Helene Knabe, MD, part one: Loss and Opportunity

Facts describing the early life of Helene Elise Hermine Knabe are hard to find. Although German record keeping is normally first-rate, some records from the area where Helene lived were deliberately destroyed — thrown into the Baltic, according to one source — during World War II, possibly as part of Germany’s efforts to erase the region’s history of Polish residents.

It’s known that Helene’s father was Otto Windschild; he was probably a structural engineer, but it’s not clear that he was married to her mother. He abandoned the little family not long after Helene was born. Her mother, whose last name was probably Knabe, passed away when Helene was very young. Daniel Ehmke, Helene’s uncle, raised her.

No record can be found that reveals what killed Helene’s mother, but many communicable diseases, especially Tuberculosis, were prevalent in Prussia back then. If her mother died from one of those diseases, perhaps that inspired Helene to become a doctor.

Women weren't allowed to study medicine in Prussia, but by 1900 they were allowed to do so in some other parts of the German Empire. However, instead of waiting, Helene opted to take a more adventurous path. She regularly exchanged letters with her cousin Augusta Knabe, a German teacher in Indiana who had attended Butler University and was living with her stepfather, Franz “Frank” Kropp, in Indianapolis. In one of these letters, Augusta informed Helene that women could attend medical school in America, and Helene set out to seize this opportunity.

Helene took on the task of preparing for medical studies and earning money to move to the United States. Helene must have developed a strong foundation in science from attending Prussia’s state-controlled, compulsory public education system, known then to be one of the most advanced and structured public education systems in the world. It’s possible she also found a way to work with a doctor prior to coming with the U.S. as a way to help prepare for medical school.

She arrived in New York on Nov. 16, 1896, and apparently headed toward Indianapolis right away. She moved in with Augusta and Frank and dedicated herself to learning English and earning money by doing domestic and seamstress work.

That same year, Butler University joined with two private professional schools, the Medical College of Indiana (MCI) and the Indiana Law School, to form the University of Indianapolis (unrelated to the modern university of that name). Butler, renamed as Butler College, became the undergraduate arm of the new university. Helene’s attendance for a term at Butler must have made for an easy transition in 1900 to the medical college, a forerunner of the Indiana University School of Medicine created in 1908.

Helene excelled in medical school despite its demanding schedule and the other tasks she was juggling to keep herself financially afloat. She earned money as a seamstress and by using her drawing skills for medical textbooks and pathology slides. Dr. Frank B. Wynn, the director of pathology at MCI, appointed her curator of the pathology museum and placed her in charge of the pathology labs at the school.  Dr. Wynn selected her to be his only preceptee — someone undergoing training or instruction under the guidance of an experienced practitioner —nfor the year. She was even allowed to teach underclassmen.

Dr. Knabe received her medical degree on April 23, 1904; she was one of two women to do so that year. She threw herself into her profession to gain credibility and acceptance. She even stayed on unpaid at MCI as a lab curator and a clinical professor.

In 1905, Dr. Knabe was appointed deputy state health officer by Dr. John Newell Hurty, the Secretary of the Indiana State Board of Health (ISBH); Dr. Knabe was the first woman to hold this office. Her duties involved investigating suspected epidemics, such as typhoid and diphtheria, and recommending ways to correct unsanitary conditions. She did these activities with vigor and success even while she was making appearances in towns all over the state to talk to the public about best practices to prevent the spread of disease. One of Dr. Knabe’s most notable contributions to public health was to prove the widespread existence of rabies in Indiana through rapid rabies diagnosis, a method she learned from Dr. Anna Wessels Williams at Maryland’s Johns Hopkins University. She implemented ways to prevent rabies’ spread by educating the public about the disease, and as a result, lives were saved.

Dr. Knabe competed for the position of superintendent of ISBH’s Bacteriological and Pathological Department, but Dr. Hurty hired Dr. Thomas V. B. Keene and made Knabe the deputy. When Keene left, Hurty made Knabe the acting superintendent, paying her $1,400 annually with promises that she would earn more when she became superintendent.

Over a year later, Dr. Hurty told Dr. Knabe he could not make her superintendent because he did not have enough money in the ISBH budget to pay her the superintendent’s salary and that in any case, a woman shouldn’t expect to be paid the salary of a superintendent.

Meanwhile, Dr. Hurty told friends and colleagues that he was searching for “a real capable man” by recruiting Dr. James P. Simonds as the new superintendent. Hurty offered Dr. Simonds, a Texan, $2,000 the first year and $3,000 in the second — 47% higher than Dr. Knabe’s salary.

When Dr. Simonds published Dr. Knabe’s findings about rabies in the first 1909 Indiana State Board of Health bulletin without crediting her, Dr. Knabe could take no more. She informed the press that she was resigning, citing discrimination and broken promises. A few years later, Dr. Simonds moved on to Chicago and became a professor at Northwestern University’s medical school.

Dr. Knabe moved on quickly from public service and renewed her dedication to individual patient care. She opened her own private practice and continued her rabies research. She treated people for free or accepted payments in goods and services if patients were short on cash; one time she received a piano and lessons in exchange for her medical expertise.

It seems, however, that she missed the collegial environment she had had in the Bacteriological and Pathological Department and the chance to have broad influence on public health practices. When another such opportunity came up, she took it.

In next month’s article Dr. Knabe takes on new opportunities to further the health and welfare of Hoosiers—opportunities she should have turned down …