Fuller, Jr., Solomon Carter 1872–1953

views updated

Solomon Carter Fuller, Jr., 1872–1953

Neuropathologist

If Solomon Carter Fuller had not been a modest man he might have become swollen with pride because of his contributions to the scientific development of medicine. He specialized in neuropathology, the branch of research that studies the neurological systems of deceased patients. As was commonplace at the dawn of the twentieth century when he embarked upon his career, Fuller also chose to combine his laboratory research with clinical treatment of psychiatric patients. A methodical man, he created a bond between research and clinical work by basing them both on the same revolutionary question: “Is there any connection between the physical abnormalities in this brain tissue and the mental illness that afflicted this patient?” Two generations after his death in 1953, this relationship between brain tissue abnormalities and mental illness was assumed to be a given in many psychiatric illnesses. Furthermore, Fuller also acted as a ground breaker for African American physicians. He became one of the first black physicians to hold a teaching post on the faculty of a multiracial U.S. medical school. And, at Boston University’s prestigious School of Medicine, he spent almost 40 years as a living example to other black graduates who longed to work alongside their white colleagues in the elite field of medical research.

Solomon Carter Fuller came from a family accustomed to taking responsibility for itself. His paternal grandfather, John Lewis Fuller, started life as a slave in Norfolk, Virginia, but preferred to control his own fate. Taking stock of the few advantages available to him, Fuller found two he could put to good use: he had a sharp mind, and he was an excellent cobbler. Combining these two benefits made it possible for him to run his owner’s business so efficiently that he received a share of its profits. The money allowed him to buy himself and his wife out of slavery.

If John Fuller had expected to live a safe and fulfilling life as a free man in pre-Civil War America, he must have been severely disappointed. The constant discrimination and lack of respect chafed so fiercely that in 1847, when the American Colonization Society gave former slaves the opportunity to settle in Liberia, he sent his son Thomas there to see whether it might be a better place to live. After assurances that Liberia’s economy was growing rapidly, John Fuller gathered up the rest of his family in 1849 and set off across the Atlantic Ocean to join his son. John Fuller noted that carpenters seemed to be in much shorter supply than cobblers in the capital city of Monrovia. He switched professions to fill this niche, and within a short time he earned such a good living that he felt able to share his good fortune. An organization called the Charitable Mechanics Society of Monrovia soon formed to provide shelter and care for aged, handicapped, and destitute carpenters.

Fuller’s ethic of public service provided an excellent example for his sons, Thomas and Solomon. Thomas became a probate judge, then rose to become mayor of

At a Glance…

Born Solomon Carter Fuller, Jr., August 11, 1872, in Monrovia, Liberia; Died, January 6, 1953, Massachusetts; son of Solomon Carter, Sr., and Anna (James) Fuller; married Meta Vaux Warrick, 1909; children: three sons. Education: Livingstone College, South Carolina, A.B., 1893; Long Island College Hospital, medical student, 1894; Boston University Medical School, M.D., 1894-1897; University of Munich, Germany, 1904-1905.

Neurologist, pathologist, and psychiatrist. Westborough State Hospital, intern, 1897-1898, head of pathology, 1899-1919, consultant, 1919-1952; University of Boston School of Medicine, instructor, 1899-1919, lecturer, 1919-1921, associate professor, 1921-1933, emeritus professor of neurology, 1933-1952. Also Massachusetts Memorial Hospital, visiting neurologist for 11 years; Massachusetts General Hospital, consultant for 10 years; Allentown, PA, State Hospital, consultant for 30 years; and Framingham Marlboro Hospital, consultant. Offered psychiatric advice for criminal investigations and court cases, published in several medical journals, and ran his own psychiatric clinic until his death.

Monrovia. Success blessed Solomon’s work equally generously. At first a coffee planter, he switched vocations in his middle years to take a position as a high sheriff specializing in land claims. This government-based post brought Solomon a bountiful salary, which he frequently received in land. Thus he won both wealth and considerable clout in the community.

Education in America

Solomon married Anna Ursala James, the daughter of two doctors and church missionaries who also had been among the settlers returning from America. Like the Fullers, the James family took their work seriously and provided their children with both medical and spiritual care. Solomon and Anna taught their son Solomon, Jr., to do his best in a methodical way. He did not let them down. All reports agree that he showed considerable diligence from his earliest years, reading Latin literature fluently by age ten and completing his high school curriculum punctually at 16-years old.

Solomon Carter Fuller, Jr. was born in Monrovia on August 11, 1872. Less than 17 years later, in June of 1899, he reversed his grandfather’s journey and traveled to the United States for a college education. He studied first at Livingstone College in Salisbury, North Carolina. This change of scene soon proved to be a bittersweet experience. The racism and enmity that he encountered shocked him since he and his family had given unstinting service to others regardless of their skin color. Nevertheless, studying remained a great joy and granted him four pleasant years as a liberal arts student before his graduation in 1893.

Fuller’s family pattern of service to others influenced his decision to become a healer. In 1894 he spent his first year at Long Island College Hospital, then transferred to the non-segregated Boston University School of Medicine in March. Fuller took a well-rounded selection of courses. He found neurology particularly fascinating, however, and worked hard enough at it to catch the attention of his professor, Dr. Edward P. Colby.

