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Vol. 18 No 3 | Spring 2016
College
Honouring Doris Gordon: the foundation of a legacy
Prof Ronald W Jones CNZM
MB ChB, MD, FRCS(Ed), FRCOG, FRANZCOG, FAOFOG(Hon)


This article is 4 years old and may no longer reflect current clinical practice.

Practitioners of obstetrics in New Zealand are standing on the foundations Doris Gordon established three-quarters of a century ago. With the re-establishment of the Doris Gordon Memorial Trust, her contribution will now be more broadly recognised.

It could be argued that Doris Gordon has made a greater contribution to the health and welfare of New Zealand women and children than any other individual. Sadly, her name and her monumental contributions have almost been forgotten. She was the catalyst in transforming largely primitive Victorian childbirth to mid-to-late twentieth century practice; she established the New Zealand Obstetrical Society in 1927, and as its long-serving honorary secretary she used the Society as the vehicle to create her visionary changes to maternal welfare. It is difficult for us today to comprehend how the vision, energy and commitment of a general practitioner from the backblocks of our country led to such enormous benefits for doctors, patients and families.

A journalist described Dr Doris (as she was always called) as: ‘A severely handsome woman with a somewhat formidable manner which concealed – or sometimes cracked to reveal – a tender compassion which made her intensely and vulnerably feminine.’ Going on to say that Doris used her determination and intelligence ‘like a flail, a barb, a pitchfork, even a pistol, to force people to attend, and to agree, and to work, and to give, and to get things done.’ During a brief time as Director of Maternal and Infant Welfare, she was described as unconventional and controversial, ‘sweeping red tape out of pigeonholes, humbug out of negotiation, cotton wool out of unwilling ears – like a young hurricane on rampage.’

Doris was born in Australia in 1890, of a pioneering and missionary background. Following the financial crash in 1893, her family moved to New Zealand where her father, a part-time lay preacher, continued his banking career, becoming a manager in Tapanui, Southland. Doris initially refused to go to high school, becoming instead the paid family housekeeper. However, at 17 she decided to become a medical missionary. Doris’s missionary zeal is illustrated in her writings on the fly leaf of her Bible where, from a very young age, she professed her Christian principles and goals in life. With the support of her parents, she made up for her previously patchy schooling and, in 15 months, gained her matriculation at Tapanui District High School.

At the University of Otago she wrestled with her creationist upbringing and the new Darwinian view of evolution. Despite her claim to be ‘probably the most poorly qualified entrant ever to cross the threshold’ of the Medical School in 1911, she was described as a ‘brilliant medical student’ and topped the class in medicine and surgery in her final year. She graduated in 1916 and, during house surgeon years in Dunedin, married a fellow medical graduate, Dr William Gordon, less than two weeks before he left on overseas war service in 1917. She also became a university lecturer in microbiology under the tutelage of Prof Sydney Champtaloup. Champtaloup was described as the driving force in the new medical laboratory and he encouraged Doris to do a Diploma in Public Health. Her brief placement in the head office of the Health Department led to her realisation that bureaucrats were frightened of newspaper publicity, an awareness she later used to good effect in her campaign for maternity reform. This experience also provided Doris with a broader appreciation of community health. It was during this time she was diagnosed with a spot on the lung that resulted in her rejection for missionary work in India. Instead, she became an obstetric missionary in New Zealand.

Following the war Doris and her husband bought a country general practice in Stratford, Taranaki. She observed: ‘My Quaker-Puritan genes found an informal life in provincial Taranaki, great fun, I was well content to be the “lady-doc” to the farmers as well as a mother or sister to their women folk’ – what an understatement this proved to be.

Her next eight years were consumed with domestic responsibilities and the role of a busy general practitioner/obstetrician. However, a series of obstetric disasters caused her to consider the shortcomings in her own training in obstetrics. Together with her husband, she sailed to the UK where they both gained fellowship of the Royal College of Surgeons of Edinburgh (FRCSEd). Doris, who was second in the examination with another New Zealander, Dr Leslie Averill of Christchurch, was the first Australasian woman to gain this qualification. After the examination she made the acquaintance of a number of leading British obstetricians and gynaecologists, including Victor Bonney, described as the gynaecologist of the century. She already understood the importance of networking. Following the establishment of the British (later Royal) College of Obstetricians and Gynaecologists, she became a Founding Member.

