Diana Beck FRCS, pioneer neurosurgeon

This year, English Heritage’s London Blue Plaques Scheme will unveil a very special plaque celebrating the life and work of one of the first female neurosurgeons in the UK. This is just one of the many achievements of Diana Beck (1902–1956), pioneer neurosurgeon and fellow of the Royal College of Surgeons of England. Her story is that of a remarkable individual who made significant contributions both to her field and the overall cause of women in medicine while striving for recognition and leadership in a male-dominated arena.

Diana Jean Kinloch Beck was not only one of the first female neurosurgeons in the UK, but one of the first in the world and her accomplishments extend far beyond this impressive claim. A successful surgeon, teacher and researcher, Beck played a large part in establishing neurosurgery in the UK. She succeeded in overcoming the sociocultural barriers of the first part of the twentieth century in pursuing not only medicine but neurosurgery, which was a nascent surgical discipline at the time and was one of the last medical fields in which female participation was very limited.

Above: Painting of Diana Beck produced by Phyllis Bliss (Dodd) alumna at The Queen’s School, Chester, UK. Image provided for use with the kind permission of Queen’s School Chester.

In 1875 medical licenses were granted to female students, thereby permitting a small number of women to graduate and become practising doctors. At the time of Diana’s birth, in 1902, there were still very few female doctors in England and Wales.

Beck was born on 29 June 1902, in Chester. Her parents James Beck, a master draper, and Margaret Helena Kinloch were of Scottish descent. She was initially educated at the reputable Queen’s School in Chester, before subsequently choosing to pursue medicine at the London School of Medicine for Women, based at the Royal Free Hospital. This hospital had been one of the earliest medical institutions to accept female students for clinical training in 1877, and it would eventually become one of the main UK centres for neurology in the late twentieth century.

Above: Diana Beck in 1915, age thirteen. Image provided for use with the kind permission of Queen’s School Chester.

Her university education was distinguished, earning her the Julia Cock scholarship, the Gwendoline Lynn prize, and the Grant medal in surgery. She graduated with an M.B., B.S. in 1925. Beck then undertook her qualification for the Fellowship of the Royal College of Surgeons, first in Scotland in 1930, and then England in 1931. In 1932, she returned to the Royal Free Hospital as surgical registrar and a lecturer in anatomy, where she remained for seven years.

In 1939 at the age of 37 she began a brain surgery apprenticeship at the Radcliffe Infirmary of the Nuffield Department of Surgery in Oxford, where she was awarded the William Gibson research scholarship for Medical Women from the Royal Society of Medicine. She was working under prominent neurosurgeon Hugh Cairns (1896–1952) who had trained with Harvey Cushing (1869–1939) in the US and is widely considered the founding figure of British neurosurgery. She was a favourite of Cairns, who put her in charge of the introductory course in clinical surgery. From Cairns, Diana Beck inherited the “Halsted Cushing Technique”, a set of rigorous aseptic practices prescribed by Cushing and his surgical mentor, William S. Halsted (1852–1922), which successfully reduced sepsis and controlled bleeding.

It was during this time that she collaborated productively with Australian pathologist Dorothy Stuart Russell (1895–1983) in investigating the causes of idiopathic intracranial hypertension on animal subjects. They co-authored an article that was important in establishing the written history of women in clinical neurobiology. Published in the Journal of Neurosurgery, the article “Experiments on thrombosis of the superior longitudinal sinus” was an experimental investigation. They also co-authored, amongst others, an important work on the spread and treatment of oligodendrogliomas (a type of brain tumour, belonging to a group of tumours called gliomas, which develop from the glial cells supporting nerve cells in the brain or spinal cord).

Beck completed her neurosurgical training at St. Hugh’s and achieved her first appointment as a neurosurgeon back at the Royal Free Hospital in 1943, where she quickly made her mark as surgeon, teacher and colleague. However, with World War II ongoing, she was called to assist the Emergency Medical Service and her career was interrupted. Initially she was posted to Chase Farm Hospital in Enfield, North London and later she was made consultant advisor in neurosurgery for the whole of southwest England based in Bristol.

There she was a key figure of the team that took over an empty neurological hospital with appropriate facilities, initially built to treat child epilepsy, and turned it into a venue for managing neurological casualties from the region. This was the beginning of the neurosurgical unit at Frenchay Hospital in Bristol, which she helped establish and run to treat the many sufferers of serious brain injuries after the war.

