- James Barry was a senior army surgeon of the Regency and Victorian eras, and also a woman in disguise.
- ‘He’ wasn’t identified as Margaret Ann Bulkley, an Irish debtor’s daughter, until 2008.
- Barry performed the first successful Caesarian section in European medicine.
- His reforms on the living conditions of soldiers make him a pioneer in what is now called public health.
While not everyone thought fondly of Barry, he left behind many friends and admirers. He had been one of the most senior surgeons in the British army, even holding the post of Inspector General until he lost it by upsetting the governor of St Helena. Whatever mixed feelings he may have inspired in life, a military funeral was his due.
The task of laying out the body was assigned to a charwoman called Sophia Bishop. She probably didn’t relish the task, but she did her duty and stripped the body. Her reaction remains unrecorded, but it’s safe to assume that she blinked a few times. Before her lay the body of an army veteran of over forty years and one of the most distinguished clinicians in history.
Before her lay the body of a woman.
A bad day for Dr McKinnon
Sophia Bishop was not a woman to be easily silenced. She sought out Major DR McKinnon, Barry’s doctor in his final years, and informed him that he was a ‘pretty doctor’ for not even noticing that his patient was a woman. What’s more, she told him, she was the mother of nine children and knew stretch marks when she saw them.
McKinnon’s consternation oozes out of his letter to George Graham of the general registry office. He reports his conversation with Bishop, even though it must have been deeply embarrassing to him and to the British army. He suggested that Barry may have been an ‘imperfectly formed man’, giving rise to speculation that he may have been intergendered that has never been discounted. However, there was no post mortem, so Bishop’s was the only examination of the body. If she said she saw a woman who had been pregnant, there is no evidence to contradict her.
The army reacted swiftly, burying Barry in Kensal Green cemetery and sealing any potentially embarrassing records. Sealing Sofia Bishop’s mouth must have been a harder task, but someone evidently did it because it wasn’t until the 1950s that historian Isobel Rae came across the documents revealing Barry’s gender. By then, James Barry had been honoured with the ‘Barry Room’, one of the reading rooms in the Royal Army Medical College. Generations of trainee surgeons had pored over their texts with no idea that the room honoured a woman.
An Irish storyThe identity of the woman who lived her life as James Barry remained a mystery until a few years ago when Hercules du Preez, a retired South African urologist, set about tracking down his origins. Du Preez followed the trail back to 1789, when one Margaret Ann Bulkley was born to a merchant’s wife in Cork, Ireland. Margaret might have lived an unremarkable life had it not been for the marriage plans of her feckless brother, John. Their father, Jeremiah, put himself in a debtor’s prison to finance John’s plans to marry upward in society, leaving Margaret and her mother destitute.
Margaret’s mother threw herself on the mercy of her only wealthy relative, her brother James Barry who was a moderately successful painter living in London. Barry brought Margaret and her mother to join him and while brother and sister never got on well, he provided for them. He died intestate a couple of years after they arrived, so Margaret’s mother received half his fortune. It did not make the Bulkleys rich, but it did make them self-sufficient.
Of equal importance for the direction Margaret’s life would take, Barry introduced Margaret to his radical friends. His set included the writer and philosopher William Godwin, who continued to promote the ideals of gender equality laid out by his late wife, Mary Wollstonecraft, in A Vindication of the Rights of Woman. In an age when the highest aspiration of a young woman on the edge of gentility was a few years as a governess and then marriage, Margaret was tutored in Latin by physician Edward Fryer and spent hours reading in the large library of General Francisco Miranda, a Venezuelan revolutionary exiled to London.
A conspiracy of gender and revolution
Margaret must have impressed her new friends because she became the centrepiece of a conspiracy. She was to become the first woman in Britain to qualify to practice medicine. There was a problem: women were not admitted to universities. The solution was simple: Margaret would disguise herself as a man.It is not known whether Margaret conceived the idea itself or one of her radical friends suggested it to her. In either case, we can only guess at her feelings when, on either the 28th or 29th November 1809, she left Margaret Ann Bulkley in her family’s London house and walked out of the door as James Miranda Steuart Barry. The young man boarded a ship for Edinburgh with his ‘aunt’ in attendance, where he took up a place at Edinburgh University’s medical school.
The name was obviously chosen to honour Margaret’s benefactors, including her late uncle James Barry, General Miranda and Lord Steuart Buchan, another member of Godwin’s set who was involved in the James Barry conspiracy. The location, Edinburgh, was presumably chosen as a place where neither the Barrys nor the Bulkleys were known.
