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And Right. Okay. So we'll move on to um welcome Katie Gilkes, who's a consultant neurosurgeon at the Walton in Liverpool, did her training some of her training in French and she's going to talk about Diana Beck as, as Hugh mentioned your thanks Katie. So my this side, please, ladies and gentlemen, it's a real pleasure to be here. Um It was David Sanderman who gave me a tip off about Diana Beck when I arrived at French A as a very junior registrar during the war drowned. You mentioned that some woman started at this department, which was in retrospect, a great lead. I'm not sure it's entirely accurate to say that Diana Beck was the founder of British of, of neurosurgery in Bristol and I'll sort of allude to that later. But um certainly by looking into her life and coming back to what, what I found out when at that stage really realized just what quite a remarkable lady she was. I have the same from me. Uh right the tree, I'm having the same problem point. Your receivers only offstage, right. Became Sudan about was born in Chester. She went to the Royal Free Medical school, which was the only medical school at a time that would admit women. She did uh neurosurgical surgical registrar jobs there. And also at the same time works as a clinical Clark at Queen's Square. But interestingly for the time, she decided to specialize in neurosurgery, which is quite an unusual thing to do. And she effectively did what we would now describe as a fellowship in Oxford under the mentorship of Hugh Cans, who was one of the founders of, of, of British neurosurgery. Having completed that, she got a consultant job at the Royal free, but was unable to really start that because the Second World War was underway. And at that time, the government had established what was called an emergency medical service for treating emergency casualties from the war. And she was initially sent to Chase Farm briefly to, to do that work. Um And then, and then came on to Bristol. Oh my goodness. I'm really sorry. So here in Bristol, she joined three people. So Wiley mckissock, it seems that he was actually been sent um as evacuated to Bristol during the war. He was what he worked at Atkinson Morley's in London. She joined Francis Will Way who I think actually was a true founder of neurosurgery here in Bristol. He worked at the Bristol Infirmary, um and he actually started some neurosurgery prior to joining the emergency medical service. And there's Prof Lambert Rogers was based in Cardiff and a member of the Navy and he was working at the Naval Hospital here, but they did there, neurosurgery at the Burden Institute as Professor Coke um has alluded to and that was a perfect site. It was effectively a dedicated neuro hospital with a neuro theatre which had been set up for different reasons but but provided a perfect facility. And then at the end of the war, they moved to French and, and established the neurosurgical service there. Uh but she didn't last, she didn't stay for very long in Bristol because she got this amazing offer to become a consultant to the Middlesex, which is an extremely prestigious position to take on and, and, and assuming that she became the first woman to be in charge of men in a consultant capacity in a major London teaching hospital. Jeffrey Jefferson sort of later described her as being the only female neurosurgeon of her era. I'm not sure that's entirely true. They're definitely been, have been reports of other female neurosurgeons working around that time, but they did qualify after Diana Beck. And I do think course you see that she probably was the first female neurosurgeon in the world. Although I think it's impossible to completely, completely prove prove that while she was working at the Middlesex, she came to public attention because she, she operated on a mill and the author of Winnie the Winnie the pooh. Um He had a stroke in October 2, 1952 and was admitted to the Middlesex for, for a good period of two months before he had any surgery. This was reported in the times as being quite remarkable. Um clue didn't do terribly well postoperatively. Um These are quotes from his biographer, his personality change post operatively, he was paralyzed and ended up in a nursing home and died very um soon after that. And one of the causes of death was listed as a cerebral abscess. However, despite that Diana Beck had had quite an interest in um hematoma. She doesn't let me get back. Um And she had earlier that year presented her experience to the SPNS. Um And this was really sort of classical um type of paper of that time, really a series of very very detailed case reports of uh of, of patient's. Um and, and it's feet about six patient's who've had instable hemotomas that she had evacuated. Um surgically, they were clearly very carefully selected because all of them did exceptionally well. And five of them returned to normal functional um uh status, which clearly hadn't been the case for uh a mill. But she was what they also does really illustrate just how, what difficult circumstances they were working in. And quite it was quite remarkable the results that she was getting given that the localization of these hemotomas was something of a challenge. They didn't have the imaging that we have today. It was based on examination, certainly even percussed the skull to try and find out where it was. And the, the, the investigations are really limited to, um, uh, air ventricular grams, direct arteriograms. They do, um, Crossett and vertebral artery, um, punctures, um, uh, and, and, and x rays and, and lumbar punctures as well. So, so it was really quite remarkable stuff in, in very challenging circumstances down. I wrote a number of similar papers, but while she was in Oxford, she did also have the uh the opportunity to do some basic science research. And she did that with Dorothy Russell who was a pathologist in Oxford at the time, apparently cranioplasty, these were done at the time using um alia graphs and she looked at alternative materials that could be used for that. And then she also wrote, wrote a paper in very early um one of the very early journals of neurosurgery about being a sinus thrombosis as an etiology for intracranial hypertension. So these are sort of neurosurgical issues are still discussed today as a surgeon. She clearly was very well respected. Um She was described as original