- Email: [email protected]
Dame Janet Maria Vaughan (1899–1993)
PIONEERS AND PATHFINDERS Dame Janet Maria Vaughan (1899–1993) David J. Weatherall
J
ANET VAUGHAN, ONE of the 6 women who were selected by the British Broadcasting Corporation in 1984 to appear in its series “Women of Our Century,” was one of the major figures in the development of hematology before the Second World War, both the science and organization of blood transfusion during the war, and the fields of bone metabolism and postgraduate education after the war. Janet was born on 18th of October 1899 to a family with a strong medical background including a great-great uncle, Henry Vaughan, who was physician to George III and IV, William IV, and Queen Victoria and also President of the Royal College of Physicians. Schools for young ladies at which she was educated, and at which her father was told that she was too stupid to be worth educating, did not prepare her for Oxford entrance examinations. However, despite this inauspicious start, she gained entrance to Somerville College in 1919 and later to University College Hospital, where she qualified in medicine in 1924. She showed an early interest in the hospital laboratory and the wards and, after her junior hospital posts, became a Leverhulme Research Scholar at the London Hospital. This was a particularly exciting time in the development of hematology, particularly because of the work of George Minot and William Castle in Boston on the partial correction of pernicious anemia by the use of liver extracts. Janet became involved in testing different extracts prepared by the Medical Research Council and drug companies, work that led to a successful DM thesis (for DM read MD; Oxford degrees never follow conventional usage). In 1929, Janet received a Rockefeller Travelling Fellowship to work with George Minot at the Thorndike Memorial Laboratory in Boston. She spent a stimulating year working with Minot and Castle and traveling to hematology centers round the States, where she met many American hematologists including Thomas Cooley, who described what was then called Cooley anemia and, later, thalassemia. On return from the United States, she established herself at the London Hospital and held
a Beit Fellowship for 3 years, working both in the clinic and research laboratory. In 1934, Janet moved to the Postgraduate Medical School at the Hammersmith Hospital, where she taught hematology, ran the hematology and blood transfusion services, and carried out a wide range of research, characterizing and trying to define the basis for a variety of anemias. Her book, The Anaemias, first published in 1933, with an extended edition in 1936, bears witness to the breadth and depth of her interests and her quite remarkable insight. There are 3 chapters dealing with deficiency anemias; others include dyshemopoietic anemias, unexplained dyshemopoietic anemias, hemolytic anemias, and unclassified anemias. It is fascinating to browse through this book today, particularly the large amount of personal material that it includes as well as some extraordinarily insightful conclusions for the time about the nature of hemopoiesis and its disorders. It was this book, together with her growing reputation, that attracted many young hematologists to work with her at the Hammersmith at that time, including John (later Sir John) Dacie. At the onset of the Second World War, Janet was seconded as medical officer in charge of the North West London Blood Supply Depot at Slough. She had the remarkable insight to anticipate the conditions that might arise after widespread injury to large civilian populations and became the leader of the group of pathologists who organized the blood transfusion services. With characteristic foresight, the then Secretary of the Medical Research Council, Sir Edward Mellanby, insisted that the Depots included research programs into the pathophysiology of hemorrhage and shock
From the Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK. Address reprint requests to David J. Weatherall. E-mail: [email protected] 0887-7963/08/$ - see front matter doi: 10.1016/j.tmrv.2008.02.003
Transfusion Medicine Reviews, Vol 22, No 3 (July), 2008: pp 243-244
243
244
and its management alongside with their service commitments. During this period, she studied the optimum conditions for the collection, preservation, and administration of blood and helped to define the role of plasma and serum for the resuscitation of the severely wounded. Her influence on the provision of transfusion services during the London Blitz cannot be overemphasized. Immediately after the war, she went on a trip to Europe sponsored by the MRC to try to define the value of protein hydrolysates in the treatment of the cases of gross starvation that had been encountered in the concentration camps. She concluded that hydrolysates and other forms of parenteral replacement were of little value compared with frequent small meals by mouth. As well as these activities, she also played a major role on a number of important committees that set the scene for the development in medical education in the postwar period. After the war, Janet moved back to Oxford as Principal of Somerville College, where she did much to lift the status of the women's colleges while, at the same time, playing a major role on national committees directed at the further development of medical education and of the universities in general. She was a major proponent of the importance of science in medical education. Despite being a Head of House in Oxford, there was no way that Janet was going to give up her research activities. Initially, she pursued her clinical interests with Leslie Witts, Nuffield professor of clinical medicine, and Sheila Callender, the distinguished physician and hematologist. However, the Nuffield department had no space to offer her, and so, in 1947, she obtained a grant from the MRC to form a small interdisciplinary group to investigate the biological effects of bone-seeking isotopes. This work was carried out first in the Nuffield Institute for Medical Research in the Radcliffe Observatory, but later, her team moved to the Churchill Hospital. Janet's team made a major contribution to an understanding of the behavior of isotopes in bone and the spectrum of isotopes involved, work that led to an understanding of several aspects of bone metabolism and also provided valuable information about the potential hazards of nuclear warfare and the nuclear industry. She published widely in this field and, after her retirement, wrote several important monographs on the physiology of bone and the effects of irradiation on the skeleton. Janet's work was widely recognized. She was elected fellow
