Sue Kelly was a consultant haematologist in Buckinghamshire for 28 years, employed initially by Amersham and Wycombe General Hospitals and ultimately, after several reconfigurations, by Buckinghamshire Healthcare NHS Trust. She retired from these roles in 2016, but continued to supervise and teach in the haematology laboratory at the John Radcliffe Hospital in Oxford. She was a hugely respected and fondly remembered doctor with a sharp intelligence and a passion for personalised patient care.
She was born in London, the second of five siblings. Her parents, Michael Everett Kelly, a civil servant, and Diana Kelly née Ritchie, a teacher, met whilst working together for BP in London during the Second World War.
Sue attended Wallington County Grammar School for Girls, where her mother taught chemistry. She was awarded an open scholarship to St Hilda’s College, Oxford, whence she gained a BA with first honours in physiology in 1970. She then received a graduate award at Wolfson College, Oxford and studied under the supervision of Christopher Graham in the department of zoology. Her work, using elegant single-cell radiolabelling techniques in mouse blastocysts, demonstrated that blastomeres remain totipotent up to the eight-cell stage and that subsequent differentiation is influenced by their positions in the developing embryo. This resulted in several publications (notably ‘Studies of the developmental potential of 4- and 8-cell stage mouse blastomeres’ J Exp Zool 1977 Jun;200[3]:365-76) and provided important information underpinning the development of blastomere manipulation in assisted fertility techniques. Her thesis, for which she was awarded a DPhil in 1975, was titled ‘Cellular interactions in early developing mammalian embryos’.
She entered Oxford University Medical School in 1975, gaining an Iowa scholarship in 1977, and qualifying in 1978. Following a house surgeon post in Banbury, she returned to Oxford as a house physician to David Weatherall [Munk’s Roll, Vol.XII, web] and John Ledingham. She continued her general medical training in Oxford hospitals, rotating through renal medicine, geriatrics, radiotherapy and neurology, passing the MRCP in 1981.
From 1981 to 1983 she worked under Weatherall’s supervision as an Action Research fellow and registrar in the haematology department. Her research investigated the regulation of the haemoglobin gene switch, necessitating the chronic catheterisation of foetal sheep, a demanding technique. The group postulated at the time that an understanding of the control of this switch could open avenues in the management of b-haemoglobin disorders, a concept that began to bear fruit some 30 years later with the advent of the gene therapy era. During this period and subsequently as a senior registrar in Oxford, Sue further honed her skills in clinical haematology, particularly in the management of lymphoma and passed the MRCPath in 1987.
She was appointed as a consultant haematologist at Wycombe and Amersham in 1988. She immediately began to develop the clinical service, repatriating lymphoma management from Oxford and developing a local commitment to clinical trials. At this time there was virtually no local infrastructure to support these developments. It was characteristic of Sue that she was equally at home talking to her patients, dealing with trial administration, preparing and administering chemotherapy on the wards, teaching and motivating junior medical and nursing staff and poring over primary paper-based sources in her seemingly chaotic office. Her ability to pay attention to detail whilst not losing sight of long-term therapeutic goals and to transmit this ethos to her team drove the development of a highly successful trials-based clinical haematology service. She retained her interest in lymphoma, but also had an encyclopaedic general haematological knowledge, managed a wide range of blood disorders and developed paediatric haematology services locally. She was very open to therapeutic innovation, having scrutinised the literature. However, she was critical of the blind adherence to guidelines that threatened to overtake medical practice in later years, and before adhering to a guideline could often be found checking primary sources. She was also acutely aware of the personal cost of failure and sometimes pyrrhic nature of success, in this era of relatively crude and toxic chemotherapy. Her balance of humanity and academic rigour was exceptional and engendered huge affection and loyalty.
At the time of Sue’s appointment in Buckinghamshire, clinical haematology’s roots remained firmly in laboratory practice and, like most of her peers, she had worked as an on-call lab technician as part of her training. This, alongside her considerable practical research experience, gave her a deep insight into the workings of the lab and credibility when working with lab colleagues. Consequently, she was a very effective chair of the hospital transfusion committee and chair of the pathology division. However, she was most at home reporting on blood films and bone marrow samples at the end of the working day – she took simple delight in haematological morphology and was a fine practitioner of this art. Laboratory practice evolved considerably during her tenure, with increasing emphasis on automation, rapid production of numerical results and centralisation of specialist testing. Whilst Sue recognised that this was largely inevitable and on the whole beneficial, she continued to emphasise the importance of basic lab technique and the role of the clinical haematologist in turning bald data into clinically useful information. After her retirement from Buckinghamshire, she returned to the John Radcliffe Hospital in Oxford to teach appreciative junior haematologists the now fading art of haematological morphology.
Sue’s scientific background and trials experience rendered her eminently qualified to chair the local research committee, which she ran very effectively for many years. She had a sharp eye for research methodology and sometimes trenchant views on the value of a research question, but ensured that every proposal was given a fair hearing and constructive feedback. Her enthusiasm and clinical acumen led her to continue to publish clinical case reports and she also contributed to national postsplenectomy guidelines. She was also a very effective, though slightly reluctant associate medical director for the now-enlarged hospital trust.
Sue was a staunch defender of the National Health Service and was uninterested in private practice. She mistrusted government drives to reorganise the NHS, and disliked the incorporation of the profit motive into NHS strategy. Her response to an article by Will Hutton in a 2014 edition of The Observer summarises her views: ‘I read Will Hutton's column with great satisfaction… his position on the NHS and condemnation of the current government's systematic and determined undermining of the organisation resonate with my own and many others' attitudes. He is right to assess that its strength lies in the underlying “value driven” ethos. His reference to the “drive to cure” uniting the teams, including the altruistic blood and marrow donors, is, in my mind, what it is all about and why I work in it. It was the freedom from having to be commercial that allowed me and my colleagues to place the patients' interests as our paramount concern. Never having to question how a patient was to pay for their treatment has been a great privilege.’
Sue developed a mucosal melanoma of the nasal cavity in 2008. She continued to work to her usual exacting standards despite the ardours of surgery and drug treatments until shortly before her death. She was an inspirational colleague and teacher, and a kind and loyal friend.
She met her husband David Robey, a professor of Italian, while at Wolfson College. They had two daughters, Rebecca and Victoria; Rebecca is following in her footsteps as a clinician with strong research interests. Sue was delighted to know her first grandson Eddie, born in 2016, though sadly not her second, Rowan, born in April 2019.
Jonathan Pattinson
[St Hilda’s College – The Chronicle 2017 p.68 https://issuu.com/sthildas1/docs/mu22789_st_hilda_s_chronicle_2017_- – accessed 5 July 2019]