The lack of regulation in American industry during the early Twentieth Century is the stuff of horrific legend – from the grotesqueries of the meat industry as unveiled by Upton Sinclair to the addition of sub-standard and often hazardous materials to children’s milk in the dairy industry, we have many examples of the effects of that era’s industrial negligence on the consumers of its products. Quick to outrage when presented with health risks to themselves in the consuming of a product, however, the American people were far harder to stir when it came to the health risks to the creators of those products.
The industrial workers of America, who were either too poor or too ethnic to rouse the sympathy of a goods-hungry public, were in desperate need of someone with the scientific rigor to impress the owners of their factories, the good breeding to speak on an equal footing with reform-minded members of the upper class, and the investigative gumption to tread where others wouldn’t in search of medical answers. In 1910, they got their someone in the form of a forty year old doctor who had, up to that point, considered herself a diffuse failure, but who would thereafter earn a world reputation as the foremost expert on the manufacturing processes and chemicals that harm industrial workers.
Alice Hamilton (1869-1970) came from an upper class family of pronounced genius. Her sister Edith was a historian whose volumes The Greek Way, The Roman Way, and Mythology are still in demand for their rich evocations of the classical past, and her other siblings consisted of other poly-lingual overachievers with distinguished achievements in the realms of classical literature and art. Wealthy enough to have leisure to pursue the works lining their father’s sumptuous library, the Hamilton children delighted in each other’s intellectually competitive company, gathering in circles in the garden to read Dante aloud in the original.
Conservative intellectual refinement was the expectation for the Hamilton brood, and so it was with much consternation that Alice’s decision to study medicine was met. Blood and sinews and various unspeakable seepages were fine for other girls to study, perhaps, girls without cultural prospects or social duties, but for a Hamilton? In spite of the disapproval of her family, Alice persisted in her choice, reasoning that, of all the professions, there is none so welcome in any corner of the world as that of a doctor. She knew she wanted to go places, and help people, and that she did not have the temperament for the missionary work which she abstractly admired, and so a medical career seemed the logical next best thing.
She studied without incident at the University of Michigan (the gender line for women medical students having long since been crossed) and graduated in 1893 only to find herself thrust into a world that had but few options for a woman doctor interested in bacteriological research. She underwent her internship at Northwestern Hospital for Women and Children and then took up a position at the illustrious New England Hospital for Women and Children only to find that its practice no longer lived up to its reputation. The hospital was awash with medical interns and doctors in high quantities but of routinely low quality, and Hamilton found herself underused and undervalued until she was finally transferred to the dispensary and gained thereby the chance to go out and work directly in the community.
To a woman bred among comfort and the refined condescensions of American Victorianism, slum life was a stomach-churning revelation. Women giving birth to babies out of wedlock went from being the stuff of illustrated cautionary tales to a living reality which no amount of overstuffed moralizing could set straight. People made mistakes and suffered and died as a result, and judging them for their actions, as she was wont to do when she first arrived, soon took second place to compassion and care.
What Hamilton was trying to puzzle out in these years was how to combine social service with research with a medical career, a problem that would only grow more complicated in 1897 when she took up a position as a professor of pathology at Northwestern University’s Woman’s Medical School. Simultaneously, she applied for residency at Hull House, the famous settlement founded by Jane Addams in 1889 to give the poor some access to the privileges of the higher classes and the higher classes an opportunity to use their skills to directly make a difference in the lives of individuals. She threw herself into the work of creating and teaching new classes, attempting to carry out research, and involving herself in all of the many social projects that originated from Hull House, and found that devoting herself to three things at once seemed to only result in never being satisfied with anything that she did. Her male colleagues who did not have the responsibilities of Hull House could attain much greater renown in research, while the social workers at Hull House seemed so much more competent than her in what they did that by 1910 Hamilton was desperately at a loss for what to make of her life.
