Four women who shaped surgery

It is tempting to view history through a lens of ‘firsts’. For example, Elizabeth Garrett Anderson was the first woman to train and qualify as a physician and surgeon in Britain, when she passed the Society of Apothecaries exams in 1865. Yet history rarely conforms to the simplicity of a single milestone or a linear path. Earlier, James Barry – assigned female at birth then living and working as a man – qualified as a doctor in 1812 and a surgeon in 1813, challenging gender norms early on. Furthermore, Garrett Anderson’s success so alarmed her male peers that the Society of Apothecaries quickly changed its rules to prevent other women from qualifying, making her accomplishment both groundbreaking and, for a time, unrepeatable. 

The problem with the paradigm of ‘the first’ is that it makes history feel clean and celebratory. It often oversimplifies the messy reality. Focusing on singular achievements overshadows the contributions of those who laid the groundwork, contributed to change or advanced the cause later, creating a narrow, one-dimensional view of progress. This perspective tends to glorify individualism while missing key people. It sidelines the collective efforts and systemic factors that make positive change possible. By moving beyond this paradigm, we can learn from and celebrate networks of change, the evolution of ideas, and the broader, shared struggles that shape history.

This article shares the stories of four women, all connected to the Royal College of Surgeons of Edinburgh, who positively shaped the development of medicine and surgery. Despite many of them being ‘firsts’, their stories are not well known. Their histories, along with countless others, are held in the collections here at the College. Surfacing and sharing them is one of the most rewarding aspects of working with such a diverse and historically significant collection.

Caroline Nompozolo (1916–2008)

Caroline Nompozolo was born in South Africa in the first part of the 20th century and grew up in a family of seven. Her path to becoming a doctor and surgeon was anything but ordinary. Nompozolo attended the Healdtown Institute in Fort Beaufort and later became the first South African woman to study science at Fort Hare University in Alice, South Africa. Her success caught the attention of the League of Coloured Peoples in London, which helped her get a scholarship to study medicine in the UK. The League of Coloured Peoples wrote of Caroline: “Ever since she was a girl at school, Dr Caroline wanted to become a doctor, and this fact was regarded as a big joke when she entered College – Healdtown Institute. Thence she went to Fort Hare, now known as the South African Native University College. Here she took the unusual course of studying Science, no other South African woman had ever done so before. Before completing her second year she came to this country, but not before she had blazed a trail in South Africa, and thus by her example encouraged other women to take up science.”

When Nompozolo applied to medical schools in the UK, she faced racism, sexism and scepticism. St Andrews University dismissed her qualifications from Fort Hare as equal to a ‘high school diploma’. However, she found an ally in John Orr, the Dean of the Extramural School of Medicine of the Scottish Medical Royal Colleges. This School offered medical and surgical training outside universities, taught by lecturers from the Royal Colleges of Edinburgh and Glasgow. It provided an alternative route to qualification through the Triple Qualification (TQ), introduced in 1884. The TQ was popular with students who couldn’t access university training, including refugees, international students, and people facing race and gender discrimination. This made the school a vital gateway for marginalised groups pursuing medical careers. Since Edinburgh was full, John arranged for Nompozolo to study at Anderson College and St Mungo’s College in Glasgow.

When Nompozolo travelled to Scotland, she was celebrated in South African newspapers. The Daily Colonist captured the excitement of her success, reporting in July 1938: “Before she sailed for Europe, she was met at nearly every railway station by teachers, journalists and clergymen who wished her Godspeed.” Her story reached international papers, too. One Australian paper, the Goulburn Evening Penny Post, reported: “Caroline Nompozolo, a Bantu girl, wants to be a doctor. She recently arrived in Glasgow from South Africa and has begun her studies at the Anderson College of Medicine… Already Caroline has the BSc. In Africa her training in medicine is looked upon as an important event. Through her pioneer work, many African women in the future may become doctors.”