What the James Barry conspirators planned once Barry had graduated is not known, but Margaret probably didn’t intend to leave her childhood identity behind forever. By the time James Barry boarded her ship, Miranda was establishing Venezuela as an independent republic, free from the Spanish empire. The plan was probably to reveal the deception once Margaret qualified as Barry, demonstrating that a woman was perfectly capable of qualifying as a doctor if she were allowed to train. She would be barred from practicing in Britain, but Dr Bulkley would be welcomed in Miranda’s egalitarian Venezuela.Plans based on revolution are rarely dependable and Miranda was defeated and imprisoned in 1812, shortly before James Barry’s graduation and entry into the Royal College of Surgeons. Margaret Bulkley was faced with a choice which her London supporters presumably left to her. She could reveal her true identity and throw away three years of study for the constrained life of a scandalous woman, or she could abandon Margaret Ann Bulkley forever and live out her life as James Barry.
Petticoats or redcoats?
She chose the latter, and with it, the task of building a career. In 19th century Britain, a surgeon was simultaneously a gentleman and a tradesman. He was accepted into the society of the upper class, but made his living by being paid for services that no gentleman would name a price for. Starting a practice with no connections and no experience was no easy task, even though Barry’s academic credentials were impressive.
One place where there was no shortage of places for untried young surgeons was the army. In 1812, the British army was stretched across the largest empire the world has ever seen, was engaged in a long and bloody campaign against Napoleon’s armies in Spain and had just begun a war in North America against the fledgling United States. The army needed surgeons, and soldiers couldn’t complain if they were a novice’s first patient.
How Barry finessed the army’s medical examination, which would have entailed being stripped naked, is not recorded. He – and from this point on, he lived as a ‘he’ – probably brought letters of certification from Fryer or one of his sympathisers and avoided it altogether. However he did it, he was accepted into the army and spent several years serving in Britain before being posted to Cape Town in 1815.Call of the Cape
Barry spent 14 years in Cape Town, the longest posting in a career that took him around the world. He established what was to become the pattern of his life: he was a superb surgeon, he advocated for what would now be called public health, he made many close friends and he quarrelled constantly with his superiors.
Cape Town was then the capital of the Cape Colony, which roughly corresponds to the western half of modern day South Africa. Barry established himself as a doctor with a much better bedside manner than most of his contemporaries, showing kindness and respect to soldiers who received very little of either. He recommended improvements in sanitation and made the recently invented smallpox vaccine to Cape Town some 20 years before it was widely used in Britain.
Barry developed an interest in gynaecology and obstetrics, which was unusual at a time when the men of the medical profession were inclined to literally avert their eyes from the arcana of the female anatomy. Women were often asked to point out their symptoms on charts to spare them the indignity of being examined.
It was that interest that led to Barry’s crowning achievement as a surgeon, when he performed a Caesarian section on merchant’s wife called Mrs Munnik. At a time when childbirth was so dangerous that the word ‘delivery’ meant not the delivery of the child into the world but the delivery of the mother from the dangers of childbirth, the aim of the Caeasrian was considered to be to salvage the child from a dead or nearly dead mother. James Barry changed that by saving the lives of both Mrs Munnik and the child that was christened James Barry Munnik in his honour. It took some time for word of Barry’s achievement to spread, but Caesarian sections ceasedto be inevitably fatal for the mother.
James Barry Munnik plays a further role in the James Barry story, as his family was presented with a miniature portrait of Barry painted between his graduation and his arrival in Cape Town. It shows us the fair haired, fair skinned young ‘man’ he must have been.Ladies, gentlemen and duellists
On a personal level, Barry was well liked by officers’ wives and soldiers alike, although the former occasionally got him into trouble. His apparent intimacy with the wife of a Captain Cloete led to a pistol duel in which Barry was wounded in the thigh. His stoicism must have drawn the admiration of the colony when he refused medical aid but insisted on dressing his own wound. He was back in Cape society within a few days, and became firm friends with Cloete.
Another part of Barry’s pattern lay in his inability to get on with the surgeon-general of the colony, though his enmity and perhaps his interest in obstetrics endeared him to the colony’s governor, Lord Charles Somerset, who blamed the surgeon-general for his wife’s death in childbirth. Barry and Somerset were so close that an ‘improper relationship’ was suggested. It would probably be a mistake to read too much into that as empty gossip must have flown constantly round remote colonial outposts such as Cape Town was at the time.
Surgeon to the empire
Barry left Cape Town in 1828 and was posted to Jamaica a year later, where he continued to advocate that the best way to keep soldiers healthy was to improve their living conditions. It was in Jamaica that he met his manservant, John, who would attend him for the rest of his life.
