Reporter 397, 17 February 1997
At the age of 73, Professor Barbara Ansell's work in the field of juvenile arthritis has been formally recognised by a British university for the first time with a Visiting Professorship at Leeds.
It was probably the family doctor who inspired Barbara Ansell to take up medicine. It had never been a burning ambition for her - her mother and father didn't have a medical background - but they did suffer from poor health, and their GP's kindness impressed her. Sometimes she would accompany him on his rounds, and when she made the decision to go into medicine she had the full support of her parents and their doctor.
After graduating from Birmingham in 1946, Dr Ansell did her postgraduate training at Hammersmith. She had shown an earlier interest in juvenile rheumatology in her thesis where she noted the different patterns of arthritis in children and it was suggested she would enjoy a period at the unit for juvenile rheumatism at the Canadian Red Cross Memorial Hospital in Taplow. There, under Professor Eric Bywaters, she became acquainted with the various forms affecting children.
Recent studies suggest as many as 1 in 1,000 children may have had an episode of arthritis. Most children are affected in only one or two joints, but this can still be debilitating and prevent their participation in normal childhood pleasures such as sport. 85 per cent go on to lead normal lives in adulthood. But a more serious condition is systemic arthritis which affects very young children and can leave them crippled - and as the initial symptom is a very high fever, diagnosis can be difficult.
Having witnessed these different forms of juvenile arthritis during her time at Taplow, Professor Ansell was awarded a scholarship to study in America. As a research fellow at the Research and Education Hospital in Chicago, she learnt a different approach to medicine than she had been used to in England - the need to understand the root problems of the disease.
On returning to the UK, her fondness for children led her back into juvenile rheumatology: "I much prefer children to babies - I like them to be able to talk back to me!" Professor Ansell has "three wonderful step-children" and numerous grandchildren. She doesn't regret not having her own children: "It wasn't a conscious career decision - just one of those things."
And Professor Ansell's love of young people has clearly helped her work: "Doctors need to be able to communicate with their patients to motivate them to get better."
She has come into contact with hundreds of patients, and has stayed in touch with many of them. As a Senior Registrar in the early 1960s she did a study of children in over 400 family homes, and is still in touch with half of those families.
At a recent dinner held for a retiring orthopaedic surgeon, Professor Ansell met up with patients from 20 years ago and, she says, it's one of the most satisfying things to see these people who now "are working and have their own families and have mainly overcome the condition."
In 1980 Professor Richard Smithells of Leeds persuaded Professor Ansell to help set up a Joint Regional Juvenile Arthritis Service - the second of its kind in the UK - together with Professor Anne Chamberlain. The service is now well established and caters for the variety of needs of young sufferers, with physiotherapists, psychologists and surgeons among the staff. Every year since she has visited the University's medical school, seeing patients and teaching at the bedside as well as lecturing. Her training of doctors has resulted in the establishment of many other new centres throughout Europe. She also took up Visiting Professorships in Canada, the USA and Greece.
Professor Ansell was awarded a CBE in 1982.
She is a firm believer in the integration of physically handicapped children into mainstream schools. She recalls a nine-year-old girl who said it was all very well having a helper at school to assist with physiotherapy or medication, but was very resentful of being protected from playing with her friends in case she fell over. Professor Ansell feels that if schools took more of a role in providing for these extra needs then children would feel more 'normal', which would in turn have a positive effect on their recovery. To suggestions that disabled children might be singled out for bullying in a mainstream school, she points out that "all children get teased about something" and that in her experience, arthritic children have not been victimised by their peers.
It was 100 years ago that Dr George Still, the first Professor of Paediatrics in London, first drew attention to the fact that arthritis is different in adults than in children. Professor Ansell feels her greatest achievements were in recognising the existence of many different types of arthritis, and also raising interest in the disease. The different forms of juvenile arthritis have consequently been identified, together with the differing responses to certain drugs.
Her work has added to the knowledge base and care of children with arthritis, and helped families to cope with the difficulties they face. She is patron of the ChildrenŐs Chronic Arthritis Association which aims to make both professional and non-professional people aware of the need to care for affected children. Her work has taken her all over the world - to Bangkok, China, Brazil and South Africa among other countries - to attend conferences and give advice on training and research.
And after a working visit to New Zealand, Professor Ansell will come to the University of Leeds in June to check on progress at the juvenile arthritis service. At 73, she continues to hold her own practice and regularly visits hospitals all over the UK.
The causes of juvenile arthritis are still not known, but Professor Ansell expects a breakthrough in the next 10 to 20 years: "I have no regrets about not making the discovery - I think I've already made my most important contribution."
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