"Julia Catherine Stimson and the Mobilization of Womanpower"

“Julia Catherine Stimson and the Mobilization of Womanpower” by Marion Hunt

The following article is reprinted with permission from the Winter 1999-2000 issue of Gateway Heritage, vol. 20, no. 3 ©1999 by the Missouri Historical Society.

Julia Catherine Stimson (1881-1948) is remembered today as a distinguished army nurse and the first superintendent of the Army Nurse Corps. She gained national fame during World War I for her distinguished service on the battlefield as an administrator and nurse. In 1976 the American Nursing Association chose her for membership in its Bicentennial Hall of Fame, calling Stimson “a driving influence” in the profession. A formative chapter of Stimson’s career took place in St. Louis, where experience as a pioneer social worker and nursing superintendent between 1911 and 1917 prepared her for later leadership roles. As the first head of medical social service at St. Louis Children’s Hospital, Julia Stimson honed political, social, and administrative skills that would serve her well on the battlefield and in the military bureaucracy. Though nursing traditionally had been considered an appropriate extension of women’s roles as mothers, it lacked the respectability and rigor of a profession until the late nineteenth century. Stimson belonged to a group of pioneer nursing leaders who raised standards of nursing education and in so doing upgraded the public’s view of trained nurses as essential to health care. Yet the brilliant achievements of her later career largely eclipsed these earlier successes.

Powerful private convictions and an intense desire to help others animated Stimson’s public achievements. As a scholar, teacher, administrator, and practitioner, Julia Stimson’s passion for excellence and deep sense of duty shaped her entire career. Energetic, charismatic, courageous, and determined, she made a powerful impression on her contemporaries. As a colleague wrote in an obituary, “A few people, only a few, are so vibrant that one cannot think of them as overcome by death. Such was Julia Stimson.”

Stimson’s family background and upbringing were essential to her successful career. Born the second of seven children of the Reverend Henry Stimson and Alice Wheaton Bartlett, she grew up in a family with a strong tradition of public service. One grandfather had been president of Dartmouth College. Her uncle, Dr. Lewis Stimson, helped found Cornell University Medical College. A cousin, Henry Stimson, would serve in the cabinets of three presidents.

Julia came to St. Louis as a child of five in 1886, when her father was appointed pastor of Pilgrim Congregational Church, which counted many prominent citizens among its members. After seven years, the family moved back to New York, where she attended the Brearley School, founded in 1883 to provide young girls with an education equal to that privileged boys received. Though in the late nineteenth century only 2 percent of women 18 to 21 years old received undergraduate educations, Julia, an excellent student, gained admission to Vassar College at the early age of 16. Among other courses, she took “argumentation,” intended to polish speaking skills by combining debate and logic. This training must have proved useful to Stimson when she needed to express her viewpoint concisely and effectively to academic physicians and army officers. Upon graduating from Vassar in 1901, she won a scholarship to attend a summer institute at the Marine Biology Laboratory in Woods Hole, Massachusetts.

Julia’s letters to her father during her college years show clear evidence of her unusually sensitive and compassionate nature. Writing in 1899, she asked, “You said you wanted us to write whenever we wanted help. . . . I'm going to ask you about something that has been troubling me for a long time. . . . Is it a possible thing to comfort anybody who is sorrowing, or must they just bear it alone?” Consoling others in pain was to be an essential aspect of Julia Stimson’s professional and personal identity.

In 1901 she wrote a letter to her father that expressed her increasing independence and confidence. Reverend Stimson had chided Julia about her tendency to get overly involved in her friends’ problems. She answered him with a vehemence unusual in a generally submissive and devoted daughter: “Please do not tell me any more that I am warmhearted, affectionate, right minded, etc. . . . in other words, I’d rather not be told it. And . . . please do not either you or mother tell me that things I may do or say are ‘silly’ or ‘foolish.’” Stimson’s ability to sympathize with others while at the same time mobilizing their strengths would prove essential to her role as a leader of nurses. Just as essential, however, would be her determination.

