In the crucible of war, heroes are forged. We remember the political leaders who made critical decisions or the soldiers who put their lives on the line. Other heroes emerge without titles or uniforms. One example is Janet Maria Vaughan, MD (1899–1993). She started life unlikely to become a physician and even less likely to be a hero.
As a young woman, she appeared to be a lackluster student, but with persistence she passed her entrance exams to Oxford University, England,and then earned her medical degree as well. She went on to have an extraordinary medical and wartime career and yet did some of her best research later in life, culminating in admission to the Royal Society at the ageof 80. She was recognized as an Officer of the British Empire and later Dame Commander of the British Empire. After the war, she became the Principal of Somerville College, Oxford, from 1945 to 1967 while working as a distinguished hematologist and radiation pathologist. The real story began several years earlier.
As the world once again moved toward war in the latter moved toward war in the latter portion of the 1930s, Dr. Vaughan worked as a clinical pathologist at Hammersmith Hospital in London. These were uneasy times for women physicians in the eyes of many patients or colleagues; however, resilience was a core quality throughout her life as she continued to build her career. She had become interested in disorders of the blood, expanding on the work of American physician George Minot, MD, who had adopted raw liver extract therapy instead of arsenic for the treatment of pernicious anemia. Her interest in blood continued as war approached.
Dr. Vaughan had developed a relationship with a visionary— Catalan hematologist Frederic Duran-Jorda, MD, who pioneered advances in blood storage during the Spanish Civil War. Despite military experience with blood storage dating back to World War I, the civilian leadership in England was committed to a “blood on the hoof ” approach to blood storage. In other words, volunteers will be called upon when needed. As a result, by 1939 only eight pints of blood had been stored in a single civilian storage center for all of London.
Not to be dissuaded by the lack of vision of others, Dr. Vaughan approached the medical school dean and received £100 to develop a method of mass blood storage. In 1938, she assembled colleagues in her flat in London and inaugurated the Emergency Blood Transfusion Service. She led her team through all phases of planning for mass blood storage. Amid the pipe smoke, fish and chips, tea, and who knows what else, the team worked out the details of citrate-based storage of whole blood. They then designed the collection bottles, tubing, and stoppers. Finally settling upon milk bottles because they were plentiful and could easily be stored, they went to work choosing four locations for depots where blood would be typed, refrigerated, and finally delivered to hospitals in need.
Based on populations and estimates of casualties, they painstakingly calculated that each depot would need to store approximately 9,000 units of blood, preferably type O. They wrestled with all the details, even down to the concerns about syphilis testing. Two sites would be chosen north of the Thames River and two sites to the south to cover a London population of approximately 8 million at the time. Dr. Vaughan became the director of the northern unit in Slough. On September 3, 1939, the Emergency Blood Transfusion Service received the initiation order by telegram, “Start bleeding.”
Reports vary, but somewhere in the range of 30,000 deaths occurred during the Blitz, with many more wounded in London alone. The men and women providing emergency care saved untold numbers of lives, aided in no small measure by the efforts of the civilian Emergency Blood Transfusion Service, who organized everything from the generous donors to the drivers who delivered the whole blood bottles by refrigerated ice cream trucks.
After her distinguished career at Oxford, Dr. Vaughan remained active long after her retirement until her deathin 1993 at the age of 93.
George R. Nine Pints: A Journey through Money, Medicine, Mysteries of Blood. 2018. Metropolitan Books, Henry Holt and Company, New York, NY.