DAVID J. WEATHERALL
of the Royal College of Physicians in 1939 and fellow of the Royal Society in 1979 and received honorary degrees from 5 British universities. She received the Order of the British Empire in 1957. What kind of woman was this who could pack so many contributions to science, clinical care, and education into a lifetime and, at the same time, manage to have a rewarding family life with an extremely happy home? When I was first introduced to her in the early 1970s by my friend and colleague Sheila Callender, she was already a legend and rather a terrifying one at that. However, the undoubted aura of authority was soon forgotten in light of her extraordinary energy and enthusiasm for discussing almost any aspect of science and her deep concern about postgraduate education and the way it was moving. Sheila described her as a remarkably good clinician, who, despite her fame, had managed to develop extremely good personal relationships with her patients while she worked in the Radcliffe Infirmary. In fact, Sheila's only advice to me was that the one thing not to do was to take on Janet as a patient. She was, said Sheila, the most impossible patient that she had ever encountered, a remarkable compliment from somebody who had had to look after the strange inhabitants of Oxford University for so many years. However, as in all things, Janet knew exactly where she was going; her physicians were not going to stand in her way. Enthusiasm for her work, and her fearsome intellect, showed no decline with aging, and she remained active until ill-health finally took its toll. In short, Janet Vaughan was one of the major figures in the evolution of hematology in the period running up to the Second World War, an equally important figure in the development of blood transfusion services, particularly at times of crisis during the war, and a major force in postgraduate education and bone research in the postwar period. The BBC chose well when they included her among the Women of the Century. ACKNOWLEDGMENT
Many of the details of Janet's early life were obtained from an excellent account of her life and work by Maureen Owen (Biographical Memoirs of Fellows of the Royal Society, 41, 483-498, 1995). Dr Sheila Callender told the author a great deal about her later career. The author thanks Liz Rose for help in preparing this essay.
J
ANET VAUGHAN, ONE of the 6 women who were selected by the British Broadcasting Corporation in 1984 to appear in its series “Women of Our Century,” was one of the major figures in the development of hematology before the Second World War, both the science and organization of blood transfusion during the war, and the fields of bone metabolism and postgraduate education after the war. Janet was born on 18th of October 1899 to a family with a strong medical background including a great-great uncle, Henry Vaughan, who was physician to George III and IV, William IV, and Queen Victoria and also President of the Royal College of Physicians. Schools for young ladies at which she was educated, and at which her father was told that she was too stupid to be worth educating, did not prepare her for Oxford entrance examinations. However, despite this inauspicious start, she gained entrance to Somerville College in 1919 and later to University College Hospital, where she qualified in medicine in 1924. She showed an early interest in the hospital laboratory and the wards and, after her junior hospital posts, became a Leverhulme Research Scholar at the London Hospital. This was a particularly exciting time in the development of hematology, particularly because of the work of George Minot and William Castle in Boston on the partial correction of pernicious anemia by the use of liver extracts. Janet became involved in testing different extracts prepared by the Medical Research Council and drug companies, work that led to a successful DM thesis (for DM read MD; Oxford degrees never follow conventional usage). In 1929, Janet received a Rockefeller Travelling Fellowship to work with George Minot at the Thorndike Memorial Laboratory in Boston. She spent a stimulating year working with Minot and Castle and traveling to hematology centers round the States, where she met many American hematologists including Thomas Cooley, who described what was then called Cooley anemia and, later, thalassemia. On return from the United States, she established herself at the London Hospital and held