After graduation, Stimson spent three difficult years trying to find a professional direction both acceptable to her family and sufficiently challenging for her – a common struggle among well-educated women from privileged backgrounds who wanted serious careers. To Julia, a college graduate of intelligence, ambition, and energy whose uncle was an eminent professor of medicine, becoming a physician seemed a natural choice. Some fifty years earlier, in 1849, Elizabeth Blackwell had encountered similar struggles to become the first American woman to obtain a medical degree. By 1900, women composed nearly 5 percent of the profession, more than seven thousand strong. Despite harsh discrimination against them in education and postgraduate training, these doctors made distinct places for themselves in the community, usually serving women and children.

Far more commonly, women with medical interests became nurses. Between 1880 and 1920, a strong national reform impulse combined with educated women’s desire to participate in solving problems of poverty and injustice. Both as paid staff and as volunteers, women provided essential skills and energy to this urban reform movement, helping staff settlement houses, schools, and hospitals.

Julia Stimson’s parents disapproved of their daughter’s desire to become a physician. Though women were entering the profession in growing numbers, medicine was still considered a man’s world, not a proper arena for a young lady. Even her uncle, Dr. Lewis Stimson, professor of surgery at Cornell University Medical College (which admitted female students) firmly discouraged this ambition in his niece, though, ironically, seventeen years later Julia’s parents permitted her younger sister to become a physician.

By adulthood, Julia Stimson’s physically imposing appearance belied a frailty of long duration. Nearly six feet tall, with penetrating blue eyes set in a handsome, firm-jawed face, she gave the impression of enormous vigor. Yet from her youth, she had suffered a chronic ulcerative skin condition affecting her legs that required weeks of bedrest and occasional surgery. A letter written to her father from nursing school shows how courageously Stimson bore this affliction: “I’m doing the work I love and am only too thankful for these blessings – but it is taking about all the nerve I have to keep the pain under control.”

Still searching for a career associated with medicine, Julia took a course in medical illustration at Cornell University Medical College and then won a scholarship for graduate study in biology at Columbia University. Hospitalized in 1903 for her skin disorder, the following summer Stimson traveled abroad and had a chance meeting with Annie Warburton Goodrich, an inspiring nurse and teacher who headed the New York Hospital Training School. When Stimson recovered her health in 1904, she became a student there. Her independent spirit was evident in a note she wrote to Miss Goodrich about her admission: “And will you tell me if you think it would be wiser to enter some other hospital? . . . I would not want anyone ever to have the opportunity of saying that I had a ‘pull’ through Dr. Stimson [her uncle].”

Although a young woman entering nursing school expected to study, her primary duty was to care for patients. In addition to a full class schedule, student nurses were expected to spend ten hours a day on the wards. For a conscientious young woman with serious health problems, this dual requirement posed a painful dilemma. In caring for the sick and training to be a nurse, Julia Stimson put her own health at risk. Even healthy student nurses frequently broke down from the strain of mental and physical exhaustion brought on by their duties. Julia Stimson’s skin disease worsened in nursing school and required absences prolonged enough to delay her graduation by a year, until 1908.

A college-educated nurse with excellent training and high marks, Stimson gained a position as superintendent of nurses at the newly opened Harlem Hospital. Stimson’s mentor Annie Goodrich kept in close touch with her. As Stimson later recalled, “My choice of position . . . brought me into a difficult, complicated, situation where almost daily [Miss Goodrich] counseled and drew out utterly unknown capacities, suggesting attitudes under stress, believing in powers to organize and create which naturally had to materialize, giving an example of inspiration to associates . . . encouraging at moments when it was most needed.” This was a model of effective professional mentoring that Stimson herself would emulate in a succession of administrative posts. During her three years at Harlem Hospital, Stimson not only fulfilled the requirements of her demanding job but also collaborated with a nursing colleague to develop a new department of medical social service.

