Gender and Medical Authority in Dana Schwartz’s Immortality

Thematic Claim

In Immortality, Dana Schwartz argues that medical authority in the early‑nineteenth century is a patriarchal construct that systematically excludes women, forcing them to practise in secret, under male pseudonyms, or through indirect influence. Hazel Sinnett’s journey from illicit bonesetter to published physician reveals that true authority remains conditional on gender—even when women possess superior skill and knowledge. The novel neither offers a simple victory nor condemns all male practitioners; instead, it traces how structural resistance and internalised complicity shape women’s access to medicine.

Secret Practice in Edinburgh

Hazel’s first appearances show her working in the shadows. She treats a teenage dockworker, Martin Potter, whose infected arm she resets with “embroidery-honed skill” (Hazel Sinnett). Because she cannot attend medical school, she learns through observation and self‑study. Her patients are the working poor who cannot afford “fancy doctor[s]” and who are willing to trust a young woman despite the gossip that surrounds her.

The danger of her position becomes explicit when she treats “Mary,” a woman who has taken abortifacients. Hazel’s maid Iona warns that a doctor caught helping an abortion risks hanging. Hazel defends herself by saying she “simply treated a woman who came to my house asking for help,” but she knows the law does not recognise her intent. In this world, female medical practice is not just unlicensed—it is criminal. Hazel must keep her work secret, even from some of her wealthy patients, who visit her because she “runs in the proper circles” and therefore seems trustworthy.

The Companions and the Cost of Publication

When the secret society the Companions to the Death invites Hazel to join them, she faces a different kind of negotiation. Marie‑Anne Lavoisier advises her that a woman cannot publish a scientific work under her own name. Marie‑Anne herself has seen her research credited only to her husband, Antoine. She tells Hazel, “It’s still not considered appropriate for a woman to be publishing under her own name. Especially for a work on science.” Hazel initially assumes her treatise will bear her name, but the Companions’ world forces her to see how even the most brilliant women must accept erasure.

Hazel’s response is to write A Treatise on Modern Medicine and to persist in attending medical school after moving to America, where she “would show up … waiting … with an embossed medical bag and a treatise she had written in her lap.” The novel records no easy acceptance; she is turned down “a dozen times” but continues. Her eventual admission is never guaranteed by merit alone—only by endurance.

The Tincture and the Pinkie Finger

The tincture of immortality is a symbol of ultimate authority over life and death, yet it is controlled almost entirely by men or by women acting in their husbands’ shadows. Dr. William Beecham has lived for generations, rewriting his own legacy and using his immortality to evade justice. The missing pinkie finger recurs as a motif: Beecham’s reattached fingers, the loose digits in Hazel’s dreams, the fingers that fall off and must be sewn back with diluted Tincture. These detached body parts literalise the fragmented, unnatural quality of male medical authority—a power that endures through secrecy and violence rather than through ethical practice.

Marie‑Anne, despite her genius, remains within the Companions as the keeper of their secrets rather than the public face of their science. When she shoots Hazel for abandoning the work, she enacts the very patriarchal control she has internalised. Her act is both a revolt and a repetition of the system that first erased her.

Complexity and Contradiction

Hazel repeatedly refuses immortality: “I don’t want to live forever. It’s too … permanent.” She fears watching loved ones die. Yet after Marie‑Anne shoots her, she consumes the Tincture to survive, and she and Jack accept eternal life together. The novel thus acknowledges that women may need to adopt the tools of patriarchal authority—secrecy, longevity, even violence—in order to practise medicine at all.

The epilogue shows Hazel in America, where she eventually gains admission to medical school, but only after waiting outside administrators’ offices for “hours … with an embossed medical bag.” She publishes her treatise as Hazel Sinnett‑Ellis, using her married name—a concession that society still demands a male‑adjacent identity. The final excerpt from the treatise invents a fictional “Alpine blood disorder” to cover her secrets, suggesting that even when she achieves publication, complete transparency remains impossible.

Study Questions and Answers

1. How does Hazel’s early secret practice in Edinburgh illustrate the theme of gender and medical authority?
Hazel treats patients who cannot afford licensed doctors, but she must work in hiding because the law prohibits women from practising medicine. Her success depends on reputation among the poor and on the ignorance of the wealthy, who see her as a “curio” rather than a professional. This double consciousness—skilled but invisible—defines the gap between her ability and her authority.

2. In what ways does Marie‑Anne Lavoisier both challenge and reinforce patriarchal medical structures?
Marie‑Anne conducts original research and controls the Companions’ operations, yet she publishes under her husband’s name and advises Hazel to do the same. Her shooting of Hazel is an attempt to force Hazel to remain within the society’s hidden power structure, thereby perpetuating the very exclusion she herself suffered.

3. Why does Hazel initially refuse the Tincture of immortality, and what does this refusal reveal about her understanding of medical authority?
Hazel refuses because she does not want to “watch the people I love die.” She sees immortality as permanent and isolating. Her refusal shows that she values human connection over endless life—a contrast to Beecham’s and the Companions’ vision of authority as a timeless, detached privilege.

4. How does the symbol of the missing pinkie finger connect to the theme of male medical authority?
The pinkie finger, repeatedly reattached, represents the unnatural maintenance of power by men like Beecham. Hazel dreams of fingers “twitching like insect legs,” linking the body parts to a grotesque, automated control over life. The fact that fingers must be sewn back with diluted Tincture suggests that male authority is only held together through desperate means.

5. Does the novel ultimately suggest that Hazel achieves genuine medical authority, or does it remain qualified?
Her admission to King’s College and her published treatise give her institutional recognition, but she still hides her identity and fabricates a disease to protect her secrets. The final line “She had time” emphasises endurance over breakthrough. Authority remains provisional—Hazel wins a place in the system but cannot fully transform it.