a Beit Fellowship for 3 years, working both in the clinic and research laboratory. In 1934, Janet moved to the Postgraduate Medical School at the Hammersmith Hospital, where she taught hematology, ran the hematology and blood transfusion services, and carried out a wide range of research, characterizing and trying to define the basis for a variety of anemias. Her book, The Anaemias, first published in 1933, with an extended edition in 1936, bears witness to the breadth and depth of her interests and her quite remarkable insight. There are 3 chapters dealing with deficiency anemias; others include dyshemopoietic anemias, unexplained dyshemopoietic anemias, hemolytic anemias, and unclassified anemias. It is fascinating to browse through this book today, particularly the large amount of personal material that it includes as well as some extraordinarily insightful conclusions for the time about the nature of hemopoiesis and its disorders. It was this book, together with her growing reputation, that attracted many young hematologists to work with her at the Hammersmith at that time, including John (later Sir John) Dacie. At the onset of the Second World War, Janet was seconded as medical officer in charge of the North West London Blood Supply Depot at Slough. She had the remarkable insight to anticipate the conditions that might arise after widespread injury to large civilian populations and became the leader of the group of pathologists who organized the blood transfusion services. With characteristic foresight, the then Secretary of the Medical Research Council, Sir Edward Mellanby, insisted that the Depots included research programs into the pathophysiology of hemorrhage and shock
From the Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK. Address reprint requests to David J. Weatherall. E-mail: [email protected] 0887-7963/08/$ - see front matter doi: 10.1016/j.tmrv.2008.02.003
Transfusion Medicine Reviews, Vol 22, No 3 (July), 2008: pp 243-244
243
244
and its management alongside with their service commitments. During this period, she studied the optimum conditions for the collection, preservation, and administration of blood and helped to define the role of plasma and serum for the resuscitation of the severely wounded. Her influence on the provision of transfusion services during the London Blitz cannot be overemphasized. Immediately after the war, she went on a trip to Europe sponsored by the MRC to try to define the value of protein hydrolysates in the treatment of the cases of gross starvation that had been encountered in the concentration camps. She concluded that hydrolysates and other forms of parenteral replacement were of little value compared with frequent small meals by mouth. As well as these activities, she also played a major role on a number of important committees that set the scene for the development in medical education in the postwar period. After the war, Janet moved back to Oxford as Principal of Somerville College, where she did much to lift the status of the women's colleges while, at the same time, playing a major role on national committees directed at the further development of medical education and of the universities in general. She was a major proponent of the importance of science in medical education. Despite being a Head of House in Oxford, there was no way that Janet was going to give up her research activities. Initially, she pursued her clinical interests with Leslie Witts, Nuffield professor of clinical medicine, and Sheila Callender, the distinguished physician and hematologist. However, the Nuffield department had no space to offer her, and so, in 1947, she obtained a grant from the MRC to form a small interdisciplinary group to investigate the biological effects of bone-seeking isotopes. This work was carried out first in the Nuffield Institute for Medical Research in the Radcliffe Observatory, but later, her team moved to the Churchill Hospital. Janet's team made a major contribution to an understanding of the behavior of isotopes in bone and the spectrum of isotopes involved, work that led to an understanding of several aspects of bone metabolism and also provided valuable information about the potential hazards of nuclear warfare and the nuclear industry. She published widely in this field and, after her retirement, wrote several important monographs on the physiology of bone and the effects of irradiation on the skeleton. Janet's work was widely recognized. She was elected fellow
DAVID J. WEATHERALL
of the Royal College of Physicians in 1939 and fellow of the Royal Society in 1979 and received honorary degrees from 5 British universities. She received the Order of the British Empire in 1957. What kind of woman was this who could pack so many contributions to science, clinical care, and education into a lifetime and, at the same time, manage to have a rewarding family life with an extremely happy home? When I was first introduced to her in the early 1970s by my friend and colleague Sheila Callender, she was already a legend and rather a terrifying one at that. However, the undoubted aura of authority was soon forgotten in light of her extraordinary energy and enthusiasm for discussing almost any aspect of science and her deep concern about postgraduate education and the way it was moving. Sheila described her as a remarkably good clinician, who, despite her fame, had managed to develop extremely good personal relationships with her patients while she worked in the Radcliffe Infirmary. In fact, Sheila's only advice to me was that the one thing not to do was to take on Janet as a patient. She was, said Sheila, the most impossible patient that she had ever encountered, a remarkable compliment from somebody who had had to look after the strange inhabitants of Oxford University for so many years. However, as in all things, Janet knew exactly where she was going; her physicians were not going to stand in her way. Enthusiasm for her work, and her fearsome intellect, showed no decline with aging, and she remained active until ill-health finally took its toll. In short, Janet Vaughan was one of the major figures in the evolution of hematology in the period running up to the Second World War, an equally important figure in the development of blood transfusion services, particularly at times of crisis during the war, and a major force in postgraduate education and bone research in the postwar period. The BBC chose well when they included her among the Women of the Century. ACKNOWLEDGMENT
Many of the details of Janet's early life were obtained from an excellent account of her life and work by Maureen Owen (Biographical Memoirs of Fellows of the Royal Society, 41, 483-498, 1995). Dr Sheila Callender told the author a great deal about her later career. The author thanks Liz Rose for help in preparing this essay.