Lives of the fellows

Charles Thomas Andrews

b.3 November 1903 d.31 March 1990
MB BCh BAO Belf(1927) MD(1930) MRCP(1932)FRCP(1943)

Charles Thomas Andrews was born in Killeter, County Tyrone, a few miles from the border with Eire. He was a member of a farming family almost certainly descended from the ‘Scottish-Irish’ settlement of the province in the 17th and 18th centuries, whence came so many leaders in politics, the professions and the Services. Charles undoubtedly upheld the traditions of his illustrious compatriots. He was educated at Edwards Boys School, Castlederg, and Queen’s University, Belfast, where he had a distinguished undergraduate career - taking many of the prizes and gold medals of his year. He believed that despite this outstanding record he was denied his honours degree and a place as houseman in the Royal Victoria Hospital owing to an argument in his final oral with a notoriously cranky professor of midwifery who disagreed with his views on the use of pituitrin in the third stage of labour. So his postgraduate experience was obtained in England at Bournemouth, in North Staffordshire, and in several LCC hospitals. In 1932, with an MD and his membership of the College, he went into private practice in Truro, was appointed consultant physician to the Royal Cornwall Infirmary in 1938 and became a member of the south western regional hospital board in 1947.

In 1946 R N Curnow, MOH for Cornwall County Council, had a letter from the Ministry of Health suggesting that it was time to investigate conditions in the former workhouses under their jurisdiction. He handed the responsibility to Charles, who gave it all his spare time for almost a year. He began with a visit to the West Middlesex Hospital to meet Marjory Warren and to see for himself the results she had published from time to time of her 12 years of work, converting wards housing some 700 ‘chronic sick' into an active 200-bed geriatric unit with two or three times the former turnover. They had much in common, both being sincere and forthright, both discerning and both good listeners, and they were dedicated to the best interests of sick people. Obviously they enjoyed mutual respect and understanding from the moment they met, and Charles said he came away with a clear idea of what was required in his survey.

There were seven workhouses scattered over Cornwall, some Dickensian beyond belief, especially Madron which always remained printed on Charles’ memory as a ‘nightmare’. He arranged to examine every infirmary patient and he presented his report in person to the County Council in 1947. It was the first of its Kind and copies were much in demand in this country and elsewhere. Charles, a modest man, was surprised by its success and as the requests came in he realized that he had missed an opportunity in not arranging to have it published for wider circulation. The County Council accepted it verbatim, including a novel recommendation that they should set up a County-wide geriatric service and appoint a consultant in geriatric medicine to direct it, backed by appropriate supporting staff. They advertised the consultant post, but the copy sent to the BMJ failed to appear. After a month had elapsed without its appearance, Charles rang up to enquire why. Apparently the idea that geriatric medicine might rate consultant status had caused some consternation because he was told that it was ‘a new departure’ which had to be confirmed by the BMA Council. He wondered what they would have done in Cornwall had it been turned down, but it was not; the applicants were remarkable in numbers and variety, many of them ex-service. Tom Wilson, the successful candidate, aged 29, became the first consultant in geriatrics in Great Britain three months before the inception of the NHS - an achievement which Charles might well have considered to be a quaint spin-off from his midwifery oral twenty years earlier.

Despite his busy life in clinical practice and administration, Charles did not lose touch with developments in the geriatric service he had initiated and his continued support was recognized in 1967 when a purpose built psychogeriatric unit (another Cornish first) was opened at the Barncoose Hospital and named The Charles Andrews Clinic. He was the source of constant encouragement also to his junior colleagues, and to general practitioners who appreciated his wisdom and experience and knew that they could rely on him for crisp, carefully considered advice.

Sometimes Charles’ geriatric interests were misconstrued as misguided eccentricity by unenlightened colleagues, one referred to him as ‘getting immersed in the "wet and dirties" ’ and another remarked that ‘it was an odd digression in a promising career’. The latter comment may have been provoked when he declined an appointment he was offered in a teaching hospital. Although the art of medicine should be learnt by students from doctors like Charles, and some students undoubtedly lost out on account of his decision, the prospect of teaching them was not enough to tempt him away from his commitment to Cornwall. To those who knew and admired his work there, his greatest achievement was his contribution as the architect of a comprehensive hospital service for Cornwall. The plan he proposed, based on a district general hospital in Truro, was approved by the Ministry of Health in 1945 but another 20 years of planning elapsed before he saw the hospital commissioned.

During his working life he wrote papers on diabetes, heart disease and myelosclerosis, and on a visit he made to Florence Nightingale’s hospital in Scutari soon after the Crimean War centenary. The SW regional board also invited him to write reports, similar to his Cornish survey, on medical problems of old age and institutional care in Devon and Somerset. In retirement, while finding more time to care for his beautiful garden, he continued to write and began the detailed research which brought forth his two splendid books on the history of the Royal Cornwall Infirmary and the Cornish mental hospitals: The first Cornish hospital, Truro, England, 1975, published privately, and The dark awakening: a history of St Lawrence's Hospital, Bodmin, London, Cox & Wyman Limited, 1978. The renown, respect and affection Charles earned as a physician in the West Country was enhanced by his devotion to poetry. He enjoyed the unusual distinction, as a doctor, of being elected a Cornish Bard. He had a particular interest in the Romantic poets and was a member of the Keats-Shelley Memorial Association. He gave many lectures in Britain, especially on Keats - the doctor poet - and on Oliver Goldsmith.

Charles claimed Charles Singer [Munk’s Roll, VoLV, p.379] as the great friend and counsellor of his working life and believed that it was to him that he owed his election to the fellowship of the Royal College when, aged only 38, he was buried away in the far west of England under a heavy wartime workload. Among others that he first met in Singer’s home was J H Sheldon [Munk's Roll, Vol.VI, p.402] who became another firm friend, sharing the same profound interest in the social medicine of old age.

Charles had married Mabel, née Henderson, in 1932 - shortly before they decided to settle in Truro. Mabel had qualified in medicine at Queen’s University, in 1928, and made her own notable contribution to geriatric medicine as a member of staff in the Barncoose geriatric unit. Considering their combined influence, direct or indirect, on the development of geriatric services in Cornwall many old people in the region must have good reason to be grateful to them. They had two daughters; one is now a doctor. The happiness of their 57 years together was blighted towards the end when Charles was overtaken by Parkinsonism, but he faced his increasing disability with characteristic courage and determination, maintaining a philosophical cheerfulness backed by the unfailing loving care and enouragement of his wife.

G F Adams

[Brit.med.J., 1990,300,1395; The Lancet, 1990,1,1452]

(Volume IX, page 13)

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