Ray of courage

Rasleen Kahai
By Rasleen Kahai     15/11/2023

Did you know that some of the most important early safety measures taken to protect radiologists from radiation were invented by a Royal Brompton clinician who suffered from severe injuries himself due to radiation exposure?

No, neither did I. But as part of Disability History Month, I can now bring you the extraordinary story of Dr Stanley Melville, who ran the radiology department at the Royal Brompton from 1910 to 1934.

Originally from Liverpool, Stanley studied law before switching to medicine where he found a fascination for x-rays when they were discovered at the end of the 19th century. He had a particular interest in their use for diagnosis of lung disease, which perhaps led inevitably to his eventual appointment at Royal Brompton Hospital.

With the introduction of x-rays in medicine, the benefit was obvious. For once, clinicians were able to use these invisible rays to locate the whereabouts of a broken bone. During this era, many radiologists worked in military hospitals using their x-ray tubes for countless hours to locate bullets and shrapnel to improve treatment. Shortly after, many were struck by a mysterious, painful disease called “X-Ray Dermatitis”, where roughly one in ten died from this, which we now know to be a form of cancer.

When Stanley’s close friend and colleague Dr Ironside Bruce died due to radiation poisoning, he felt compelled to act: “I began to think that steps must be taken to rid x-rays of their terrible danger”. Realising the dilemma he and his fellow radiologists faced, Stanley focused on how to make x-rays safer: “I heard there was going to be a great outcry against x-rays to warn the public against their danger. This would have been a calamity and I pledged myself to work to discover a means of protection.”

In 1925, he proposed what then became the standard method to conduct chest radiography, crucially putting the x-ray tube itself in a different room, thus affording substantially more protection for the operator than ever before. The x-rays passed through a hole in the floor and the patient lay on a couch in the room above.

Unfortunately for Stanley, his innovative safety ideas were too late to save his own suffering due to radiation exposure. He lost a finger, the use of one of his hands, and towards the later stages of his career worked in pain and discomfort, daily.

By the time Stanley himself died in 1934, deaths from radiation had effectively been eliminated. The nature of his own death, which was sudden at the age of 67, has led Stanley to be acknowledged as a ‘Radiation Martyr.’

Stanley risked his life so that we today can safely use radiation with our patients. He could have easily retired and opposed its use due to its harm. Instead, he realised the huge benefits it had and putting himself knowingly and painfully in harm’s way, worked tirelessly to improve the safety of x-rays, of his working environment, to secure a better future for his profession, his colleagues and patients.

Stanley was always described as an incredibly altruistic and humble man. Colleagues reflected within his memorial: “if Melville had a hobby, it was helping people” and “Melville never spared himself when any work in medical radiology had to be done; that he should be ever ready to step into the breach seemed to be the natural course of events”.

This Disability History Month, Stanley’s moving life story reinforces the narrative around the social model of disability, which is focused on improving the environment around us. It is a poignant reminder for us all to look at the environment we live and work in to make it a better and safer place. As Stanley put it in 1933: “Today x-rays are absolutely safe but they must always be classed as a dangerous occupation for the radiologist, unless he takes every care.”

I’ve been lucky enough to be able to explore Stanley Melville’s inspiring legacy as part of an upcoming history project dedicated to celebrating innovators within our hospitals. A colleague at the British Institute of Radiology described the safety pioneer as “a very important figure in early British radiology and it’s difficult to overestimate his importance”. To which I can only agree. We must not forget to keep in our hearts the ethos, selflessness, and contribution of Dr Stanley Melville to the healthcare we all give today.