Her outstanding work led her to the appointment of consultant neurosurgeon at the Middlesex Hospital in 1947, which at the time admitted only male applicants. Her appointment was believed to be the first of a woman to the senior staff of a major teaching hospital in Greater London. At the height of her career, she ran the hospital’s neurosurgical service. This made her the first female neurosurgeon on staff, the first female consultant, and the first female to run a department.

Above: The memorial plaque at Fitzrovia Chapel. Image by MumphingSquirrel, licensed under the Creative Commons Attribution-Share Alike 4.0 International license, available from Wikimedia Commons.

While in this leadership role, she performed a lifesaving neurosurgical procedure on acclaimed children’s book author, Alan Alexander Milne (1882–1956), author of Winnie the Pooh, following a stroke in 1952. That accomplishment attracted public and media attention and made her something of a household name in Britain. In the same year, Beck presented a landmark paper on six case studies of patients suffering from spontaneous intracranial haemorrhages treated neurosurgically. She argued that all six patients made excellent recoveries, with five of them attaining independent functional status. This seminal study on the surgical management of intracerebral haemorrhage is considered to have revolutionized the perception of this condition in both Europe and North America.

During the latter part of her career, in addition to her clinical practice, she also took an active academic role, publishing her research in journals and accepting presentation invitations throughout Europe, Canada, and the United States. The focus of her latest work was on the neurosurgical treatment of intracerebral haematomas, based on her own clinical experience with these conditions and successful outcomes. Her innovative publications offered a series of recommendations, often emphasizing early surgical treatment. She published widely in Brain, The British Journal of Surgery, and elsewhere.

During her 31-year career, it is possible that she was the only female consultant neurosurgeon in Western Europe and the United States, at least during the first half of the 20th century. Her awareness of this distinction inspired her to actively participate in improving women’s role in medicine and in society. For two years she served as president of the London Association of the Medical Women's Federation. In the Memory Book of that organisation her obituary recorded her as being “immensely proud of the distinction her appointment (at the Middlesex) conferred on her” and by extension her fellow female surgeons.

Beck was above all a woman of action and service. She was competent in everything she endeavoured to do, with a particular aptitude for research and with outstanding teaching skills. Her composure, ability and confidence to take on groundbreaking operations at a time when knowledge of the brain and neurosurgery was just developing were extraordinary. Her popularity as a teacher was demonstrated by her students’ willingness to sacrifice their weekends to attend her ward rounds.

While Beck was renowned for delivering results in her discipline, she also seemed to have mastered soft skills whose importance was not always recognised at the time. Her empathy with patients was possibly a result of dealing with health limitations of her own. Even though she led a fruitful academic and clinical career, Beck herself suffered from a neurological condition: myasthenia gravis (a rare, chronic autoimmune disorder that causes muscle weakness and fatigue in the body's voluntary muscles). Her care for the patient, her confident level-headedness, her devotion to her profession and her unwavering sense of duty and service, even against limiting personal circumstances, make her a true pioneer.

In 1956, she sustained a myasthenic crisis and underwent a thymectomy. Postoperatively, she suffered a fatal pulmonary embolism which prematurely ended her life on 3 March 1956. She was survived by her two brothers.

Dr Wilder Penfield summed her up as “A great surgeon and a gallant woman…to me she was remarkable because she was a mechanic as well as a wise physician. She had enough equanimity for her job.” Her legacy remains that of an extraordinary neurosurgeon, inspiring teacher, and researcher, trailblazer and role-model.

As a final note, and to better convey a sense of her thoughtfulness, intent and personality, here is the conclusion of one of her articles: “There is a special exultation in occasionally being proved right by subsequent investigation and operative findings: and a stimulating challenge in the more common, if sobering, experience of being wrong.” (From “The diagnosis of tumours of the central nervous system”.)

Above: Diana Beck in the Medical Women's Federation Journal. Credit: The Medical Women's Federation Journal. Source: Wellcome Collection.

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Articles referenced in the text:

• Beck D.J.K., Russell D.S. “Oligodendrogliomatosis of the cerebrospinal pathway”. Brain. 1942;65:352–372. doi: 10.1093/brain/65.4.352.
• Beck D.J. “The diagnosis of tumours of the central nervous system”. Bristol Med Chir J (1883). 1946 Summer; 63(226):65-72.