James Joseph Magennis VC Frances Elizabeth Clarke Stewart Parker Samuel Beckett Sam Hanna Bell William Carleton John Hewitt Rosamond Praegar Bernard (Barney) Hughes

George Fegan (1921 - 2007):
Surgeon; antique and art collector


William George Fegan, George as he was known, was born in Cavan on 27 March 1921, elder son of a prosperous retailer and merchant in the town and with other interests in the county, and of his wife Phoebe (née Reid) from County Antrim. George attended Cavan Royal School (he was dyslexic but avoided attending a “school for slow learners” because of his ability with numbers, a skill which never left him, and his mother’s reading textbooks with him at home which lasted up to and through medical school) and he entered Trinity College, Dublin (TCD) in 1939 to study medicine graduating MB, BCh, BAO in 1945 and is entered in The Medial Register on 10 December that year. After resident junior appointments at Sir Patrick Dun’s Hospital (“Dun’s”) he joined the surgical unit at the Royal Northern Hospital, Holloway Road, London as House Surgeon and Casualty Officer. Returning to Dublin within two years he took the Fellowship examination of the Royal College of Surgeons in Ireland (FRCSI) in 1949 and was appointed (in 1950) Surgical Registrar at Dun’s, a part-time non-resident specialist post (though without public beds under his name) by which he could further his surgical experience and at the same time enter into private specialist practice, which he did and had independent consulting rooms at 43 Fitzwilliam Square. In 1952 he attained the higher degree of Master of Surgery (MCh) at TCD and was appointed Assistant Surgeon at the Royal City of Dublin Hospital, Baggot Street, but relinquished the post in 1960 in order to concentrate on his career at Dun’s where he was soon appointed a consultant surgeon on the visiting staff and, about the same time, also at Drogheda Hospital working closely with the prominent practitioner in the town, Dr. Herbert Walker. By now he was a dexterous and successful surgeon known for his enthusiasm, restless energy, ebullience and gregariousness, his humour and above all for his loquaciousness which was infectious rather than deterrent. He was also known for his interest in Irish antiques, mostly silver and other works of Irish origin, and the good fortune to have the means for their acquisition. He had a contented marriage to Pamela (née Shaw), elder daughter of Captain Shaw, a senior member of the administrative staff at TCD, and his wife May (née Fisher) of a well-to-do family from Newry, County Down. (The younger daughter, Jane, would marry Ian Dalrymple, Master of the Rotunda Hospital, 1974-1980). Pamela and George were married on 3 July 1950 in Zion Church, Rathgar, and now settled into a comfortable home at 25, Rostrevor Road, Rathgar. A bright future beckoned for George as a general surgeon; George, however, had an agenda of his own. 

This agenda had three objectives; two were closely, the third only peripherally, related. The two former were, firstly, to be a leader in the rationalisation of the out-dated, small voluntary hospital system in Dublin and the attendant deficiencies in practice and teaching which flowed from it and was Dublin’s inheritance from its medical and social past; the second was to placate the Regulatory Bodies concerned while the requisite, longer-term reforms were being carried out which would rectify these deficiencies which had in fact already persuaded these Bodies in Britain and in some of the states in the United States of America to consider denying recognition of Ireland’s professional medical qualifications and therefore the legality of their holders to practice in the relevant jurisdictions. George played a role in both where his boundless energy, commitment, negotiating skills and above all his entrepreneurial instincts (George always saw opportunities where others, if they saw anything at all, saw only high risk and deep and certain failure) were put to good use, and the resultant arrangements became those of the present St James’s and Tallaght medical complexes. George’s third agenda objective was, quite simply, to develop the scientific study of the treatment of varicose veins and to instigate active programmes of the best procedures to adopt. Varicose veins may seem a somewhat mundane subject of study for such a lively and ambitious surgeon to embrace. There is however a possible reason; shortly after George’s birth his mother developed a deep vein thrombosis with near-fatal pulmonary embolism and it was this that could have inspired George not only to become a surgeon but also to study venous pathology and, hopefully, improve varicose vein treatment, all of which he was to do. As a recently-qualified doctor he had run de facto the varicose vein clinic at the Royal Northern Hospital, London. However, there was no such clinic at his training hospital (Dun’s) at the time, but as usual he turned difficulties into opportunities and after becoming Surgical Registrar at Dun’s in 1950 he was appointed by a sympathetic Master of the Rotunda Hospital in Dublin (helped by the timely resignation of the clinic’s incumbent) to be head of the varicose vein clinic at the Rotunda Hospital where there were varicose veins aplenty. Results improved dramatically and George soon developed a varicose vein clinic at Dun’s and ultimately, as his reputation grew, he took over much of the basement of Dun’s (which was then used mainly for storage) for research and teaching facilities not just on varicose veins but for post-graduate instruction and researches generally, and these became more extensive after he became Professor of Clinical Surgery at TCD in 1967. But the kernel of his work would ever remain varicose vein treatment by “Fegan’s technique”, more descriptively “compression sclerotherapy”, which involved injecting a sclerosing substance into an empty (varicose) vein, applying compression with tight bandaging, and requiring mandatory exercise the aim being to fibrose the empty vein (rather than produce a thrombosis in a full one which was then the practice), and to control significant points of reflux. In all these, and indeed in all his activities George’s energy was boundless and has been likened to that of a whirlwind or a comet. The analogy, however is inappropriate: George was certainly a force but, unlike whirlwinds and comets, he was a creative, targeted and discerning force only destroying to build something better in its place. 

