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Anastasia Katherine (Anna) Donald (1966–2009)

by Malcolm Brown

Anna Donald's brilliance bubbled to the surface wherever she went, at North Sydney Girls High, Sydney University, Oxford, Harvard, British Government service and internationally, where she helped pioneer a new medical discipline.

Insatiably curious, she had a mission: that high quality health care be available to everybody. Entirely comfortable with mathematics and economics, she saw that inflation in the cost of health care always ran ahead of general inflation. This would eventually make health care unaffordable, particularly for the poorest.

As a young doctor in Oxford when evidence-based medicine was being born, Donald published in 1995 one of the first articles on the subject. She was convinced that a package of evidence-based interventions, with all the excesses of medicine stripped away, could make high quality care affordable for all. She lectured to sceptical, sometimes, hostile professors without trepidation.

Anna Donald, who has died at 42, was born Anastasia Katherine Courtice. Her father, Tony Courtice, was a biologist, and mother Janet a classics honours student at Sydney University. Her mother's uncle won an early Nuffield scholarship to Oxford, and her paternal grandfather a Rhodes scholarship in the 1930s.

Her parents separated when she was two. Her mother remarried and, with her husband Bruce Donald, a lawyer, brought Anna up. At North Sydney Girls High, Anna's ideas tumbled out so quickly that fellow students had to race to catch up. She won state and national prizes in mathematics and French and was in the Australian team for the Mathematics Olympiad.

Anna Donald entered Sydney University's Wesley College in 1985, enrolling in arts and medicine. She became president of the Sydney University Union in 1987, the year she won a prize for short stories. Presiding over the world debating championships in Sydney, she met the leader of the winning Oxford team, Michael Hall.

Graduating in 1989 as a Bachelor of Arts in history and preclinical medicine, she won the Convocation Medal and a Henry Lawson prize for prose. She became the second Australian woman to win a Rhodes scholarship and was elected to the University Senate.

In 1992, she graduated at Oxford as a Bachelor of Medicine and Surgery, did her internship at Oxford and residencies in Kenya, Oxfordshire and Glasgow. The next year Dr Donald won a Kennedy fellowship, Caltex and Menzies scholarships and declined a Fulbright because she had sufficient funds.

She went to Harvard in 1994, with time at Oxford working in the new medical sub-speciality called evidence-based medicine, which was replacing tradition, influence and ideology in public health policy with an information-based approach. It captured her imagination. She called it evidology.

Now a Master of Public Policy from Harvard with degrees in medicine, economics, and history, Donald became a lecturer at the University College London. She co-created a reference text, Clinical Evidence, for the British Medical Journal and the Journal Of Evidence-Based Healthcare.

In 1996, Donald co-wrote House Officers Guide To Survival, which went into three editions and was credited with saving thousands of young doctors from nervous breakdowns. She served on an inquiry into health inequalities and became founding clinical editor of the BMJ's Clinical Evidence Service.

In 1999 she co-founded Bazian, a company providing evidence to health systems and developing evidence-based medicine from an academic idea to a working profession. Although a steadfast supporter of Britain's National Health System, Donald knew that the public sector would almost always compromise. Bazian found clients in Britain, Germany and Japan.

She addressed audiences around the world.

In 2003, she reconnected with Michael Hall, who had become a lawyer. Soon after, she was diagnosed with breast cancer. He cared for her while she received treatment and they married in 2005.

But cancer returned early in 2007, more aggressively. She responded philosophically, continuing her search for better understanding of sickness and health.

Comparing herself to one of those 19th century Oxford scientists injecting themselves with mushrooms to see what would happen, she explored different ways of responding to her illness. And she reported her findings in a series of 22 blog entries for the BMJ, writing from the heart, directly and wittily.

Richard Smith and Muir Gray said in her obituary in the journal: "Meeting her could be like walking into a red-haired hurricane ... She was relentless in pursuit of the truth but so full of humour and sympathy for others that she was loved as well as respected."

She said: "When you discover you have metastatic cancer you think you've picked a black ball in the lottery. But I've discovered it's a luminescent ball. I'm becoming the person I want to be. I'm not putting it off until I retire." She thought cancer gave her the time "to tell people how much you love them, to de-clutter your wardrobe of the clutter you don't need. While I don't know how long I have to live, I know for sure that I have had the most rewarding and privileged life."

Anna Donald is survived by her husband Michael Hall, her mother Janet Donald and stepfather Bruce Donald, brother Tom and sisters Michaela and Rosie, and by her father Tony Courtice and his children.

Original publication

Additional Resources

Citation details

Malcolm Brown, 'Donald, Anastasia Katherine (Anna) (1966–2009)', Obituaries Australia, National Centre of Biography, Australian National University,, accessed 15 April 2024.

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