2. 196 Peter J. Dawson
Figure 1. Dorothy Reed on her way to her first horse show, aged about 13 years (courtesy of Mrs Thomas C. Mendenhall).
in William Welch’s department. She loved pathology two others, one “A Case of Acute Lymphatic Leuke-
– investigative work enthralled her. In addition to her mia Without Enlargement of the Lymph Glands,” in
now famous paper on Hodgkin’s disease, she wrote which she postulated that both myeloid and lym-
phatic leukemia could arise in the bone marrow.7
The other, entitled “The Bacillus Pseudo-Tuberculo-
sis Murium; Its Streptothrix Forms and Pathogenic
Action,”8 was based on work she performed as a
medical student.
Her fellowship year passed quickly and happily.
She performed 13 autopsies at Hopkins, as well as a
number at Bay View Asylum. Reading her reports, it
is interesting to see the improvement in their qual-
ity and her increasing pathologic sophistication.
She also helped teach the second-year medical
students.
In her memoirs, Dorothy wrote how, on New
Year’s Day 1901, “I met my fate. I can’t remember details
of the meeting and I have no desire to go into further
particulars of my unhappy love affair, except to make clear
what happened in 1901 to change my entire life and to so
twist my character through sheer misery, that I wonder
how I had strength of will to go on living. . .”9 That
winter day, in the rotunda of the Johns Hopkins
Hospital, she met and talked to a medical graduate
recently returned from a year’s study in Europe.
“Then when the gathering broke up, I went to my room
. . .and cried my heart out. I knew I had met my man and
that fate was against us.”9
Figure 2. Dorothy Reed as a student at Johns Hopkins Med-
Dorothy was then an intern, so time off for
ical School (photograph by A. Pearsall, courtesy of Alan Mason
lovemaking was snatched between her long work-
Chesney Archives of Johns Hopkins Medical School).
3. Whatever Happened to Dorothy Reed? 197
ing hours. She kept the identity of her lover a secret thy of her. His cardinal sin was making passes at her
all her life. In her memoirs, she refers to him as girlfriends after he was engaged to her. “Influenced
‘A.J.’ A tall, good-looking, well-bred young man, by the necessity of not seeing him constantly if we were not
undoubtedly clever, who was already a celebrity in to marry, I decided to leave Baltimore, to go out of
pathology and take up pediatrics as a profession.”9
his field, but early on she detected a certain self-
ishness and conceit for which she did not care. But When she told Welch of her decision, he seemed
she was passionately in love, so she overlooked his relieved. He helped her secure the position of
faults. Resident Physician and Assistant Pathologist at the
Later that same year, Dorothy received a visit newly opened Babies Hospital in New York, at a
from Charles Mendenhall, a childhood friend who salary of $1,000 per year, plus room and board.
had been a graduate student in physics at Hopkins Because the position was not available for 6
when she was in medical school. During that time, months, she passed the interval doing obstetrics at
they became firm friends and would spend Sundays the New York Infirmary for Women and Children.
together exploring the countryside around Balti- When Dorothy arrived at Babies at the beginning of
more. Afterwards, she would take him to the wom- January 1903, she was horrified to find that she was
en’s residence for dinner. He was clearly in love the only physician in attendance, and that there
with her and proposed marriage, but she turned were no proper patient records. With the aid of one
him down. Now, together again on the grounds of of the young nurses, she was able to figure out most
the hospital, Charles Mendenhall once again asked of the diagnoses and no great harm seems to have
her to marry him. But behind every tree she saw the befallen the children. When the Medical Director,
face of ‘A.J.’ and so refused him. L. Emmett Holt, returned from Florida, she real-
Nineteen hundred and two was the turning point ized at once that he was very different from the
in Dorothy’s career. She was worried, upset, and ebullient William Osler, her idol at Hopkins. Holt
unhappy. Three issues concerned her: money, her was a small, precise man, highly organized, who
future prospects at Hopkins, and her relationship had little time for pleasantries and never gave
with ‘A.J.’ Welch, who was pleased with her work, praise. In some ways, his personality was too close
asked her to stay on and even offered to get her a to Dorothy’s for them to establish a good interper-
Rockefeller fellowship, which would increase her sonal relationship. She spent 3 years at Babies and
income from $500 to $800 per year. But this would was able to institute many of the practices such as
not be enough, because her mother had spent proper medical charts that were current at Hop-
practically all the family money and Dorothy was kins. The main illnesses then were infectious, pneu-
having to support her. monia and gastroenteritis. Many children were un-
Dorothy always favored the direct approach, so dernourished or even malnourished, and Dorothy
she went to see Welch and asked him about her learned all there was to know about nutrition from
prospects. He looked puzzled and then embar- Holt, who was the leading pediatrician of the day.