confident her at the time, they've been so few neurosurgeons that your technique was basically named after who you trained with. And, and um uh in Oxford had trained and hosted and cushing and that was the description of her um technique you take what you will um from Jeffrey Jefferson's comment there in her victory. It's not terribly um pleasant, but, but generally she was thought to be a good surgeon, but she certainly didn't try and um conform to the, to all of the men around her. Um Many of the reports talk about how, how feminine she was. Um she was into needlework art flowers, she was a Catholic reader. Um And whilst her professional colleagues found her extremely private and difficult to get to know those that did know, obviously found her a great friend and quite a personality. She was extremely popular amongst the medical students of the Middlesex and they would join her ward rounds at any cost. But the Oxford medical students apparently found her London weighs a bit too much and a bit strict. Um And uh but it's really no surprise that this lady, she was a tough cookie and would definitely make her view known when um when, when it was necessary. Um I did have the opportunity to speak to a number of anesthetists who had worked with Diana Bec. Um And uh and they sort of reiterated a lot of these themes. This was a very feminine lady who was pretty tough and stuck and and stuck her ground and was also really very um cultured. They, they maintain that she was the person who first thought of using elastoplast to get rid of all the hair around a a surgical wound. Um As ever, they had to make mention of the length of cases of her cases which by all accounts were extremely long. Um One of them talked about going to extraordinary lengths to make sure that you could actually stay in the theater for the whole of her case. And uh and apparently the the Cushing Tech Nique was one that was very meticulous and she took this possibly two extremes. I did receive a letter from an East test which was actually quite damning about Diana Beck and how he found her extremely difficult to work for a very demanding. But that does really bring, bring to mind this, this quote from Susan Lawrence who was an MP over 100 years ago. But how the three stages to the public life of a woman. First, she's that charming and intelligent girl. Second, she becomes an awful woman and then she becomes that marvelous old lady and older life. And I hope the really awful thing is that I think that is possibly quite relevant today as it was 100 years ago. And it was certainly relevant to um Diana Beck. The very sad thing is that she never got the opportunity to become known as that marvelous lady because she had my senior gravis and that was the symptoms that she had for that were put down to her frail constitution. She was diagnosed with hysteria, um and it was noted that she operating was becoming an increasing physical strain and it wasn't until she had a myasthenic crisis in the beginning of 1956 that, that her diagnosis was made and she died very soon after that. When she, after following a thymectomy, she had a P so I was pretty proud of myself when I arrived at French. And I, and I realized that following my research and David Santon's comment that I've been royally picked to the post, not just by 60 years by, by some really quite in credible lady who had established a neurosurgical service with my senior Gravis in a fairly hostile environment where uh colleagues couldn't even resist having a bit of a stab at her in her obituary. And, and she managed to do some pretty incredible research which is still relevant to her 60 years later. So I set my sights a little bit lower and this is a picture of the fridge that was in the registrars room at French um at the time and I put together the information I got and I wrote a paper is published sort of the in the red journal of Diana's Beck's Life and then sort of got on with my own life. Um And uh and career. So in, in preparing for this talk though, it then came to some sort of some amusement that writing about women in neurosurgery has become fairly popular in the past few years. And uh there's a paper about the contributions of women to neurosurgery, just about every country, every continent and every subspecialty. And uh these are all the papers about the history of, well, some of the papers about history of neurosurgery in women in neurosurgery in Europe and it transpires. My paper effectively has been paraphrased at least four or five, at least four or five times. And then the question as to whether Diana Beck was, in fact the first female neurosurgeon in the world and I was pretty cagey about that because I think it's extremely difficult to prove these things. Um And, and the way history is and the way women have been, um in, in professions, there's always going to be somebody who's been under the covers. Anyway, the Romanian contingent not in there anyway, and cautious about that and have very much laid claim to this, this, this status for their lady, um severe ionesco. And part of me thinks it's slightly ridiculous, but part of me is slightly indignant um in that they've really used completely incorrect facts and data to make their claim. Um And not only have they published this, but they've had it validated by what the W FNF and, and she is recognized, I think wrongly as the first uh neurosurgeon in the world. I think Diana vet certainly deserves that, that, that status more, more than this lady. So I, you know, part of me just think this is ridiculous. And uh, but part of it is a slightly indignant, I'm taking solace from this quote um from a Mills Winnie the pooh. That really maybe I should just sort of relegate WFS and World neurosurg in Romania, neurosurgery to a ball of historical neurosurgical fluff and just be happy that I actually know the history and now and now you all to, to, but I'd be keen to know whether you think I should take up Diana Becks cause any further. Thank you. Uh Thank you very much Katie for telling a story. Probably very, very few of us have ever heard or know about. It's a point of interest. I don't know if the building of the New Burden Institutes that exist in Stoke Park. But in the 19 seventies, her operating theatre was part of the institute in the right in the center, a beautiful room with a glass domed roof, very spacious and an ideal operating theater. In fact.