Fifteen Eighty Four

On 15 October 2024 I attended the UK premiere of Joy at the Royal Festival Hall — part of the 68^th annual British Film Institute gala sponsored by Cunard.  Directed by Ben Taylor and produced by Finola Dwyer and Amanda Posey, it was based on the ‘true story’ of the work of scientist Robert Edwards and gynaecologist-obstetrician Patrick Steptoe that led to the birth of what in popular parlance became known as the world’s ‘first’ test-tube baby Louise Joy Brown. Focussing on the biography of Nurse Jean Purdy, their chief assistant, it featured a screenplay devised by Jack Thorne and Rachel Mason, a married couple who, in publicity associated with the screening, disclosed that they themselves had experienced female-factor infertility and acquired a child by successful in vitro fertilization (IVF)¹. Having never witnessed a VIP event in person before, I stood shivering in the twilight drizzle with other onlookers, marvelling at the dazzling lights, fine clothes, attendant celebrities and press.  It certainly was, momentarily, quite thrilling to watch Louise Brown herself (who only months before I had been photographed with as the lead author of my book) sashay in a silver dress down the red carpet in a frenzy of camera flashes.

The film itself, which was later released on Netflix, was a satisfying watch providing an array of light-hearted and emotional moments.  Competently put together and slickly-crafted, it opened with a nod to the heritage industry with wide shots of campus life from late 1960s Britain: students whizzing around on bicycles, and scurrying academics, all set against a backdrop of the colleges of Cambridge University.  Well-timed comic elements peppered the screenplay from the ‘meet-cute’ of Jean Purdy’s initial encounter with her prospective employer Robert Edwards, to a love-affair sub-plot with postgraduate student Arun and Purdy’s blunt disclosure to her elderly mum one evening that ‘I’ve been having unprotected sex since 1964.  You’ve a sinner under your roof’.  A pleasant soundtrack, with a range of jaunty and beloved tunes from both the classical and popular world cast wry and sometimes piquant commentary on the plot.  Opening scenes play out to Here comes the Sun and the Oogum Boogum Song whilst Vaughan Williams’s Lark Ascending, based on a mellifluous English folk melody accompanies the fateful egg collection that ultimately led to successful in vitro fertilization followed by a live birth for Mrs Brown.  This latter instance perhaps hints that the final scientific and medical breakthrough was a very British triumph (though in the face, we must not forget, of considerable documented rivalry from very similar teams working in parallel in Australia, the USA and India).  The final scenes are played out to the American folk tune Five Hundred Miles (‘If you miss the train I’m on, you will know that I am gone’).  The exhibiting of clips from the video news release of the actual delivery of Louise Brown, and archival photographs of the ‘real’ Jean during this tune emotively remind us of Purdy’s apparent ‘absence’ from the popular traditional narrative around the ‘first’ test-tube baby – even though historians have highlighted her key role for almost a decade² and Edwards and Steptoe themselves were always very careful to include her name in their key journal publications³.

By and large, the spirit of the whole medico-scientific enterprise was well captured in this film and it was clear that some solid documentary research had been done.  The exhausting, tedious car journeys undertaken by Edwards and Purdy back and forth from their laboratory base in Cambridge to Steptoe’s hospital in Oldham Lancashire over a long period featured frequently. The closeness of the team and the many hurdles they encountered along the way from professional colleagues, the Church, Ethics committees, the Medical Research Council and certain members of the Press featured prominently.  The sheer will of the threesome to persevere over a decade despite repeated technical failures and other life events was well represented and, as the character of Edwards specified in the film, ‘I’m a scientist Jean. I fail every day in the hope that I’ll succeed once in 20 years’. Above all, the kindness shown by Purdy towards research subjects and patient volunteers was very apparent

Yet this movie was, of course, a filmic interpretation of real events. Consequently and perhaps inevitably there were a number of chronological and other inaccuracies that will become apparent to those like myself working as archival historians.  Examples are numerous and only a few can be mentioned here.  Purdy and Edwards never went together to the first meeting with Steptoe in 1968;  Kershaw’s Cottage Hospital was not used by them from the outset in 1969, but only after 1971; Edwards never clashed with the Nobel prize winner James Watson specifically ona televisedlive studio-based discussionprogrammein the way the movie indicates, although there were definitely public disagreements between the two in conferences and also the press⁴. Technically the research programme did not result in ‘five pregnancies’ as end credits suggest.  Whilst it is accurate and factually verifiable that the research work resulted in two live births and living children, as many as fourteen additional patient volunteers between the years 1969-1978 experienced either a ‘late return to menstruation’, an ectopic pregnancy, a late pregnancy loss and a biochemical or clinical pregnancy⁵.  The Ovum Club, which certainly did exist⁶ has to date left mere fragments of documented evidence and its members are not, at the time of writing, known to have visited any beach together.  Access to the names of Oldham patients, who are shown in the film, is currently restricted for decades in the official archives of Edwards’s papers held at Churchill College Cambridge owing to current GDPR regulations concerning individuals’ private medical information.

In the light of this latter point, perhaps the most pertinent issues this film brings into focus then are the tensions that inevitably arise between filmic re-presentations of ‘real’ events occurring within living memory, the requirements of dramatic narrative, audience reception, historical accuracy and ‘truth’ and the ethical questions relating to the privacy of individuals regarding medical issues.  For example, the character of Matron Muriel Harris is beautifully portrayed as a woman of Afro-Caribbean descent.  This is a thought-provoking dramatic device perhaps recognising the wonderful work of the many immigrant staff from the Commonwealth who served in our nation’s NHS during the period in which the story occurred.  Yet, by depicting the redoubtable Muriel (an experienced White-British nurse of formidable character, whose professional work is documented in public archives⁷ and who is remembered fondly by many of Steptoe’s team still alive today) in this way, her personal identity is completely obscured.  Such a move is somewhat surprising (original though it is) in a creative enterprise that, as the actors, writers and director claimed at the Gala opening night⁸, purports to render visible and applaud those particular women who have hitherto apparently been ‘written out’ of official histories.  

