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Sofia Ionescu, the First Woman Neurosurgeon in the World

Alexandru-Vlad Ciurea1, Horatiu Alexandru Moisa1, Dumitru Mohan2
LEGACY

Key words
The authors present the activity of Mrs. Sofia Ionescu, the one female surgeon
- Dumitru Bagdasar who was nominated as the first woman neurosurgeon in the world. Sofia
- First woman neurosurgeon Ionescu worked in the field of neurosurgery for 47 years, performing all the known
- Harvey Cushing neurosurgical procedures of the time. She made herself known through her
- History of neurosurgery
- Romania
incredible surgical skill and her enormous work power. Due to her incredible
- Sofia Ionescu modesty and workload, she never participated at international congresses or
- WFNS manifestations. The nomination as first woman neurosurgery took place in Mar-
rakech, Morocco, during the 2005 WFNS Congress. Although some claim that
From the 1“Carol Davila” University School of
Medicine, The National Center for Excellence in Diana Beck was the first woman neurosurgeon in the world, our theory suggests
Neurosurgery, Bagdasar Arseni Teaching Hospital, otherwise. The first documented surgical intervention performed by Diana Beck
Bucharest; and 2Department of Neurosurgery, University of dates to 1952. Sofia Ionescu operated for the first time on a human brain as early
Oradea, Faculty of Medicine, Oradea, Romania
as 1944. Furthermore, Diana Beck’s actions surfaced in the year 1947, long after
To whom correspondence should be addressed:
Horatiu Alexandru Moisa, M.D. the war had ended and Sofia Ionescu had become a neurosurgeon.
[E mail: [email protected]]
Citation: World Neurosurg. (2013) 80, 5:650 653.
http://dx.doi.org/10.1016/j.wneu.2013.02.031
Journal homepage: www.WORLDNEUROSURGERY.org Prof. Jacques Brotchi who was the presi- desire to better prepare for neurology,
Available online: www.sciencedirect.com dent-elect of the WFNS, and Prof. Jose which she studied in her fifth year of
1878 8750/$ see front matter ª 2013 Published by Elsevier
Martin Rodriguez (8). medical school, that made her choose
Inc. Sofia IonescueOgrezeanu was born in spending her summer internship in the
Falticeni, a small city located in the north neurosurgical unit of the “Central Hospital
east of a struggling Romania (Figures 2, 3, for mental, nervous and endocrine
INTRODUCTION and 4), in the year 1920, a time that bore the diseases” in Bucharest in 1943. This event
As time passes, the privilege of stating that stamp of the First World War. Although her marked her first contact with “the golden
one is the very first to have achieved father’s wishes were for her to become an neurosurgical team,” led by Professor
something, particularly in the field of educated young woman, who would know Dimitrie Bagdasar, the founder of the
medicine, seems to be wearing thinner and how to sing, speak several languages Romanian Neurosurgical School, alongside
thinner. In a time when equality of sexes fluently, and bear children, she decided that his disciples Dr. Constantin Arseni and Dr.
was only something to aspire toward, she wanted more from life, following the Ionel Ionescu, who would later become
Doctor Sofia Ionescu (Figure 1), born Sofia example of other doctors in her family. Sofia’s husband (3).
Ogrezeanu, became the very first female Thus, after attending the Girls’ Gymnasium Professor Dimitrie Bagdasar (1893e1946),
neurosurgeon, with a career spanning more in Falticeni, she transferred to Bucharest to was a neurology specialist, for several years
than 47 years of devoted work, between 1943 the “Maria Brâncoveanu” Girls’ School, from he had trained in Professor Harvey Cush-
and 1990. where she could apply to study medicine ing’s clinic in Boston at the Peter Bent
Her status, although continuously in the capital city. She attended the Faculty of Brigham Hospital between 1927 and 1929.
debated for more than three decades, was Human Medicine of Bucharest between 1939 He had newly founded neurosurgery as an
finally acknowledged during the 13th World and 1945, a time providing the opportunity independent branch of medicine in south-
Congress of the World Federation of to study under great figures of medicine eastern Europe (7). In a filmed interview,
Neurosurgical Societies (WFNS) in such as Francisc Rainer (anatomy), George Sofia Ionescu tells of that one decisive
Morocco, in 2005, crowning an evolution Emil Palade (cell biology), Oscar Sager and moment that came to shape her entire future
that could only be praised by the hundreds Arthur Kreindler (neurology), Nicolae Cajal and the lives of the many she touched after
of patients who are still alive due to her (pathology), Daniel Danielopolu (patho- first operating. It was under the supervision
wonderfully skilled hands (8). This official physiology), Alfred Rusescu (pediatrics), of Professor D. Bagdasar, who was unable to
nomination as the first woman neurosur- and Iacob Iacobovici (surgery). operate due to a wound on one of his fingers,
geon was presented by Dr. Irina Ogrezeanu Her early years in the clinic were under that she performed her first surgery, saving
and recognized by the president of the the influence of the Second World War the life of an 8-year-old comatose boy
Women in Neurosurgery Committee of the whose casualties filled the beds of every with an extradural intracranial hematoma—
WFNS, Yoko Kato. At this presentation the hospital and required all available hands. when no one else would even dare operate.
audience included Prof. Edward Laws as The war found her attending patients in the Professor Bagdasar had just discovered a
acting president of the WFNS at the time, hospitals of her native town. It was her “diamond in the rough” and a great surgeon.

