Hard work and perseverance put her at the top of her class when she graduated in 1849 (medical schools were two-year programs at this time). Even this excellent academic record did not win her a job at any of the US hospitals she applied to. Taking advice from older colleagues, she moved to Paris, to try her luck there. After many rejections, she applied as a midwife-trainee at La Maternite, in order to continue her education, if not her career.
While caring for an infant with an eye infection, Dr. Blackwell also became infected. Despite quick treatment, and long weeks of bandaged eyes, she became blind in one eye. Because of the nature of the infection, this eye was eventually removed and replaced by one of glass. This loss was more than a blow to vanity; it put an end to her dreams of becoming a surgeon.
Resolved to continue, no matter the obstacle, she moved to London in 1850 and was accepted as an intern at St. Bartholomew's Hospital, one of the most prestigious in the country. After a year there, she returned to the US, settling in New York City. There, she ran into problems with suspicious landlords that did not want to rent office space to a woman, especially one that claimed to be an M.D. When one finally did relent, she was charged three times the normal rent.
In order to increase business, and provide information to the general public, Dr. Blackwell began giving lectures on women's health. In 1853 she opened a clinic for poor women and children in Manhattan. From this point on her career took a steady upward trajectory.
She made some changes in her personal life at this time as well. In 1854 she adopted a little Irish orphan named Kitty Barry; Kitty becomes a lifelong companion, as well as adopted daughter. Elizabeth's sister Emily receives her medical degree, amid much discrimination, and they begin to work together.