Lives of the fellows

Graham Macgregor (Sir) Bull

b.30 January 1918 d.14 November 1987
Kt(1976) MB ChB Cape Town(1939) MD(1947) MRCP(1947) FRCP(1954)

Graham MacGregor Bull was born in Burma, where his father Arthur Barclay Bull, was a medical officer to an oil company. He was brought up in South Africa, where he attended the Diocesan College in Cape Town and subsequently graduated in medicine, with distinction, at the University of Capetown. After a short spell in general practice, he was appointed tutor and assistant in the department of medicine at the Groote Schuur Hospital, where his students - some of them now medical men of distinction in the UK - still recall his talents as a memorable teacher even in those early days.

In 1947 he was awarded a travelling fellowship by the South African Council for Scientific and Industrial Research, which he held at the Postgraduate Medical School at Hammersmith. His MD thesis on postural proteinuria had drawn him to the attention of John McMichael, later Sir John, who appointed him to a lectureship in his department of medicine. W J Kolff had already left the school but his pioneering work on the artifical kidney was being continued by E G L Bywaters and A M Joekes. Bull joined this team and, when Bywaters returned to his original interest in rheumatology, he took over the renal unit. With Joekes and K G Lowe, he evaluated renal function in acute tubular necrosis and proceeded to develop a conservative form of treatment, the ‘Bull regimen’, for use in the acute phase of renal failure. In simple terms this involved measuring and replacing fluid and electrolytes lost by the patients to keep them in balance until natural recovery could take place. This resulted in an immediate reduction in what had previously been a high mortality rate. As postgraduate students from all over the world flocked to Hammersmith in the postwar years, Bull’s teaching had a profound influence on the future practice of renal medicine.

In 1952, at the early age of 34, Bull was appointed to the first full-time chair of medicine at Queen’s University, Belfast. After surviving, with good humour, a gruelling initiation ceremony by the students, ‘The Bull’ - as he came to be known - set about introducing a modern approach to medical teaching and practice, which swept like a breath of fresh air through the whole of Ulster. His outstanding expertise at the bedside and his encyclopaedic knowledge of the medical field, which included such neglected subjects as psychiatry and geriatrics, earned him the respect of senior colleagues, assistants and students alike. His early experience in general practice helped to ensure the cooperation of general practitioners in establishing record linking systems, and his support gave an impetus to Belfast’s flying ambulance service for the early treatment of cases of myocardial infarction. He brought to the medical school an appreciation of the importance of mathematical accuracy in both clinical and research work, and he was influential in establishing a department of medical statistics. As chairman of the Northern Ireland Hospital Authority’s education and research committees he played a dominant role in developing postgraduate education and promoting research over the whole field of medicine in the province.

In 1966, following the untimely death of the director-designate, John Squire [Munk's Roll,Vol.VI,412], Bull was appointed director of the Medical Research Council’s new clinical research centre at Northwick Park, with Richard Doll, later Sir Richard, as his deputy director. The centre had been sited deliberately at a district general hospital rather than in a university environment so that emphasis could be placed on studies of human disease as it presented in a defined community. Bull took over when the plans for the centre and the hospital were complete and building had begun. He promptly turned his attention to recruitment and operational policies, with a steady resolve and dedication, cloaked by a relaxed, informal and good-humoured manner. By the opening day, in 1970, he had in place a happy and well organised force of research workers ready to occupy their new laboratories and carry on their work without loss of momentum.

Bull was a dominant figure both in the centre and in the hospital; he himself had an imaginative and highly original approach to any problem and he was always available for advice. He stood behind his divisional heads, never seeking to direct them but encouraging them to develop their research programmes in their own way. He played a major role in ensuring that the Northwick Park complex, including the research centre with its own wards, was first accepted and then highly regarded by the health authorities, the local community, and the patients treated there. He himself was widely respected and rightly trusted, but he had no easy task. The Northwick Park scheme was from the beginning the subject of frequent and often carping criticism in university circles. The staff at the centre were employed predominantly for their research prowess, without recourse to the other outlets open to university employees, and this selective approach made recruitment more difficult. The initial concept of joint NHS/MRC appointments to integrate more fully hospital and research staff met with insuperable problems. Decisions taken by the MRC itself closed various options for the newly established institute and its director. The strong emphasis on technology in the early days may have reflected in part the pressures emanating from the Rothschild proposals. Nevertheless, in spite of these and other difficulties, Bull succeeded in commissioning from scratch a burgeoning centre for clinical research which conformed with the MRC's intention that the programme should be orientated to those conditions common in the community which are so often neglected as subjects for research in traditional university departments - such as infectious diseases, nutrition and metabolic disorders. Bull's achievements received national recognition when he was knighted in 1976. He retired in 1978.

Bull served as a member of the Medical Research Council from 1962-66. His continuing interest in tropical medicine made him a distinguished chairman of the Council's tropical medicine research committee, the medical advisory committee of the Overseas Development Ministry, and the clinical investigation committee of the SEATO Cholera Research Laboratory. He became a member of the executive council of the Ciba Foundation in 1970, and was a trustee from 1979 until his death. He was second vice-president of the Royal College of Physicians from 1978-79.

Graham Bull was essentially a kind man. He was humane and compassionate, as well as highly ethical, in all his dealings with patients and their kin. He was loyal and trusting in relation to his staff, who had not only a great respect but also a deep affection for him. He was a congenial, buoyant and rational colleague. As a committee member he was full both of original ideas and benign amusement, and only occasionally expressed exasperation. And he was unostentatiously faithful as a friend. He had many interests outside medicine and was a wide ranging traveller; his knowledge of the Stock Exchange would have put many professionals to shame, and he was also an expert cook, keen wine-maker, and genial host.

He married in 1947 Megan, née Jones, who had been a fellow student in Cape Town. Her career in the prison medical service culminated in her appointment in 1973 as governor of Holloway Prison, a post she held for nine years, being awarded an OBE. She shared her husband's wide interests and his pleasure in entertaining colleagues and friends. There were four children of the marriage; a daughter who is a consulting paediatric cardiologist, and three sons - an accountant, a zoologist and a musician - whose interests reflect the broadly based interests of their father.

In 1988 the Sir Graham Bull Memorial Prize was founded at the College to commemorate the achievements of a fine man. The prize is awarded annually for meritorious research carried out by a scientist under the age of 45 in the field of clinical research in its broadest sense, to include such areas as surgery, psychiatry, pharmacology, molecular biology etc.

S Howarth

[Lancet, 1987,2,1346; BMJ.,1988,296.; The Times,18 Nov 1987; The Independent,4 Dec 1987; The Daily Telegraph,1 Dec 1987; MRC News,Mar 1988,28-29; Medical News,5 Mar 1966; Belfast News Letter,5 May 1954]

(Volume VIII, page 65)

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