The present
Q. It is a joy and blessing to see you at the most events of Manchester Lit &Phil. What do you most hope to get from an evening at the Society now?
A. The convivial atmosphere engenders mutual aspirations to learn about relevant subjects and partake in lively dialogue.
Early Life and Formative Influences: From Cape Town to the United Kingdom
Q. Looking back to Cape Town: what early experiences or influences nudged you toward medicine in the first place?
A. From my early years I wished to become a doctor. I strove to acquire the criteria to enter medical school at the University of Cape Town. I held our family GP in high esteem. During my medical school years, I helped organise clinics for African and mixed-heritage communities who were disadvantaged under apartheid.
My first publication as a student was on the importance of psycho-somatic medicine.
During my training I was inspired by one of my Obstetrics teachers, David Friedlander who was visionary in encouraging husbands to support their wives in labour. During my residencies, I was inspired by the dedication and surgical skills of the Professor of Surgery – Jannie Louw, and the Professor of Gynaecology – James Louw. Professor of medicine – John Brock, opened vistas of the importance of social medicine, and RNA, and DNA, molecular biology.
My next appointment was in Infectious Diseases where I acquired much experience and clinical skills and hands-on involvement in the Polio epidemic of over 500 cases.
Cecile Hoberman and I got married when I was working at the Infectious Diseases Hospital. Cecile was an early career artist specializing in Portraiture and Sculpture.
My direction was towards Obstetrics and Gynaecology, but General Practice was the next step for me to broaden my horizons and confirm my aspirations to specialize in Obstetrics and Gynaecology.
I joined a Group General Practice in Stellenbosch, which was a rural University town, famous for its wine growing, near Cape Town. A vast clinical experience followed coupled with the responsibility of setting up a separate Maternity service in the hospital for the underprivileged non-white people. As a GP, I carried out a survey of undiagnosed sickle cell trait (Sickle cell trait: a family study and a report of three further cases of Sickle cell disease L. Anstey and M. Elstein S.A. Medical Journal, April 1960, p 282 -284)
Q. In 1961 you moved to London. What prompted that decision, and what were your first impressions of professional life in the United Kingdom?
A. We were distressed by the inequities of the Apartheid System. In my working life, I accosted this degrading system; life had become challenging. We decided we needed to leave South Africa. After our decision and informing my GP partners and family, a few weeks later, the historic Sharpeville massacre took place.
We emigrated to the UK in May 1961, which was timely as it enabled us to acquire British Citizenship by right as South Africa was leaving the Commonwealth at that time. Moving to the UK, presented an opportunity for me to follow my aspirations for a holistic approach to the broader aspects of Obstetrics and Gynaecology such as reproductive health care, the provision of contraception, sexuality and the potential of endocrinology.
My impressions of professional life in the UK were more aspirational than experiential. My brief exposure to the NHS as a GP locum was a ‘learning experience’. The opportunities for embarking on specialist training in the discipline I had chosen was inspirational. I set my sights on getting training posts in premier institutions where there was emphasis on academic discourse and research.
Clinical and Academic Career: What Mattered Most
Q. You held posts at Queen Charlotte’s, Hammersmith, and Charing Cross, and you also lectured. How did this period of your career unfold?
A. I was fortunate to obtain a post in Obstetrics, at Queen Charlotte’s – the premier hospital in Obstetrics, under Professor Jack Pinkerton. My appointment was extended to do research with Carl Wood, a pioneering researcher into Uterine Activity. I also did research at the Chelsea Hospital for Women on the endocrine vaginal cytology of newborn girls – resulting in a notable publication. At that time, I became involved in teaching for the membership of the Royal College of Obstetricians and Gynaecologists (RCOG).
My next post was at the postgraduate medical centre at the Hammersmith Hospital under Professor John Browne. I continued to teach on the course for the membership degree of the RCOG. I obtained Membership of the RCOG at that time.
