Sir William Ferguson Anderson, (1914-2001) Post 2

President of the British Geriatrics Society (1975-1978)

‘Illness in old people is interesting, commonly remediable, and treatment is thus very worthwhile. What’s more, the elderly remain among the most grateful patients it is possible to have.’

Sir William Ferguson Anderson, the world renowned geriatrician, a President of the BGS and known as ‘Fergie’, died in 2001 at the age of 87. He had enormous empathy towards neglected old people, brought academia into the speciality, lectured across continents bringing the achievements of UK geriatric medicine to worldwide audiences, was a prolific author, championed teaching medical students about the diseases of old age, promoted community and preventive care and by his ambassadorial abilities raised the whole status of geriatric medicine. His immense skills in communicating could induce a standing ovation from any audience: even medical students! His ‘charisma’ and sincerity made him the most approachable of men. Anyone wanting to hear his wonderful mellifluous voice can do so by listening to the British Library Sound Archive.

So what is the story of this most good-natured champion of geriatric medicine? William Ferguson Anderson was born in 8th April 1914 in Glasgow, the only son of James Kirkwood Anderson, a master plumber and later a captain in the 7th Scottish Rifles, and Sarah Barr Anderson, a driver for the British Red Cross between 1914 and 1918. Unhappily his father was killed on active service in Gaza in 1917. From the age of 12 years Fergie decided he wanted to be a doctor. His education fees were paid by his grandfather as along as he did not fail his examinations. His general and later medical education all took place in Glasgow from where he qualified M. B, B. Chir, with honours in 1936. After house posts he was appointed medical registrar in the University‘s Department of Materia Medica and Therapeutics from 1939 to 1941. This appointment brought responsibility for beds at Stobhill hospital, a very large corporation hospital with 1709 beds containing many elderly patients with chronic diseases. It was here that Fergie had his first involvement of elderly people and which was to influence his future career direction. On 25 September 1940, he married Margaret Battison Gebbie. He was awarded the Bellahouston Gold Medal of the FRFRS (now the FRCPG) for the premier MD thesis of the year 1942. He joined the RAMC in 1941, had a ‘wonderful’ war serving in India, Ceylon and later in Germany. At one point he was sent to Singapore to assist in the repatriation of POWs. He was demobilised in 1946 with the rank of major.

For the three years after demobilisation he worked once more in the Department of Materia Medica and Therapeutics but was now senior lecturer and honorary physician at Stobhill General Hospital. Once again he worked with the Regius Professor, Noah Morris (ODNB), who headed the Department and who had responsibility for wards in Stobhill hospital. Fergie visited Marjory Warren, found her to be very forthright and knew exactly what she wanted. These attributes did not endear her to her local colleagues and relationships were strained. Fergie thought that the antagonism/prejudice towards her attached to any doctor who worked with the elderly and did not stem from her being a woman. His experience at Stobhill aligned him with Noah Morris’ view that an academic unit was needed to bring recognition to the speciality of geriatric medicine and to improve teaching of medical students.

Professor Noah Morris. It is relevant, here, to digress to discuss the role of Professor Morris in the development of geriatric medicine in Glasgow and elsewhere. His appointment to the Department of Materia Medica of Glasgow University at local municipal hospitals was the result of pressure from two successive vice-chancellors of Glasgow University, Sir Donald MacAlister and Sir Hector Hetherington. They sort to promote and improve medical education by appointing whole-time university staff with scientific backgrounds to training clinical students. This had the ‘knock on effect’ of improving patient care and staff morale. Professor Morris, himself, had a major interest in the elderly, arranged for some of his staff to visit Marjory Warren, and his presidential address to the university medico-chirurgical society was entitled ‘De senectute’. Unfortunately he died from stomach cancer at the early age of 54. His passion for the study of ageing was continued by his successor, Stanley Alstead. It is significant that three of the early professors of geriatric medicine (Fergie, John Brocklehurst and Bernard Isaacs) had all worked in Professor Morris’ department.

To return to Fergie, he moved to Cardiff in 1949 as senior lecturer at the Welsh National School of Medicine and honorary consultant physician at Cardiff Royal Infirmary until 1952. He then returned home, so to speak, to Glasgow where he stayed for the rest of his professional career. He was appointed consultant physician at Stobhill and Foresthall hospitals where he stayed until he retired in 1979. His post was initially in general and geriatric medicine, which helped to make geriatric medicine respectable, but he relinquished the general medicine part of the post as the demands of elderly care increased. As with many new specialities in the history of medicine, geriatrics encountered a considerable scepticism, not to say hostility, from his colleagues, particularly those who previously had had some responsibility for care of these neglected patients. This occurred at Stobhill Hospital: indeed the proposed establishment of two geriatric wards was initially opposed by the medical staff committee who feared it would ‘adversely reflect on [Stobhill's] status as a teaching hospital’. Fergie proved to be the ideal person to overcome this prejudice with his calm and persuasive personality, his authority within medicine, and the support of the Western Regional Hospital Board of Scotland who had appointed him as their advisor in diseases of old age.

