1. Profiles in Cardiology
This section edited by J. Willis Hurst, MD and W. Bruce Fye, MD, MA.
Jane Somerville
Address for correspondence:
Carole A. Warnes
From the Division of Cardiovascular
Diseases and Department of
Internal Medicine
Mayo Clinic
Rochester, MN 55905, USA
Warnes.carole@mayo.edu
Carole A. Warnes, MD, FRCP, FACC
Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic,
Rochester, Minnesota, USA
Jane Somerville (Figure 1), born Jane Platnauer in London,
England, in 1933, can arguably be described as the mother of
‘‘Grown up Congenital Heart Disease (GUCH).’’ Although
officially retired, she continues to travel the world and
pursue her passion of clinical teaching of this sub-specialty.
There can be no doubt she has trained more fellows in
congenital heart disease than any other physician, so much
so that a large fan club of ex-fellows called ‘‘the Unicorns’’
gathers at every World Congress of Pediatric Cardiology (a
meeting she founded) to celebrate her life and work. She
pursued her interest in adult congenital heart disease at a
time when the focus of the world was on pediatric cardiology
and cardiac surgery; no one having recognized the need to
take care of this increasing population as they grew up. In
an era when very few women physicians were recognized,
she became internationally renowned as a world leader in
her field.
Her father was a theater critic, and her mother, a strong
influence in her life, worked on Vogue magazine. In World
War II, Somerville was sent to a boy’s school, which she
believes, helped shape her life and her later interactions
with the male-dominated medical profession. She went on
to study science at Queens College, London, and was
accepted by Guy’s Hospital Medical School when it was
only the third year that female students were admitted
and comprised only 8% of the class. She still recalls the
excitement surrounding a medical school lecture from the
visiting US surgeon, Dr. Alfred Blalock of Johns Hopkins.
He described his success with the Blalock Taussig shunt, a
pioneering surgical procedure for the treatment of cyanotic
heart disease (usually tetralogy of Fallot) that transformed
the lives of children with this form of congenital heart
disease. The novel extra-cardiac operation turned them
from blue to pink in minutes. She decided then to become a
cardiac surgeon and worked for Sir Russell Brock, a leading
surgeon of the day.
She remembers long and difficult surgical procedures,
high surgical mortalities, and harrowing nights with
severely ill children. She recognized her limited technical skills as a surgeon and changed course to become a
cardiologist. In the late 1940s, she met her future husband,
Dr. Walter Somerville, a distinguished cardiologist whom
she married in 1957. He introduced her to Dr. Paul Wood
who captivated her with his diagnostic clinical skills and logical deductive reasoning. In 1958, she became a registrar at
the National Heart Hospital where she later was responsible
to Paul Wood. This was an exciting time in congenital heart
Received: July 2, 2007
Accepted with revision: August 17, 2007
disease when much was being discovered in the area of clinical diagnosis and cardiac catheterization. Wood, a master
clinician, taught Somerville about meticulous interpretation
of clinical signs and auscultation in relation to physiology
and hemodynamics. Fascinated by congenital heart disease,
she recognized the need to understand pediatric cardiology
and, against the rules, escaped periodically to work at the
Hospital for Sick Children in Great Ormond Street in London, learning about infant medicine and surgery with Drs.
Bonham Carter and David Waterston.
Despite the challenges of being a woman cardiologist in
that era, Dr. Somerville ‘‘broke the glass ceiling’’ and was
appointed as a Consultant at the National Heart Hospital in
1967. She recognized that following the huge successes of
pediatric cardiac surgery there was a rapidly increasing
population of adolescents and adults with congenital
heart disease requiring informed medical care. Their
new medical issues were challenging and serious, often
needing reoperation, and cardiologists were not trained
to deal with their special problems. Thus, the concept
of GUCH was born. Pioneering cardiac operations were
undertaken at the Heart Hospital by her friend and surgical
colleague Donald Ross with whom she wrote many groundbreaking articles,1 – 7 including the first report of the use
of a homograft aortic valve to repair pulmonary atresia in
1966.2 She began to understand the unique needs of this
population, and became determined to develop a special
hospital unit to provide care. When she set her sights
on a goal, no obstacle got in her way. Always feisty and
prepared for battle, she succeeded in raising money and in
1975 opened the world’s first dedicated ward for children
and adolescents with congenital heart disease: appropriately
named after her mentor, the ‘‘Paul Wood Ward.’’ This was a
unique environment where children and adolescents could
mingle with each other and their families. It included an area
to play for younger patients with a dedicated play leader who
could help them talk through their problems, and a kitchen
where adolescents and families could make coffee or have a
snack. Older adolescents enjoyed the interactions with the
younger patients, often trying to help and support them.
