This biography is based on an interview with Elizabeth Berry in 2016 for the Early Medical Women of New Zealand Project. The interviewer was Lucy Goodman.
“I’m the only medical person in the entire family. Everyone else is in the arts or sciences.”
Elizabeth Berry was born in 1937, the oldest of three children. Born into a family of university graduates, Elizabeth always knew she would do tertiary studies. Her father was a Lecturer and later the Principal of Lincoln Agricultural College, who had met his American wife during his postgraduate studies at Cornell University. In 1936, he brought his brave new bride back to New Zealand with him, during the days when it took six weeks for a letter to travel from one side of the world to the other.
Their daughter Elizabeth developed an interest in medicine at a young age.
“I think the idea came into my head when I was about eight, and a cousin said she was going to be doctor, and I thought, “Oh that sounds quite interesting”. So, I kept it in my head throughout school. At that stage, there were only three career options. You were a teacher, or a secretary, or perhaps you were a nurse. So, to become a doctor, once you had said you were going to become a doctor, you felt as though you ought to carry on and do this.”
Her family encouraged her to follow her dreams. Although her secondary school education had not prepared her sufficiently for her choice of studies, she persevered through a competitive medical intermediate year at Canterbury University and was accepted into medical school in 1956.
“My father said, “You do whatever you would like to do. I just have one piece of advice, and that is whatever you start, you finish.” School was very discouraging, but that just made me more determined. So, I had special coaching for physics, for example, because no physics was taught at girls’ schools. That made intermediate with compulsory physics very difficult for most of the women to pass, and is I think one of the reasons why there were so few women at medical school.”
Medical school: a group of high-achieving women
Elizabeth spent the first four years of her training in Dunedin at Otago Medical School, where she experienced the highs and lows of student life in New Zealand’s southern climate. She was supported financially by a boarding bursary and her family. There was no need to pay university fees in those days, although she worked during the holidays to earn extra money and lived a fairly spartan lifestyle.
“It was cold. It was damp. One didn’t have transport, but it was still very enjoyable.”
Elizabeth was one of 11 women in her class, including one woman who had returned to medical school after 12 years away having her three children. Rather than celebrating achievements such as these, Elizabeth and the other female students endured a degree of social stigma during medical school that she felt was archaic and “completely ridiculous”.
“We were not allowed to share a common-room—the boys said they couldn’t tell their jokes at morning tea time. So, we had a separate common-room, which actually had more space per person… We couldn’t go into pubs. We weren’t invited to the fifth-year dinner—that’s the year before you go away for your final year in one of the four main centres—the women had a separate lunch, hosted by the Medical Women’s Association.”
Considering the challenges that she and her peers faced, Elizabeth is particularly proud that the women in her year managed to achieve so much during their careers.
“We were all told many times that we were taking the place of a good man. That is why I am so pleased that so many of my classmates have done extremely well. I followed up all the women and am really pretty proud of the fact that of those 11 women, nine got post-graduate qualifications. That’s a higher percentage than the men.”
Clinical training: thrown into the deep end
With only one hundred or so house surgeons available to service the entire country, the less-experienced final year medical students were often called in to fill the gaps. During the summer break between her fifth and sixth year, she found herself thrown into the deep end of clinical practice, where she was asked to manage a level of responsibility beyond her training. The experience was an adventure for Elizabeth.
“In later days when students did their OE, they trotted off to Jamaica and Afghanistan and other exotic places, but in my day you went somewhere else in New Zealand. I went to Cook Hospital Gisborne because it was the furthest place away from anyone I knew. I thought I’d make my mistakes somewhere else! There were two of us, and then the supervising registrar had a back injury and he was flat on his back, and the one fulltime hospital consultant and two of us were effectively on the front line in the Cook Hospital for the summer. I have indelible memories of typhoid—I missed the first two cases because they were quite atypical. I finally got the third one right. We saw diphtheria and rheumatic fever. We saw incredible diabetics, tuberculosis, unusual fractures, hydatid cysts—all sorts of things that you barely see now.”
