NHS 75! Carmel’s story: a lifetime with the NHS

62 years ago, Carmel Proctor was born at home in a little corner of Doncaster. But instead of it being a happy moment, her parents were told that she may not survive.

As she was born, it was discovered Carmel had myelomeningocele, the most severe type of spina bifida. This is when a baby’s spine and spinal cord don’t develop properly in the womb, causing a gap in the spine.

In this particular type of spina bifida, the spinal column remains open along several vertebrae. The membranes and spinal cord push out to create a sac in the baby’s back.

Sometimes the sac is covered with membranes called meninges, although it often remains open, leaving the nervous system vulnerable to further complications such as infections. It is estimated that it affects one baby in every 1000 that are born in Britain.

These days, Carmel’s condition would most likely be found during the routine ultrasound scans that are done at antenatal appointments. It can be diagnosed from the 12-week pregnancy scan but is more likely to be found during the anomaly pregnancy scan that is done at around 20 weeks.

Surgical and medical advances have also significantly improved outcomes for babies born with spina bifida today, but these weren’t available in 1960 – just 13 years into the life of the NHS.

Carmel said: “I was very poorly indeed, my parents would tell me later that I wasn’t expected to last 60 seconds. My mum took me to her GP who had heard of a doctor at Sheffield Children’s Hospital who was doing some pioneering treatment for patients with spina bifida. Two days later, I was in the operating theatre.

“If it had not been for Sheffield Children’s, I would have been what they referred to back then as ‘nourished’, which was a kind of ‘hope and see’ treatment.”

Step forward Robert Zachary. Mr Zachary was the first full-time surgeon employed by Sheffield Children’s Hospital. He developed an international reputation for his expertise on spina bifida and hydrocephalus – a condition where there is excess fluid (CSF) in the brain. Severe spina bifida can often lead to hydrocephalus.

Alongside Paediatrician John Lorber and Orthopaedic Surgeon John Sharrard, Mr Zachary showed that if babies with spina bifida were operated on within hours of birth, the survival rate could be improved from less than 10% to almost 90%. Now children with the condition are cared for by specialist teams across the country.

Following in Mr Zachary’s footsteps at Sheffield Children’s is Lee Breakwell, Consultant Spinal Surgeon.

Lee said: “Even 60 years ago we were a pioneering centre of excellent and innovative care. It’s great to be a part of a still thriving specialist centre, continuing to look after patients in regards to spina bifida. We are able to treat babies early and continue to support them throughout their childhood with a multidisciplinary team.”

Carmel would go on to spend almost three months in the Thornbury Annexe at Sheffield Children’s Hospital, now the private Thornbury Hospital, on Fulwood Road. She would continue to have check-ups, ranging from every three to six months, until she reached the age of sixteen.

Carmel then continued her connection with the NHS, working as a Medical Secretary before retiring recently. These days you might spot her volunteering in her library or in a local school as an exam invigilator – “but my happiest time is spent looking after my beautiful grandson.”

Meanwhile, babies born with spina bifida today are cared for by our multi-disciplinary neurosurgical team at Sheffield Children’s. Spinal repair usually takes place within 48 hours after birth and patients will meet a range of specialist services to help them achieve their potential. Recreational and employment opportunities are also better now than at any time in the past.