Doris was an enthusiastic advocate for safe, widely applicable methods of pain relief in labour. While male bureaucrats in the Health Department were advocating nature’s ways – no doctors, no anaesthetics – she was promoting ‘twilight sleep’ (morphine and scopolamine). Her research on the topic led to an MD thesis, which was accepted with commendation, but she never completed the written section of the examination.

Not content with her FRCSEd, Doris was already planning the next stage of her mission: to improve the teaching of obstetrics, initially at her alma mater, the Otago Medical School. In 1926 she proposed a remit to the Napier Division of the British Medical Association, recommending the formation of a New Zealand Obstetrical Society; this was founded in Dunedin the following year. The Society was to be the vehicle for her life’s mission. The stated aim of the Society was ‘to correlate the efforts of individual workers and to promote the scientific study of obstetrical matters in New Zealand … and to give the art of obstetrical practice the status it so rightly deserved, but at that time lacked’. Doris said, ‘We are the watchdogs to see that bureaucracy keeps obstetrics and gynaecology on a sane level and progressive keel in New Zealand.’ Doris recognised that if this new Society was to achieve her long-term goals, she needed to have firm control over its destiny and, as she would later write, ‘the assemblage took for granted that my husband would be the honorary treasurer and I would be the pen-driving honorary secretary.’ As a consequence, she largely controlled the Society until her death.

The early Minutes of the Obstetrical Society provide a fascinating insight into the important issues of the day: the inadequate teaching of obstetrics in Dunedin; a remit to Otago University regarding the establishment of a Chair of Obstetrics; the possibility of a postgraduate school of obstetrics in New Zealand; the establishment of a resident obstetric training post for New Zealanders in Melbourne and a supporting scholarship fund; the possible involvement of the National Council of Women in fundraising; the possibility of a Maori obstetric hospital; and research into stillbirths, neonatal deaths and puerperal sepsis. The great Victor Bonney, whom Doris had recently visited in London, accepted her invitation to be present and speak following the foundation meeting of the Society. He travelled New Zealand extensively, both lecturing and fishing; described New Zealand as ‘the finest country God ever made; the best rank and file doctors I have met’; and promoted an Obstetric Professorship in Dunedin. The new honorary secretary declined an honorarium.

The University of Otago accepted the Obstetrical Society’s offer of a £25 000 endowment for the establishment of a Chair in Obstetrics and Gynaecology together with an undertaking that the Otago Hospital Board would build a large, new maternity hospital suitable for training medical students. Doris relished the challenge of raising the necessary funds and organised provincial committees. She enlisted the assistance of the National Council of Women and women in power. For instance, Lady Bledisloe, the wife of the Governor General, organised a supportive letter from Queen Mary, the Queen Mother. Men’s groups, in particular Rotary, were supportive; every member of the ASB Board was personally interviewed, resulting in a gift of £2000. She was proud of the ‘press agitation’ she achieved with the editors of all major newspapers, together with the broadcasting service. While her husband ran his own practice, as well as hers, Doris criss-crossed the length and breadth of New Zealand with ‘midnight journeys’ addressing 200 women in Auckland, 300 in Gisborne and many thousands elsewhere; which she described as ‘prospecting’. The six-month campaign raised £31 741 (current equivalent, NZ$3m) of which £25 000 was presented to the University of Otago for a chair in obstetrics and gynaecology, and the remaining £6 000 was directed for two postgraduate travelling scholarships.

Dr Bernard Dawson took up the Otago chair in 1932, impressing Doris with his ‘quick brain, military precision and eloquence’. He quickly established an effective and harmonious relationship with her, aimed at improving obstetric practice in New Zealand. Later their relationship cooled when Doris promoted the development of a postgraduate department of obstetrics in Auckland, diminishing his sphere of influence.

Doris Gordon’s sterling work on behalf of the women of New Zealand led to the award of an MBE in 1935, and an Honorary Fellowship of the RCOG in 1954. At this time she was the only woman outside royalty to be so honoured and the only recipient in the southern hemisphere.