Fortunately, an offer came her way that year from the governor of Illinois to serve as a medical investigator for a commission on occupational diseases that had been formed two years earlier but had as of yet accomplished little. Through Hull House Hamilton had been building a reputation as a thorough and deeply resourceful disease sleuth, who had traced a typhoid fever outbreak to slack regulation of undrained toilets in Chicago’s poorer districts back in 1903. Being a medical investigator proved to be the perfect career for Alice Hamilton, whose first task involved uncovering the medical risks faced by workers in the lead industry. She scoured hospital records, visited sick workers in their homes, and gathered information from insurance agents, company doctors, local doctors, and European industrial periodicals until she knew the chemicals and techniques of every process that either produced or employed lead in modern American industry. She detailed a system where workers toiled in rooms filled with lead dust because American companies refused to employ the submerged techniques of England and German industry or even give their workers simple breathing masks and coveralls, were regularly tasked with dangerously stuffing white lead by hand into barrels, and then took their breaks in lunchrooms where the food itself was covered in smears of lead.
Hamilton’s gifts lay not only in the thoroughness of her medical and chemical knowledge, or the resourcefulness with which she tracked down causes and effects that others were actively trying to conceal, but in her sure sense of the balance between publicity and diplomacy. She was rarely turned away from a factory because owners knew that she never exaggerated her claims and would always give them options for how to improve the lot of their workers before resorting to the court of public opinion. She believed that owners, properly educated and reasonably spoken to, would implement improvements that were in the best interests of themselves and their workers, and often was proven right. That said, if the owners did not show themselves amenable to change, she had no fear of publicizing the diseases and deaths that resulted from their persistent negligence, allying with the Department of Health to create better regulations for businesses that would not regulate themselves.
Her ironclad findings showed the dangers of not only lead exposure, but the mounting issue of industrial benzine use, the poisons employed in the production of viscous rayon, and the toxins associated with the creation of munitions in World War I. Within a decade, she had made herself the absolute world authority on the biochemical dangers of the modern industrial factory, a fact that was made clear in 1919 when Harvard Medical School broke its centuries-long ban on women professors by inviting her to join the newly formed Department of Industrial Medicine, a position she maintained until being forced to semi-retire in 1935.
Between her position at Harvard and her evolving portfolio of government commissions, Hamilton had become industry’s go-to scientist for truthfully evaluating the dangers of their new chemical processes. Thanks to Hamilton’s position as the living connection between academia, government, and industry, American safety standards slowly began creeping towards and eventually equaling those of Europe. Casualties at lead factories that were annually measured in the hundreds before her time sank to the single digits, radium poisoning was investigated and detailed, and routine medical exams for workers were integrated into the policies of the more hazardous industries.
An innovator in medicine, Hamilton was also fearless in the public realm, standing by Jane Addams’s side as a pacifist while abuse was thrown upon them both by an America drunk on the prospect of entering World War I. She traveled to the Soviet Union in 1924 and reported back favorably on their advanced workers’ health initiatives and gender equality to hissing audiences, and visited Nazi Germany in 1933 and 1938, which resulted in a series of articles lambasting the rise of fascism in Europe. She spoke out for the creation of meaningful child labor laws, and for a sensible approach towards birth control education as a way of mitigating the misery of the tenements. Always claiming to hate conflict, she was incapable of backing down before great moral wrongs no matter the cost to herself, which earned her the grudging respect of her more conservative family members, and a position on the government’s suspected socialist agitator list well into her nineties.
She was sought after as a speaker for her ability to extemporaneously produce emotionally stirring but scientifically rigorous speeches to audiences of every educational level, while her books on industrial medicine were not only critical successes and best sellers, but stood for decades as standard texts in that field. The six decades that separated her entry into industrial medicine in 1910 and her death in 1970 saw the condition of the worker evolve from that of a being of lead-coated lungs for whom even a set of work coveralls was considered too extravagant a company expense to a closely monitored human federally protected by the Occupational Health and Safety Act (or OSHA, passed the year of her death) from the cavalcade of chemical, vibrational, thermal, sonic, and sanitary threats that Alice Hamilton, the woman who believed she had nothing to offer, had given her life to discovering and documenting.
Dr. Alice Hamilton died in 1970 at the age of 101.
Lead image via Library of Congress
FURTHER READING: Hamilton wrote an autobiography in 1943 but I would add Barbara Sicherman’s Alice Hamilton: A Life in Letters to get the whole story. There is a lot of family gossip in those letters that probably won’t interest the reader who just wants to know the story of industrial medicine’s heady pioneering days, but for those wanting to see the evolution of Hamilton from a self-doubting scientist working herself to exhaustion for no discernible end to a world authority communicating with the heads of industry and government who are palpably falling over themselves for her opinions, it is deeply satisfying.