Persepctives

Something Different for International Women’s Day

In honor of this past Sunday’s International Women’s Day, I want to take a break from my usual style of blog posts and tap the other side of my creative and indulge my love of history for a bit. We will return to our regularly scheduled ultrasound posts next week. Still, today, I want to celebrate two women who helped lay the foundations that we stand on today. One directly affected the creation of ultrasound, delivery of point of care diagnostics, and was an all-around bamf. The second does not have much to do with ultrasound. Still, she is a figure of medical history that I feel is not well known outside of a few niche circles, but whose name should be known wherever medicine’s light touches.

To keep myself brief and from writing what we all probably know could be a doctoral dissertation on these two, I will focus our attention on a period at the beginning of the 20th century, The Great War. For those of you who do not know, The Great War was when the Victorian Age died violently, it thrashed itself to death against the rocks of the coming modernity to the staccato music of Maxims, 42 cm Krupp’s, flamethrowers, green cross gas corrupting everything it touched and the late-night screaming of a generation. In this bloody morass of where nightmares and industry meet, we find Dr. Marie Curie and Dr. Nicole Girard-Mangin.

Through Force of Will, Point of Care Imaging 

We won’t begin with the subject of our story, but with another, Dr. Wilhelm Röntgen and his discovery in 1895 of X-rays. It was not long after Dr. Röntegen’s X-ray machines, Medical Doctors began to see the apparent benefits of being able to see inside of the body without cutting someone open. The first use in war was during the Abyssinian War by the Italians in Military Hospitals. X-ray machines or “Röntegen-ray apparatus” were further used in the late Victorian Wars, such as the Spanish-American War, Boer War, and Russo-Japanese War. These were still huge machines during those conflicts and would remain immobile in Military Hospitals for the next decade. 

When the July Crisis finally spiraled out of control, culminating in German Empires troops marching into Belgium on August 3, 1914, Marie Curie had already won two Nobel Prizes in two different subjects. Madame Curie’s laboratory and institute were located in Paris, Paris, the same city that the entirety of the invading German was aiming to capture. As the government of the Third French Republic moved its capital to Boudreaux, Madame Curie followed suite, moving the radiological assets of her laboratory to safety in the same city. Once her research was safe in Boudreaux, Madame Curie turned back toward Paris, to help her adoptive country stem the ever-growing tied of field grey and pickelhaube helmet’s swinging like the hinge of a door toward Paris. 

Dr. Marie Curie “…in one of her mobile X-ray units…”. (Credit: Eve Curie, found at Smithsonian Magazine)

Madame Curie did not have much experience with X-rays, she had only lectured on them. She did, however, see their immediate use if they could be brought closer to the battlefield. Madame Curie’s idea was to make these early diagnostic tools mobile, so they could be driven to the forward aid stations to where their diagnostic power could be leveraged by Physicians to save soldiers’ lives at the point of need. Initially, the French Military did not see the utility in placing these diagnostic machines in the hands of surgeons or how a few mobile units would help. Frustrated by the lack of funds and buy-in from the French Military, Madame Curie turned to the women of France and raised money to buy several trucks, outfitting them with portable x-ray machines. Power generation was an issue as vehicles were new not only on the battlefield, but in society as a whole, an early type of generator was further fitted into these trucks. She next sought out training for her, her daughter Irene, and their first few volunteers. The first of these portable radiological units entered service during the First Battle of the Marne, taking place September 6-12, 1914. I point this out for one reason, hostilities between the land powers of Europe started on August 3, and little over a month later, Madame Curie took a formerly hospital only diagnostic tool and put it in the hands of front-line physicians.

Point of Care X-ray (Credit: Bibliothèque nationale de France, département Estampes et photographie, Found at Smithsonian Magazine)

Next, Madame Curie and her daughter Irene (who would go on to win the 1935 Nobel Prize in Chemistry) created the first training program for their combat point of care X-ray cars. By the end of the war, Madame Curie and Irene had trained 150 female volunteers, but oversaw the construction of 200 radiological examination rooms at fixed Field Hospitals but helped treat 1 million injured soldiers. 

