EyeWorld Asia-Pacific December 2020 Issue

In Memoriam James Finbarr (Barry) Cullen Born Cavan, Ireland 13th July 1928 - died Edinburgh, Scotland 23rd September 2020 James Finbarr (Barry) Cullen Barry Cullen was a Titan of Ophthalmology though the very notion would never have crossed his mind because he was one of those rare figures who pass through life, modestly unaware of the impact they have on a world that is always the better for their having been in it. He qualified in Dublin in 1952, trained in Newcastle where he became FRCS, studied Neuro- Ophthalmology in Baltimore then came to Edinburgh in 1962 as Senior Lecturer with Professor George Scott. He selected the equipment for the new Eye Pavilion, brought structure to the training of the junior staff, promoted the Ophthalmic Nursing Diploma and was always on hand to help any one on the hospital payroll. Barry was an effervescent character, radiating enthusiasm and a chuckle, more like a cackle, was never far away. He was first described to me as a blur, talking rapidly. The explanation for this was simple. There was an asynchrony between brain and tongue, with several simultaneous strands of thought spinning too fast for his words which tumbled behind, never quite catching up and never fast enough to stop him from saying “gambit” when he meant “gamut”. One learned never to take his first answer to any question as definitive because he was always thinking of something else when he replied. The key technique was, to wait until question and answer were likely to be in unison before trying again. But the genial flood of words concealed a serious mind ever reflecting on how to improve the quality of patient care. He was one of the first to foresee the coming of the sub-specialist and that the days when everyone would have a go at whatever surgical problem presented, now belonged to the nineteen-thirties. However, reforming any practice sanctified by long usage, is rather like swimming for the shore against an ebb tide but his modernising persistence was not lost on the medical students who fell under his spell. Like the Pied Piper he enticed a group of the top graduates to follow him into the labyrinths of the eye from which they never escaped. And it was not only medical students from Edinburgh. The message spread along the pre- fellowship grape-vine and from all corners of the globe came the response - the Far East, the Middle East, Africa, Europe. In due course, these surgical trainees returned home, to be replaced again and yet again. Such a cosmopolitan influx drawn to Edinburgh by Barry, naturally expected to find a department equipped with the latest. But Ophthalmology is an expensive speciality and although money was for ever scarce, Barry always seemed to find a way to loosen the purse- strings - a touch of intrigue, a cascade of honeyed words and lo - Edinburgh was the first centre outside London, to have an Argon Laser. Using the same approach somewhat later, he unearthed sufficient funds to build a new theatre. As well as being expensive, the hallmark of an eye hospital is a very crowded outpatient department. Barry’s clinics were, as might be guessed, the most crowded and generally conducted in an atmosphere of anxiety allaying good humour. The action would spread from the consulting room, to the ante-room, to along the corridor to the telephone - the patient, a cloud of medical students, trainees, opticians, other staff in search of help and Barry - flitting between, like the Scarlet Pimpernel, sought here, sought there, sought everywhere. In his chosen area of Neuro- Ophthalmology he was supreme, reserving an amused condescension for those who could not come to any clinical conclusion before they deployed complicated radiology and indeed sometimes after they had, when he then provided them with a diagnosis over the telephone. Yet despite the pressing demands for his intra-cranial expertise he still brought his surgical skill to the correction of drooping eyelids, corneal reconstruction. And if that were not enough there were the management of diabetic eye disease, chairing the College Examination Committee and meticulously looking after the funds of the Ross Foundation Charity. When he retired in in 1994, his unforgettable contributions to Edinburgh were celebrated and his final departure lamented at a dinner that filled the great hall of the College of Surgeons. But it was quickly evident that retirement didn’t mean that. He was invited to Singapore for two years and stayed for seventeen. During that time, his new department of Neuro-Ophthalmology, brought world fame to the Singapore National Eye Centre. Just as in Edinburgh, it was also the concern for the education and the future placement of his pupils there that turned Barry into an iconic figure who was treated by his new family with God like reverence, an indication of deep and grateful affection attested by the tributes that poured in from the Far East when they heard the news of his death. He also played a vital role as ambassador furthering the interests of the Edinburgh College of Surgeons in setting up joint examinations with Singapore, Malaysia and Hong Kong. The College, in addition to the honorary FRCSEd, conferred years before, awarded him its highest honour - the Gold medal, this latter being but one of a catalogue of accolades that would require a separate tribute to list. It would be wrong to think it all work and no play. He was equally competent at the bridge table and on the golf course. He began the Scottish Ophthalmological Golfing Society - SOGS and as a trophy, conjured forth a silver cup from some hospital in Glasgow. I owe my career to Barry. He opened doors for me which he had first bothered to find, to learn a new technique in America then discovered further doors to open on my return. Similar claims can be made by just about every trainee who worked with him. His death was shockingly swift but it was as he would have wanted and it spared him the indignities of old age. He was a towering figure in our speciality, a man of deep principle and one whom it was very easy to love. He leaves behind him a very close-knit family - Ann whom he married 66 years ago, Paul, Stephen, twins David and Peter, Sally and 11 grandchildren. He also leaves a legacy of professional skill, compassion, care for patients and staff and devotion to his subject as revealed by his myriad papers in major journals, the last as recent as 2019. He was too humble to think himself in any way special. Well he was right about most things but in that matter he was wrong. Hector Bryson Chawla MBChB(StAnd) DO(Lond) DDRCOG(Lond) FRCS (Edin) FRCOphth, Formerly fellow in Retina Service, North Western University, Chicago, USA; Formerly Consultant Ophthalmic Surgeon with special responsibility for retinal surgery, Princess Alexandra Eye Pavilion, Royal Infirmary of Edinburgh, UK. Originally printed in Eye News 2020;27(4). Tributes from Singapore Barry has been my teacher, examiner, mentor, role model, colleague and friend for decades. Prof Arthur Lim and he set up the first formal training programme for ophthalmic trainees when he arrived in Singapore in 1986. He established unique institutional links between Singapore and the Royal College of Surgeons of Edinburgh and especially the Princess Alexandra Eye Pavilion of the Edinburgh Royal Infirmary. These crucial early academic networks opened many doors all over the world for generations of our ophthalmologists. He also sacrificed many years of ‘retirement’ to build the Neuro-Ophthalmology Service at the Singapore National Eye Centre from scratch. All of us will recall vividly his generous smile, boundless optimism and compassion for all. Dr Vivian Balakrishnan Minister for Foreign Affairs, Singapore Former Medical Director Singapore National Eye Centre