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 PEER-REVIEW REPORTS
ALEXANDRU VLAD CIUREA ET AL. SOFIA IONESCU

specialist neurosurgeon, a statement in

the ongoing war with disease and death
that would toward the end of her life
culminate as chief of ward (2).
In her 25 years as chief of the Cerebral
Tumor Department and the 22 years that

LEGACY
followed as chief of the Spinal Pathology
Department, Dr. Sofia Ionescu found the
time to teach while always coming up with
creative solutions to the ongoing challenges
(4). One such account tells of an intervention
to release the pressure caused by a blockage
in the ventricular system (Figure 5). Having
read about a drainage system imagined by
a Norwegian scientist, she decided that she
had to take the risk and perform a premiere
surgery to save the life that lay in her hands.
As the nurse walked by with a tray of Foley
catheters, she felt that spark that encouraged
her to try. She carved a groove in the bone,
fixing the catheter between the cerebral
hemispheres and the meningeal sheath (5).
The patient lived.
The year 1970 found Dr. Sofia Ionescu
facing yet another interesting challenge, as
she was obligated to confirm the fact that she
truly was a neurosurgeon. Accompanying
one of her patients, a member of the French
Embassy in Bucharest, to Paris and Lyon, she
met a team of French doctors who were
astonished to discover that the woman in
front of them truly was a surgeon operating
on the human nervous system. Undergoing
the “gouge forceps test,” her hands
undoubtedly stated what their true mission
was, the callosity on her ring finger proved
Figure 1. Portrait of Sofia Ionescu.
once more that she was the only woman to

He asked the young student to remain on his

team.
Graduating in 1945, she married Dr.
Ionel Ionescu around the same period.
Her newlywed life had a strong connection
to the profession, bearing the marks of
self-sacrifice and devotion as one can
rarely observe. The young couple lived for
7 years in the hospital, ensuring perma-
nent watch in the emergency room. She
had no rest leave for more than 15 years,
and only 1 month maternity leave after her
second daughter was born. She herself
states that she had operated the day before
giving birth to her first child. “My children
had no mother. I was almost always tired,
I worked extra hours in the pediatric clinic
to supplement the family’s income” (9). Figure 2. Sofia Ionescu’s house in Falticeni.
The year 1954 marks her becoming a

WORLD NEUROSURGERY 80 [5]: 650 653, NOVEMBER 2013 www.WORLDNEUROSURGERY.org 651

 PEER-REVIEW REPORTS
ALEXANDRU VLAD CIUREA ET AL. SOFIA IONESCU
LEGACY

Figure 3. Sofia Ionescu’s bust in Falticeni.

