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• 1 2018-08-30T21:50:10-07:00 An hidden legacy 15 image_header 2022-11-07T11:46:40-08:00 Despite the shortcomings in the operation of the école d'infirmières et de visiteuses there was an enduring but hidden legacy of the fellowships given to the nursing school in Lyon.
  
  Firstly, within the school itself, the fellows in charge of the health center kept their position from 1931 until the 1950s. This was the only place where the nursing cadre was stable. And, although they worked under the supervision of a physician, these nurses were in a position of responsibility in an important service of the school. It welcomed several thousand patients a year and it was the practical field of public health training for  every  nursing student at the school. Miss Courthial (1928 fellow) was still around in the 1940s and Miss Vallée (also a fellow in 1928) took over  as head of the Health Centre, which she directed until 1958. It was also a place with room to maneuver.  The public health activities that took place in the center had to be invented from scratch, and this invention took place mostly beyond the eyes and control of the hospital and its administrative and medical hierarchy. Ultimately, this was the field where the fellows were able to leave their mark and organize the practical teaching of the school students. Not surprisingly, this was also Crowell’s pride, and a subject of self-satisfaction for the Lyon direction staff. The school in Lyon, they said, was a unique case of a French nursing school that controlled its public health practical training field and therefore was able to implement its own guidelines for the nurse students.
   
  Secondly, it should not be forgotten that the fellows who left the school used the insights of their training abroad to the benefit of other hospitals and public health organisations. In the early 1930s, Hélène Mugnier took over as directress of La Musse, near  Arnières sur Iton, one of the largest  sanatoriums in France. Mrs Fressenon directed several public health nursing services in the French provinces. Miss Bauer occupied  various public health positions, including the direction of the nursing service at the  Office d’Hygiène Sociale in Tunis, and the direction of the Social Insurance branch of the Mutualité Maternelle in Paris later in the 1950s. Mrs Denoël, a fellow initially assigned to become a directress in Lyon, also had creative opportunities when she became directress of a new Red Cross hospital in Paris.
   
   
  By and large, though, the most important impact of the Rockefeller grants to nurses connected with the Lyon school was not the one expected. Especially from the point of view of the American nursing leaders and their Rockefeller sponsors, who were so keen to train educated and emancipated women that would become leaders of a new profession. Whereas the lay fellows and travellers tended to leave  the scene, the 12 religious sisters who held a fellowship, and the 3 chieftains who received travel grants, stayed in the Lyon hospitals until their death. Some were still active in the 1960s.Many sisters who received a fellowship or a travel grant were young, and had been chosen with an eye to their potential for leadership.  Their record is quite impressive by that measure.
  Several played a major role within communities of sisters, and seem to have been recognized as group leaders: when the community of sisters of the new Édouard Herriot Hospital elected its ‘mother’ for the first time, in March 1938, 3 out of  the 4 candidates were former Rockefeller Foundation fellows or travelers. Most of the sisters who had received such support became ward supervisors and head nurses (cheftaines), often in the most prestigious services like the surgical ward of the new Édouard Herriot hospital. This was especially trues for the 11 nurses who went to England in 1925 and 1926. When they returned, they were installed in positions  as instructors in the school, or at/near the head of new model school services in children medicine and gynaecology. This  gave them a pivotal role in the practical instruction of student nurses until 1934, when the new hospital was opened. They trained a large number of nurses,  including not only the students from the school supported by the Foundation, but also dozens of other student nurses that came from private nursing schools in Lyon to get some practical training at the Hospices Civils hospitals.
  In addition, they were a constant presence near the young religious nurses from the Lyon hospitals,  in the special model teaching service that was created for their use in 1927 or later in the dedicated noviciat-école created by no other than Sister Daudet. Besides, some religious fellows  also lectured in other nursing schools in France and beyond, as Sister Walter did at the Red Cross school and at the École Catholique  d’Infirmières in Lyon in the 1930s and 1940s, or Sister Daudet at the nursing school of Freiburg in Switzerland (see "Sister Daudet, or the great diversion" section).
  Tennant and Crowell’s diaries are full of glimpses on the work of these former nursing nuns fellows during the years 1925-1935. Notwithstanding that they were certainly eager to stress how much the fellows were doing good work, their notes also suggest that the religious fellows became a moving force within the hospital. Especially by pressing the cause of training and education of the religious nurses to the hospital authorities, something Frances Elizabeth Crowell welcomed as a confirmation of her initial wager and advocated with those authorities .
   