rassed. She explained that the man who had the However, her tenure as Assistant Pathologist came
fellowship the year before her, and who had com- to an early and abrupt end when she charged Holt
pleted no research, had been made an assistant in for his private pathology work.
pathology and could look forward to promotion in That summer, she was sent to take charge of the
the Medical School. Why not she? After a moment’s hospital’s summer branch in Oceanic, NJ. There
pause, Welch answered that “no woman had ever held she had time to think things over. She much pre-
ferred investigative laboratory work over clinical
a teaching position in the school, and that he knew there
would be great opposition to it.”9 Dorothy wrote in her pediatrics, but where was she going to do this and
memoirs, “Suddenly, as I saw what I had to face in what would it pay? By now she had not only her
mother to take care of, but her sister had died,
acceptance of injustice and in being overlooked - I knew
leaving three young children who would need ed-
that I couldn’t take it. And I told Dr Welch that if I
ucating and a feckless, improvident and, as it would
couldn’t look forward to a definite teaching position even
after several years of apprenticeship, that I couldn’t stay.”9 turn out later, dishonest husband. Dorothy was still
And then there was the problem of ‘A.J.’ Dorothy a very attractive 30 year old (Fig 3). She desperately
could not bear to be around the man she loved so wanted a home of her own and a family. How was
dearly but whom she knew in her heart was unwor- this to be accomplished? She had made up her
4. 198 Peter J. Dawson
train pulled out she shouted, “Take me with you.”
Not understanding, he replied, “Now?” And she
answered, “Next time.”9 Poor man, he was too bewil-
dered to sleep that night and sent her a telegram
from Albany asking what she had meant and if he
had heard correctly. She put his mind to rest, but
said that she must first settle things with ‘A.J.’
before their engagement could be announced.
Her family, who had strenuously opposed her
entry into medicine, were now just as adamant
about her giving up medicine to marry Charles.
The wedding took place on Valentine’s Day 1906 in
the ancestral eighteenth-century stone manor
house at Talcottville in upstate New York, where
snow covered the fence posts. Even then, Dorothy
was conscious that she did not love Charles in the
way she loved ‘A.J.’
The couple spent a long honeymoon in Italy,
where Dorothy became pregnant. Their arrival in
Madison, where Charles had a faculty appointment,
must have been something of a cultural and cli-
matic shock. Flushed with the excitement of a new
marriage, a new home, and above all the prospect
of a baby, Dorothy accepted her new surroundings
and did not regret leaving the practices of medi-
cine, as she then thought, forever.