A few months after he arrived, Barry visited London without having applied for leave. He was summoned to the offices of his superior, James McGrigor, for an ‘interview without tea’, more colloquially known as a bollocking. McGrigor asked what he was playing at and Barry, rising to authority as always, said he couldn’t get a decent haircut in Jamaica. McGrigor took it no further.As Barry was posted from one outpost to another, John must have contributed to a rather eccentric looking entourage. Barry would only eat goat’s cheese, so he took a goat with him wherever he went. He also had a succession of dogs through his life, all called Psyche. In Greek mythology, the nymph Psyche wandered the earth looking for her lost love and became a servant of the goddess of love. Perhaps Barry saw some reflection of his own situation, wandering the world and unable to fall in love, in Psyche’s story. Or perhaps he just liked the sound of it.
Most of his career took place in the relative peace of the post-Napoleonic world. There were constant colonial conflicts but no major wars until 1853, when Britain, France and the Ottoman empire invaded the Crimean peninsula on Russia’s Black Sea coast. By then, Barry was one of the most senior surgeons in the army with a rank equivalent to Brigadier-General. He was posted to Corfu to set up a hospital to receive wounded troops evacuated from the Crimea itself. Middle age had not mellowed Barry, whose gifts as a surgeon gave his hospital a mortality rate of below 5%, which was extraordinarily low at the time.
Nor had he lost his talent for annoying the wrong people.
James Barry and Florence Nightingale
When Barry visited the Crimea itself, he naturally took an interest in the infamous field hospital at Scutari where Florence Nightingale was bringing order to a particularly hideous form of chaos. Barry and Nightingale had much in common. They both advocated for improvements in the living conditions of soldiers, they were between them laying
the foundations for the medical discipline of public health and, although only one of them knew it, they were among the most important women in medical history.
They hated each other on sight.Nightingale’s biggest contribution was the application of mathematics to medical practice, developing statistical techniques that are still used in modern epidemiology. She applied those techniques to her organisation of the Scutari hospital, and to the living conditions of soldiers more generally. While she is known to posterity as ‘the lady with the lamp’, perhaps because nursing better suits popular perceptions of Victorian womanhood than mathematics and organisation, the War Office at the time recognised her ability and accorded her considerable influence.
In his brief biography of Barry, Robert Leitch suggests that getting on the wrong side of Nightingale’s influence hindered Barry’s career and led to his reforms receiving less recognition than it deserved. It’s impossible to say, and Nightingale was only one of many influential people who rolled their eyes at the mention of Barry’s name. It’s also possible that Barry recognised that his talents better suited him to the field than to politics, so he spent his career applying reforms and practicing medicine around the world rather than building career and influence at the seat of power in London.
A legacy of questions
Whatever the reason, the end of the Crimean War saw Barry posted to Canada in 1857. He continued to apply his reforms on behalf of soldiers and presumably annoyed yet more influential people while he was at it. Advancing age caught up with him before long, and he retired to London until he fell afoul of the 1865 dysentery epidemic.While Du Preez’s 2008 paper answers many questions about Barry’s early life, many more remain. Was there no one who knew what lay under Barry’s uniform, or were there trusted friends who knew the secret? His long association with John, his Jamaican manservant, suggests that John at least might have known and been trusted. From the perspective of a century and a half after Barry’s death, it’s impossible to tell.
Above all, what to make of those stretch marks? Could a woman living as a man hide a pregnancy? Was the child carried to term, and if so, what became of it? Was that the real reason for Barry’s return to London from Jamaica in search of a decent haircut? If there was anything in it at all, who was the father? We will probably never know.
The great legacy of a great deception
James Barry was the first woman licenced to practice medicine in Britain. The second didn’t follow until 1865, the year of Barry’s death, when Elizabeth Garret Anderson fought her way through the systemIf you have ever been admitted into a hospital and noticed the without disguising her identity. Yet Barry’s legacy lies not in the truth of his gender, which wasn’t known until women had been admitted to medical school for decades. It lies in his medical achievements, both in developing obstetric techniques like Caesarian sections, and in reforms that made soldiers, as well as prisoners and lepers, less dependent on a medical profession that was less than dependable at the time.cleanliness around you, and left without having contracted a new infection, you owe a debt of gratitude of James Barry, aka Margaret Ann Bulkley.
What we cannot know is when and why she decided she would never be Margaret Ann Bulkley again but would live the rest of her life as James Barry. What do you think? Please share your thoughts in the comments.