  
         
   
• 1 2018-08-30T21:50:11-07:00 Lost fellows 13 image_header 2022-11-07T10:28:04-08:00 A reconstruction of the fellows and travellers’ trajectories shows that many of them evaporated from the school rather quickly. A focus on Marie Isaac, the last Lyon nurse who received a Rockefeller fellowship, epitomizes the record of many Rockefeller fellows at the Lyon school. Miss Isaac received her fellowship in December 1937. Elisabeth Crowell's diary entry about her initial interview with Miss Isaac was enthusiast. Indeed, not only did she belong to one of the most important upper middle class families of the city (and was close to Mme Motte-GIllet, the patron of the school), but she also had obtained the two diplomas of hospital and public health nursing, and received some field work training in social activities. Add the fact she had studied English for 6 years and only lacked spoken practice, and Crowell tagged her 'a find'. Indeed, it was a constant concern of her to attract young women of high social status within the nursing sphere of the Foundation work: they were the ones, whe thought, who could help nursing thrive as  profession and  training.
   
   
  The Lyon’s school directress, Miss Roberti reported how Isaac was admired by all other pupils during her school years, and that her very high moral qualities were matched by a perfect balance of character and an unimpeachable behaviour. In other terms, she was the perfect ‘subject’, a classical term used in fellowship parlance.  Her fellowship program was to study methods of teaching nursing procedure and ward administration in the US and Canada, before returning to Lyon to install and supervise the long awaited model school ward in the new hospital opened in 1933, across the street from the École d'infirmières et de visiteuses new building, and from the new building of the School of Medicine (also built with a substantial Rockefeller Foundation grant)
   
  
  Miss Isaac enrolled at the New York Hospital on January 1^st 1938, and worked in different departments from surgery to the outpatient department. She subsequently spent a month at the Western Reserve Nursing School in Cleveland, and at the  Department of Public Health Nursing of the University of Toronto, directed by Kathleen Russell. In those years, the Department seems to have been the most important hub for foreign nursing fellows who visited or studied North America, and Russell was much in sync with the Foundation's nursing officers conception of nursing.  Her North American itinerary was rather typical, but some signs suggest she was not considered as an ordinary fellow. Although  Lépine, the president of the Lyon school governing body, asked for an anticipated return date so that he could substitute a departing instructor, Crowell did not cave and Isaac only came back to Lyon in due time at the end of November 1938.
  
  She immediately took charge as  instructor and supervisor of studies. But the model school service she was to head was never set up. Isaac remained on the Foundation's radar, though. In March 1941, although the Foundation had dramatically decreased its activities in European countries now occupied by Nazi Germany,  the governing board of the École d’Infirmières et d’assistantes du service social  de Lyon et du Sud Est proudly reported that Miss Isaac had been invited by the Rockefeller Foundation to be the assistant director of a new nursing school to be opened in Lisbon, Portugal. The sudden death of the current directress of the Lyon school changed these plans, and Miss Isaac stayed in Lyon as directress. The efforts deployed by Crowell between 1922 and 1938 were crowned, so it seemed:  a former fellow, member of the local upper class and trained in North America, was taking the reigns of the school. But it did not happen.
  In  July 1942,  Miss Isaac married Doctor Jean Nova and left her nursing career . Not a rare case when you look at the fate of the hundreds of nursing fellows supported by the Rockefeller Foundation between 1915 and 1971. But a blow for the Lyon school.  Not only the ‘gem’ was not able to fulfil the original plan that presided over the granting of her fellowship, but she eventually worked no more than 4 years for the school.
   
  Like Isaac, other fellows at the Lyon school got married or found new positions. The teaching staff of the school was indeed very volatile and had to be reconstituted several times over the years. In different instances, Crowell blamed the reluctance of French girls to leave home as a factor in explaining the difficulty to find suitable French candidates for Rockefeller fellowships. Elsewhere, she also indicted 'the attitude of the average French nurse towards institutional work and above all school work' that made it so difficult to find, prepare and keep an adequate teaching staff (Rockefeller Archive Center, Rockefeller Foundation papers, RG 12.1, Crowell’s diary, 20 November 1933).
  