Most significantly in relation to this point is the issue of whether or not Jean Purdy herself suffered from endometriosis which rendered her infertile — a central theme that drives and underpins the entire plot.  Time Magazine reported that for screenwriters Mason and Thorne there was absolutely no doubt that ‘she did’, and this confident assertion was reported to have been obtained through a named individual working with the team in the 1980s and still alive and contributing to the official history today⁹.  Yet this was a diagnosis made at second hand several years after Purdy’s untimely death in 1985.  Recollections from certain other key individuals who knew Purdy well at the time differ from this¹⁰.  Neither does this apparent ‘fact’ seem to appear anywhere in the publicly-accessible written record.  More importantly it is also something of an anachronism: Purdy simply could not have obtained a definitive conclusion about her perceived gynaecological affliction in the late 1970s and early 1980s because the chief tools used today (laparoscopy and ultrasound) to provide reliable diagnoses were not routinely available in clinical settings (because as the movie indicates, Steptoe was pioneering one of the methods).  A very brief pelvic exam — depicted in the film — could not have provided the information it was shown to give.   Finally if it really is true, it is a very public revelation of a deeply-personal medical condition about which Purdy, who still resides in the living memories of colleagues who worked with her at that time, has not been able to consent to. 

Thus, it is the insistence of truth in relation to this specific matter in attendant publicity that jars here.  For, as the cautious end credits remind us, some aspects of ‘this portrayal have been fictionalised for dramatic purposes. The characters portrayed have also been fictionalised for dramatic purposes and any resemblance between them and actual individuals should not be inferred’.  Therefore it does not need to be ‘true’ (as claimed) to be meaningful.  That it was assumed to be so, and was deemed to be one of Purdy’s main motives that drove her professional success is possibly what is most significant and should be further explored. As I left the auditorium that night it was clear audience reception was positive, and deservedly so.  Yet I must confess the historian in me was troubled to hear some people profess their comprehensive acceptance of what is effectively still only one version of events because they ‘never knew that’ about the test-tube baby (a sentiment similarly repeated in online write-ups and discussions)¹¹.  Perhaps what we must ultimately take away from this film, as we do from all movies in a similar vein based on ‘real’ events, is the necessity of reflection on what it reveals about our values, beliefs and attitudes today.  Purdy’s work was vitally important in this medical breakthrough and there is certainly no doubt about that.   Yet in this very entertaining, technically well made and affectionate film her (apparent) gynaecological condition is placed front and centre without her consent; her sexuality, social mores and love life are explored and exposed and her reproductive organs are examined by a male clinician who on that occasion worked without a chaperone.  Like all of us she was no doubt a human being of rich complexity and contradictions; a woman of multiple identities, skills and abilities who may well have experienced many passions and emotions throughout her regrettably-short life.  A friend who worked with her in IVF research for many years, who knew her well, described her as ‘a very private person’¹².Therefore I wonder, in what could have been the year of her 80^th birthday… ‘what would she really have thought?’  None of us can ever know.

¹ https://www.theguardian.com/film/2024/oct/14/joy-bill-nighy-james-norton-thomasin-mckenzie-film-ivf-playing-god accessed 25/01/2025.

² M. H. Johnson and K. Elder, ‘The Oldham Notebooks: an analysis of the development of IVF 1969-1978.V. The role of Jean Purdy reassessed’, Reproductive BioMedicine and Society Online 1 iss. 1 (2015), 46-57

³ For the bibliographies of Edwards, Purdy and Steptoe see F. Kisby Littleton, S. Bewley and J. Drife eds., Presenting the first test-tube baby. The Edwards and Steptoe Lecture of 1979 (Cambridge, Cambridge University Press, 2023) p. 41 note 5, 11.

⁴ R. Edwards and P. Steptoe, A Matter of Life (Sphere Books, Glasgow, 1981), chapter 15.

⁵ K. Elder and M. H. Johnson, ‘The Oldham Notebooks: an analysis of the development of IVF 1969-1978. II. The treatment cycles and their outcomes’, Reproductive BioMedicine and Society Online, 1 iss. 1 (2015), 9-18.

⁶ K. Elder and M. H. Johnson, ‘The Oldham Notebooks: an analysis of the development of IVF 1969-1978. II. The treatment cycles and their outcomes’, Reproductive BioMedicine and Society Online, 1 iss. 1 (2015),  9-18, Supplementary Material: Interview with Grace Macdonald.

⁷ M. Harris, ‘Louise: The test-tube miracle’, Nursing Mirror supplement, November 2 1978, p. XV.

⁸ The Q&A session at the opening of the London Premiere: https://www.youtube.com/watch?v=_LKjlHB3rE8 accessed 25/01/2025.

⁹ https://time.com/7178799/joy-true-story-jean-purdy-netflix/ accessed 25/01/2025.

¹⁰ Personal communication, Dr John Webster 18 October, 25 November 2024; personal communication Professor Kay Elder 18 October 2024.

¹¹ E.g. a commentator on the BBC Front Row reported they enjoyed this film ‘particularly because it rid me of a tremendous amount of ignorance’, minutes 30-32, https://www.bbc.co.uk/sounds/play/m0024x1l accessed 26/01/2025.

¹² https://time.com/7178799/joy-true-story-jean-purdy-netflix/ accessed 26/1/2025.

Title: Presenting the First Test-Tube Baby

ISBN: 9781009211031

Author: Fiona Kisby Littleton, Susan Bewley and James Owen Drife