In the beginning

In 1951, Barbara Ansell, a young 28-year-old physician and aspiring cardiologist, was encouraged by Professor Eric Bywaters to join him in the Special Unit for Juvenile Rheumatism, recently created by the Medical Research Council (MRC) of UK, located at the Canadian Red Cross Memorial Hospital in Taplow, Buckinghamshire, UK. She had been advised that cardiology ‘was a man’s world’. Although initially aimed at research and treatment of rheumatic fever, this unit of pathologists and clinicians morphed into a unit for juvenile chronic arthritis as the incidence of rheumatic fever gradually waned. At that time, a child with chronic arthritis would mostly be confined to bed at home, perhaps with aspirin and/or cortisone medication and bore a grim prognosis regarding both function and survival. She began her pioneering work there with her MD thesis (1965) on the classification of children with chronic arthritis. Her clinical skill and experience were legendary. Her major clinical achievements are listed in box 1. She also was actively engaged with scientists in the search for the causes of the diseases she encountered. She was ideally placed in the shared environment of MRC facilities next to a general hospital. Box 2 is a short summary of the main milestones and breadth of her work. In 1988, the world-renowned paediatric rheumatologist, Barbara Ansell CBE, FRCP, FRCS, FRCPCH, retired as director of the MRC Division of Rheumatology at Northwick Park, Harrow, UK. She left as a legacy an army of former colleagues, protegées and friends from all areas of healthcare, dedicated to children and adolescents with rheumatic diseases. By then the outcome for such young patients had improved dramatically. Gratifyingly, Barbara did see the fulfilment of her long-held dream, expressed passionately at her retirement Festschrift: the beginning of truly effective therapies.