They Tried to Bury Her in Obscurity  

Dr. Nicole Girard-Mangin, I cannot recall where or when I came across her story, but I can tell you she is a difficult person to track down. There are so few sources directly about her. She is mostly mentioned as a background character in other’s stories or in passing when discussing the events she was involved in. I believe this to be the greatest tragedy of all, as she is a person of incredible resolve that the power hierarchy of the day tried to bury. She was to be their victim. Not due to any significant lack of knowledge or skill but only because of her gender. Those who tried to bury her, they didn’t know that they would be putting her right in the middle of a storm that would make her rise undeniable. 

Nicole Mangin started Medical School in 1896. If it was not relevant, I would not mention this, but it leads to an interesting twist in our story. Nicole Mangin paused her studies when she married André Girard, adopting her husband’s name to her own as “Girard-Mangin.” After the birth of her son, the couple divorced, Nicole kept her name as it was and continued her medical studies. Once graduating, Dr. Nicole Girard-Mangin specialized in tuberculosis and later began to study and treat cancers. This was until August of 1914 when France realized that no matter how brave their Cuirassiers were, belt-fed MG 08 machine guns played 21 every time they faced each other. However, a day before hostilities started, August 3, 1914, Dr. Nicole Girard-Mangin was mobilized by the French military. This is possibly due to clerical error as women did not serve as Physicians in the French army at this time. The clerk who mobilized her may have only seen a “Dr. Girard Mangin” on their roster and selected her, not realizing she was not a man. Either way, on that date, Dr. Girard-Mangin became the first female physician in the French military.

Dr. Nicole Girard-Mangin (Credit: Wikimedia Commons)

Despite the thousands being slaughtered on the front lines, despite their desperate need for trained physicians, Dr. Girard-Mangin’s first commanding officer was embarrassed that a woman was part of his staff. He attempted multiple times, demanding even of his superiors to have her removed from his command. His attempts were rebuffed every time. Desperately needing physicians, the French army could not afford to lose her. The did, however, deny her rank. Even after being in the military for a year, she still did not carry an official rank like her male counterparts, and she was receiving the same pay as a nurse. I can’t find the source, but if I remember correctly, she was also at this time campaigning to be sent closer to the front to where she felt her skills could be better used. I like to think this is the reason she was sent to the quietest part of the front. Still, whether or not my memory is correct or not, she was reassigned in December of 1915 to one of the quietest sectors of the front, Verdun. Arriving in December 1915 with a puppy named “Dun” that her friend gave her, she was assigned to the Typhus ward. She was closer to the front now, but it was a place the army thought they could bury her away at.

The German world Gericht has fascinated me since I first heard it. Interestingly, it doesn’t have just one stable meaning, its context drives what the word could mean. To General Erich von Falkenhayn of the Imperial German Army, it either meant “Place of Execution” or “Judgement” as Operation or Unternehmen Gericht was his brainchild. If his post-war memoirs were to be believed, this operation would turn the sleepy sector of the front, Verdun, into a human slaughterhouse meant to bleed the French army to death. The guns of the apocalypse opened up on February 12, 1916, starting a battle that would last ten months and would lead to almost 800,000 casualties, including 306,000 dead on both sides. I won’t go into the details of the fight further or the artillery barrages and flamethrower fights in underground forts, but suffice it to say, the battlefield today is still littered with live ammunition and corpses that will take another 100 years to clean up.

In the middle of this, Dr. Nicole Girard-Mangin rose to the occasion. Her experiences during this period are not well known, I cannot find a diary of hers, but only an autobiography was written in French, not available online. What we do know is that early on in the battle, it looked like her hospital was going to be overrun by the German army. She organized a tactical retreat of her patients and her staff, was wounded by a shrapnel shell, continued to maintain command and control of her staff, finish the evacuation, and survived her wounds. She would use this experience to further campaign the army for a proper military rank, which she would receive, still though, with nursing pay. The average wounded received by all medical units per day during this time was 875 patients. She would stay here treating patients, performing surgeries, driving ambulances, and at times venturing out into no man’s land to retrieve the wounded. This was until the end of 1916 when she would be sent to the Somme. 

Later in 1917, she would be given command of the Edith Cavell School of Nursing in Paris with the rank of Doctor Captain. Here she would be the director, responsible for the education of auxiliary nurses. This was in addition to caring for patients in the hospital that the school was attached to. Following the war, Dr. Nicole Girard-Mangin continued to fight; she campaigned for Women’s Suffrage in France with the French Union for Women’s Suffrage. She was part of the Inter-Allied Women’s Conference, meeting with leaders of women’s suffrage movements from the other allied nations to achieve women’s suffrage through the Paris Peace Conference.

