Lives of the fellows

Matgorzata Borzyskowski

b.30 January 1947 d.? 2002
MB BS Newcastle(1971) MRCP(1973) FRCP(1993) FCPCH(1997)

Matgorzata, known to her friends and colleagues as 'Margaret', was a consultant paediatrician and researcher on the management of the neuropathic bladder. She was born into a Polish family: her mother ran a Saturday school for Polish children, which ensured Margaret's fluency in Polish, and guaranteed her understanding of her Polish cultural heritage.

After qualifying at Newcastle and doing her house jobs there, she secured the membership in the shortest possible time, did her required stint as an SHO at Great Ormond Street, and then started a research fellowship on the management of the neuropathic bladder, which laid the groundwork for the rest of her medical career. When she started, the main cause of death in children with spina bifida was renal failure. The technique of self-intermittent catherisation had just been piloted in adults in the USA. The major concern was whether a clean, as opposed to a sterile, technique would suffice. In a controlled trial, Margaret showed that emptying the bladder thus was not attended by an increased incidence in infection. Whilst some children became dry, not all did, and in others, some decline in renal function continued. Because she combined the trial with another new technique, namely video urodynamics, she was able to propose solutions to these additional problems.

The successful application of these solutions now means that children achieve continence, and no longer die of renal failure. Not only has this had a major effect on the children's social acceptability and self esteem, it has also helped to change the profession's attitudes towards survival of the more handicapped children with spina bifida, which when Margaret started her career was not encouraged. With this hurdle, amongst others, now treatable, the children are encouraged to reach their potential.

Margaret went on to define similar problems, not only in children with other spinal cord problems, including sacral agenesis, occult spina bifida and spinal cord tumours, in children with cerebral palsy and muscular dystrophy, but also delineated that group of children with day-time wetting with no overt neurology and normal cords on imaging, but who nevertheless possessed bladders with the same dangerous characteristics. She achieved this by establishing a multi-disciplinary clinic in which the children were seen at the same time by all the relevant professionals. She pioneered the use of home liaison nurses, who, present at the hospital clinic, ensured that the solutions proposed there could be applied in the home and school setting. It was no accident that she was the first doctor to be invited to chair a national conference of nurse specialists in the UK.

Margaret contracted cancer eight years before she died, which recurred in a more malignant form four years later. Despite undergoing surgery, courses of chemotherapy and radiotherapy, she continued working throughout with the minimum of fuss, and not a trace of self-pity. She continued to lecture nationally and internationally, and published up to the year of her death. She remained cheerful and undaunted throughout.

Her fortitude and cheerfulness was an example which all who knew her would wish to emulate in similar circumstances. Children in the clinic always drew her with a smile, which was nothing short of the truth. She was sustained in this by the unwavering support of her two sons and husband, a chest physician. She died still with plans to develop her service in other directions, at a time when she still had much to contribute.

Richard O Robinson

[Brit.med.J.,327,2003,55]

(Volume XI, page 71)

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