The first results were published in 1963 and with strong support from Sir George Godber (Chief Medical Officer of England and Wales). These were striking and “Fegan’s Technique” seemed at a stroke to make other techniques redundant. George was immediately in demand as a speaker showing himself to be an admirable prophet for his results and his enthusiasm for his work to be genuine and infectious. His consultant practice thrived and larger consulting rooms were taken in Wellington Road in Dublin’s most prosperous residential district. As well as clinics in Ireland he founded and ran several in London, Paris and elsewhere and recruited colleagues to help him handle the large and growing demand. Such now was his reputation that he was elected to the Council of the RCSI in 1966; and he was persuaded to apply for the Chair of Clinical Surgery at TCD in 1967 but would accept appointment only if it remained a part-time post since the then salary for the full-time chair was £900 per annum! “They couldn’t afford to employ me full-time” as he said! The pace however was unsustainable even for such an energetic prophet and moreover his results seemed almost too good to be true and were increasingly being questioned in some, mostly self-interested circles, on the grounds that strict clinical trial and statistical discipline were at times wanting. Although George and his team published many numerical results his critics were not wholly convinced; and when pressed as to why he did not publish more disciplined statistical results George seemingly would say that he was somewhat dyslexic, though whether they believed him is unlikely! Caught in this classical tension-enhancing situation George started to have symptoms of coronary artery disease and in 1973 had a severe coronary occlusion. He refused (perhaps wisely at the time) to undergo coronary surgery deciding instead to seek peace and tranquillity in warmer climes. He resigned from his professorship at TCD and all other posts, and TCD showed its regard by appointing him to an Honorary Emeritus Professorship of Surgical Research with life-time tenure.

George now wandered the world and finally settled in Lamu, a Kenyan island off the African coast inhabited mainly by older folk of many persuasions but having in common ample resources. George was fondly known as “Dr George” and became a leader and spokesman for the island community, appearing on BBC television as such, and with health somewhat restored on a modest diet with a nip (or two!) of whiskey, long walks on the beach pausing only to draw the venous system of the leg in the sand with his stick and describe it to passing neighbours. Friends, colleagues and family members visited him from time to time and he himself travelled quite widely for some years including lecture tours. In September 1974 he was the house-guest in Belfast of the present writer, who had been a junior colleague at Dun’s, and gave an invited lecture at the Queen’s University Belfast Medical School; and for some years he ran a short course, always over-subscribed, at the Middlesex Hospital, London twice-yearly from 1986 to international colleagues including some who had been unable to reproduce his results, and left them wiser and often more proficient. However, failing health and eye-sight were to restrict his travelling; the results of a serious machete attack on the beach at Lamu which required some reparative surgery and hospitalisation when in his eighties, ended it completely and he died “suddenly” on 13 January 2007 aged 85 and is buried in Lamu, his condition at death being given as “fever with headache and stiff neck”. A Memorial Service was held in the Chapel at Trinity College Dublin on 17 February 2007. He left issue: Susan Mulhall, Corrie Jeffery, Sally Wyles, William Fegan, Jenny Richardson, and Gina Morris, and eleven grandchildren. His wife, Pamela, had pre-deceased him. For some years she had continued to live in their last home, Moyglare House, Kilcock in County Kildare to which they had earlier moved from “Landore”, Orwell Road, Dublin, and she ran a craft shop in Maynooth, but latterly she had moved to Alderney in the Channel Islands where she died of cancer some ten years later. 

