Lives of the fellows

Susanna Elmhirst

b.11 April 1921 d.16 February 2010
MD Chicago(1943) MB BS Lond(1944) DCH(1945) MRCP(1946) FRCP(1970) FRCPsych(1971)

Susanna Isaacs Elmhirst née Foss (‘Sue’) dedicated her life to helping children and young people cope with traumatic and damaging events in their lives. A child psychiatrist when the discipline was in its infancy, she overcame her own unhappy childhood to help others deal with theirs.

Born in London, her father was Hubert Foss, who was a famous musician responsible for founding the music department at Oxford University Press. Her parents separated when she was young and she did not see her father for a long time. Her mother did not enjoy being a parent and sent her to a boarding school in Cambridge for two terms when she was still quite small. It was not a success and she was later to comment that it was only by winning a scholarship at the age of 10 to Dartington Hall, the progressive boarding school in Devon, that she survived these difficult years.

She became the first Dartington pupil to study medicine, enrolling at Bristol University. Due to lack of support from her family she nearly abandoned the course through financial hardship but then she won a Rockefeller scholarship which enabled her to continue at Chicago University. She crossed the Atlantic in a convoy at the height of the Second World War. Qualifying MD in 1943, she returned to Bristol to obtain her final MB. There the examiners failed her – apparently due to her enthusiasm for the new drug penicillin. After that she proceeded to London and passed her examination in 1944, starting to specialise in paediatrics. Training for a while in London, she then moved to Sheffield where she worked with the pioneering paediatrician, Ronald Illingworth [Munk’s Roll, Vol.IX, p.259].

In Sheffield she met Alick Isaacs, a gifted young virologist, when he managed to botch the job of taking a blood sample from her. When he left for Australia, she followed him in 1948, having recently obtained her consultancy in paediatrics. Having worked her passage as an assistant ship’s surgeon, she spent a year in Melbourne where they married in 1949.

On their return to the UK, Alick began working at the National Institute for Medical Research and, while there, did the research that led to his discovery of interferon. They had twin boys in 1950 and a daughter in 1953. During the 1950s she trained in psychiatry and psychoanalysis becoming a qualified child psychiatrist in 1960. She was a keen follower of Melanie Klein, who believed that observing young children at play could give useful guidance on emerging personality disorders. At Paddington Green Hospital for Children, she worked with Donald Winnicott [Munk’s Roll, Vol.VI, p.471], the physician and child psychoanalyst, and, when he retired in 1961, she succeeded him as head of the department of child psychiatry, now part of St Mary’s Hospital.

At St Mary’s she met with some prejudice, as women consultants were rare at that time. Managing to counter opposition by the strength of her personality and great determination, she showed a natural talent for dealing with her young patients. One of her colleagues commented that ‘She could absolutely connect, engage, empathise and understand what was troubling a child.’ She remained there for 12 years building up a significant professional reputation and treating both NHS and private patients.

In 1973 she moved to Los Angeles as associate professor of clinical child psychiatry at the University of Southern California and consultant at the children’s hospital. She spent six years there before returning to the UK in 1981 and joining the staff of the Child Guidance Training Centre in London. The following year she also became director of the child and adolescent department of the London Clinic of Psychoanalysis, a position she held into her 70s. She retired from the NHS in 1986 but continued her other activities, serving on the council of the British Psychoanalytical Society from 1990 to 1994 and acting as consultant to the Corum Adoption Service from 1988 to 1996 where the head of adoption said of her ‘it was like having access to a gold star service within the team’.

Working in paediatrics at a time when child abuse was just beginning to be identified and discussed, she was much in demand as a speaker on topics such as the implications of Kleinian psychoanalysis for childrearing or transitional phenomena in the treatment of psychotic adolescents. Among her many publications are two early and prescient papers, ‘Physical ill-treatment of children’ (Lancet, 1968, 291, 37-9) and ‘Neglect, cruelty and battering’ (BMJ, 1972, 3, 224-6) in which article she urged doctors to keep vigilant for signs of child abuse yet warning against a ‘suspicious, over-simplified and potentially accusatory approach.’

During her time at St Mary’s in the 1960s her husband, Alick, was suffering from devastating bouts of manic depression and he also suffered a brain haemorrhage. He died at the early age of 45, in 1967. She had maintained contact with Dartington over the years and, after Alick’s death, she met up with Leonard Elmhirst, who had founded the school with his wife in the 1920s. He was then a widower and 25 years older than her but they married in 1973 and moved to Los Angeles together. They had a brief but happy marriage until his death 18 months later.

After a severe stroke in 2001, she had to finally give up working. When she died of pneumonia nine years later, she was survived by her sons David and Stephen, who is also a child psychiatrist, daughter Harriet and nine grandchildren.

RCP editor

[The Guardian www.theguardian.com/society/2010/apr/29/susanna-isaacs-elmhirst-obituary - accessed 29 April 2005; BMJ 2010340 2809 www.bmj.com/content/340/bmj.c2809 - accessed 29 April 2005]

(Volume XII, page web)

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