HISTORY OF PEDIATRIC RHEUMATOLOGY

REMEMBERING BARBARA (#3)

Excerpts from “Remembering Barbara”: Tributes to Barbara Ansell, CBE 1923-2001

Used with the permission of Patricia Woo from the collection of memories compiled by Patricia Woo, Bobbie Jarvis, and Alan Craft.

Peter Hollingsworth

Rheumatologist, Bristol, UK

We remember Barbara because she had an impact on each of our lives; Such an impact that we can usually remember our first encounter with her. She announced on my first day as a locum at Taplow that I was going to be her senior registrar and added (can’t you hear her now?) “I am never wrong”. This absolute certainty that surrounded her obsession with rheumatology set her apart as a true eccentric. Someone observed that, if she landed on the moon, she would pick up pebbles and look for erosions. Engrossed in some lecture, she paused mid-sentence, then out came the word “semi-colon”. That obsession lies at the nub of nearly every funny story we tell each other about her; we are repeatedly amazed that anyone could be that outspoken. She never allowed herself the luxury-or vulnerability-of wallowing in any setback in life: “There is no emotional problem you can’t get around by hard work”. And her obsession sometimes made her intolerant of those who did not share it.

What drove her? Someone said that rheumatology “was her baby”. But if rheumatology was her family, then we are her children, and I do believe that she loved us and most of our memories are marked with laughter. Her obsession has changed the face of paediatric rheumatology throughout the Western world. Its development in Europe and North America can be traced largely back to her. At her retirement, she dispatched the first wave of her trainees throughout the U.K. like apostles spreading the word. The second wave has been prodigious: just look at the number of those wonderful, enthusiastic, young pediatric rheumatologists. Our duty is to spread the word to every part of the world.

Right now, she won’t be among the saints, but St. Peter certainly wouldn’t have dared to deny her access to heaven. And when our time has come, and those gates close behind us with the air filled with such sweet music, we should not be surprised to hear it shattered by that familiar bark, “Come on in, sit down and tell me all the gossip”.

Barbara, thank you. And, in case we didn’t tell you before, we do love you.

Bobbie Jarvis

Physiotherapist, now Rehabilitation Manager

I met Barbara in 1970 when she was dictating letters, surrounded by notes, in a small office in King Edward VII Hospital, Windsor. Her greeting to me, when I was introduced as a Physiotherapist looking for a job, was ”You don’t want to work here, go over to Taplow, that’s where you are needed”.

That was the start of a professional relationship which developed into a close friendship.

Barbara recognized the value of the multidisciplinary approach to the management of Paediatric Rheumatology and was the first Consultant to take the whole team to an International Conference-EULAR/WHO in Oslo 1977. She inspired many Allied Health Professionals throughout the world to train and work in Paediatric Rheumatology.

Barbara’s hospitality was legendary. Thirteen years ago she insisted that I stay at Dumgoyne when she heard that I was going to commute from Shropshire to Berkshire following our family move. During this time, particularly following her retirement, we spent many evenings reminiscing about Taplow, the patients, relatives and staff, the parties, the social events, developments and the effects of its closure on us all.

About three months before Barbara died, she realised that she would no longer be able to travel and enjoy the meetings with her many friends throughout the UK and the world. One evening remains in my memory when she said “I shall not be attending any more meetings. I think that I helped Paediatric Rheumatology to develop and now I will leave it to all the youngsters to continue to take it forward”. Barbara knew that time was running out but remained positive when her friends and colleagues called in or telephoned.

Barbara’s work was her life. We shall miss her.

David Yeoman

A Patient

In 1958 at the age of 17 I met Barbara Ansell, she became my consultant and I became initiated into what she called her family.

I considered Barbara to be a very important friend and she helped to give me the kind of life that I could only dream of, and thanks to her my dreams became a reality.

I can only say God bless to a very trusted and loved friend.

Patricia Woo

Professor of Paediatric Rheumatology, UCL, London

The first time I heard of Barbara’s name was when I was leaving the SHO rotation at Northwick Park Hospital in the 1970’s. Rumour was rife that she was to come to the Clinical Research Center to be head of the Rheumatology Division. There was talk of how she was a fierce woman and that a senior registrar had developed a stammer after his time in Taplow.

The second time was when I was looking for a job at the end of my PhD years, and Michael Denman and Tom Plattes tried to interest me in a new registrar job that they were creating between rheumatology and immunology at the CRC. My supervisor told me that she was the only person to go to if one has a child with arthritis but was not an immunologist. Another interesting comment was from Tom, who said that if I worked for Barbara, she would get me to do Rheumatology, even though I wanted to be an immunologist at the time. Well, that was a prophetic comment.