When she went into labor, she was surprised to
see that her physician, said to be the best in town,
did not wash his hands in antiseptic before exam-
ining her, as they did at Hopkins. She was fully
Figure 3. The portrait Dorothy had made for Charles Men-
denhall at the time of her engagement (photograph by The dilated and, after an attempted version, he deliv-
Misses Selby New York, courtesy of Sophia Smith Collection,
ered the baby as a breech. Dorothy was horrified
Smith College).
when she realized what was happening, for she
knew only too well the grave risk to the baby.
mind that she could never marry ‘A.J.’, even However, it was a recognized procedure at the
though they were still secretly engaged. She had time, and the risk to the mother’s life from caesar-
met few eligible men in New York. The thought of ian section in that setting and in the pre-antibiotic
life as a spinster living in a hospital or institution era, would have been unacceptable. Her little girl,
was simply too depressing. That fall she learned Margaret, was born severely distressed and died
that Charles Mendenhall (her friend from medical after 20 minutes. Poor Dorothy was left with puer-
school days) was returning home by ship from a pural sepsis and a massive perineal tear. It was a
post-doctoral year in Germany. Wearing her smart- year before she was fully recovered. She got preg-
est coat and hat, Dorothy met him on the dock. She nant again and delivered a fine baby boy, who later,
felt “a surge of renewed hope when she saw his face with the exuberance of a 2-year-old, ran through an
again.”9 They spent the day together, chatting open, second floor window and fell to his death.
about old times. She found it “good to be able to talk Her husband, Charles, a naturally quiet and ret-
icent individual, was unable to express his emotions
freely with one who knew my family and with one whom
I knew cared deeply for me and mine.”9 Charles left that verbally, although he wrote her passionate love
evening for Madison, WI, and she saw him off at letters. He felt it sinful to indulge himself or his
Grand Central Station. Suddenly, the thought wife, and was ill equipped to provide the emotional
struck her, “Why not make this the solution?” As the support that the distraught and demanding Dor-
5. Whatever Happened to Dorothy Reed? 199
othy so desperately needed. His response to domes- bearing and rearing of children. Most of my work came
out of my agony and grief.”9
tic crises was to retire to his lab at the University.
Sad, depressed, and lonely, she thought long and In 1915, the Attic Angels, a philanthropic orga-
hard about abandoning her marriage and return- nization, opened the first infant welfare clinic in
ing to medicine. But she stayed with Charles and the state in Wisconsin, with Dorothy as Medical
tried to work things out and gave him two fine, Director. There were no standards for child height
healthy boys who held the marriage together. She and weight in those days and she had to develop
worked hard at being a good wife. She entertained her own. The question she always asked was, “Why is
your child undersize?”9 From this starting point, a
the faculty wives and helped them with their chil-
dren’s problems. She joined the Walrus Club, a diagnosis might be made and appropriate action
small, select group of professors’ wives, who met taken. She was popular with the clinic staff, and
monthly for uplifting conversation and to read years later women would stop and greet her in the
learned papers to one another. But she needed street with progress reports on their children. In-
something more. fant mortality then was about 120 per 1,000 live
Two events rekindled Dorothy’s professional life. births and, for mothers, the risk of death in child-
The first was when Abby Marlatt, the head of Home birth was very real. Dorothy became a member of
Economics at the University of Wisconsin, asked the home economics department at the University
her if she would give some lectures on child health of Wisconsin (she never had an appointment at the
in the small rural communities around Madison. medical school), where she lectured on child de-
The second was when Julia Lathrop, Chief of the velopment and introduced one of the earliest
US Children’s Bureau, asked her to review a book, courses on sex hygiene for students.
“The Health-Care of the Growing Child.” Although During World War I, Dorothy moved to Wash-
she panned the book, she was delighted to find an ington to be with her husband who was in the army.
outlet for her energies and to be active again in her She joined the staff of the US Children’s Bureau in
profession. 1917 and took up the cause for women and chil-
By this time, the Mendenhalls were well estab- dren at the national level.
lished with sufficient domestic help to take care of At the beginning of the twentieth century, one
the children while she was away. Her first foray into quarter of all deaths occurred in children under 5
the country, by her own admission, was a disaster. years of age. Although the federal government
In the fashion of the young and inexperienced, she spent huge sums of money to control hog cholera
compressed all there was to know about infant and the boll weevil that infested cotton, it was not
feeding into an hour’s talk . As she put it, the until 1912 that the US Children’s Bureau was es-
audience “were very patient looking at me with the tablished. With an annual budget of $25,000, the
expression of the mother of eleven who had buried seven.”9 Bureau could do little except gather infant mortal-
From the questions, it was clear that what most ity data and institute a nationwide educational cam-
interested them was prenatal care, because they paign, which it did by publishing pamphlets and
usually breast-fed their babies. Dorothy learned answering queries on all aspects of maternal and
quickly and changed her topic and style of delivery. child care.