By sixth year, the hard work and responsibility only continued. Elizabeth spent this last year living and working in Christchurch Hospital, where she felt a sense of community with her fellow students and colleagues.
“It was very busy, but it was very stimulating, because if you’re actively following people up for 24 hours, you actually learn a great deal. Quite honestly, in those days, working those hours, I fell asleep in the middle of dinner so often. Every time I went to the theatre, I fell asleep. It was very demanding, but it was also quite enjoyable. There was a tennis court, and we used to play a lot of social bridge. So, yeah it was quite a community and it was quite enjoyable—parties and so on.”
Elizabeth returned to Dunedin in 1960 for her graduation, which she found a relatively non-ceremonious affair after her year away training. Now as a qualified doctor, Elizabeth returned to Christchurch Hospital with an open mind towards her future specialty.
After graduation: specialising in haematology
“I didn’t really have a clear idea as to where I wanted to go after I graduated. I think when you start medical school you’re focussing on finishing. When you finish, you think, what line am I going to pursue?”
Elizabeth’s area of specialisation was serendipitous. Despite her exhaustion from working 100 hours a week for two years as a house surgeon, she wondered about doing a year as a medical registrar, but with so few jobs available she was not successful in securing a role. Next she considered working as a paediatric registrar, however that vacancy was filled when a visiting paediatrician joined the team.
Instead, Elizabeth accepted a job as a pathology registrar. During medical school she had been inspired by Bruce Howie’s lectures in haematology, and now as a registrar she was fortunate to have wonderful teachers, including Dennis Stewart and Fred Gunz, who furthered her interest in the field. She discovered that she enjoyed the mix of laboratory and clinical work.
“I love looking down microscopes and seeing things, solving puzzles, but I also like people.”
Elizabeth spent three years training in all branches of pathology including haematology. She sat the exams for her MD in pathology—the only qualification available at the time. With internationally recognised teachers to support her, Elizabeth was in the fortunate position of being able to choose where she wanted to continue her studies. She chose America, and together with her new husband—a fellow medical graduate who she had met during her years working as a registrar—Elizabeth travelled overseas to spend two years training in haematology at Boston City Hospital.
Training overseas: from the wards to a subterranean research laboratory
“It was quite different, because it was just haematology, and included quite a lot of clinical work, so I was back in the wards. It was a different spectrum of diseases – haemoglobinopathies such as sickle cell anaemias and thalassemias, which we don’t often see in New Zealand. My bosses there were leaders in various trials for new drugs for leukaemia and lymphoma, so I was involved with those too. We also had to do our own laboratory work unlike New Zealand where there is a skilled laboratory work force. My special laboratory project was setting up a cytogenetics service. It was a very interesting and stimulating environment and my husband and I spent a lot of time going to interesting lectures by eminent physicians.”
After leaving Boston, the couple moved to Edinburgh so that Elizabeth’s husband could complete his own postgraduate training in anaesthesiology. Here Elizabeth worked as a Lecturer in Haematology at Western General Hospital, where she completed the research for her thesis entitled ‘Cytogenetics of Myeloproliferative Disorders and other Potentially Leukaemic States’, to complete her MD. The couple spent the following year in Oxford, where Elizabeth gained some important experience in blood coagulation research and the management of haemophilia that would later shape her career in New Zealand.
“When I was in Oxford, I got a research job, and I was told to investigate lysis of blood clots. I didn’t know much about blood clotting, so I scrambled around, and eventually decided to look at the fibrinolytic activity in post-mortem blood. This involved going down to the morgue, collecting blood and separating out the lytic activity. This was really quite fascinating, because depending on what people had died of, they would have varying degrees of lytic activity. You had to make an agar plate, and then see how much of a hole appeared in it after you’d added your globulin fraction. That was quite an intriguing thing to do.”
“I was working in a lab which was subterranean—there was just a small window near the ceiling where you could see feet walking past. One tended to feel stir crazy. So, I would go off and attend a few ward rounds in the Oxford Haemophilia centre which was internationally renowned. I found that very interesting.”
Elizabeth and her husband returned to New Zealand in 1970. Much to Elizabeth’s dismay, the new College of Pathologists had established their own postgraduate qualifications and her MD was no longer recognised, forcing her sit both Part 1 and Part 2 of the College exams.
