Dr James Barry
Author: Michael du Preez and Jeremy Dronfield

Overview

This thrilling and fast-paced biography does justice to the adventurous life of a woman who qualified and practiced medicine at its highest level at a time when the profession was off-limits to all women. James Barry is undoubtedly the most audacious and enigmatic doctor to practice medicine, and her gender only serves to magnify the scale of her tangible achievements. In a masterpiece of storytelling, the biography forensically pieced together her versatile character and extraordinary career; it charted her life leading up to her qualification as a doctor masquerading as a man, and it followed her profession as she rose to the rank of Inspector General of Hospitals – a feat it commemorated as ‘the first time in history’ that ‘a woman had achieved general rank in the British Army‘. The full portrait of Barry that the book eventually paints is of an idealistic doctor who was passionately dedicated to improving the lot of her patients, and to enhancing the wider practice of medicine. It also presents her as a combustible personality with complicated relationships but whose life emboldened women to challenge the resistance that ‘the male old guard‘ had placed to ‘block and hinder the female incursion’ into medicine (pages 288, 352 and 386).

Synopsis

In its exploration of John Barry’s early life, the book focused on how her gender stifled her ambitions and potential in the 1800’s when she was born and raised as Margaret Anne Buckley. The book particularly explored how being a girl at the time became a barrier to any educational aspirations she might have harboured, the authors remarking that ‘she may have been cleverer, more literate and more industrious than her brother, but she was a girl, and little else was expected of her’ apart from a destiny of marriage. In her case, it was rather ironic that this male preference precipitated the family’s downfall because her father had ‘wagered the family’s financial security’ on the various careers of his inept son who was ‘less intelligent, lived in the moment and gave little thought to the consequences of his actions’. It was these ‘follies of their male relations’ that the authors said prompted Margaret and her mother ‘to save themselves‘ by setting out to London in search of Margaret’s renowned artist uncle, John Barry. In a story worthy of a fairy tale, the book chronicled how she inherited a large part of her uncle’s ‘substantial estate‘ after he died, a fortuitous event that released her bold and enterprising spirit (pages 5-10 and 13-28).

The circumstances that led to Margaret’s decision to study medicine were as fascinating as the cunning she needed to carry it out. The book described how her newly acquired fortune enabled her to abandon her previous plan to become a governess, and how it opened the doors for her to pursue other career opportunities. More importantly, the book showed how it broadened her social connections especially to Don Francisco de Miranda, a Venezuelan general whose ‘enthusiasm for revolution was unquenched’ as he planned military campaigns to liberate his country from Spanish rule. The book described his meeting with the equally ‘daring‘ Margaret who was craving ‘a release from the life that lay ahead of her’, asserting that this led to the ‘revolutionary‘ plan for her to train as a doctor. The authors speculated that Miranda probably conceived of ‘the idea of Margaret studying medicine by disguising herself as a man’ because the paths to medicine were ‘firmly closed to women’ at the time. The authors argued that Miranda’s expectation, ‘if Margaret should succeed in gaining a degree’, was that ‘she would accompany him on his next expedition and live an altogether new life as a participant in the fight for freedom‘ – a prospect that the authors asserted ‘appealed to Margaret’s natural courage and sense of adventure  (pages 31-32 and 51-55).

The biography provided a detailed account of Barry’s studies in Edinburgh, the ‘pre-eminent’ medical school at the time, where the authors remarked that he studied extremely hard, attended courses, passed his examinations, and was awarded his degree. The book also chronicled how he proceeded to undergo tutelage at Guy’s and St Thomas’s Hospitals in London where he expanded his knowledge and skills especially under Astley Cooper, the great surgeon renowned for his ‘professional brilliance’ and his ‘amazing devotion to the minutiae of his science and craft’. But with his ambition to join the Venezuelan revolutionary struggle scuttled by Miranda’s untimely death, the book related how he channeled his ‘adventurous spirit‘ into an equally intrepid career as an army doctor. The authors dedicated a major part of the book to portraying his foreign posting at the Cape of Good Hope where he quickly formed a lasting and complex friendship with the Governor, Sir Henry Somerset, and straight away established a reputation for clinical excellence by correctly diagnosing and treating Somerset’s daughter. With subsequent similarly remarkable feats, the book depicted how Barry came to be regarded as ‘the best doctor in the Cape of Good Hope’, and how he became enshrined as ‘a part of Cape legend‘. The book also vividly recounted his other remarkable foreign military postings to such places as Mauritius, Jamaica, St Helena, Antigua, Barbados, Trinidad, Malta, Corfu, and Canada (pages 60, 63, 68-93 100-106, 120-123 and 214-219).