In ordinary stories, at this point, you would be whispering to yourself and your book, “just keep going, just keep going.” It is hard to end on a high note with Dr. Nicole Girard-Mangin, just as she was rising higher, she suddenly exits the historical record. I don’t know if it’s because of this, or her perseverance, or the way she rose to the occasion, but she is one of my favorite figures of history. Her story is hard to end on a high note. I’ve tried to write several of them, and I am sorry to end this story on this note, but on June 6, 1919, Dr. Nicole Girard-Mangin died at the age of 40. Throughout her career, many people tried to bury her, but what they didn’t realize was, she was a seed.

Dr. Nicole Girard-Mangin and her beloved dog, Dun (Credit: Wikimedia Commons)

Thank you for allowing me to indulge in my love of history as well as ultrasound. I know this was different than what you are all used to, but remembering these stories is essential. It has always been this odd thought in my head when I read history, that we bear witness to those who came before us, and if we forget them, they are lost forever. Like Dr. Nicole Gerard-Mangin, if we do not remember her, she will slip into time, be forgotten, and the structures that tried to bury her will win. If you want to read more on either Dr. Marie Curie and Dr. Nicole Girard-Mangin, I have my sources listed below. Check them out, continue to learn, continue to hunger to be better, and do better.  

References

Badash, L. (2003, July 1). Marie Curie: In the laboratory and on the battlefield. Retrieved from https://physicstoday.scitation.org/doi/full/10.1063/1.1603078

Bibliothèque nationale de France, département Estampes et photographie. (2017, October 11). One of Curie’s mobile units used by the French Army [Photograph]. Retrieved from https://www.smithsonianmag.com/history/how-marie-curie-brought-x-ray-machines-to-battlefield-180965240/

Curie, E. (2017, October 11). Marie Curie in one of her mobile X-ray units October 1917[Photograph]. Retrieved from https://www.smithsonianmag.com/history/how-marie-curie-brought-x-ray-machines-to-battlefield-180965240/

De Morant, G. (2014, August 4). Nicole Girard-Mangin, première femme médecin sur le front. Retrieved from https://www.parismatch.com/Actu/Societe/Nicole-Girard-Mangin-premiere-femme-medecin-sur-le-front-578852

The Great War. (2018, May 12). Marie Curie in WW1-Who killed the Red Baron? Out of the trenches [Video]. Retrieved from https://www.youtube.com/watch?v=17LnMIe-4Bo

Inspirational Women of World War One. (2016, July 25). Nicole Girard-Mangin (1878 – 1919) – French WW1 doctor. Retrieved from http://inspirationalwomenofww1.blogspot.com/2016/07/nicole-girard-mangin-1878-1919-french.html

Jorgensen, T. (2017, October 11). How Marie Curie brought x-ray machines to the battlefield. Retrieved from https://www.smithsonianmag.com/history/how-marie-curie-brought-x-ray-machines-to-battlefield-180965240/

The Nobel Prize. (n.d.). Marie Curie. Retrieved from https://www.nobelprize.org/womenwhochangedscience/stories/marie-curie

Plancard, P. (2013, March 15). Médecine de guerre. Retrieved from https://www.vosgesmatin.fr/actualite/2013/03/15/medecine-de-guerre

Shipton, E. (2014). Female Tommies: The frontline women of the First World War. Retrieved from https://books.google.com/books?id=9kcTDQAAQBAJ&pg=PT4&source=gbs_toc_r&cad=4#v=onepage&q&f=false

Unknown. (2013, November 25). Nicole Girard-Mangin (1878-1919) avec sa chienne Dun[Photograph]. Retrieved from https://en.wikipedia.org/wiki/File:Nicole_Girard-Mangin_avec_Dun_(1878-1919).jpg

Unknown. (2013, November 25). Nicole Girard-Mangin (1878-1919) Première femme médecin à exercer durant la première guerre mondiale [Photograph]. Retrieved from https://en.wikipedia.org/wiki/File:Nicole_Girard-Mangin_(1878-1919).jpg

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