“So, I had to re-sit everything all over again… It was a totally different type of exam, but fortunately the exposure I had had overseas was very helpful and even though I hadn’t been to a formal training course, I’d had a sufficient range of experience to be able to pass the exam.”
Postgraduate training: challenges for a medical woman
“It took a male medical student a certain amount of courage to ask out the medical women. I think people have a fascination with bodies and bodily functions, and the thought that this woman might know all about them inside—lawyers and others—would go, “ew, a medical student”.”
Elizabeth’s husband, himself the son of an early medical woman, Doris Berry, was supportive of his wife’s medical career. In practice however, he would start work at 7:30am while Elizabeth was left to juggle the practicalities of caring for their three children. Fortunately, she found haematology a favourable career for a working mother, as she could work part-time with some flexibility in her working hours.
Not all women were in this fortunate position. The lack of part-time work and training opportunities made it difficult for working mothers to gain the postgraduate qualifications that they needed to specialise. Elizabeth stands by her strategic decision not to have her children until she finished her postgraduate training.
“I decided not to have any children until we came back to New Zealand. So, I did not ever juggle training and small children. It can be done, but it’s a very hard ask. To work with small children, you’ve got to be physically very fit, mentally fit, and have children without problems, so, it’s a big ask. And a husband who’s sympathetic to what you’re doing.”
Aware of the problem that many medical women faced, Elizabeth worked alongside Barbara Heslop and the New Zealand Medical Women’s Association to establish the Medical Reserve Scheme in 1984—an initiative that allowed training clinicians with children to regain confidence in their abilities, move into part-time work, and eventually into a specialisation.
“You lose confidence, and the less training you have, the more confidence you’ll lose. People could continue working maybe two sessions a week, or three, in order to keep their hand in. It was called the Medical Reserve Scheme, and they could keep their hand in by doing a little bit of work. There was a big shortage of doctors in those days. It kept people able to work, and in the program.”
Negotiating the terms of the scheme was challenging. The logistics of part-time training and work was, and still is, difficult for employees, as well as their colleagues and employers who must pick up the slack. While Elizabeth advocates for women’s rights and training opportunities, she would still strongly recommend that doctors, male or female, avoid training while caring for young children, if possible.
“You really can’t expect to be left out of weekend call rosters, and everything else, because you have family commitments; everybody has commitments—everybody’s made decisions to do things one way or the other, so it’s got to be fair. It’s a thorny issue.”
“One of the other problems is that people come into medicine after having done something else, and as they’re getting older they don’t want to delay having babies, and this is very difficult. I think the whole scene for childcare is better than my day, because in my day you didn’t have au pairs or nannies. It was really hard to get help, and I think that has improved quite a bit.”
Career highlights: New Zealand’s first haemophilia centre & a safer blood supply
“What I did realise when I went overseas was how incredibly good my two mentors in New Zealand had been. In fact, there was a sense of disappointment in Boston, because the histopathology lab was run by the great Stanley Robbins who had written the textbook of pathology that we used. It was absolutely surprising to me to find that that department was not as good as the one I’d come from. So, some things Kiwis do extremely well.”
While her mentors were leading the way in management of leukaemia and lymphoma, the care of patients with bleeding and clotting disorders was significantly lacking in New Zealand. With her postgraduate training complete, and both clinical and research experience in blood coagulation disorders to her name, Elizabeth found herself in a perfect position to specialise in this area.
“It was perhaps quite fortuitous, because when I came back to New Zealand, the need was for somebody to work in the area of clinical bleeding and clotting.”
In 1974, the Auckland Hospital Board sought to establish a centre for haemophilia management and care. Elizabeth played a key role in establishing and then directing this first Haemophilia Centre in Auckland City Hospital. The centre provided specialty care for haemophilia patients who previously had been scattered throughout other wards. Over the years, Elizabeth worked to improve quality of life for haemophiliacs in New Zealand, introducing home therapy options, and responding to patient requests for more information and support by establishing annual haemophilia family camps. Elizabeth attended these camps every year and was known to host additional meetings for mothers of young children with haemophilia in her own home.