Doctors in the 1930s had little knowledge or training in contraceptive instruction and were reluctant to discuss birth control with their patients. At that time New Zealand needed more, not fewer, births. The Obstetrical Society was prepared to give instruction in birth control where reasons of the health of the mother demanded it, but only through hospital clinics. The Society was, however, concerned there was no restriction on the sale of contraceptives, including to minors, and felt it was ‘contrary to the public interest’ for contraceptive knowledge to reach single men and women. During this time illegal abortion was a major source of concern for the Society and women’s groups, leading to the establishment of a Committee of Inquiry in 1936. During the previous year, 45 maternal deaths had been attributed to criminal abortion and the average number of children born to each of these women was eight. In 1937, together with Dr FO Bennett from Christchurch, Doris wrote a controversial polemic, ‘Gentlemen of the Jury’, in which they described their conservative views on contraception and the problem of illegal abortion. While this book created controversy in the community, it expressed the views held by most of the medical profession of the time. Doctors had created a dilemma for themselves: on the one hand there was an abhorrence of criminal abortion and its sequelae, while on the other a reluctance to promote birth control. The book aroused parliamentary debate, one MP observing: ‘Tomorrow the Springboks play the All Blacks in Auckland. I wonder how many of the 55 000 people who will be present will realise that during the actual period of play, one child – perhaps a potential All Black – will have been wilfully destroyed in the womb of its mother.’!

If obstetric care was to progress in New Zealand it needed young trained specialists and, to this end, the vision of Doris and the Society in providing scholarships for young doctors to gain postgraduate examinations and overseas experience in obstetrics and gynaecology was farsighted. The first Scholarship was awarded in 1928, and from that time they were awarded annually. It soon became apparent that the young, newly trained specialists were not returning to New Zealand as had been hoped, but remained in the UK, where better job opportunities existed. Dr Ken Pacey from Wellington was the only scholar among the first ten awardees to return to New Zealand. Doris noted: ‘The only way to get the Scholars [back] is to have a good obstetrics and gynaecology centre anywhere in the country … our Hospital Boards were badly advised by medical interests that did not want to see gynaecology exulted as a specialty.’ Doris must have sensed she would not have received the necessary support for her nascent plans in New Zealand and decided to enlist assistance from the powers that be in the UK; she attended the RCOG meeting in Edinburgh in 1939. The RCOG president, William Fletcher Shaw, was sympathetic to her plight and, together with previous scholars now permanently resident in the UK (including John Stallworthy, William Hawksworth and Robert Reynolds MacIntosh, a New Zealand anaesthetist at Oxford), they organised meetings in Manchester, Oxford and London. The outcome of these meetings was the decision to build a New Zealand postgraduate obstetric and gynaecological hospital that would attract young specialists back to the country of their birth. With British support, the Obstetrical Society resolved: ‘The time has arisen for the establishment of a postgraduate centre for obstetrics and gynaecology’. It is noteworthy that Stallworthy, Doris and others made a strong case to recruit Hawksworth back to the Foundation Chair. Hawksworth’s case for limited private practice (the funds to go to the departmental research fund) was the public basis for his rejection, but the real reason was personal jealousy from some senior members of the profession for his right to private practice.

Prof Ronald Jones and Alison Van Der Oest, Doris Gordon’s daughter, at the RANZCOG New Zealand Annual Scientific Meeting, Wellington, 2 October 2015.

In 1940, the remarkable Auckland thoracic surgeon, Douglas Robb, wrote to Doris asking if he could become a member of the Obstetrical Society. Doris described Robb as ‘an academic visionary who was always in hot water with the more myopic of his professional brethren’. Doris and Robb formed a powerful partnership, teaming up with Stallworthy at Oxford and the College President, Fletcher Shaw, to make a case for the establishment of a postgraduate school of obstetrics and gynaecology in Auckland. Speaking at an Obstetrical Society meeting March 1941, Robb quoted the Rockefeller Foundation’s lament:

In the shadows that are deepening over Europe, the Lights of Learning are being extinguished one by one … more and more institutes of learning are being blotted out.’ New Zealand has hitherto been content to send its doctors to Europe for higher training in obstetrics and gynaecology. Now that Europe is plunged into a scientific and cultural blackout it behoves New Zealand to ‘light its own light of Science’ and preserve (in the South) the learning we borrowed in happier years from the old world.

Once again Doris’s organisational skills came to the fore and, with the assistance of businessmen, women’s groups and the public at large, £104 594 (current equivalent, NZ $7.6m) was raised to endow a postgraduate Chair in Obstetrics and Gynaecology in a new women’s hospital promised by the government.

Towards the end of the war, Doris invited one of New Zealand’s most eminent sons, Charles Read, an obstetrician and gynaecologist soon to be knighted following his elevation to the Presidency of the RCOG in London, to advise on matters related to the new postgraduate hospital in Auckland. Dawson, jealous of the projected new academic department, wrote to Fletcher Shaw, the immediate past-president, in London, expressing the opinion that ‘someone – not a New Zealander – should be sent in order to give a more detached view’. Fletcher Shaw came instead.

