Diana Beck - The First British Woman Neurosurgeon Michael Powell FRCS FRCP
Diana Beck was born in or around 1900 (some sources say 1902) in the ancient Roman city of Chester, in Northwest England, to a family that was both sufficiently wealthy to privately educate her and were prepared to support her in tertiary education, often denied to daughters of wealthy ‘middle class’ families. She chose to study medicine, a tricky route for a woman at that time, but could be studied at the London School of Medicine for Women, in the Royal Free Hospital, then in Fitzrovia, a district of central London. There, she excelled as a medical student, winning many prizes and scholarships, and where she would have undoubtedly have come under the inspirational influence of the redoubtable woman surgeon, Dame Louisa Blake Aldrich, who was the Dean of the Medical School. Graduating, she decided to specialise in surgery, and took a number of junior posts at her medical school, then part of the pathway to a surgical career, including teaching anatomy and becoming a ‘junior dresser’. It is not clear where she went next, although her family believes she headed to Scotland, where her family had originated and medical women were better received. She certainly received the Fellowship of the Royal College of Surgeons (Edinburgh) in 1930, one year before taking the English College exam. At that time, senior surgical posts in England were not open to Scottish College fellows, as the Edinburgh based, Cushing trainee, Norman Dott discovered in 1932 on applying for a new post at the National Hospital, Queen Square, London! In 1938, she won a scholarship sponsored by the Royal Society of Medicine, awarded to women who wished to train in a surgical specialty. For reasons we can only guess at, whilst admiring her courage, she chose neurosurgery – a very lonely and isolated professional life. In the UK at that time, there were only six hospitals with an established neurosurgical service. The dominant two were led by Cushing’s trainees, Geoffrey Jefferson in Manchester, and Hugh Cairns, recently moved from the Royal London Hospital in the East End, to Oxford. At Oxford, along with opening his unit, he had been one of the driving forces to set up the clinical school of medicine , becoming their first professor of surgery. Cairns had wanted to establish formal neurosurgical training along ‘Cushing’ lines - a neurosurgeon needed to study neuropathology and neurology, in order to produce all round competency. Thus, Diana Beck was sent to a major ally of his, the neuropathologist, Dorothy Russell. In her department, Beck impressed, studying intracranial hypertension and superior sagittal sinus thrombosis and experimenting with skull replacement, and the two women became friends. Beck was already in her late thirties, and probably had at least a decade of surgical experience over most British trainees of her era. By 1940, Cairns, who had been appointed as a colonel in the Royal Army Medical Corps to establish a military neurosurgical service, had created the Mobile Neurosurgical Units (MNSU’s). He had scoured the UK’s junior surgeons to staff these units. Needing juniors at home, and with Russell’s encouragement, he allowed Beck to take on training in the OR. Impressing him with her neat competency, Cairns who was a fussy, slow and irritable surgeon, apparently came to rely on her ability and also to enjoy tete a tete’s with the two women, to relieve pressures from his wartime commitments.
In 1943, Jefferson, who had been given the task of staffing emergency civilian hospital neurosurgical units, part of the UK wide ‘Emergency Medical Service’, recruited her to help set up the service in Bristol, the major city in the South West with its important ports and huge aero engine and aircraft manufacturing factories. This city did not have a neurosurgical service, at that point. There, she was able to create a unit with her colleague, George Alexander, a Dott trainee from Edinburgh. She had also been appointed as neurosurgeon to her medical school, although this had been temporarily moved from central London to avoid the Blitz. It is not clear if she ever either had beds to admit patients to or carried out surgery there. In 1947, after the war’s end, she was recruited to the vacant post at the Middlesex Hospital Medical School. This major London school had had surgeons interested in neurosurgery from the early 20th Century, but the brilliant academic surgeon, Peter Ascroft, who had served in the MNSU’s, and had been expected to carry on post war, had taken early retirement in 1947, for unstated reasons. Amazingly, the Middlesex, like the other London medical schools, had never had a woman on the staff in any capacity, making Beck’s appointment, another British milestone. The Middlesex had, at the same time, started to accept women medical students, and one of the first of these (Prof Clara Lowey, endocrinologist at St Thomas’ Hospital Medical School) recalls her as rather quiet woman, although others, whom she was to teach, apparently thought of her as a bit of a martinet. Although attitudes to women in medicine may have been changing for decades and possibly to the present, women have to be seen to excel over men. Diana Beck certainly excelled academically, but she also faced harsh criticism. The slightest perceived slip was viewed unfairly. For example, she treated a famous author, A A Milne, for an intracerebral haemorrhage, Initially feted for her operation on him, she was later castigated as his personality had changed. Few would have pointed out that not only was survival in that era surprising, but character change was far from unusual in those that did. Sadly, Beck was not to last long at the Middlesex. She had developed the debilitating neurological condition of Myasthenia Gravis. An effective treatment for it had just been developed, thymectomy. Undergoing it, she was reported as recovering well when she died on the tenth postoperative day from a pulmonary embolus. She was only fifty-six years old. Diana Beck had been forgotten until a Bristol trainee, Catherine Gilkes, discovered her existence. At the neurosurgical unit in French, she had to dig deep to discover any trace of her, but her research led to the publication of an article, now much cited. Equally, at the Middlesex Hospital Medical School, she had been completely forgotten: this author not only trained there but took ‘her’ post after her successor retired, without ever having any knowledge of her. He had been unaware of a small plaque to her in the hospital chapel. The Middlesex was swept away by health care reorganisation in Central London, but the chapel remains, listed as an historic building, and can be visited to this day. Diana Beck was finally resurrected to public recognition when a London Blue Plaque was erected in her memory, on the exterior of her apartment in Wimpole Street in London’s West End in September 2024. It was unveiled by Britain’s third woman neurosurgeon, Ann Moore; herself a woman who broke through a number of glass ceilings, as President of the Society of British Neurological Surgeons and vice President of the Royal College of Surgeons, England. Curiously, there are few pictures of this remarkable woman. Her portrait was commissioned by her school in Chester, during her life, but there are no formal photographs.
[All News]