   
  But she knew well that other reasons were at play to explain why fellows were routed away from school work. Take Madame Fressenon, for instance, who spent 16 months in the USA and Canada in 1926 and 1927, her program of study  being designed for her to become the director of the new health centre (follow Madame Fressenon's program on Google Maps here). The catholic authorities of Lyon disapproved of her for moral reasons, although it is not known what was the feared impact of this middle-aged widow on the young religious and lay pupils of the nursing school. Or consider Madame Denoël, who was to be appointed directress  in 1931, and balked at management difficulties when faced with the uncertainties about the availability of the new school building. Miss Crowell blamed it on her egotism, and on an excessive sense of  the prerogatives of the Englihs matrons and the US superintendents of training schools: training people into higher standards sometimes turned out to be a sour experience.
  Some other fellows were shrewdly misappropriated by local partners of the Foundation, and their fellowship or travel grant seem to have been  a tribute paid by the Foundation to its local allies.  Marthe Jouffray, a school graduate and protégée of Mrs Motte Gillet, was one of these "perks". She received a travelling grant to visit public health activities in the USA:  East Harlem, Providence and Alabama were on her list. On her return, she joined the Fondation Franco-Américaine pour la Sauvegarde de l'Enfance  ( for more, in addition to this newsreel about the Fondation franco-Américaine work,  see Hervé Joly, Les Gillet de Lyon. Fortune d'une grande dynastie industrielle (1838-2015), Genève, Droz, 2015, chapter 13). This child welfare organisation was run by Lépine and Madame Gillet-Motte, the two major forces that made it possible for the school to be set up in 1923.
  Miss Jouffray became the director of the Franco-Américaine. Even if the Fondation Franco-Américaine was associated with the school, being its practical field for students being trained as child visitors, Jouffray  was not a  member of the school staff. Marguerite Michel, who had been sent on a fellowship in France and Belgium to become an instructor at the new health centre, followed a similar path after a few months working as instructor in the school. She ended up her career as a director of the Fondation Franco-Américaine in the 1950s. Lépine also appropriated a fellow as a head nurse in his own ward at Hopital Edouard Herriot. Such diversions of resources made it hard for Elizabeth Crowell to feel that the school was slowly building up as an institution.
   
• 1 2018-08-30T21:50:10-07:00 Hitting the glass ceiling 5 image_header 2022-03-08T09:32:18-08:00 But there was more. There was something specific to the Lyon school  that drove out  several fellows or travellers  with managing responsibilities.  The trajectory of  Miss  Hélène Mugnier, one of the first French nurses sent to London for training in the summer of 1922, provides the first clues as to the configurations of power that ultimately prevented  the fellows from leaving their mark on the Lyon school.
   
   
  It was in the Spring of 1923 that Crowell ‘set the wheels in motion’ for Mugnier to  become directress of the Lyon school.  When the school was inaugurated in the Fall, Mugnier was in charge of running the school with the support of Georgette Bauer, the other French nurse sent to London with a fellowship in 1922 (Bauer was hired in Lyon  as assistant-directress). At  Crowell's initiative and despite some reluctance from Mme Motte-Gillet, Mugnier went to England and the United States and Canada in 1926 (and recounted her experience at a  Congress of French nurses). Crowell organized this new fellowship  with the idea that this would strengthen Mugnier's managing capacity and expand her vision. However,  Mugnier eventually resigned in 1929, after a bitter showdown with Professor Lépine and a couple of disease / burn out leaves. A couple of interim directresses took charge until 1933, when a new, permanent directress was hired,  Miss Roberti.
  
  Crowell again embarked on ‘building her up’, one instance of that counseling and mentoring work being the tour of  Rockefeller Foundation supported European nursing centres that  Crowell and Roberti made together in the Spring of 1935. Elizabeth Crowell came out even a  stronger supporter  of Roberti, but the latter resigned from her position in the Fall of 1938. It was not only the directresses who found it hard to stay in charge in Lyon. Marguerite Ducroux, a 1928 fellow and instructor at the school, resigned in May 1929. Crowell was well aware of the difficulties that caused this resignation and showed no hard feelings, offering her help for guidance and advice. Other fellows like Hélène Rioux (a fellow in 1937) or Jeanne Coutagne, who had received a travelling grant in 1934, also resigned.
  
  The reason behind all these difficulties and departures seems to have been  the unwillingness of Dean Lépine, who presided the school Comité Directeur (Executive Board), to yield power to the directresses and staff of the school. Lépine, professor of Medicine and Dean of the Medical School, was in favour of higher standards in nursing education, and this was one of the reasons of his early and committed cooperation with the Rockefeller Foundation in this field since the Great  War. But he did not support the women’s empowerment side of the issue. As suggested by some of his positions as a member of the Hospices Civils Governing body, he was hostile to the idea that women physicians would get supervising responsibilities in hospitals. His ideal of nursing, though it was never formulated explicitly, might have been as mostly the provision of informed, effective and obedient subalterns to physicians in and out of the hospital. In any case, he was not willing to give leeway to the directresses of the school, which school regulations placed very strictly under the control of the Comité Directeur which he chaired. The directress was not even part of this committee.
  
  Alhough Crowell was not a staunch feminist, considering some hints in her diary, she was keen to have nursing schools run by women nurses with a high salary and the power to decide about educational issues. This proved impossible in Lyon, where Lépine did his best to keep the reigns in his hand, while the Comité Directeur, especially its ‘ladies bountiful’ committee led by Léonie Motte Gillet, constantly checked the directresses’ activities. In Lyon, Rockefeller fellows and travellers hit a wall  of male, medical  and class control: while practical aims of increased technical ability were certainly achieved by the provision of fellowships and other means, the social goal of turning nursing into a profession for women  and led by women was not fulfilled.