George Fegan’s interests and activities outside his work and family were entirely constructive and limited in that he was a noted collector of Irish antiques, mostly silver, and also paintings by Irish artists: he neither played nor seriously followed any sporting activity, was uninterested in music and literature and had only a limited interest in the performing arts. He read only what he had to and with difficulty. He was a Freemason as were many of his colleagues at the time, but one sensed that he was an unenthusiastic one. His instincts were acquisitive, competitive and innovative. His accumulation of a considerable holding of delightful (and valuable) Irish silver artefacts may have been a joy to be surrounded by as examples of the craftsman’s art but it may also have been important to him that it was, allegedly, very possibly one of the more important Irish silver collections in private hands. His importing of Charolais cattle from France and Fleckvie cattle from Austria could be seen as satisfying any or all of his instincts. His commercial activities were real but details are unknown to the present writer. He certainly helped to build up an important tile and brick enterprise in Kingscourt, County Cavan and this necessitated his occasional attendance at Board meetings and the lik, and on several occasions the present writer drove a sleeping, over-tired George, in George’s 2.5 litre Riley saloon car to Kingscourt for meetings of the Board and, less frequently, to Kilkenny for meetings connected with the nut and bolt works in which George had a substantial interest. He and Pamela enjoyed entertaining friends and colleagues at their home especially at the magnificent Moyglare House amid paintings and beautifully crafted silver artefacts and antique furniture and all set in 300 acres of fertile land with a good working farm, a vintage Rolls-Royce at the door, and specially created walks around the property which helped George to relax after his hectic days in Dublin and elsewhere. He was kind and helpful to students, especially ‘deserving’ ones, and the present writer who served as a resident student and House Surgeon when George was Surgical Registrar at Dun’s, has nothing but praise for the sheer professionalism, good nature, humour and understanding which George showed at all times; and perhaps above all being and working with George was exciting!



Born: 27 March 1921
Died: 13 January 2007
Peter Froggatt
Acknowledgements:

The author is greatly indebted to several relatives and close friends of George’s for reading a draft of this entry, supplying some additional facts, correcting errors and making many constructive suggestions.

Bibliography:

R Bartlett (ed), Trinity College Dublin Record Volume, 1991, compiled by DA Webb. Dublin: Trinity College Press, 1992, pp.123-4. Davis Coakley, Medicine in Trinity College Dublin: An Illustrated History. Dublin: Trinity College, 2014, pp.252-3, 273-4. William George Fegan, Varicose Veins: Compression Scleropathy, 1965 (cited in Davis Coakley, 2014, above). Ibid, “Continuous compression technique of injecting varicose veins”, The Lancet, 20 July 1963, pp.109-113. “In Memorium, William George Fegan, 1921-2007, Emeritus Professor of Surgery, Trinity College Dublin”, by Mitchel P Goldman: in Dermatologic Surgery, March, 2007, 33 (3), pp. 355-6. Obituary “William George Fegan MB, MCh, FRCSI (1921-2007)”, by John H Scurr, in Phlebology, 22(3), 98-9, 2007. David Fitzpatrick (ed), “’The Feds’: An account of the Federated Dublin Voluntary Hospitals, 1961-200”. Dublin: A & A Farmar Ltd, 2006. Barry O’Donnell (ed), Irish Surgeons and Surgery in the Twentieth Century. Dublin: Gill & Macmillan, 2008, pp 178-9; Alan Browne (ed), Masters, Midwives and Ladies-in-Waiting: The Rotunda Hospital 1745-1995, Dublin: A & A Farmar, 1995, pp196-8. Davis Coakley, Baggot Street: A Short History of the Royal City of Dublin Hospital. Dublin: Board of Governors of the Hospital, 1995, p 120.  Entries in: The Medical Register, The Medical Directory, The Irish Medical Directory and Hospital Year Book.