The early twentieth century brought increasing public acceptance of the hospital as the best place for people of all classes to seek medical treatment. In cities across the country, hospitals expanded in number and size as new machines and techniques made home care impractical even for the wealthy. Many hospitals began to strive for increased medical efficiency, minimizing wasted effort by ensuring that patients and their families were educated and supervised to follow doctors’ orders. The new philosophy of medical efficiency gave rise to the medical social worker, whose basic function was to serve as the vital link between doctors and patients. Medical social work grew from this need to organize the modern hospital more effectively. Social workers in settlement houses and hospitals wanted both to monitor and to improve the behavior of their clients, a desire consistent with other Progressive reformers, who employed both compassion and control in dealing with the urban poor.

In 1911 Stimson returned to St. Louis to become director of social service at Children’s Hospital. The female managers of this institution, which had served the city’s poor since 1879, understood how useful medical social service could be to their patients. Originally staffed by homeopaths because the women felt regular medicine was too harsh for children, Children’s Hospital had grown steadily in size and prominence and had a loyal and active constituency. By 1911 this once modest institution had become a crucial component in Robert Brookings’s plan to reorganize and improve medical education at Washington University. Barnes Hospital had yet to be built.

In 1909 Brookings and his neighbor, Grace Jones, president of the board of managers and wife of Robert McKittrick Jones, a trustee of Washington University, had agreed informally to the affiliation over tea at her Westmoreland Place home. Brookings had served on Children’s Hospital’s male advisory board since 1895. Brookings and the Joneses moved in the same social circles and had similar philanthropic interests. Grace Jones and the other hospital managers realized that affiliating with Washington University would give the medical school faculty a major role in running the hospital. Aware that a new era in hospital governance was about to begin, the managers realized that if they wanted to maintain power, they needed to establish a distinct sphere of influence within the changing hospital. No documents survive that detail their strategic planning, yet the managers’ decision to seize the initiative and install a department of medical social work suggests a sense of urgency. Indeed, the term “emergency fund” was used to designate the money that managers gave to start the new service.

Grace Jones’s comments in the 1912 annual report showed her grasp of the institution’s changing role: “The importance of hospitals for research into the causes and means of prevention, as well as the cure of diseases . . . has but lately been recognized. . . . A children’s hospital is as truly a specialty hospital as one for maternity. . . . Physicians and nurses must be specialists [and] sympathy and motherliness must be in the atmosphere of the wards. The home conditions which caused the sickness . . . must be bettered by educating the parents.” This last sentence spoke directly to the goals of social work. Since social workers or volunteers were to counsel every patient’s family before discharge, this innovation insured that managers would have an ongoing role in both the hospital’s day-to-day clinical activities and the lives of its patients.

Essential to the success of their enterprise was picking an effective chief executive. Again, no surviving documents explain how the managers chose Julia Stimson. However, on 9 August 1911, she noted in her diary that “Mabel Riddle [a Vassar friend] came to see me about St. Louis Social Service work.” (The fact that Julia Stimson continued to call this college friend by her maiden name suggests the ties of friendship between them. Indeed, many managers were graduates of Mary Institute and enjoyed friendships from their student days – such friendships were crucial to the governance of the hospital. As one of Grace Jones’s granddaughters remarked, “No one got on the board who wasn’t a friend of Granny’s.”) By the end of the month, Stimson had accepted the offer to head medical social service at Children’s Hospital. The 1911 annual report, published just a few weeks later, included a note from the department, signed by its chairman, Mabel Riddle Fouke. In her report, Fouke stated, “The social service department holds itself in readiness to be the means of communication between the hospital and the doctors and the outside world in order that a permanent cure may be effected. . . . It is the aim of the Department to go into every child’s home before it leaves the hospital. It is useless to spend all the energy and money on curing a child and then return it to the same conditions that produced the disease.”

