About Molly Towell

pic-molly-towell-slidesThe source of the following information was Dr Fred Bryans who was a colleague and dear friend of Molly. As the chair of Obstetrics and Gynecology at the University of British Columbia, Dr Bryans recruited Dr Towell to Vancouver. She subsequently moved to McMaster University in 1979.

“Dr Molly Towell and the Molly Towell Perinatal Research Foundation” written by Dr Fred E Bryans, MD, FRCSC in J Obstet Gynaecol Can (2001) 23(7): 610-2).

Molly Towell was born in Sussex, England and graduated from the Royal Free Hospital School of Medicine in London in 1952. Following house officer positions in England in medicine, surgery, and obstetrics, she came to Canada in 1955 to accept a position as a rotating intern at St. Joseph’s Hospital in London, Ontario.

During 1956 and 1957, she was Ship’s Surgeon on the Columbia Coast mission boat operated by the Anglican Church, serving approximately 3500 people in widely scattered fishing and logging camps, fish canneries, lighthouses, and Native villages along the British Columbia coast. Her detailed diary, now housed in the B.C. Archives in Victoria, captures a glimpse of the lives of the isolated workers and their families to whom she became a counsellor and a friend. It is clear that many times she disregarded personal safety in reaching the sick or injured and in transferring from the Columbia to small boats and canoes in inclement weather or darkness. Her cheery and helpful manner must have made her a welcome visitor to the well and to the sick alike. She readily identified with the people, their ways and their culture. In the year 1956 when she was aboard, the Columbia cruised 12,000 miles making 140 points of call in all seasons and in all weathers, during which visits she treated 1000 patients.

Towell returned to Great Britain in 1957 to pursue post-graduate training in obstetrics and gynaecology, spending the next three years in training posts in Edinburgh hospitals. In 1961 she returned to Canada, completing her final year of residency at the Vancouver General Hospital. She entered clinical practice in Vancouver in 1962 but after one year
shifted to an academic and research career. As a Queen Elizabeth II Canadian Research Fellow, she examined thermoregulation in the fetus and newborn with Karlis Adamsons at Columbia University until 1965, when she returned to Vancouver to join the Department of Obstetrics and Gynaecology as an assistant professor at the University of British Columbia.

In 1967, She become a Medical Research Council Scholar and began what was to be a career-long interest in the cardiovascular and respiratory effects of intrauterine hypoxia. She developed a model for studying the fetal lamb and fetal goat by implanting catheters and electrodes at surgery which then permitted observations to be made on the undisturbed fetus in utero over an extended number of days or weeks. To more directly study fetal asphyxia, she developed a compression device which could be attached to the umbilical cord at operation and subsequently inflated to allow study of the cardiovascular, respiratory and acid base response to varying degrees of cord compression. In collaboration with Sam Bessman in Los Angeles, she demonstrated the practical application of techniques for measuring fetal oxygen levels. By the implantation of galvanic oxygen electrodes she was able to obtain the first measurements of tissue oxygen concentrations in the fetal lamb during parturition. Pursuit of the metabolic significance of changes in oxygen tension in the antepartum and intrapartum periods remained a major focus of her research. She was a highly regarded early member of an elite, international group of workers in this specialized field of research.

Her work has been published in 70 papers and abstracts in which she was either author or co-author, including those on the metabolic significance of changes in oxygen tension, thermoregulation, biochemical monitoring of the fetus, catecholamine depletion, cortisol as inducing premature labour, and the effect of labour on uterine blood flow, and in eight book chapters, including three in James Goodwin’s classic perinatal medicine text.

pic-molly-towell-dataIn addition to her role as a research scientist, she was a conscientious and caring obstetrician and teacher. In the mid ’60s and early ’70s, concepts and procedures that are now firmly established in practice were new and unproven and represented departures from established obstetrical thinking. At that time, few centres in Canada were actively exploring and evaluating the clinical application of the new understanding of the fetal environment. More than any other person, Molly Towell influenced and guided the introduction of several measures which elevated the standards of obstetrical practice in British Columbia. She led the move to a new and more objective era of obstetrics with increased awareness of fetal well-being. Advances that occurred “on her watch” were improved antenatal records, the designation of antenatal beds in hospital staffed by specially trained nurses, close working relationships with neonatologists and medical geneticists, and the team approach in the management of high risk pregnancies. She had a keen analytical interest in fetal monitoring at a time when its value was in the early stages of assessment. She introduced fetal scalp sampling to British Columbia in 1966 and continuous internal fetal heart monitoring in 1968.

In 1979, she moved to McMaster University, where she worked until her death from breast cancer in 1989, at the age of 60. Her main time commitment there was to her research in fetal oxygenation using animal models. However, she remained involved in the care of high risk pregnancies and served as coordinator of the Regional Perinatal Program and head of the Division of Maternal Fetal Medicine of the Department of Obstetrics and Gynaecology from 1981 to 1986. As a tutor and supervisor to undergraduate and graduate students and residents, she continued her interest and participation in teaching. She was a willing and popular teacher to all levels of maternity caregivers, extending her influence beyond the major teaching hospitals. Although she was always clear and articulate as a teacher, it was less what she said than the conviction of her thoughts and the way she lived them that left a lasting impression with her co-workers and students.

In her final illness, she endowed the Molly Towell Perinatal Research Foundation, which continues to foster and support original research in fetal and neonatal medicine. It was her wish that young investigators and those with original and untried ideas be encouraged. As of 2015, the Foundation has spent more than $1.5 million to support research in Perinatal Medicine. This includes stipends for 18 Fellows from across Canada, the U.S.A., Europe and Australia and start-up operating funds to 18 new investigators in Canadian Universities. These awards have led to publication of more than 40 publications in the peer-reviewed literature. Some of these papers can be found in the “Previous Awardees” tab.

Yet it is Molly Towell the person that most remember. Molly was greatly admired by the physicians, nurses, scientists, and technicians with whom she worked and whose efforts she warmly encouraged. She judged herself and her co-workers against a very high standard, in a way that elevated the expectations and performance of those around her. As her department head at the University of British Columbia I could be visited by Molly in a rage about one of my sins of commission or omission, and the next day she would be back with a story or joke accompanied by her hearty laugh. Her uncompromising work schedule had its personal cost, but most of the time she was able to keep in the air the three academic balls of clinical care, teaching and research. She brought relaxation and balance to her busy life by pursuing a wide range of interests that included music, gardening, and cooking. In all her relationships, she engendered a sense of loyalty that was almost unique, and that in itself tells us a great deal about her.

The legacy of this remarkable person who contributed so much during her lifetime continues to be extended through the work of the Foundation that she created.