In my Appointment as Registrar at Charing Cross Hospital, I became heavily involved in the teaching of students in Obstetrics and Gynaecology. I then became a lecturer in Obstetrics and Gynaecology for Professor Norman F Morris. My initial research was in management of labour. I then focused on contraception and obtained a fellowship of the RCOG to study the effects of progestogens on cervical mucus. This research resulted in my obtaining a Doctor of Medicine (MD) from the University of Cape Town (UCT).
Further research was on hormonal methods of contraception and intrauterine contraceptive devices.
During the sixties, I was able to extend the provision of contraceptive services irrespective of marital status. I pioneered the teaching of sexuality to medical students and doctors.
Q. What did you most enjoy about the balance between clinical practice and teaching?
A. My time at Charing Cross was busy clinically and in research, the most satisfying part was the creative rapport with the medical students.
Q. When you moved to the University of Southampton – first as Senior Lecturer, then as Reader – what were you seeking to build or explore academically?
A. Before we moved to Southampton, in 1970, I had a visiting Fellowship in Cape Town, this enabled me to defend my MD thesis. We had an extended tour of South Africa. I did a lecture tour presenting developments in oral conception. My family accompanied me on this eventful experience.
In 1970, the establishment of the new Medical School at the University of Southampton was an appealing challenge.
I was appointed as Senior Lecturer in Human Reproduction and Obstetrics to the Foundation Professor, David Millar. Within a few months, he developed cancer and died. I then took over the responsibility of planning and setting up the new curriculum. This entailed central allocation and subsequent peripheral location of the students throughout the Wessex region. The aspirations of the New Medical School were revolutionary and requested inspiring the NHS consultants to be involved.
Innovative teaching involved the establishment of early medical contact of the medical students during ante-natal care, in the delivery and subsequent development of the child.
The curriculum included the teaching of human sexuality, recognizing the broader aspects of human sexuality. This was extended to the GPs in the Wessex region. This resulted in seminal publications evaluating this teaching.
The postgraduate teaching of family planning was established; this formed the basis for the RCOG Faculty programme.
A major research project was established in women with intrauterine devices investigating the possible role of the IUD’s cervical appendage in the genesis of infection involving a clinical research fellow and a bacteriologist.
Research activities were extended by obtaining funding for the appointment of a lecturer in Reproductive Biochemistry.
I established a postgraduate teaching programme for RCOG Membership in the Wessex region.
Involvement in several clinical developments such as establishment of Day Case Surgery.
Q. In 1977 you came to the University of Manchester as Professor of Obstetrics and Gynaecology. What was the challenge you were most eager to undertake here?
A. On my professorial appointment to the University of Manchester, I changed my title by adding “Reproductive Health Care “to Obstetrics and Gynaecology.
I introduced the teaching of sexuality in the early years of the medical curriculum.
The introductory clinical skills programme at the end of the 3rd year, for students about to commence placement in the region, was made obligatory. This programme presented the opportunity to teach medical ethics in collaboration with Professor John Harris and Professor Margot Brazier.
The establishment of the discipline of Family planning and Reproductive Health Care followed. The appointment of the first clinical Consultant/Senior Lecturer in Reproductive Health Care in the UK was enabled by obtaining funding from the postgraduate dean and the District Health Authority. Higher Training in Reproductive Health Care, recognised by the RCOG followed. Subsequently over 100 Consultant posts in the discipline of Reproductive Health Care have been established. The clinical challenges were improvement in Obstetric / Neonatal care in the Withington Hospital, provision of Abortion services, pelvic microsurgery for female infertility.
Q. Which of your research areas felt most urgent or exciting as they were unfolding: contraceptive development, endometriosis, fertility mechanisms, pelvic blood flow, assisted reproduction, patient safety, or something else?
A. All held a genuine interest for me. The most exciting, however, was the development of hormonal contraceptives and the refinement of their formulations. Of comparable importance was the role of the cervical appendage of the intrauterine contraceptive device in the transmission of pelvic infection.
