Dr Elizabeth Bryan: Pioneer in twin studies

Elizabeth Bryan was a consultant paediatrician at Queen Charlotte's and Chelsea Hospital in London from 1979 until 2005. In 1978 she was the founder of the Twins and Multiple Births Association (Tamba) and in 1988 of the Multiple Births Foundation (MBF), a London-based charity which provides support to parents and information for professionals dealing with the challenges of multiple births. She was director of the MBF until 1998 and subsequently its inaugural president.

The fact that twin studies are now part of the clinical domain is largely a result of Bryan's work; and it was an uphill struggle to convince her medical colleagues of their value. Through her clinical work, she was able to provide support to parents who were often overwhelmed by the practical burdens of raising two or three, often premature, babies at the same time. Marital difficulties were frequently overlooked by general practitioners, health visitors and paediatricians alike. The particular psychology of being a twin or triplet can lead to emotional and intellectual challenges that until Bryan's work had remained unrecognised and misunderstood. Her Twins, Triplets and More (1995) has been translated into seven languages.

Elizabeth Mary Bryan was born in Sowerby Bridge, Yorkshire, in 1942, the eldest of three sisters. Her father, Paul Bryan, was a politician who became MP for Howden and Vice-Chairman of the Conservative Party. Her mother, Betty, died when Elizabeth was a junior doctor. She qualified from St Thomas's in 1966 and specialised in paediatrics, working at York Hospital and Hammersmith.

In 1979 Elizabeth Bryan was appointed Senior Research Fellow at the Royal Postgraduate Medical School. Her MD thesis Serum Immunoglobulins in Twin Pregnancy with Particular Reference to the Fetofetal Transfusion Syndrome (1977) led her to a lasting and pioneering interest in twin studies and multiple pregnancy. Her focus sharpened as she became increasingly concerned about the special problems facing families with twins. This coincided with the ever-increasing challenge faced by couples undergoing in vitro fertilisation and the multiple pregnancies that often ensued.

From 1987 onwards, she established specialist twins clinics, first in London, then in Birmingham and York. As Elia Malouf, editor of Early Human Development, wrote on Bryan's retirement in 2005: "Increasing contact with families confirmed the overwhelming requirement for better professional support – not only for the children themselves but to prepare parents for their birth and to help them meet the unique challenges of bringing up two or more babies. With typical energy and a refusal to be deterred by funding difficulties, Elizabeth responded by setting up the Multiple Births Foundation."

Her clinical teaching and academic work resulted in numerous publications, both for professionals and the public. She gave lectures all over the world and was appointed to several Visiting Professorships. Later she became the President of the International Society of Twin Studies (1998-2001) and produced an extensive series of publications, books, CDs, DVDs, videos and papers.

In 1974 she had married Ronald Higgins, a diplomat and writer, and herself went through an unsuccessful series of in vitro attempts to conceive. Her characteristic empathy was profoundly deepened by this experience. It also brought about a very creative co-authorship with her husband, and together they published a number of books and papers on infertility and the problems surrounding in vitro fertilisation.

Libby Bryan's retirement in 2005 coincided with her next big challenge, to which she responded with prodigious courage, effort and skill. A spelling mistake in the breast-cancer gene BRCA1 runs in the Bryan family. If a woman inherits the faulty copy of the gene, there is about an 80 per cent chance of her developing cancer of the ovary or breast. Libby's youngest sister, Bernadette, a priest in the Anglican church, died of ovarian cancer in 1995. Felicity, a literary agent in Oxford and Libby's other sister, also developed breast cancer and a melanoma, and after much deliberation, Libby herself had preventive surgery.

As Libby Bryan then recorded in her inspirational book, Singing the Life (2007), she was "taken by surprise" when, in June 2005, she developed obstructive jaundice caused by cancer of the pancreas. Notwithstanding all the subsequent surgery and chemotherapy, she set about researching her family's genealogy, contacting cousins in South Africa, Scotland and elsewhere. With the determination and indomitable spirit she demonstrated throughout her life she set her own and her family's story against the universal problems and worries that face those affected by cancer.

The publication of Singing the Life was greeted by acclaim from reviewers, friends and family, and the public at large. She responded generously to requests for lectures, both from professionals and the public, which culminated in a memorable interview at the Hay Festival Winter Weekend in December 2007. Libby Bryan managed that most difficult paradox – to be a stellar act without the accompanying celebrity performance. Her book is a lyrical celebration of life and what is to follow.

Patrick Pietroni

Elizabeth Mary Bryan, paediatrician: born Sowerby Bridge, Yorkshire 13 May 1942; honorary consultant paediatrician, Queen Charlotte's and Chelsea Hospital, London 1979-2005; director, Multiple Births Foundation 1988-98; president, International Society of Twin Studies 1998-2001; married 1974 Ronald Higgins; died Vowchurch, Herefordshire 21 February 2008.

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