Perhaps as expected, an engaging running theme throughout the book was how Barry successfully pulled off his charade to his death. Whilst his disguise never fully masked his obvious feminine features, the authors argued that he usually succeeded in passing off as ‘an effeminate-looking young man, slightly built and small’, and that whilst he took careful measures to hide his identity, he frequently feared disclosure. They illustrated this with the time he was on ship for three months on the way to his first posting and was forced ‘to live, eat and sleep alongside…men who hadn’t any occupation to distract them from scrutiny of their fellow passengers’. Indeed the authors maintained that Barry was never able to successfully masquerade as a man ‘in voice and manner‘, and that many people ‘noticed his effeminacy and his struggle to overcome it’. And despite his precautionary efforts, it was perhaps inevitable that his pretence was exposed on a few occasions, such as when a nurse ‘saw enough to know that Dr Barry was a woman’, and when a ‘gossip‘ went round ‘among the servant women of St Helena that Dr Barry might not be a man’ (page 64, 115-116, 125, 133, 151, 154, 273 and 294-295).

Beyond the drama of concealing his gender, and more relevant than his adventurous spirit, are the exceptional clinical and administrative skills Barry demonstrated throughout his career. For example, the authors stated that amongst his contemporaries, ‘none of them individually could outmatch him for medical skill…and for wholehearted devotion to duty, zeal for improvement and determination to alleviate the plight of the Colony’s most vulnerable people’. The book also documented striking examples which illustrated how he ‘thought only of medicine, health, welfare and radical reform‘ to the exclusion of the politics of situations, and how he pursued his medical career with conscientiousness ‘to an extraordinary degree’ and with a visceral ‘intolerance of incompetent practitioners’. It was perhaps this diligence and dedication to duty that engendered the other qualities the book attributed to him such as his ‘forthrightness‘, his ‘ungovernable impulse to speak truth to power’, and his ‘typical lack of reserve and discretion‘ – traits which may also explain why he was ‘constitutionally incapable of backing down‘ once he had ‘taken a moral stand on any matter’. It is therefore understandable when the authors pointed out that these qualities inexorably and repeatedly put him in conflict situations – duels and court cases, arrests and imprisonments, demotions and dismissals – all of which the book explored in depth (pages 207, 267, 168, 171, 177, 191 and 280).

Opinion

With a colourful and imaginative narrative, this book chronologically relates the story of a groundbreaking and creative woman who left her mark on the medical profession whilst practicing as a male doctor. The biography is spellbinding not just as a story of upward mobility, but also as a medical account replete with the lessons of high ideals, dedicated clinical practice, and passion for patient welfare. The book’s emphasis on some stories, such as the skirmishes in the Cape, felt gratuitous and irrelevant. However, its enlightening historical perspective of the medical dimensions of such wars as the Crimean, of the evolution of such diseases as cholera, and of the impact of slavery and colonial politics of the British empire, were very well-told and illuminating. This broad brush greatly elevated the book above a mere biography to a valuable medical document.

Overall assessment

This detailed reconstruction of the life of a fully qualified and exceptionally gifted doctor is well-written even if rather overdramatised for effect. Unconventional in many respects, Dr Barry’s life of industry and scrupulous practice reflect the high ethical principles of the profession and are profound lessons for all doctors. Her unblemished and exceptional career is a testimony to the damage done by medicine when it unfairly excluded women from the profession. The ingenuity she demonstrated in carrying out a life-long scheme of deception, with higher goals in mind, is perhaps a lesson in how to pursue all avenues in the service of mankind. The book has done justice to a life well spent, and I recommend it to all doctors.

Book details

Publisher, Place, Year: Oneworld Books, London, 2016
Number of chapters: 34
Number of pages: 479
ISBN: 978-1-78607-119-4
Star rating: 5
Price: £10.19