Her report explained that the social service department had been organized in December 1910 through a five hundred-dollar “emergency fund” contributed by three managers who immediately employed a full-time secretary to help them. In ten months, Fouke, her volunteer colleagues, and students from Washington University’s School of Social Economy made more than five hundred visits to patients’ homes.

In October 1911 Julia Stimson took charge of the department, dividing her time between Children’s and the Washington University Hospital. Although she was the second full-time employee the managers hired, Stimson was among the first professional social workers in St. Louis, many of whom came from nursing backgrounds. Introducing a new activity into the rigid, authoritarian hospital setting took considerable political skill. However, Julia Stimson had several advantages. While social workers at many hospitals found their duties restricted to the outpatient department, from the outset Julia Stimson was allowed to organize social service throughout the wards and clinics of both hospitals. Unlike many hospitals, Children’s Hospital managers were enthusiastic advocates of and participants in medical social service. Stimson’s previous success in initiating social work at Harlem Hospital had given her invaluable experience. Finally, childhood social connections with powerful St. Louis families who had known her father at Pilgrim Church afforded Stimson access to new sources of financial support.

By November 1911, one month after starting the job, Stimson had persuaded the Bible class of Pilgrim Congregational Church to support a social work assistant’s salary. Three months later she obtained additional financial help from the alumnae of Mary Institute, who had a long tradition of serving on the hospital’s board. Next, the Bible classes at Union Avenue Christian Church joined in paying the salary for a prenatal worker. Thus, in seven months, Stimson had gained new financial support that allowed the social service department to expand from a staff of two to four full-time members and several assistants, in addition to numerous volunteers.

However, the hospital managers had hired Stimson to head social service without consulting the medical school faculty, and the doctors regarded her with a certain skepticism. With characteristic pragmatism, she began an energetic and effective campaign to win their approval. In her first letter to Dr. George Dock, who served as both head of medicine and dean, she carefully outlined the department’s goals. Just two weeks after her arrival, in a memo dated 31 October 1911, she explained social work’s collaborative role, following this communication with a monthly series of reports that showed how social workers improved physicians’ efficiency and effectiveness.

Stimson’s reports cited concrete evidence and specific examples. In addition to providing statistics, she described how social workers helped families follow doctors’ orders and found community resources for discharged patients. In May 1912, nine months after Stimson’s arrival, her salary rose from $1,500 to $2,000 a year. Secretary of the Executive Faculty Professor Robert Terry wrote a letter demonstrating the respect she had gained at the medical school: “Miss Stimson has shown marked ability, and she has bona fide offers for two positions at this salary. . . . We feel that it is essential to have an active and effective [social work] department.”

While forging links with physicians, Stimson solidified her relationships with women volunteers who supported social service. By far the largest number of the department’s workers were volunteers, including the wife of the medical school’s dean. Without undermining the new salaried workers, Stimson made volunteers feel they were essential partners in the growing social service staff. In addition to giving their financial support, these women gave generously of their time, spending hundreds of hours with patients in the hospital and making pre-discharge visits to their homes. On home visits, they evaluated the sanitary conditions based on their own middle-class values of hygiene – looking for fresh air, clean bedclothes, enough eating utensils – and improved them when they could. Volunteers also educated patients’ mothers about the need for sanitary conditions in the home, sometimes providing them with their own domestic furnishings, as lists of donations in the annual reports showed.

During her St. Louis years, in addition to a full work schedule, Julia Stimson constantly accepted new challenges. In 1913 the American Red Cross Committee on Nursing Service called her to active duty during the Ohio River flood; she spent two weeks with a group of fifteen nurses providing relief to disaster victims. When the superintendent of the Washington University Nurses Training School resigned in 1914, Stimson assumed that post in addition to her social service duties. Her title thus became Head of the Department of Nursing and Social Service of Washington University. She earned $2,500 a year and was permitted to hire an adequate staff of assistants for each department. By 1915, four years after her arrival, the medical social service advisory committee at Children’s Hospital had grown from four to thirty women. The annual budget had increased from $1,500 to nearly $10,000, an expansion that reflected Julia Stimson’s skill at mobilizing support for the new enterprise. In addition to her busy professional life, Stimson entered graduate school at Washington University, earning a master’s degree in sociology in May 1917 with a thesis advocating national health insurance.