Q. Of all your published work and clinical contributions, of which are you personally most proud, and why?
A. The enhancement of oral contraceptive formulations resulting in the reduction of the amount of hormone was significant with an improved level of acceptance.
Q. You have been involved in infertility care and reconstructive pelvic microsurgery. How did you approach the human side of that work: hope, disappointment, resilience alongside technical expertise?
A. Pelvic reconstructive surgery most often resulted in relief of pain and some achievement of pregnancy. The women who had chronic pelvic pain would affirm alleviation of the pain within days of their surgery which made the painstaking surgery and the preoperative preparation worthwhile. The surgery was often prolonged. I took tremendous pleasure in the fact that I could pass these skills onto my colleagues, which they applied in their practice thus helping even more women. Where surgery was unsuccessful, I would support women in accepting that hysterectomy was required entailing appropriate empathic management.
Medicine, Law, and Bioethics: The Institute Years (IMLAB)
Q. After retiring from St Mary’s in 1995, you became Executive Director of the Institute of Medicine, Law and Bioethics, an institution spanning several universities. What drew you to that role?
A. I was privileged to facilitate the teaching of medical ethics to medical students with John and Margot. From my experience in medicolegal practice and having served as a Council member of the Medical Defence Union, it was fitting to accept the invitation from Professor Martin Harris, particularly as it involved linking up with the teaching of ethics and medicolegal law in Liverpool. This joint venture, funded by the Regional Health Authority, allowed me to raise funds for research projects and staff in these areas in Manchester. My initial three-year half-time contract was extended to five years.
Q. Which ethical questions in reproductive health care have you found the most persistent or the most difficult, whether then or now?
A. One of the most difficult aspects of this work was challenging the entrenched views of some experts.
The Manchester Literary & Philosophical Society: Joining, Belonging, Contributing
Q. How did your first contact with the Manchester Lit & Phil come about? How did you discover the Society, and what persuaded you and Cecile to join?
A. I was initially approached on my appointment to become a member, but my responsibilities precluded me from taking this on, which I regretted. On my first retirement, Cecile and I decided that we wished to join, even though we had some heavy commitment in looking after our son, Paul. I was approached by some council members to become a member of Council, which I found rewarding.
Q. What did the Manchester Lit & Phil offer that you did not find in academic medicine or in the professional societies?
A. Cecile served initially as a member of the Arts Committee, which she found very rewarding. We found that the lectures which we attended broadened our horizons, which for me, were invaluable. When I was invited to serve on its Council, I wished the Society to become more in tune with the changes in society and to become more financially secure.
Q. You served as Vice-President and, later, as a Director from 2009 to 2014. How did you see the Society’s role within Manchester and beyond?
A. I recognised that the Society needed to extend its membership, particularly to younger people and to be more efficient. I welcomed the opportunity to chair Task and Finish groups on how this might be achieved. Despite the difficulties that the Society has faced before and during Covid, I am pleased to see that many of our recommendations have been implemented. The present management of the Society can open vistas of creative development. One area I would like to see reinstated is a thriving young people’s forum, which Professor Derek Crowther had initiated.
Q. Are there particular moments, talks, debates, or people at the Manchester Lit & Phil that you remember as especially significant?
A. The Dalton Lecture series is particularly memorable; my grandson Adam, whom the Society generously permitted to attend, valued it greatly. More opportunities for young teenagers to take part should be explored.
Memorable events reflect my bias and are the Discussion between Sir Mark Elder and Michael Kennedy and of course, Cecile’s presentation.
There are many more!
In particular, there have been many recent outstanding events in the rejuvenated Society!
Q. If you could capture the “spirit” of the Manchester Lit & Phil in a single sentence, what would it be?
A. The current involvement of volunteers, and their dedicated commitment is truly inspiring.
Family, Care, and Resilience
Q. How did you experience the relationship between your two worlds – medicine and reproductive health, and Cecile’s artistic practice? Was it one of contrast or of harmony?