Every winter, when farms were less busy, she went Dorothy was, for a long time, a medical officer on
out on week-long trips, accompanied by experts on the staff of the Bureau. She wrote a number of
home economics and sanitation. She began to re- important pamphlets including “Milk: The Indis-
alize the terrible lot of country women – poverty, pensable Food for Children” (1926), “What to Feed
hard physical labor on the farm, daily hand laun- the Children” (1917 with Amy L. Daniels), and
dry, and, all too frequently, drunkenness and spou- supervised the production of “Childcare and Child
sal abuse. There was nobody, except untrained Welfare” (1921). She carried out an important
midwives, to deliver their babies, and no medical study that resulted in “Midwifery in Denmark”
care for their children. While Dorothy was clearly (1929). She was impressed with the practices and
touched by their experiences, her real motivation standards there and felt that there was too much
came from within “. . .the tragic death of my first child, ‘hurry’ and interference in the United States. She
had long espoused the training of midwives, as she
Margaret, from bad obstetrics in 1907, was the dominant
felt that a well-trained midwife was a lot better than
factor in my interest in the chief function of women, the
6. 200 Peter J. Dawson
sor of Surgery at the University of Wisconsin Med-
ical School.
By now, the beauty of youth had been replaced
by a certain serenity and strength of character that
had its own particular charm. The hair remained
dark brown and the gaze direct and unflinching;
the jaw was firm and the mouth even, but the
sadness of her bereavements and her determina-
tion to overcome so many obstacles had left their
mark. She remained an effective and outspoken
advocate for women and children. She saw a pat-
tern to her career and felt that, in some preor-
dained way, her training in obstetrics and pediat-
rics had prepared her for her life’s work with
women and children.
In 1945, when Harvard was again, and finally,
considering admitting women, Alice Hamilton told
her that her case had been presented in a faculty
meeting as an argument against the admission of
women into medicine. Dorothy was absolutely furi-
ous as she felt, and in my opinion quite rightly, that
she had done more good for more women and
children, both in Wisconsin and nationally, than
most male physicians of that era.
In 1934, her husband developed pancreatic can-
cer and she gave up her professional work to care
for him during his final illness (he died the follow-
ing year). She returned to work and continued
during World War II.
Figure 4. Professor and Mrs Charles Mendenhall, with their
To me, the really intriguing question is: Who was
dog, Noah, on the 25th anniversary of their marriage (courtesy
‘A.J.’ to whom she gave her heart? Why was she so
of Mrs Thomas C. Mendenhall).
determined never to reveal his identity? When I
first looked at Dorothy’s papers, I found this letter.
an absent physician, which was so often the case in (Fig 5)
rural areas, and she gave testimony to this effect to
“Dear Dorothy,
a Congressional committee. I had not heard of your engagement – appar-
By 1934, Madison had the lowest infant mortality ently nobody liked to tell me – and it was hard to
in the nation for a city of its size, 30 per 1,000 live grasp for awhile. Since you are going to be married
births, in part because of Dorothy’s efforts, which though I cannot think two ways about your state of
were recognized by an award of an honorary Doc- mind and I most sincerely pray whatever powers
there are that you may find entire happiness in
tor of Science by Smith College.