The degree was awarded in absentia. By then, Julia Stimson had resigned her positions at Barnes and Children’s Hospitals and enlisted in the Army Nurse Corps to serve as head nurse for Base Hospital 21. This hospital, one of many organized by the Red Cross at medical schools across the country, consisted of 26 physicians, 55 nurses, and 156 ancillary personnel. Base Hospital 21 drew its medical staff from the Washington University hospitals and was the first such unit in the country mobilized for overseas service. Five weeks after the United States declared war on Germany, on 17 May 1917, Base Hospital 21 departed with great ceremony from Union Station, bound for a hospital near Rouen, France, that served the British Expeditionary Forces. Her superiors soon recognized Julia Stimson’s superb organizational skills, honed by her years of service in St. Louis. In April 1918 she was appointed chief nurse of the American Red Cross in France. The army called her back from the battlefield to Paris seven months later to direct the American Expeditionary Forces’s nursing service. The extraordinary demands of the First World War put Stimson’s personal courage, political savvy, and leadership ability to the test.

Her father was so proud of her accomplishments that he compiled a book of her wartime letters home, which he entitled Finding Themselves. Published in 1918, the book received praise in the popular press, but the title offended the nurses Stimson had led in France. They felt its wording suggested that Stimson saw herself at a distance from them, operating on a higher level. Ironically, her father had taken the title from a letter that Dr. Borden Veeder, a prominent St. Louis pediatrician and member of Base Hospital 21, had written to his wife in December 1917: “Julia is as usual . . . running her department in a splendid way. The nurses have a fine spirit and are very happy as a whole under conditions which are definitely masculine and not adapted to women. . . . The spirit of the unit is really wonderful. . . . It is most interesting watching people finding themselves.”

In a 1918 Christmas letter to her family, Stimson wrote of the pain this book inadvertently had caused her: “I am simply crushed that I could have been so misunderstood by the people I care so much about. . . . How could anyone have thought I wasn’t including myself in the ‘themselves’ of the title?” Four years later, another publication upset her. The official history of Red Cross Nursing, published in 1922, contained a paragraph referring to her that Stimson found offensive:

In the blinding light of war, her dominant personality stood out in the same bold outline as did her Amazonian physique. Her regular boyish features habitually wore a thoughtful expression which brought to the observer an impression of dignity and power. Her well-trained mental processes, clean cut often to the point of brusque speech, were as direct in their focus as her clear blue eyes.

Stimson wrote to the head of the National Committee on the Red Cross Nursing Service, “It seems to me that professional experience, preparation, and attainments are entirely appropriate, but I can see no point to the addition of personal appearance or characteristics.” Over her objections, the text was published as written. Despite her intimidating appearance and manner, Julia Stimson was a shy, sensitive, and surprisingly vulnerable woman. This only made her accomplishments more remarkable.

Stimson’s outstanding record at Children’s and Barnes Hospitals in the five years prior to her wartime service is significant. This period of professional growth shows that while her rise during World War I may have seemed swift, her promotion was based on a foundation of solid accomplishment and rare organizational skill. Indeed, her imposing height, dignified bearing, and social sophistication may well have enabled her to work more effectively in the male-dominated cultures of the hospital and battlefield.

During the war, class strictures that previously had kept privileged young women from entering the nursing profession were relaxed in the name of patriotism. As Winifred Tittman, the daughter of a prominent St. Louis family, would recall a half century later, “Once my brother was shot down, I was allowed to go to nursing school.” Though they were given medals for bravery and died for their country, army nurses were not granted military rank until 1920. Even so, their rank was “relative” and did not confer the same privileges as commissioned rank. During both world wars, this deficiency put army nurses at a serious disadvantage in military life, and they suffered inequities in pay and leave.

