Dame Clare Lucy Marx

15th March 1954 – 22nd November 2022

Obituary by Mark Bowditch and Deborah Eastwood

Clare was a true ‘one off’

Clare was a remarkable woman and orthopaedic surgeon. An inspirational leader, good company with a mischievous sense of humour.

She was born in Coventry on 15th March 1954, her father an industrial chemist and her mother a schoolteacher and childcare specialist.

In her early years she spent time in Switzerland, where she had family. She learned French, became an accomplished skier and developed a love of Alpine walking that was to stay with her throughout her life.

Educated at Cheltenham Ladies College, she was introduced to medicine and surgery through an attachment to a local general surgeon in Coventry.

She subsequently studied medicine at UCH London. Thereafter, on the UCH/Westminster orthopaedic rotation, she developed a reputation as a hard worker who would never let you down – traits she continued to demonstrate throughout her career.

Following a fellowship in hip and knee arthroplasty at the Robert Brigham Hospital in Boston, she was appointed as a Consultant Orthopaedic Surgeon at St Charles Hospital Paddington, London, in 1990, moving into a new unit at St Mary’s hospital a year later.

With her passion for training already apparent, she promptly revised the medical student teaching, and took a keen interest in the Wednesday afternoon sessions. As well as developing her arthroplasty practice, she instigated daily trauma meetings, despite some resistance!

By this time, she had married her London neighbour, Andrew Fane, who had a family farm in Suffolk and decided a post nearer to ‘home’ was preferable.

When a post came up in Ipswich, she applied and became their first woman surgeon of any speciality, in 1993. Although potentially challenging, she experienced nothing but encouragement.

So, she joined seven rather large male consultants and naturally got given the nickname ‘Snow White’. After a few months, a colleague told her husband, as a compliment, that East Anglia hadn’t seen a woman wielding a knife like Clare, since Boudicca had been in business!

Things could be a bit different in rural Suffolk to central London. One registrar recalled being bleeped urgently by Clare to help in fracture clinic early one morning, only to arrive and then be asked to help catch a brood of ducklings that had hatched in the plaster room! They were given a new home in Clare’s pond.

Her generosity and support for the T&O department was legendary. Many will fondly remember her lunchtime picnics in theatre with homebaked bread. She would host the annual department summer garden party for all staff, and would organise (and fund) the Christmas week staff buffet lunch in fracture clinic waiting room each year, visiting the wards over Christmas to thank the nursing teams.

She would welcome new colleagues joining Ipswich whenever possible with welcome dinners and indeed several current consultants stayed in the Fane farm self-contained flat for a few months when first moving to Suffolk prior to finding a house.

She focused on high standards, patient safety, honest communication, and team engagement. Registrars treasured being on the ‘Marx firm’ for the ‘good surgeon’ apprenticeship, enhanced by her genuine personal interest, good humour, and generosity. For many, it established the core principles of their own professional practice.

Much of this was a daily demonstration of her ‘would you be happy for ourselves, or a family member, to be treated in that way’ approach to patient care.

Within a year of arriving in Ipswich, she was the clinical director for T&O, Rheumatology and A&E, quickly gaining the respect of management and colleagues. Her door was always open, prepared to listen carefully first but never afraid to politely disagree with a characteristically unthreatening “may I suggest…” and a clear explanation of why. Always acting firmly in support of patient care.

She became the ultimate counsel for senior clinicians and executives alike. Referred to by some colleagues as the ‘headmistress’, somewhat cheekily and unbeknown to her, but always respectfully acknowledging a well-run team.

Her passion for high quality education ran through her entire career and led her to becoming Chair of the Joint Colleges Specialty Advisory Committee (SAC) in T&O, and as Chair led a small group to produce the first T&O surgical curriculum in 2007. The T&O curriculum was a seminal piece of work and was the first of the surgical curricula and has been honoured worldwide.

In 2013/14 after 20 years at Ipswich, she was deeply honoured to be awarded the East of England Trainer of the year award, presented at Clare College, Cambridge.

She was elected British Orthopaedic Association President in 2008, a role she often described as the best and most enjoyable time of her career. She was the first woman President, breaking through a glass ceiling in a male dominated profession.

She brought diversity, fun, and strong but compassionate leadership to orthopaedics whilst Andrew similarly revolutionised the accompanying person’s programme. Together they were great company establishing friendships with orthopaedic leaders worldwide.

In 2009 she was elected to RCSEng Council with a role on the finance committee, and became Chair of the Invited Review Mechanism (IRM) in 2011. Her career long focus on improving the quality of patient care was reflected in the RCSEng Good Surgical Practice document in 2014 and extended later into the GMC – the role of Good Medical Practice.

She became President of the RCSEngland in 2014, serving until 2017, and proved to be a true reformer as she drove through the redevelopment of the College buildings. This was not an easy time but her calm, measured approach and her ability to grapple with the difficulties she encountered meant that she was respected by all.

As at the BOA, she was the first female RCSEng President, but again this was never an issue for her. When someone commented that “at last the surgeons had appointed a woman President”, Sir Norman Williams, her predecessor as RCSEng President, retorted “My colleagues appointed Clare because she was best person for the job.”

Clare reluctantly stepped back from clinical work in 2014 after she had torn her rotator cuff whilst reducing a hip but did not slow down!

She became Associate Medical Director and was integral to the development of a major new elective orthopaedic centre for Ipswich and Colchester, appropriately now named the Dame Clare Marx Building.

In 2018, she became Chair of the Faculty of Medical Leadership and Management, and in 2019 the first woman Chair of the General Medical Council. At a time when its reputation amongst doctors was low, she brought a steadying sensible hand, enthused by the challenges.

She was honoured for her services to medicine, becoming a CBE in 2007 and a Dame in 2018.

Outside of medicine, in recognition of her contribution to the Suffolk community, she was appointed a Deputy Lieutenant in 2008, and in 2022 was one of five recipients to receive the Suffolk Medal.

She enjoyed life, particularly spending time with Andrew, enjoying the rural passions of the potting shed and countryside walks. She shared her love of music and opera with family and friends.

In 2021, she was diagnosed with pancreatic cancer and her GMC resignation letter highlighted Clare’s approach to medicine: “Since receiving this news, I’ve have been reminded once again of the importance and power of kindness in everything we do as doctors”.

Her husband recalled that this was brought home when as ‘Mrs Fane’ she was undergoing chemotherapy and a delightful elderly lady next to her regaled her with memories of a wonderful Miss Marx who had so kindly replaced her knee over 20 years ago – did Clare know her? – Clare admitted she did but nothing more.

She left us on the 27th November 2022.

The loss of Clare will be felt deeply across orthopaedic community and by those who knew and loved her, but her influence on the practice of surgery will be apparent for many years to come.

A senior surgeon in Norwich said, “it is a tribute to her that her fame and ennoblement never changed her – she remained the modest, charming, sharp witted and amusing young woman I remember from many years ago.” Fittingly, the last words should go to her.

During an appearance on Radio 3 in April 2022 reflecting on her diagnosis she said: “You only look back to learn, you must look forward for the future”

A truly remarkable woman.