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Andrew Fullerton (1868 - 1934):

Andrew Fullerton was a highly distinguished surgeon, in the field of urology, from south central Ulster, practising largely in Belfast. 

“Andy” Fullerton as he was often known, was born at Wesley Street, Cavan, third of the seven sons (of whom two died in childhood) of Rev Alexander Fullerton, a Methodist minister and formerly an incumbent of that church in Dalkey, County Dublin, and whose forebears can be traced to Castlebar, County Mayo, in the 18th century, and of Mary Jane (née Moffitt) a close relative of General “Chinese” Gordon of Khartoum fame. Andrew, who was a younger brother of Thomas William Archer Fullerton (1867-1907), a Major in the Indian Medical Service. was educated at Lurgan College, County Armagh, and in 1885 enrolled at Queen’s College, Belfast (QCB) where, after a difficult  undergraduate existence largely sustained  by resources he received by private coaching and where he first learnt the art and craft of teaching in general and to small groups in particular, which was to become a hallmark of his later career, he graduated MB, BCh (with first class honours) of the Royal University of Ireland (RUI) in 1890 having that year also won the Gold Medal of the Belfast Hospital for Sick Children and the Coulter Exhibition of the then Royal Belfast Hospital. After a short and difficult period in general practice he was appointed house surgeon at the Miller Hospital, Greenwich in London, and then at the West Kent General Hospital at Maidstone, before returning to Belfast where he proceeded MD (RUI) in 1893. He now recommenced general practice spending much of his (ample!) spare time as honorary demonstrator in anatomy at QCB under the dynamic Professor Johnson Symington where he furthered his interest in anatomy and his skills in teaching.

After some career disappointments and frustrations he was appointed junior assistant surgeon at what would become the Royal Belfast Hospital for Sick Children (RBHSC) in 1898 progressing to surgical registrar at the Royal Victoria Hospital in Belfast (RVH) in 1900. He successfully sat the Fellowship of the Royal College of Surgeons in Ireland (FRCSI) in 1901 and, now a “qualified” surgeon, was appointed, in 1902, to the RVH as assistant surgeon with duties mostly in the Outpatient Department but with the privilege on (very) rare occasions of also admitting patients under his care to a small number of beds, usually fewer than four, if available. In 1911 he was promoted to surgeon in charge of outpatients at the RVH, and from then until the outbreak of World War I he built up a modest private practice though one barely commensurate with his growing reputation as a dextrous surgeon with a fertile mind (he took the Master of Surgery or MCh of QUB in 1913), and later to be increasingly, but not exclusively, focused on techniques of urological surgery to which throughout his career he was to introduce new methods and refinements of established ones. 

From early in his career Fullerton made and maintained close contacts with his professional bodies. He joined the British Medical Association (BMA) in January 1893 and was voted a member of its Representative Body for the three-year period, 1906-9, and attended its annual meetings in Toronto (1906), Exeter (1907), and Sheffield (1908), and was Secretary (1909) and later Vice-President of the section on surgery when it met in Aberdeen (1914). Especially he made and kept contacts with the Association of Surgeons of Great Britain and Ireland and later (1931) hosted a successful meeting of the Association in Belfast at which he was appointed President for that year. He was also elected an Honorary Fellow of the American College of Surgeons (Hon FACS) in 1922 due in no small part to his contact with many influential American surgeons during and after World War 1 (vide infra). Nor was Dublin excluded from his attentions: having taken the Fellowship of RCSI in 1921 and, no doubt, helped by the tongue of good report of some of his Belfast colleagues, he soon became an examiner for the College diplomas and was elected to the council in 1922 and ultimately, in 1926, to the presidency, the first Belfast surgeon and, reportedly, the first provincial surgeon for some 80 years to be so honoured. 

These early contacts with the RCSI facilitated his being their nominee, on the outbreak of World War I, as a consultant surgeon willing to join the Army Medical Service (AMS), and he was appointed with the rank of full Colonel and ultimately surgeon to the 5th Army. Arriving in France in early 1915 with the British Expeditionary Force he was stationed at the base hospital on the Camiers-Etaples Plain south of Boulogne, a complex which ultimately comprised British, French and American hospitals (the last named largely Harvard-connected until USA entered the war in 1917) and this allowed him to broaden further his experience of general and especially traumatic surgery involving his main interests of genito-urinary lesions and serious bone fractures, and also to work with leading international surgeons (the famous Harvey Cushing for one) as well as British colleagues including leading London surgeons.  He also developed from his experiences, when called to the forward areas, a method of blood transfusion direct from the donor’s artery to the recipient’s vein subsequently known eponymously as the “Bazett-Fullerton procedure”. He was gazetted CMG in 1916, was mentioned in dispatches three times and was appointed CB on discharge in 1919. His skills were further recognised in his selection to write the section “Gunshot wounds of the kidney, ureter and bladder”, in History of the War (Medical Services). 

On his return to Belfast, Fullerton was elected President of the Ulster Branch of the BMA (1919) and of the Ulster Medical Society (1919-20) in recognition of his war service, was appointed attending surgeon at the RVH (1918) and gave the annual winter oration at the RVH in 1923 (he had also given it in 1904). Later he would be President of the Belfast Medical Students’ Association and also of the Queen’s University Services Club, and in 1930 he gave the Campbell Oration at the RVH on the subject “Progress in Urology”. Also, in 1923, with the retirement of Thomas Sinclair and at the age of fifty-five he was appointed professor of surgery in preference to the promising all-rounder Samuel Thompson Irwin (Irwin was knighted in 1957, when he was 80, for his political as well as his surgical achievements being MP in the Stormont legislature).