Barbara’s influence on her trainees around the world was truly remarkable. Most of them were fired with interest in rheumatic diseases in children and continue to practice the discipline. Her total involvement with the child’s disease and their lives was inspirational. She certainly gave me the “cause” that I was looking for at that stage in my career. I also found that she did bark but her laugh was equally famous.

Jane Schaller

Paediatric Rheumatologist, Boston, USA

President of International Pediatric Association

Barbara Ansell was a pioneer and leader in paediatric rheumatology. There is no quarrel about this. She was an absolute model of the best things that a physician can be. Her devotion to her patients was legendary, and they loved her. Eric Bywaters brought her into the field of rheumatic diseases in children which had lain fallow for many years and together they cultivated it into an important branch of rheumatology and paediatrics. Barbara was instrumental in gathering patients and studying them with great honesty and alacrity. She was always abreast of the newest ideas in paediatric rheumatology; indeed, she originated many of them. It is greatly to her credit that paediatric rheumatology is today a recognised and valued branch of rheumatology.

Barbara was a mentor and teacher to generations of rheumatologists and other health professionals. She was always generous with her time and with her contributions to the ideas and careers and hopes of her colleagues. She understood the broad needs of children with chronic diseases. She deserves special mention for her devotion to the allied health professionals; physical and occupational therapy. She worked seamlessly with other medical colleagues so important to the care of children with rheumatic diseases; the orthopaedists, the ophthalmologists, and the physiatrists. The unit which she and Professor Bywaters maintained at Taplow was a model of people working together effectively and pleasantly for the good of children with complicated problems. No one has ever done it better. All were included in the mix: doctors from various fields, allied health professionals, and other indispensable contributors like staff assistants, the children’s photographer, the school teachers, and the librarian-this list could go on forever. I have never enjoyed working moiré than with Barbara and her colleagues in those pleasant days among the holly bushes and woods of Taplow.

Barbara was also a generous friend to many of us, and a particular friend to my family and me. I will never forget the first time I met her in Detroit at an ACR meeting when I was very young. She simply sailed down a hall toward me, business-like and direct, and said “You must be Jane Schaller. When will you come work with us?” She welcomed me to Taplow in 1971 with an open heart and open files. Together we, with the capable help of stalwarts like Ken Smiley, and Bobbie Allen and Elizabeth Stevenson and John Holborow, managed to find every one of the juvenile arthritis patients with iridocyclitis who had been through Taplow. We contacted all of them and saw nearly all of them and their antinuclear antibodies in that fine year.

Through the years, Barbara became a dear friend to my family, as did her Angus. They always paid special attention to the children, and they were great favourites. Barbara and Angus, and then just Barbara, spent many happy times with us in the United States, and we spent many happy times with them at Dumgoyne and Ealing. Barbara would often meet me at Heathrow and whisk me off someplace, perhaps to her consulting rooms where a devoted patient from Taplow was calling in for a follow up visit. If I was staying in London, Barbara would often gather me at my hotel for a trip to dinner or an opera or the theatre. She had broad interests in the arts and also in the history of her homes in Warwick and Stoges-Poges, so we enjoyed visits to places like the famous church yard of Thomas Gray. As I became more involved with international concerns, Barbara always listened and was a marvelous critic for all kinds of ideas and topics ranging from the problems of childhood tuberculosis to issues of human rights. Barbara read the Daily Telegraph faithfully and was a regular consumer of BBC News which we watched many times together.

During the last years, Barbara loved to reminisce about her girlhood in Warwick where her father was mayor, and their interesting times during the Second World War when her family house became an open house for children brought from London for whom she was responsible and for whom she learned to grow he needed vegetables. She often spoke of her early career, meeting up with Eric Bywaters, and her history at Hammersmith and then at Taplow. We sometimes visited the countryside and Taplow together, at least as close as you could get to Taplow, most recently the summer before last. And Barbara loved her dear Dumgoyne, sitting in her living room or her greenhouse amidst her teddy bears and watching the birds flock to the bird feeder in the front garden. She was always alarmed when the big birds came to elbow out the little birds, and always curious which usually necessitated her neighbours Anne and Dennis being summoned with their bird books for more accurate categorisations. Barbara was ever the gracious hostess, and she was good company for all times.

Barbara was a great lady, a fine human being, and a dear friend. I and many others will miss her greatly, and I know that will always remain a presence among us. And she will surely remain a major presence in the field of pediatric rheumatology.