked tirelessly until mere months before her death. Frances L. Bishop, a fellow Michigan graduate, wrote an obituary for McLean in the Weekly Bulletin of the St. Louis Medical Society that noted her legacy of helping women, especially other physicians: "She was … a true friend to many young women medical students and there is in St. Louis today hardly a woman physician who does not owe in some way her introduction to medical circles to Dr. McLean." 

SOURCES: 
Bishop, Frances: The Weekly Bulletin of the St. Louis Medical Society, vol. 24, no. 2, June 27, 1930. 

Hunt, Marion: "Woman's Place in Medicine: The Career of Dr. Mary Hancock McLean," The Bulletin of the Missouri Historical Society, vol. 36, no. 4, 1980. 

Van Hoosen, Bertha: Petticoat Surgeon. Pellegrini & Cudahy, 1947.