In Glasgow, Nompozolo studied a range of medical subjects and undertook clinical training at Glasgow Royal Infirmary and Western Infirmary before qualifying as a physician in 1942. She then travelled to Dublin to specialise in midwifery and paediatrics, with support from philanthropic South African organisations. 

Nompozolo’s story, while remarkable, remains incomplete. Later records show that she practised medicine in London in the 1950s. Her obituary says she was a retired anaesthetist living in Glastonbury when she passed away in 2008.

Margaret Todd (1859–1918)

Margaret Todd, a Scottish doctor and writer, was central to preserving the legacy of Sophia Jex-Blake. If you read about the history of women in surgery in the UK, you can’t escape Jex-Blake – and rightly so. As the leader of the Edinburgh Seven, Jex-Blake spearheaded the groundbreaking but ultimately thwarted effort to enrol women at the University of Edinburgh’s medical school in 1869. Undeterred by fierce resistance, Jex-Blake earned her medical degree in Berne, Switzerland, before returning to the UK to cofound the London School of Medicine for Women, and then establish the Edinburgh School of Medicine for Women. 

Jex-Blake’s life and work are meticulously documented in the biography The Life of Sophia Jex-Blake (1918), written by Todd. This biography remains a vital record of both Jex-Blake’s and the collective efforts to open the medical profession to women. In addition to being Jex-Blake’s biographer, Todd was herself a remarkable figure, her own story part of the complex history of societal change.

Todd was one of the early graduates of the Edinburgh School of Medicine for Women, completing her qualifications through the TQ programme – the same qualification Nompozolo would earn 48 years later. While studying, Todd wrote the novel Mona Maclean, Medical Student under the pen name Graham Travers. She graduated in 1894, earned her MD in Brussels, and took up a role as Assistant Medical Officer at the Edinburgh Hospital and Dispensary for Women and Children. While retiring after five years, Todd’s literary achievements continued, with six novels and numerous short stories, which included reflections on being a woman in the medical profession. Her pseudonym eventually became a semi-open secret, with publishers adding ‘Margaret Todd, MD’ to her later works. Todd was a family friend of Frederick Soddy, a chemist and lecturer at the University of Glasgow. In 1913, Soddy shared with her his research on radioactivity, which would later earn him the Nobel Prize in Chemistry in 1921. He had discovered that certain radioactive elements could exist with identical chemical properties but different atomic masses, effectively occupying the same position in the periodic table. Todd suggested calling these variations ‘isotopes’, derived from the Greek for ‘same place’. Soddy embraced the term, which has since become a cornerstone of scientific language.

Evidence shows Todd and Jex-Blake were romantic partners. Given the strong social taboos surrounding same-sex relationships at the time, it is no surprise they never publicly acknowledged this. When Jex-Blake retired, they moved to Sussex where the 1901 and 1911 censuses record them as living together. Todd continued writing while Jex-Blake stepped back from public life. 

Following Jex-Blake’s death in 1912, Todd published her biography then undertook the extraordinary act of destroying all of Jex-Blake’s personal papers. She followed the instructions in Jex-Blake’s will, which stated: “I leave my papers, letters, diaries, letter books, case books and all other private documents to my residuary legatee,
Dr Todd, but in case she should not survive me, then I desire that all such books and papers should be burnt without examination in the presence
of my executor or witness.” Todd also destroyed her own papers before she died. 

Todd died in 1918, three months after her biography of Jex-Blake was published. A scholarship was established in her name at the London School of Medicine for Women and she also left £3,000 in her will (approximately £350,000 today) to support the advancement of women in medicine. Todd and Jex-Blake are buried together in St Denys’ Churchyard, Rotherfield, Sussex, the home they shared. 

Ann Ker (date of birth and death unknown)

In 1752, Ann Ker became the first female Licentiate of what is now the Royal College of Surgeons of Edinburgh. On 24 December 1751, Ann petitioned the then Incorporation of Surgeons for formal recognition of her midwifery skills, requesting “a Licence to practice Midwifery in any Town or Shire.” Following her request, the Incorporation appointed a group of members to examine her. The members’ report on Ker shows that after thorough examination, she was found to be “in every respect extremely well qualified to discharge the office
of a midwife” and that she deserved “the favour of a licence from the Corporation”.