A. I should like to answer this by sharing with you something Cecile said to me after we had discussed the very question: “What connects art to science is an abiding similarity between the artistic and the scientific mind; it is as if both were motivated by the pangs of discovery and a desire for the consummation of ideas into beautiful totalities.”
Q. Cecile’s practice ranged from sculpture and printmaking to environmental art, with a profound attention to empathy and to accessible environments. What do you think she most wished people to feel or to notice?
A. Many of Cecile’s works reflect upon the relationships between people. She espoused the following four guiding principles: awareness, respect, loyalty, and the desire to negotiate.
Q. You and Cecile cared for your son Paul through many years of illness. If you are comfortable sharing it, what did that period teach you about love, patience, and the limits or the strengths of medicine?
A. It was a privilege for us to look after and provide for our wonderful son, who was empathic, resilient to his sufferings and always had a sense of humour and related well to his carers and visitors who all felt enhanced by his presence. We learnt to cope with the erosion of our privacy because of the carers that Cecile managed with considerable skill and empathy for their needs as well as that of Paul. We enjoyed positive relationships with the carers.
Q. How has family life: your children, grandchildren, and great-grandchildren shaped your sense of meaning and continuity?
A. I feel truly blessed by the joy I have had, and continue to have, from my extended family.
Q. You and your daughter have been involved in preserving and sharing Cecile’s legacy. What forms does that work take: archiving, exhibitions, public artworks, talks, education?
A. Maureen, my daughter, responds:
“The Cecile Elstein Studio Team’s curatorial work offers fresh insights into Cecile Elstein’s creative practice, her spheres of influence and artists’ circles.
The Cecile Elstein Studio Team have been cataloguing and curating Cecile’s Studio. This includes her artwork, artefacts and the artwork’s provenance. Her artefacts include her studio notebooks and writings. Through this process we are discovering extraordinary insights into her creative practice.
This year, we have been talking to the Didsbury Arts Festival and hope to feature during the end of June 2026, Open House tours, Curators’ talks and Film screenings. Currently curatorial topics include: ‘Women at Work’, ‘Portraits of Medical Scientists’, ‘Print-making Innovation’, ‘Sculpture’, ‘Ceramics’, ‘Site-specific Installation Public Sculpture’, ‘Art as Environment’ ‘Empathy in Design Education’, ‘20 years of the Didsbury Drawing Group using the Philosophy of Non- Interference’, and ‘I and Thou – Relational Philosophy’.
In the future, we plan to hold a Retrospective Exhibition, alongside an Academic symposium, outreach workshops and book publication with gallery, museum and publisher partnerships.”
Q. What would you most like the public to understand about Cecile as an artist, something that a brief obituary or an exhibition label might overlook?
A. Cecile was an insightful, compassionate and understanding person, with an expansive love of humanity and the aesthetic. We enabled each other’s development. Throughout our life together, we wished to explore the broad spectrum of philosophy, literature and the arts and to facilitate its general availability in society.
The Future: Medical Science, the Life of the Society, and Counsel
Q. What do you believe the next generation of clinicians and researchers should protect, even as technology and systems continue to change?
A. The importance of personal interaction and communication is key. In the care of patients, human contact can never be wholly supplanted by machines.
Q. What role do you think a learned society such as the Manchester Lit & Phil should play in the coming decade, particularly in a world of rapid information and polarised debate?
A. The encouragement and availability of learned societies like the Manchester Lit &Phil to young aspiring professionals and knowledge and culture seekers need to be facilitated and encouraged by their mentors.
Q. What would you like younger members of Manchester Lit &Phil to know about how to get the most from the Society?
A. The involvement of volunteers from amongst the more senior members of the Society to take on a ‘buddy-role’ should be considered and evaluated.
Q. If you could leave readers with one thought about curiosity, service, partnership, or a well-lived life, what would it be?
A. Remain curious; never stop learning.
By Dr Eda Gliga-Baubec PhD, Trustee and member of Manchester Lit & Phil