Left to right: Dr Ngaire Anderson, Prof Ronald Jones, Alison Van Der Oest, Nicky Gordon (Doris Gordon’s granddaughter), Matthew Heard (Doris Gordon’s great-grandson), Leah Heard (Doris Gordon’s great granddaughter in law) with baby Evelyn Heard (Doris’ great great granddaughter), Philip Ashcroft (O&G Society), Rae Duff (President NCWNZ), further NCWNZ representative.

Doris Gordon died in her own hospital, Marire, in Stratford, in 1956, and did not see the opening of the new National Women’s Hospital in 1964. In a memorial broadcast, Robb remembered her:

No one who knew Doris Gordon, or at least no one who was being used by her for her high purposes, would remain long in doubt about her tenacities and inflexibilities in pursuit of her ends. A mere male, the ordinary peace-loving type, might even be a little afraid of her energy and the services she required. Fear was even, on occasions, known to develop into alarm as the pressure was put on and the chariot wheels revolved faster and faster. To be of any use to Dr Doris you had to be ready to write letters, ring people up, try to put pressure on them, and generally leave your bed at any hour of the day or night. Nice work if you were pleasing her, but not so nice if you were dragging your feet or getting her to change her mind. Some mere males have even been so peevish as to characterise her communications as unparliamentary or even unscrupulous, but these persons take no account of Doris Gordon as a creative woman. Any person, male or female, who can cause to be endowed two medical chairs in the University of New Zealand in addition to leading a full professional, business and family life, as Doris did, deserves our admiration and grateful thanks.

Following her death, the New Zealand Obstetrical Society and the National Council of Women raised £4793 to establish the Doris Gordon Trust, to ‘promote, sponsor, cooperate in, and otherwise further the study and/or practices of gynaecology and obstetrics’. Hawksworth delivered the first Doris Gordon Memorial Oration in New Plymouth in 1963. He recalled she was an examiner at his final oral medical assessment and he thought she was ‘a bit of a dragon’. In the absence of Trust or later Obstetrical Society records it is not possible to know if there have been other memorial orations. Sadly, in recent decades, both the Doris Gordon Trust and the Obstetric Society she established have been largely forgotten. The establishment of the new Trust should hopefully restore the recognition owing to Doris Gordon.

The rebirth of the Doris Gordon Memorial Trust

Following an inquiry by the Inland Revenue Department in 2011, my accountant asked if I knew anything about the Doris Gordon Memorial Trust. I had heard of the Trust, but knew nothing more; however, my recent retirement provided me with an opportunity to investigate what had happened to it. There were no living Trustees, and at that time no known Trust Deed, and although a bank account was known to exist, in the absence of a Trustee it could not be accessed. After making extensive national inquiries, I met with an enthusiastic young solicitor, Mary Joy Simpson, who finally located the Deed in the stored documents of a long-forgotten legal firm. In the absence of Trustees and with the demise of the Obstetrical Society, I sought the assistance of Mrs Marie Taylor, an active member of the National Council of Women and wife of obstetrician, the late John Taylor, and asked if she would agree to be nominated as a Trustee by the National Council of Women. The Trust bank account was finally accessed and revealed a balance of $130 000, which provided an incentive to re-establish the Trust. The Obstetrical Society had been inactive for some years so I approached the Chair of the RANZCOG New Zealand Committee, Dr John Tait, who, following consultation with the College Council, kindly agree to assist in re-establishing the obstetrics and gynaecology arm of the Trust in partnership with the National Council of Women. This required a new Trust Deed.

Following Doris Gordon’s death, the New Zealand Obstetrical Society continued to play an active part in general practitioner education through regional Society groups, particularly in the Waikato region. The National Executive role was rotated around the regions; periodic meetings were held, sometimes with overseas speakers; and the Society also played an active role as a Maternity Benefits negotiator. For many years the Society contributed a regular section to the New Zealand Medical Journal. The New Zealand Obstetrical Society was struck off the New Zealand Register of Incorporated Societies in 2000, presumably a result of its lengthy period of inactivity. Falling numbers of GP obstetricians led to the demise of the Society in 2004, following its last meeting. I approached Dr Phillip Ashcroft, the last President of the Society, and he generously agreed to transfer the residual funds, $177 000, to the new Doris Gordon Memorial Trust.

The text of this article has been taken from the Doris Gordon Memorial Oration, delivered at the RANZCOG New Zealand Annual Scientific Meeting, Wellington, 2 October 2015.

A transcript of the Oration was frst published in the New Zealand Medical Journal. 2016; Vol.129, No.1437. Reproduced with permission.


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