“One of the most important things I did was to establish haemophilia camps along with some of the members of the Haemophilia Foundation of New Zealand —for people with bleeding disorders, and they’re still going really well. We were the first people in the world to actually start running camps for families. There’s no point in taking the child and educating him, if you don’t educate the whole family as well. That would probably be the most beneficial thing I’ve done for anybody else.”
Elizabeth believed strongly in maintaining a high-quality, safe, blood supply for haemophiliacs and those in need of donor blood services. In 1977, the Haemophilia Centre together with the Auckland Transfusion Service established a national haemophilia register to ensure blood products were available for patients. In the early 1980s, Elizabeth led the nationwide response to the HIV epidemic, arguing for locally sourced blood products. When New Zealand haemophiliacs inevitably contracted HIV, she stood beside her patients, writing to the Accident Compensation Commission on their behalf to ensure they received appropriate compensation. In the late 1980s, she lobbied for Hepatitis C testing and improved heat-treatment of donor blood. Her recommendations were not enforced until several years later, a delay that lead to the 1992 ministerial enquiry into the safety of blood products in New Zealand.
“These were certainly very stressful times, because patients can get extremely ill, and some died. I would have to say that the whole of the AIDS epidemic significantly impacted on my patient population. It was terrible. I know a number of my colleagues oversees who had more affected patients than I did—that was their entire life’s work, these people were dying in front of them. They had to leave for their own sakes. It was a very difficult time. In addition to HIV we also had the other major blood-borne infections Hepatitis B, and Hepatitis C. The nett result of all of this is that the blood supply is very much safer for everybody.”
Looking back: awards, advice, and retrospections
Elizabeth retired from clinical practice and her work in the Haemophilia Centre in 2002. Throughout her career, she was a prominent haematologist, recognised both in New Zealand and internationally. Her work throughout her career raised haemophilia treatment to new heights, earning her a Queen’s Service Order for public service in 1988. As well as publishing extensively in the haemophilia literature, she served on the committee for the New Zealand Haemophilia Society until 1989 when she stepped back into the role of Medical Advisor so that she could chair the Medical Advisory Board of the World Federation of Haemophilia. Her international connections brought further expertise to New Zealand, always with the aim of enhancing the lives of her patients.
“I really enjoyed looking after people with bleeding disorders, because you look after one aspect of care for the whole family and you also have a longitudinal perspective Even now people ring up from time to time with news of their progress or that of their children and grandchildren—people I’ve looked after since I first came back in 1970. It’s wonderful to see them doing really well.”
Elizabeth looks back on her career with pride, and a sense of gratitude towards the harmonious and congenial group of people who she had the good fortune to work with.
“I think I’ve been quite blessed because the particular department I worked in was very pleasant. Not all departments are, but this was a very nice, harmonious and congenial group of people, and I totally enjoyed my working life.”
Elizabeth’s advice for men and women entering medicine is pragmatic.
“I would still say that you need to think very hard—if you really want to be a doctor, and you have thought about it properly, go for it. There is a place within medicine for all the different personalities, but you will be with a whole pile of other people who have got Type A personalities, and that can be challenging. In this sense I’m not really sure that medicine is different from engineering or law, or anything else.”
“I also think you have to have quite a bit of ‘stickability’. Medicine is really like doing a lot of Stage 1 subjects; rather than necessarily doing something very academic, there’s a huge amount of rote learning, I think is what I’m trying to say.”
Elizabeth now spends her retirement focused on other activities she enjoys, such as tramping, art collecting, and continuing her education in other areas. However, she remains interested in a field that she dedicated her career to—a sure sign of a job well done.
“I’ve maintained an interest in knowing what’s going on medically. My husband, much to my annoyance, brought a very expensive life subscription to the New England Medical Journal back in the ‘60s but it enables me to keep up in a peripheral way which is very nice and there is of course the internet.”
“I remember my mother saying to me once that she would like to be able to put on her tombstone “She done her damndest“—an adaptation of The Cowboy’s epitaph. I like that sentiment too!”