In 1965 he was appointed as the David Cargill Professor of Geriatric Medicine, (University of Glasgow), the world’s first such post. He often recalled that the antagonism towards geriatric medicine made it was infinitely more difficult to persuade the university to accept the benefactor’s funding for the chair than to raise the actual finance.

He was a wonderful communicator. He fulfilled the role as international ambassador for geriatric medicine and was adviser to the World Health Organization on the medical care of older people from 1973 to 1983. He undertook visiting professorships in many centres including Canada, Denmark, Israel, New Zealand, Australia, Yugoslavia, Japan, the USA and the USSR. He was always ready to praise the achievements of others.

Honours and appointments followed in perfusion. He was appointed an OBE in 1961. He was made a fellow of the Australian College of Medical Scientists (1971), and Fogerty international scholar at the National Institute on Aging, USA (1979). 1974 proved to be a particularly prolific year for awards and presidencies. In that year he was knighted, made a knight of the order of St. John, elected President of the RCPSG until 1976, appointed as Chairman of the WHO expert committee on the organisation of geriatric services, elected Chairman of the BMA working party on geriatric medicine and awarded the Mungo prize, which was awarded to the person who had done much to make Glasgow a more beautiful and healthy place. The following year he was made President of the BGS and in 1977 he was President of the BMA. He was made an honorary fellow of the American College of Physicians (1980). In 1984 he was awarded the Brookdale Award of the Gerontological Society of America. He played a major role in the Scottish developments of the Abbeyfield Society, Marie Curie Care, Crossroads Care Attendant Schemes, Age Concern (Scotland) and Red Cross Housing for Younger Disabled People. Together with Dr. Taylor Brown and Lord Amulree he used his persuasive powers to overcome resistance within the BGS to create of the Scottish section of the Society.

He wrote prolifically with creative energy and intensity that hardly waned. He was author/co-author of 3 books, several monographs, some 30 chapters in books as well as 93 papers whose early themes retaliated to drug action. Later subjects were prevention, community health and health centres, teaching and training in geriatric medicine, preparation for retirement and nutrition in older people. He edited jointly with Bernard Isaacs Current Achievements in Geriatrics (1964). In the decade after his official retirement in 1979 he completed a further two editions of his textbook Practical Management of the Elderly with Brian Williams.
What was his philosophy? He stressed that old people were here to stay and the very old were increasing steadily in number. Their needs could not be neglected or pushed under the carpet. Medical and social services must be planned to ensure that their life is happy and as health as possible. A constant reiteration of the message was required to drive the point home to politicians. Unfortunately, even his eloquence failed to convince ‘the powers that be’ to create an Institute of Gerontology.

Fergie developed three strands to his philosophy to improve quality of life in later years: preretirement planning, early detection of disease and education of health professionals. Thorough planning could improve the pleasure to be derived from retirement. Part time employment should be continued if so wished, hobbies and crafts developed, use made of all day clubs, senior citizen orchestras created and health education promoted via radio and television. Such activities would improve morale and motivation.

Prevention of illness in older people and how to help them to continue to live at home were probably his major themes. Many older people attributed their health problems to old age and did not seek medical advice until late in their illness. Therefore there was a strong argument in favour of health checks to find undiagnosed disease, to start treatment and supply social support where required, and to arrange joint assessment of confused older people. This reasoning followed from his pioneering work in the drop-in Rutherglen health clinic, where he worked with Nathan Cowan. He believed that nothing improved the mental health of older people more than a complete physical examination and argued that health centres could act as a central focus for planning an integrated service for older people. This would in turn provide help to the carers and improve their morale.

Health professionals needed training in geriatric medicine, the difficulties in the diagnosis of disease, the problems of drug treatment and the promotion of health in older people. This would be best achieved when the geriatric unit was within an academic department, which would help to establish geriatric medicine as a speciality in its own right. Fergie supported the concept of community geriatricians, who could help with epidemiological studies, planning preventive services, developing overall therapeutic services and organising after care and rehabilitation. Geriatric physicians required drive, initiative, knowledge about the patient’s home circumstances and, perhaps most importantly, have the ability to lead a team.

Outside geriatric medicine, Fergie enjoyed foreign travel, played tennis and golf and had a penchant for fast cars. At his death he was survived by his wife, Margaret, their son, James, and their two daughters, Mairi and Kathleen.

British Geriatrics Society

Sir William Ferguson Anderson, (1914-2001) Post 2

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