loving and being loved by this man. Of course you
By the time of their 25th wedding anniversary
mean the Meredith verse to refer to the past. I shall
(Fig 4), Dorothy and Charles were well established
not forget it or feel any the less remorseful, any
in a fine house in Madison where he was Chairman
more than I can forget you for as I look back over
of the Physics Department and a member of the
my whole life what little love was given me of love
National Academy of Sciences. Dorothy could look
for woman I in turn gave to you and now for the
back on a marriage in which fondness had matured rest I am left I think absolutely indifferent and
to love under the tutelage of mutual respect, and careful only of things in the laboratory. I regret it
she felt her greatest achievement was raising two but believe me you should not. I – about to con-
fine boys, one of whom became President of her tinue in this loveless life – congratulate you and am
alma mater (Smith College) and the other, Profes- glad with you that you are to have someone else’s
7. Whatever Happened to Dorothy Reed? 201
Figure 5. Letter to Dorothy Reed, probably from William MacCallum (A) beginning and (B) ending.
love than mine. I am very grateful to you for your but I hope that in other ways he is as good as he has
kindly feeling for me altho I don’t see why you shown himself in loving you. Really moved [?] I do
should have it. I haven’t much to look forward to. care intensely that you should be happy and you
I shall achieve a mediocre success I suppose in my must be – won’t you write and tell me a little more
about it and then if you will, forget me.”10
work – not more probably and I shall always be
alone and live in or about a hospital. Already I have It was signed: “W—”
lost interest in nearly everybody and feel old. I care
Of course, letters of this type are not uncommon
more for John [his younger brother and Dorothy’s
classmate] than all the rest put together and the and many people have sent or received them and,
poor boy is dying. Last summer we went to Canada indeed, they tend to follow a certain formula.
and slept outdoors all summer and as soon as I can Who could “W” be? William Welch? He was a
leave I shall go out to him in California and per-
confirmed bachelor who lived in men’s clubs.
haps if he can stand the trip take him to Honolulu
Apart from his sister, he had no real women
for the summer.
friends. Besides, in 1901 he was not returning from
Do let me do something for you some time –
a year’s study in Germany. William Osler was hap-
anything if only to show you that I care a great deal
pily married to the widow of a successful Philadel-
for you – I don’t know anything about Dr Menden-
phia surgeon by whom he had one son.
hall (who I suppose is after all the “mythical man”)
8. 202 Peter J. Dawson
In 1901, William G. MacCallum, who graduated
in the first class at Hopkins, was an assistant in the
pathology department and had just returned from
a year in Germany working and visiting laboratories
there. MacCallum, of course, became Chairman of
the Pathology Department at Hopkins and was the
author of a standard American textbook of pathol-
Figure 7. Notation of A.J.’s death in Dorothy’s copy of the
ogy.11
“Medications of Marcus Aurelius.” Note the stain on the left-
The evidence that suggests that her lover ‘A.J.’ hand side produced by the newspaper clipping (courtesy of
was in fact MacCallum may be summarized: He Mrs. Thomas C. Mendenhall).
returned from Europe at the end of 1900. The “W”
in the letter is similar to his handwriting, but hardly
conclusive. He had a series of rather prominent of Marcus Aurelius” on a daily basis. These consist
high-class women friends and, like the author of of 12 chapters with numbered paragraphs that
the letter, he never married. Among Dorothy’s roughly correspond to the days of the month. She
papers, there is a photograph of MacCallum as a used her copy as a sort of commonplace book, and
young man (Fig 6), and on the back is a list of dates it included clippings of poems and prayers that she
that may correlate with their meetings. Finally, it liked and notes of birth dates and deaths. In Book
was Dorothy Reed’s habit to read the “Meditations 2, opposite paragraph 3, she has written “A.J. 1944”
(Fig 7) and, pressed between the pages, is a faded
clipping from the New York Times dated February
3, 1944, announcing the death of William George
MacCallum, formerly Chairman and Professor of
Pathology at Johns Hopkins Medical School.
