Lives of the fellows

James William Douglas Bull

b.23 March 1911 d.5 July 1987
CBE(1976) BA Cantab(1932) LMSSA Lond(1934) MA(1936) MB BChir(1936) MRCP(1937) DMR Lond(1938) MD(1947) FRCP(1951) FFR(1954) FRCS(1977) FRCR(1978) Hon FACR

James Bull, an only son, was born and brought up in Stony Stratford, Buckinghamshire, where his father, Douglas William Anderson Bull, MD Cantab JP. was a general practitioner. His mother was Eileen Comfort, née Waddell. Recording his own biographical details, James, in the manner of the time to which he whole-heartedly belonged, wrote as the profession of his mother’s father, James Waddell, the single word ‘Gentleman’.

Educated at Dumpton House preparatory school, Repton and Gonville and Caius, Cambridge, where he obtained a second class honours degree in the natural sciences tripos. Part 1, he won an entrance scholarship to St George’s Hospital in 1932. Jobs as casualty officer, house surgeon and house physician were followed by that of assistant curator of the pathology museum, and then medical registrar. His use of pathological specimens, and his special interest in the anatomy that they revealed, lasted all his life. He began to specialize in radiology and, fired by Wylie McKissock, he won a Rockefeller travelling fellowship to Sweden in 1938, to study the new techniques of neuroradiology under Erik Lysholm at the Seraphimer Hospital in Stockholm. Lysholm had made great progress in the technical precision and interpretation of skull radiography and ventriculaography. He and the Lysholms became great friends.

The war intervened before he considered that his studies were complete, though he was appointed radiologist at Maida Vale Hospital in 1939. In 1940 he joined the RAMC and was sent to the head injury hospital at Oxford. There he met and married Edith Burch, the undergraduate chemistry student elder daughter of Charles Schiff Burch, chairman of Halesowen Steel. Almost immediately afterwards he was posted to Singapore. With the fall of Singapore there began three and a half years of very difficult life for James, and of loneliness for his young bride. James was never afterwards able to accept even casual social contact with the Japanese, but was unwilling to talk about what he had seen and suffered himself. He did, however, leave a short memoir that he allowed to be passed on to the keeper of the department of documents at the Imperial War Museum in which he briefly describes the savagery of the invasion of his hospital, and something of the starving years in Changi POW camp, where he had managed to import a fluoroscope. When the X-ray film stock ran out, he used fluoroscopy to good effect in spite of causing erythema on some patients’ backs and his own chest.

Following his release and repatriation, he was on the first ship back to Stockholm. After Erik Lysholm’s death, Erik Lindgren had taken over and work was proceeding at the Karolinska Hospital on percutaneous angiography and on pneumoencephalography. In 1946 James Bull was appointed to the staff at St George’s, where he worked at the Atkinson Morley as neuroradiologist for Wylie McKissock. In 1947 he joined Hugh Davis at the National Hospitals for Nervous Diseases, Queen Square. At both centres his energy, determination and ability in negotiation and persuasion were instrumental in the introduction of the new methods that he had learned in Sweden.

James had played tennis for Buckinghamshire in his youth. Later he played golf. He was a little over six feet tall, handsome and with a strong and commanding voice. It came naturally for him to be first, and for the whole of his active career, up to his retirement from the health service in 1975 following a coronary artery thrombosis, from which he made a good recovery, he led the enlargement, teaching and changes in neuroradiology in Britain. From his position as second consultant to Hugh Davis, and then as director of the Lysholm department of radiology at the National, named after his teacher and friend, he was able to train many of the next generation of neuroradiologists for the world at large; those who had spent time at Queen Square played a particularly prominent role in North America.

From his 1946 visit to Sweden he brought back with him the rediscovered technique of percutaneous angiography. The first percutaneous carotid angiogram in England was performed by him in a small department near outpatients in the National Hospital, Queen Square. He was a competitive man and a stimulating rivalry was instigated and stoked by Sir Geoffrey Jefferson, [Munk's Roll,Vol.V., p.213], between him and Reginald Reid who worked at the Manchester Royal Infirmary.

By 1950, if not earlier, he was experimenting with vertebral angiography both at Queen Square and St George’s. At about the same time he initiated Myodil ventriculography, which proved to be a very benign and much used method of investigating posterior fossa tumours for many years. On the other hand, he refused to employ water-soluble contrast media for intrathecal use until Metrizamide came along, a conservatism that was justified by events.

The next innovation for Britain, seen by James Bull in America and introduced to Queen Square in 1963 - with his customary passionate, practical drive, creating not only the funds but also the building alterations and necessary assistants - was radionuclide brain scanning, which maintained its place in neuroradiology until the EMI scanner displaced it. His part in the CT revolution was also characteristic. First he made sure that Queen Square obtained a preproduction prototype, then - worried at the slow progress of EMI Ltd towards quantity production and finding himself in the company of Zena Powell, the managing director’s wife, at a reception, he convinced her of the importance of the new imaging method and she convinced her husband, John.

James Bull, a member of the councils of both the Royal College of Physicians and of the Royal College of Surgeons, was president of almost everything including, at the age of 44, of the 4th Symposium Neuroradiologicum - the ultimate honour for a neuroradiologist. He was once described, slightly enviously, by a neurologist who did not know him very well, as ‘Such a very grand man’. His generous support for his colleagues, especially younger ones, had to be contrasted with his public presence; splendid, dominating, English. Naturally he was foundation president of the British Society of Neuroradiologists. He was successfully wooed by the very innovative young French also to become president of the European Society. He had a great respect for them. As he said, aside, at an early meeting in Strasbourg, in that magnificant carrying voice of his: ‘No flies on these frogs, George.’

His scholarly enthusiasm for another subject, the history of the building of the London-Birmingham railway, impelled him on to the footplate of the locomotive drawing the first morning train for that journey, shepherded, naturally, by a senior manager of British Rail who had been got out of bed for the purpose. And his enthusiasm for opportunities of scholarship for students drove him to great efforts for the creation of radiological chairs.

His wife Edith had been his closest friend and ally and her sudden death in 1979 was a very hard blow. He tried to recover from his loneliness by marrying again; a disaster which was of very short duration. He taught himself then to live alone but his children and the friends of his more active years, loved as they were and loving, never replaced the companionship that he had had from Edith. She, in her own right a leader, knew how to care for the demands of leadership in him. On Friday, 3 July, 1987 while driving at twilight in Henley’s Fair Mile, he struck the back of a lorry that had pulled out into the road. He suffered, as was shown by the CT scan, an irreversible brain injury.

GH du Boulay

[Brit.med.J., 1987,295,337; The Times, 9 Oct 1987]

(Volume VIII, page 62)

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