Observations BMJ Confidential

Susan Bewley: Still hoping to make a difference

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1936 (Published 06 March 2014) Cite this as: BMJ 2014;348:g1936

In the latest in its series asking the movers and shakers of the medical world about work, life, and less serious matters, the BMJ spoke to the breast cancer screening sceptic


Susan Bewley, 55, specialises in tricky births. A professor of complex obstetrics at King’s College, London, she is a clinical academic with wide ranging interests but is focused on severe maternal morbidity. Evidence is important to her: she triggered a national review of breast cancer screening with an open letter to the BMJ arguing that NHS leaflets given to women exaggerated the benefits and failed to spell out the risks.1 And, as a trustee of Healthwatch, she has attacked homeopathy as “naked quackery.”

What was your earliest ambition?

Getting published in the BMJ, of course!2

Who has been your biggest inspiration?

My hardworking parents; at 87 my father is busy writing his latest book (a Quaker psychiatrist’s view of pacifism).

What was the worst mistake in your career?

After a bad obstetric outcome, when my mind was filled with the competing demons of guilt, denial, and blame, a wonderful chaplain pointed out that all humans err; it is repetition that makes it unforgiveable. The worst mistakes are the unrecognised and unreflected ones.

What was your best career move?

I was exhausted by writing my doctoral thesis while working a 1 in 3 (86 hours a week) obstetric registrar rota, and I took a year out to self finance an MA in medical law and ethics. It’s been a fertile source of inspiration.3 4 5 I also met the forensic psychiatrist who started my academic career in domestic violence.6 7 8 9

Bevan or Lansley? Who has been the best and the worst health secretary in your lifetime?

I find them difficult to distinguish.

Who is the person you would most like to thank and why?

Geoffrey Chamberlain, who nurtured my interest in obstetrics and gynaecology as a student. He was a hardworking, inspiring teacher and a genuine supporter of women, who was badly let down by a wretched protégé.10

To whom would you most like to apologise?

Everyone I challenged or offended: for the first time to those I didn’t even realise I’d offended, and again to those I did.

If you were given £1m what would you spend it on?

Half as prize money for getting a genetic man pregnant,11 and half on the charities I work for: Healthwatch UK (for treatments that work), Sophia Forum (the UK branch of the Global Coalition on Women and AIDS), and Maternity Action (which works to end inequality and promote the health and wellbeing of pregnant women).12 13 14

Where are or were you happiest?

The day I gave birth was the happiest of my life. In that moment of relief following the delivery of a watermelon covered in razor blades, I realised that I could face death fulfilled and unafraid.

What single unheralded change has made the most difference in your field in your lifetime?

Reproductive technologies designed to help women (contraception, ultrasound, and in vitro fertilisation) have been followed by a rise in childbearing age, infertility, anxiety, severe maternal morbidity, and mortality.15 16 17 18 Pregnancy is increasingly “difficult” and fear filled. It is dismal how some women (and doctors) lose confidence in their bodies’ ability and then avoid the labour that “enlivens” and benefits babies.19 20 21 22

Do you believe in doctor assisted suicide?

No, despite being pro-choice.23 If parliament legislates to allow people to choose to end their own lives I’d prefer the Swiss to the Dutch model. The medical profession must not abandon, and must not be seen to abandon, people who are vulnerable from age, illness, or frailty—even if they no longer value life.

What book should every doctor read?

Against Our Will by Susan Brownmiller.24

What poem, song, or passage of prose would you like mourners at your funeral to hear?

Elvis Presley’s “Always on My Mind,” for those loved family and friends I didn’t tell enough.

What is your guiltiest pleasure?

“Tingle factor” foods: mature cheddar and rich chocolate mousse.

If you could be invisible for a day what would you do?

Sabotage the grandiose NHS IT programme, as there is no evidence that it improves patient outcomes.25 26 27

Clarkson or Clark? Would you rather watch Top Gear or Civilisation?

Clark. Any educated expert, every time.

What is your most treasured possession?

A letter from George Godber written in his late 90s. Out of the blue the greatest chief medical officer, who set up the confidential inquiry into maternal deaths, was congratulating us on the first population study of severe maternal morbidity.28

What personal ambition do you still have?

I’m still hoping to make a difference.

Summarise your personality in three words.

Cheerful, energetic, enthusiastic.

Where does alcohol fit into your life?

A friend I’ve outgrown but can’t entirely shake off.

What is your pet hate?

Like Sisyphus, compelled to eternal punishment, I’m that eccentric dog walker who picks up other people’s litter.

What would be on the menu for your last supper?

Irish smoked salmon on soda bread.

Do you have any regrets about becoming a doctor?

You should not look back but turn the paths you take into the best ones. I didn’t have the imagination or courage to choose not to be a fourth generation doctor, but I’ve made a good life out of it.

If you weren’t a doctor what would you be doing instead?



Cite this as: BMJ 2014;348:g1936


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