There is a final twist to this story. How did
Dorothy Reed’s name become associated with the
giant cell in Hodgkin’s disease? It appears her
name and the cell were not linked before the
publication in 1916 of MacCallum’s “Textbook of
Pathology.”10 In his 6-page, copiously illustrated sec-
tion on Hodgkin’s disease, MacCallum put her
name on every page except one. Nowhere in the
book is anybody else’s name given such promi-
nence. Dorothy would have us believe that it was
because somebody was trying to take credit for her
work and MacCallum wanted to set the record
straight. But I think that we both know that the
reason had more to do with the heart than the
lymph glands. Dorothy’s grand passion had been
‘A.J.’ The wound never healed and more than 40
years later, when she wrote her autobiography, she
was still unreconciled. She gave him her heart and
in return he gave her international fame.
Following World War II, Dorothy traveled widely in
Mexico and Central America, but with the passing
years, she grew heavier and more infirm. She sold her
home in Madison and moved to Tryon, NC, to escape
the harsh midwestern winters. Gradually, her friends
departed and she was very lonely. She always said that
Figure 6. Dorothy’s photograph of William G. MacCallum
she would not impose on her two sons, but in the
(photograph by Elmer Chickening, Boston, Sophia Smith Col-
end, as age and infirmity took their toll, she moved to
lection, Smith College).
9. Whatever Happened to Dorothy Reed? 203
lymphadenoma and leucocythaemia. Trans Path Soc Lond
a nursing home in Connecticut to be near her older
1878;29:272-304
son; she died in her 90th year.
¨
3. Sternberg C: Uber eine eigenartige unter dem Bilde der
Perhaps, in retrospect, this article should have
Pseudoleukamie verlaufende Tuberculose des lymphatischen
¨
been titled, “The Love Story of Dorothy Reed.” Apparates. Z Heilk 1898;19:21-91
4. Dawson PJ: The original illustrations of Hodgkin’s dis-
Acknowledgements ease. Ann Diagn Pathol 1999;35:386-393
5. Mann RB: Dorothy Reed Mendenhall (1874-1964) JHU
The author wishes to thank the late Dr John T. Mendenhall
and the late Mrs Thomas C. Mendenhall for all their help and SOM Class of 1900. Path Ways 2001;5:5and 10
kindness, as well as permission to publish photographs from 6. Zwitter M, Cohen JR, Barrett A, et al: Dorothy Reed and
their personal collections. Thanks are due to the Alan Mason Hodgkin’s disease: A reflection after a century. Int J Radiat
Chesney Archives of Johns Hopkins Medical Institution, Balti- Oncol Biol Phys 2002;53:366-375
more, MD, and Sophia Smith Collection, Smith College, 7. Reed DM: A case of acute lymphatic leukemia without
Northampton, MA, for permission to publish photographs and enlargement of the lymph glands. Am J Med Sci 1902;124:653-
other material and also to their staffs for a great deal of help and 669
many kindnesses. Paul Berman, MD, provided data on the 8. Reed DM: The bacillus pseudo-tuberculosis murium; its
inception of the term Reed cell. Sincere thanks to Susan Nord- streptothrix forms and pathogenic action. Johns Hopkins Hosp
strom for help with the manuscript and to Danny O’Neal and Report 1901;9:527-541
Laurie Barnett for library assistance. 9. Dorothy Reed Mendenhall papers, Sophia Smith Collec-
tion, Smith College, Northampton, MA
References 10. Letter to Dorothy Reed Mendenhall, probably from Wil-
liam G. MacCallum. Mendenhall papers, Sophia Smith Collec-
1. Reed DM: On the pathological changes in Hodgkin’s
tion, Smith College, Northampton, MA
disease, with especial reference to its relation to tuberculosis.
11. MacCallum WG. A Textbook of Pathology Saunders,
Johns Hopkins Report 1902;10:113-196
2. Greenfield WS: Specimens illustrative of the pathology of 1916. Philadelphia, pp 791-796