Fullerton at once re-vitalised the department introducing a revived interest in research and teaching. His own teaching skills had been well honed in the days before the war: clarity, relevance and application being the main objectives which he sought and which he achieved for all but the least involved students. His ward rounds were crowded; his lecture and case notes were both copious and masterpieces of precision. But above all he liked teaching, he liked the students, he liked his subject and these combined with his own patent enthusiasm won the devotion of those he taught. On his retirement he was presented by the students with a handsome silver salver of which he was justly proud.

The students may have liked and respected him but patients often found him abrupt, always brusque and often even surly and on occasions tactless, and so he never developed an obviously sympathetic or “bedside” manner which meant that his private surgical practice was never as extensive as that of many of his less able colleagues. His research fame (he published some 80 papers, by invitation as well as chapters in books, one textbook and other professional communications), and his important visiting surgeons from USA and elsewhere who included, among many others, the famous Mayo brothers of the Mayo Clinic of Rochester, Minnesota, Hugh Hampton Young of Baltimore, Ernest Miles, and Sir Arbuthnot Lane of London ensured that surgery in Belfast would no longer be parochial. He had few hobbies outside his work, golf being the main one. A member of Royal County Down GC (usually referred to simply as “Newcastle”) he was captain of that club in 1932 and 1933 and for him the climax was when the Prince of Wales (later King Edward VIII) played there in November 1932 during his captaincy and in his company. A diligent Freemason, he was a former Worshipful Master of Queen’s University Lodge.  

Although generally in good health and seemingly with enduring youth in his energy and enthusiasms, despite his being far from robust in appearance, he suffered for some years from chronic indigestion and was operated on by Berkeley (later Lord) Moynihan for duodenal ulceration, though unsuccessfully. However, he later developed prostate disease and was operated on in London (possibly by fellow Ulsterman, Terence Millin) but in convalescence he failed to regain health or strength due to an unsuspected abdominal cancer which was operated on by two Belfast colleagues, and with one of his best surgical friends from England, Sir Geoffrey Jefferson in attendance, who had strict instructions that on no account should he have a colostomy. He died a few hours later, on 22 May 1934, at 1 College Park East and is buried in Belfast City Cemetery. 

Fullerton married, firstly, on 26 April 1897 in Holy Trinity Church, Upper Tooting, Caroline Bulloch (died 1926), daughter of the late Mr. John Thornton Bulloch of 48 Louisville Road, Upper Tooting and of Aylsham, Norfolk; they had two sons (Cecil and Eric) and one daughter (Irene). His second marriage on 8 June 1928 in St. George’s Church of Ireland Church, Belfast, was to Norah Digby Counihan, daughter of Rev Robert Digby French of Sandford, Dublin and widow of Randall Counihan, MD, FRCSI, of Ennis, County Clare, who nursed him for a year before his death when his health was failing.

To general surprise Fullerton was never honoured either by his country (in peacetime) or by his university even though recognised by the wider profession in Ireland and abroad. The reason is based on the story, which may be apocryphal, that when speaking at a function in RCSI when he was President of the coll3ege (1926-7), Fullerton is alleged to have said, “that in the field of surgery in Ireland there should be no border…” Next day the diurnal press (perhaps by an oversight!) omitted the qualifying words “in the field of surgery”, when reporting, otherwise verbatim, that part of the speech. The truncated extract reached the politically sensitive ears of the Unionist government of Northern Ireland and the equally politically sensitive ones of the Queen’s University of Belfast Senate, and Fullerton’s name disappeared forever from their potential honours lists!  His 77 professional monographs (including articles he authored) suitably bound, and many case notes and other written memorabilia including a duplicate copy of all his hospital cases of urological interest, were left by him to the Ulster Medical Society, and these and a fine portrait in the Royal Victoria Hospital by the Ulster artist William Conor, constitute his memorial.

Born: 20 March 1868
Died: 22 May 1934
Peter Froggatt

RSJ Clarke: A Directory of Ulster Doctors (who qualified before 1901) (Belfast: Ulster Historical Foundation, 2013, vol 1, pp 367-8);  Sir Ian Fraser: “The first three Professors of Surgery [at Queen’s University, Belfast]”, (Ulster Medical Journal, 45, 12-46, 1976); Sir Ian Fraser: “Great Teachers of Surgery in the Past: Andrew Fullerton (1869-1934)”,  British Journal of Surgery, 51, 401-405 (1964);  Richard Clarke: A Surgeon’s Century: The Life of Sir Ian Fraser DSO, FRCS (Belfast: Ulster Historical Foundation, 2004); Obituary, “Andrew Fullerton CB, CMG, MD, MCh, .FRCSI, FACS”, British Medical Journal, p 1011 (2 June 1934);  WA Page MB: “Prostatectomy as performed by the late Professor Andrew Fullerton”, (British Medical Journal, pp 578-9, 23 March 1935). (For a review of Fullerton’s surgical work, see Sir Ian Fraser’s referenced articles particularly one in the June 1964 British Journal of Surgery, vol.51, pp 401-405)