Even patients in their 20s needing admission wanted to go
to the Paul Wood ward rather than a regular adult ward, and
it was hard to deter them.
Always passionate about patient care and teaching,
Dr. Somerville was a hard task-master. As well as quickly
pointing out others’ shortcomings, she could be self-critical;
indeed a sign on her office door read ‘‘The courage to be
imperfect.’’ Teaching was an important part of her clinical
Clin. Cardiol. 31, 4, 183–184 (2008)
Published online in Wiley InterScience. (www.interscience.wiley.com)
DOI:10.1002/clc.20279  2008 Wiley Periodicals, Inc.
183

2. Profiles in Cardiology
continued
life: she traveled worldwide and many fellows went to
London to study with her. Her ward rounds were legendary:
though she was often late, fellows stood to attention and
waited patiently for the ‘‘arrival’’ knowing that great clinical
teaching was to follow and there was much to be learned.
Any debate about the nuances of a murmur or heart
sounds, and the phonocardiogram was produced so the
issue could be resolved. Students could not be faint of
heart, since if they had not studied, they might be loudly
chastised, and the morning rounds might last until 3 PM.
when hypoglycemia might supervene. Those who stayed
the course were rewarded with her generosity, support, and
friendship.
In 1980, she held the first World Congress of Pediatric
Cardiology in London (an idea she conceived in the bath,
she relates), which was a huge success, and enhanced the
visibility of the subspecialty. She later united this meeting
with the Congress of Pediatric Cardiac Surgery to enhance
collaboration and research between the two disciplines.
In 1989, the National Heart Hospital was closed and
absorbed into the Brompton Hospital. This was not an easy
transition, but undeterred, with her usual determination,
she reestablished a special ward for the adolescent and
adults, ultimately named the Jane Somerville GUCH Unit
in 1996. In the early 1990s, she was the founder, and then
Chairman, of the European Society of Cardiology Working
Group on GUCH. She developed, and became President
of the GUCH Patients Association in 1994 and secured its
funding from the British Heart Foundation. In 1995, she
gave the first Paul Wood lecture at the British Cardiac
Society appropriately titled ‘‘The Master’s Legacy.’’ She was
appointed Professor of Cardiology in 1998 and retired from
the Brompton Hospital in 1999.
Despite this busy and successful professional life, Jane
and Walter had 4 children, with whom she is very close, and
she now has 4 grandchildren. Her beloved Walter passed
away in 2005. She has many interests outside medicine
including roof gardening, antique collecting, particularly
opaline glass and silver, and opera. Never idle, she still
lectures worldwide with wit and wisdom, and helps establish
GUCH services around the world. When asked the 3 things
of which she is most proud, she reports ‘‘My family,
marrying Walter and my Unicorns everywhere.’’ The 100strong group of ex-fellows was named the Unicorns because
of Somerville’s characteristic response to someone who
lacked imagination was to prod her forefinger repeatedly
to her forehead and ask ‘‘Have you ever seen a unicorn?’’
184
Clin. Cardiol. 31, 4, 183–184 (2008)
C.A. Warnes: Jane Somerville
Published online in Wiley InterScience. (www.interscience.wiley.com)
DOI:10.1002/clc.20279  2008 Wiley Periodicals, Inc.
Figure 1: Jane Somerville (1933 –).
Her Unicorns are now scattered all over the world,9 many
having established Adult Congenital Heart units of their
own, continuing to spread the passion for this unique
subspecialty that she inspired in them. Truly, she is the
mother of GUCH.
References
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9.
Somerville J: Gout in cyanotic congenital heart disease. Br Heart J
1961;23(1):31–34
Ross DN, Somerville J: Correction of pulmonary atresia with a
homograft aortic valve. Lancet 1966;2:1446–1447
Somerville J: Management of pulmonary atresia. Br Heart J
1970;32:641–651
Somerville J: Congenital heart disease–changes in form and
function. Br Heart J 1979;41:1–22
Taylor NC, Somerville J: Fixed subaortic stenosis after repair of
ostium primum defects. Br Heart J 1981;45:689–697
Warnes CA, Somerville J: Tricuspid atresia in adolescents and adults:
current state and late complications. Br Heart J 1986;56:535–543
Bull K, Somerville J, Ty E, Spiegelhalter D: Presentation and attrition
in complex pulmonary atresia.[see comment]. J Am Coll Cardiol
1995;25:491–499
Somerville J: Paul Wood lecture. The master’s legacy: the first Paul
Wood lecture. Heart 1998;80:612–618, discussion 618–619
Somerville J: Spotlight: Jane Somerville, MD, FRCP, FESC.
Interview by Robert Short. Circulation 2007;115:f61–f63