George Adams - BGS President 1973 - 1975
Physician in geriatric medicine, founder member of the British Geriatrics Society and pioneer in stroke medicine, who transformed the medical care of old people in Northern Ireland.
George Fowler Adams (b 1916; q Queens University, Belfast 1938; MB ChB MD, FRCP, CBE); died on 13 March 2012 from bronchopneumonia.
As consultant in Belfast City Hospital in 1949, Adams was responsible for 300 elderly in-patients in overcrowded workhouse accommodation without resources for treatment or rehabilitation. He drove changes in medical policy, replacing passive custodial care with the active approach to illness and old age pioneered by Dr Marjory Warren and others, diagnosing treatable conditions, mobilising patients and closing beds. He inspired a team of nurses, therapists and social workers and persuaded the authorities to renovate the wards, creating the first purpose-built geriatric unit in the UK with therapy departments expressly designed for the treatment and rehabilitation of the elderly sick. The unit’s reputation for restoration of activity and independence in disabled hemiplegics attracted visitors from around the world.
Adams surveyed patients > age 60 in all hospitals in Northern Ireland, later combining this with a social survey of living conditions and disabilities in a representative sample of old people in their homes. His work underpinned the Hospital Authority’s policy for the development of geriatric medical services. Rosemary Kelly, Chair of the Northern Ireland Branch of the British Geriatric Society (BGS) writes “he will always be regarded as the Father of Geriatric Medicine in Northern Ireland”.
Adams came to geriatric medicine almost by chance. WWD Thomson, Professor of Medicine, Queen’s University, Belfast (QUB), concerned about care of the elderly in the impending NHS, encouraged him to review 400 elderly patients in the “chronic sick” wards of the City Hospital. Postgraduate training with Thomson (1946-49), included a one year secondment to the Postgraduate Medical School, Hammersmith. In London, Adams was introduced to Marjory Warren, with whose writing he was already familiar. He wrote “she gave me a practical illustration of what we might achieve one day with the neglected human wreckage in the dingy over-crowed wards in the City Hospital”. Adams was appointed Consultant Physician in Geriatric Medicine at the Belfast City Hospital (1949) and Honorary Lecturer in QUB. He believed his lectures and bedside teaching, approved by the department of medicine, were the first formal recognition of geriatrics by a University.
Adams was a member of the Council of the BGS and Chairman of the Executive Committee (1965-67) and was the second BGS President (1973-75). He claimed only one truly effective contribution to the affairs of the Society- attending Comitia of the RCP and making a persuasive case to the Fellows for a College Committee in Geriatrics. He recalls that he prepared the case “with care to be brief and to the point” but that he remembered “the tachycardia and extrasystoles better than its content”. His reputation was international. He wrote influential reports on geriatric services in Malta and the Isle of Man and as visiting professor at the University of Manitoba, Winnipeg, helped establish teaching in geriatrics.
George Fowler Adams was born in Aberford, West Yorkshire, the fourth of seven children of an Ulster father and Lancastrian mother. He was educated in Northern Ireland and graduated in medicine from QUB in 1938 (with a hockey blue). As houseman at the Royal Victoria Hospital, Belfast, he joined the Royal Naval Volunteer Reserve - Ulster Division. He served as medical officer on the Empire Mackendrick, a Merchant Aircraft Carrier (MAC-Ship) in the Atlantic convoy escort. Making intricate scale models from of the ships helped him fill in time on slow trans-Atlantic voyages. Adams encouraged a “keep-fit campaign including strenuous gymnastic classes on the flight deck, deck hockey with a home-made rope quoit and boxing in the hanger”, but recorded that this brought a stream of minor injuries through the sick bay. On one memorable occasion he operated for appendicitis, with the doctor from the accompanying rescue ship as anaesthetist, when at the last minute the sick-berth attendant confessed that he fainted on seeing blood. Adams and the fully recovered patient remained firm friends. Both were grateful for the excellent training Adams had received in Belfast.
He was modest and self-deprecating. His daughter, Susan Burge, recalls how he enjoyed describing events on a ward round with colleagues and students in tow when he tested an elderly patient’s memory by placing his pen under her pillow and asking her to remember where it was. After examining her, he came to write up his notes but could not find his pen. As he patted each pocket in turn, and to the amusement of the assembled company, the old lady reached under her pillow and delivered the pen, saying “Is this what you’re looking for?”
His major research interest was stroke. Studies were based on careful clinical examination and meticulous record keeping. He was a master of the English language. Editing with scissors and glue on the dining room table produced a screed of paper, which was returned to his secretary for retyping. In the 1960s, he collaborated with Louis Hurwitz, a neurologist, and together they published what Adams regarded as his most important paper, Mental Barriers to Recovery from Stroke. Hurwitz’s death ended a very productive partnership. Adams collected his experience and research on stroke in a book, “Cerebrovascular Disease and the Ageing Brain” (1974).
Adams’ honours include FE Williams Lecturer, RCP (1965), FE Williams Prize, RCP (1971), Campbell Orator of the Ulster Medical Society (1972) and CBE (1973). He was one of the first recipients of an Honorary Chair at Queen’s University (1971), only the second geriatrician at that time to occupy such a position, and his contribution to geriatric medicine was recognised by the Founder’s medal of the BGS (2008).
His wife, Mary, provided unstinting support. They celebrated their golden anniversary in 1996. He retired to Oxfordshire, where he enjoyed painting, gardening and golf. He was loved and respected for his wisdom, grace and humour and admired for knackety repairs that could extend the life of any household object. He cared devotedly for Mary, when she developed Alzheimer’s disease, until her death in 2005. He coped philosophically with late-onset ulcerative colitis and an ileostomy.
Adams leaves behind three children, four grandchildren and three great grandchildren. A daughter and two grandchildren followed him into medicine.
Susan Burge OBE DM FRCP
Oxford University Hospitals