One of Ker’s examiners, Thomas Young, went on to become a pivotal figure in midwifery education. In 1756, Young was appointed the first University Professor of Midwifery in Britain. Renowned for his meticulously organised and frequently revised lectures, in 1756 he established a lying-in ward in the attic of the Edinburgh Royal Infirmary, creating a dedicated space for childbirth and midwifery training. At his own expense, Young fitted out the ward to accommodate eight pregnant patients with the stipulation that those admitted would submit to be delivered by students. Young went on to teach both men and women, holding separate classes but issuing the same printed certificates, leaving blank spaces for names and personal pronouns. 

As a working woman in the 1700s, it is unsurprising that so little is known about Ker – historical records rarely deemed the lives and achievements of people like Ker worthy of preservation. We do know she sought institutional recognition during a period of intense tension for female midwives, who had traditionally honed their skills through intergenerational learning, observation and experience, and male-led institutions striving to standardise and regulate the profession. 

The contributions of Ker and Young were part of a broader movement to advance and formalise obstetrical education. While this movement was not without its flaws, their actions reflect efforts to foster expertise across genders in a period of entrenched misogyny. Their stories highlight a recognition of the need for inclusivity to advance a field that continues to be critical to public health.

Lisa Megginson (1970–)

Through powerful advocacy, Lisa Megginson has positively influenced the field of women’s health, not as a medical professional but as a patient. After experiencing a transvaginal mesh implant, Megginson became a vocal advocate against the procedure. Prior to the removal of her implant, she contacted Surgeons’ Hall Museums to arrange for it to be donated, ensuring systemic medical challenges faced by women worldwide, along with the urgent need for change, are highlighted for generations to come.

Megginson underwent surgery to have a transvaginal mesh implant in 2006, a procedure designed to address urinary incontinence and pelvic organ prolapse. Unfortunately, like many women, she experienced severe complications. These implants, made from polypropylene, were considered a breakthrough in medical technology but, for Megginson and thousands of others, they led to chronic pain, infections and reduced quality of life.

For Megginson, the implant caused persistent discomfort, making everyday activities unbearable. Her case echoed the stories of many other women who had undergone the same procedure, drawing attention to the wider crisis surrounding transvaginal mesh implants where women experiencing pain were not heard in the medical system. 

Despite the significant toll on her health, Megginson became a vocal advocate for women facing similar issues. Her decision to have the implant removed was both a personal necessity and a public statement. The removal procedure itself was complicated as the mesh integrates with body tissues over time, making extraction a high-risk process. Megginson used this experience to expose the need for better-informed consent and greater scrutiny of medical devices, calling for awareness, regulation and improved healthcare practices for women affected by transvaginal mesh complications. This movement has led to significant changes, including the suspension of mesh implants in the UK for certain procedures in 2018.

In 2022, Megginson donated her surgically removed implant, and attached tissue, to Surgeons’ Hall Museums. Here it is shared online and in the galleries, spotlighting a pivotal moment in the history of women’s health. Megginson’s donation is currently the only human remains in the Museum’s collection fully documented to meet modern consent standards. In an era when the ethical complexity of human remains in museums is widely debated, her mesh serves as a powerful example of how these collections can engage audiences in profound and meaningful ways while meeting today’s ethical standards.

Megginson’s story is a call to ensure future generations receive better care, understanding and consideration in today’s medical field. Her actions demonstrate that catalysts for positive change come from many places.

Acknowledgement 

The author thanks Jacqueline Cahif, College Archivist, whose passionate critique of ‘the first’ paradigm inspired this article and who provided invaluable source material. Thanks also to Lisa Megginson and Louise Wilkie, Curator of Surgeons’ Hall Museums, who accessioned Megginson’s mesh to the collections and whose insights informed this article.