When America entered the war in April 1917, the army’s need for nurses was so desperate that a voluntary aide system was considered. Nursing leaders were divided on this issue; some agreed with the idea, while others believed it undermined professional standards. A meeting of nursing associations in May 1918 reached a consensus that more personnel should come from a new Army School of Nursing, higher enrollment in civilian training schools, and training for college-educated women. The flu pandemic, which caused more deaths than battles did, broke out two months before the November armistice, aggravating the national nursing shortage. Despite the army’s desire for more nurses, military authorities failed to grant generous treatment to nurses upon their discharge from service.

At the end of the war, General Pershing himself awarded Julia Stimson the United States Distinguished Service Medal; she also received medals from the French and British governments for her work. Unlike the majority of nurses, who saw medical social work as a step up from nursing toward a more collegial relationship with doctors, Julia Stimson never returned to social work. Instead, she gave the nursing profession many more years of devoted service after the war, beginning in 1919, when she was appointed the first dean of the Army School of Nursing. Though she retired as superintendent of the Army Nurse Corps in 1937, Stimson returned to the field in 1942 to head the Nursing Council on National Defense. In that position, she used her speaking skills and personal charisma to mobilize a new generation of womanpower, urging young women to serve as nurses in a second world war. In only three months, she visited twenty-three cities, making fifty talks to potential recruits. The first woman to achieve the rank of major in the U.S. Army, Stimson was promoted to full colonel on 13 August 1948, six weeks before her death.

In all, Julia Stimson’s life in St. Louis amounted to little more than a decade, five years of her early childhood and five years as an adult. The first five years provided her with social ties to elite St. Louis families. Years later, she could turn to them for help in subsidizing the new social work department at Children’s and Barnes Hospitals, access to a charitable constituency that may have eluded an outsider. During the second five-year period, she embraced leadership opportunities that sharpened her administrative skills for later professional challenges. Though Julia Stimson achieved national fame as a military nurse, her experience as a civilian nurse and social worker in St. Louis shaped her skills in mobilizing womanpower.

SOURCES

Julia Stimson’s family papers are at the New York Hospital-Cornell Medical Center Archives. These include letters, diaries, and photographs. Her work at Barnes and St. Louis Children’s Hospitals is documented in hospital annual reports and photographs in the Washington University Medical Archives, Bernard Becker Medical Library. References to her appear in Lavinia Dock et. al., History of American Red Cross Nursing (New York: Macmillan Co., 1922). For an incisive analysis of the divisive challenges the profession faced, see Susan Reverby, Ordered to Care: The Dilemma of American Nursing, 1850-1945 (New York: Cambridge University Press, 1987).

For more detailed information on Stimson and St. Louis Children’s Hospital, see Mary T. Weber Sarnecky, “A Woman for All Seasons: A Biography of Julia Catherine Stimson.” D.S.N. diss., Washington University, 1992. Lynn Gordon’s Gender and Education in the Progressive Era (New Haven, Conn.: Yale University Press, 1990) analyzes the importance of the college experience of women at this time and describes the particular sense of mission among Vassar graduates.

Katharine T. Corbett’s In Her Place: A Guide to St. Louis Women’s History (St. Louis: Missouri Historical Society Press, 1999) contains essays on Julia Stimson and the St. Louis Children’s Hospital managers as well as other women active in urban reform. For World War I’s catalytic effect on women reformers, see G. Stanley Lemons, The Woman Citizen: Social Feminism in the 1920s (Urbana: University of Illinois Press, 1973).

ABOUT THE AUTHOR:

Marion Hunt served for four years as Assistant Director of the Program for the Humanities and Medicine at Washington University Medical Schools. She is now a consultant to the history division of the National Library of Medicine, preparing an exhibit on the history of women physicians.

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