operate on the human brain. Another

confirmation of this fact came in the form of
a request sent out by the Sheik Zayed bin
Sultan al Nahyan, from Abu Dhabi, who had
requested the urgent presence of a female
neurosurgeon for one of his wives due to
religious constraints that prevent male
physicians from consulting muslim women
(Figure 6) (9). Figure 5. Dr. Sofia Ionescu during surgery.
In between brain surgery in the morning,
operating on the spine in the afternoon,
being a wife and mother of two, Dr. Sofia articles per year, published both in her Society for History of Medicine. The prestige
Ionescu found the time for research and country and abroad. Even after her retire- surrounding her career could only be
publishing, which was, as she amusingly ment, she continued with her writing, with acknowledged by a number of honorific
stated, done under a strict schedule, articles in Romanian medical journals. titles and diplomas, culminating with her
between two and four AM “The fight I strove Although many claim that the first woman Decoration with the Star of the Republic
against death, the final struggle of my neurosurgeon in the world was Diana Beck, and her becoming a knight—this is the
patients helped a great deal in strength- Sofia Ionescu performed her first successful highest distinction that could be granted to
ening my character.” As soon as 3 years after surgery on a living human being in the year a Romanian citizen. International approval
obtaining her primary physician diploma, 1944 (1-5, 8, 9). Diana Beck’s activities following the title of the first female neuro-
she started writing at a rate of two or three gained momentum only in 1947 when she surgeon came only 1 year after, when the
set up the neurosurgical unit at Frenchay World Health Organization declared her as
Hospital in Bristol before becoming well as 65 other doctors as heroes who have
a consultant at The Middlesex Hospital in dedicated their lives to the profession.
London (6). All literature confirms that Sofia But perhaps a greater role in the encour-
Ionescu’s first documented surgery dates at agement and moral support of this first lady
1944 while Diana Beck’s first documented of neurosurgery was the appreciation of her
surgery dates at 1952 (6), secondly. patients and those that knew her both as
The interest in interacademic cooperation a physician and as an individual. In 1946, the
resulted in numerous memberships—The last words of Professor Dimitrie Bagdasar to
Romanian Academy of Medical Sciences, his fellow neurosurgeons were not to let this
Figure 4. The Ogrezeanu House in Falticeni.
Honorary Membership of The Romanian specialty die, but to continue to develop it in
Society of Neurosurgery, The Romanian the same spirit, united, in the same rhythm,

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 PEER-REVIEW REPORTS
ALEXANDRU VLAD CIUREA ET AL. SOFIA IONESCU

her the legacy of an exceptional destiny for

the history of modern neurosurgery.
We salute you Dr. Ionescu!

LEGACY
REFERENCES
1. Aldea H: Famous neurosurgeons [in Romanian].
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2. Arseni C, Aldea H: Milestones in the history of

Romanian neurosurgery [in Romanian]. Bucharest:
Romanian Academy Publishing House; 1988.

3. Arseni C, Ciurea AV: The history of Romanian

neurosurgery. Bucharest: Medical Publishing
House; 1981.

4. Ciurea AV: History of Romanian neurosurgery [in

Romanian]. Bucharest: Viata medicala romaneasca
publishing house; 1995.

5. Ciurea AV. Textbook of neurosurgery, vol. 1.

Bucharest: Romanian Medical Publishing House;
2010.
Figure 6. Sofia Ionescu in Lebanon (en route for Abu Dhabi).
6. Glikes CE: An account of the life and achievements
of Miss Diana Beck, neurosurgeon (1902 1956).
Neurosurgery 3:738-742, 2008.
with the same passion and with the highest
of moral sense. Bearing such a heavy task, 7. Greenblatt SH, Dagi TF, Epstein MD: A history of
Dr. Sofia Ionescu performed masterly, as neurosurgery. New York: Thieme Publishing; 1997.
the words of Dr. Constantin Arseni (Figure 7)
8. Ogrezeanu I: Women in neurosurgery. Romania.
stated in his first volume in collaboration, The 13th WFNS Congress, Marrakech, Morocco,
Neurosurgical Diagnostic Elements, written in June 19 24, 2005. Oral presentation mentioned in
1958: “To the distinguished surgeon, Mrs. the abstract book of the Congress.
Dr. Sofia Ionescu-Ogrezeanu, with the 9. Simionescu R: Neodihna binelui. Neurochirurg
highest consideration.” Sofia Ionescu. Bucharest: Atlas Publishing; 1998.
Guided by true and solid coordinates,
such as modesty, respect, and devotion, the
Conflict of interest statement: The authors declare that the
life of Dr. Sofia Ionescu is one great
article content was composed in the absence of any
achievement after another, something that is commercial or financial relationships that could be construed
rare to stumble on nowadays. Her deepest as a potential conflict of interest.
regret, as she herself states, was not writing Received 19 November 2012; accepted 5 February 2013;
her memoirs, for she had much to teach even published online 22 March 2013
in her final years, her thoughts going out to Citation: World Neurosurg. (2013) 80, 5:650 653.
young neurosurgeons looking for more than http://dx.doi.org/10.1016/j.wneu.2013.02.031
just technique and scientific details. Journal homepage: www.WORLDNEUROSURGERY.org
Sofia Ionescu, the first woman neuro- Available online: www.sciencedirect.com
Figure 7. Sofia Ionescu (right) and Prof. C.
surgeon in the world, passed away at 88 1878 8750/$ see front matter ª 2013 Published by Elsevier
Arseni (center).
years in the spring of 2008, leaving behind Inc.

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