Climbing the Ladder

Few black medical graduates at the end of the nineteenth century received offers of employment. In such a job market, Colby became a valuable contact for Fuller when the time came to look for a post. After Fuller graduated in 1897, Colby introduced him to Dr. George Adams, the highly-respected superintendent of a facility outside Boston called Westborough State Hospital for the Insane. Colby also encouraged Adams to give him a job. Struck by the eager young doctor, Adams offered him his choice of a six-month unpaid internship at Westborough or a two-year stint as an assistant in the pathology laboratory. Fuller knew that either experience would offer him a rare chance to get ahead. Despite the color of his skin, the internship surely meant an eventual lucrative practice and maybe even a staff position. The laboratory could not promise prosperity, but it certainly lead to a life of scholarship and potential discoveries that would benefit mankind.

In May of 1894 Fuller had attended the fiftieth annual meeting of the Americo-Psychological Association and heard the keynote address by revered neurologist S. Weir Mitchell. Dr. Mitchell’s speech proved to be a major factor in Fuller’s decision. In Mitchell’s estimation, the field of psychiatry required major changes, including better training for nurses and doctors alike regarding the causes of and the treatments for mental illness; more humane conditions; and rigid application of the rules of science and statistics in the laboratory, especially as far as cleanliness and record-keeping were concerned. Mitchell’s ideas appealed to the young doctor, and the temptations of a lifetime spent experimenting, writing for scholarly journals, and teaching proved greater than monetary success.

In 1897 Fuller walked into Westborough Hospital as an intern in the newly-formed pathology lab. Working under the direction of his mentor, Dr. E. L. Mellis, he examined the brain cells of deceased psychiatric patients to see whether he could find any link between their mental problems and their anatomy. He also collected blood samples from living patients, hoping that close scrutiny might yield further clues to the mystery. In a small way these blood tests made him a trailblazer. They would lead to an indispensable partnership between the physician trying to cure or improve a patient’s mental illness and the researcher bent over a microscope attempting to determine its cause.

Fuller had been in his post for less than a year when Dr. Mellis accepted another position at Johns Hopkins University in Baltimore, Maryland. Fuller was left to run the laboratory on his own. Knowing he could handle this responsibility, he continued testing his findings against established knowledge, documenting everything meticulously, and suggesting future lines for exploring his chosen topics-paranoia, melancholia, and pernicious anemia.

While work provided a happy and fulfilling pastime, other areas of his life caused problems. His unfairly-low salary-with which many of the 1,733 black doctors in the United States could sympathize—was a thorn in his side. Although the medical community respected him highly as Westborough Hospital’s pathologist, Fuller received a meager $25 per month--$300 annually-whereas a white physician one-year his junior earned $45 per month. When he discovered this injustice, Fuller threatened to resign. Eventually the hospital persuaded him to stay at a salary of $800 per year. As an added lure Adams threw in six weeks of time off per year as long as he consented to remain with the hospital for at least one year.

Comfortably ensconced in his job, Fuller began to spread his wings a little. In 1900 he decided that the hospital should establish a museum to display the causal connection between diseases that affect brain tissue and the behavior associated with many mental illnesses. He also invented what he called a “photomicrograph,” a method for taking photographs of pathology slides through the lens of a microscope that later became standard practice for medical textbooks.

Psychiatry’s Founding Fathers

Concurrently with his work at Westborough, Fuller had accepted an instructor’s appointment in the pathology department at Boston University’s School of Medicine. By 1904 he had been on staff long enough to merit the sabbatical year that most academics spend either teaching or studying in an institution other than their own. Because psychiatry in Europe had advanced far more than its U.S. counterpart, Fuller decided to spend his year in Germany.

Fuller chose the University of Munich so that he could study with the influential neuropsychiatrist Emil Kraepe-lin. Since its first appearance in 1883, Kraepelin’s book Compendium der Psychiatrie had become a basic text for most psychiatrists. It played a huge part in setting scientific parameters for psychiatry and displayed the first attempt to classify mental diseases into two general groups: dementia praecox-later called schizophrenia-and manic-depressive psychosis. He also had designed objective tests to study the effects of certain medications on mental disorders. Fuller admired Kraepelin for these achievements but respected him equally for his consistency of methodology. Kraepelin’s laboratory modeled precision and order, and his experiments and results exhibited painstakingly-detailed documentation. These accolades remained true for Kraepelin because he believed that psychiatry must be subjected to the same rigorous standards as any other medical discipline.

Fuller spent the academic year in the most fruitful study period he had ever experienced. Kraepelin’s lectures alone instilled Fuller with ideas that endured the rest of his life. He also learned a great deal from Dr. Alois Alzheimer of Hamburg, who would shortly earn renown for describing the progressive dementia that bears his name. Though Fuller found Alzheimer “the poorest lecturer I ever heard at the clinic,” he declared him to be “a delightful, sweet, warm, most unassuming man,” and an absolutely peerless scientist at the microscope.

In 1909, Fuller’s austere bachelor life of living quietly at the hospital and fishing in the pond behind the main building when the need for fresh air and recreation drove him outdoors changed. Fuller married Meta Vaux Warrick, a talented sculptor who had studied in Paris with the famous Paul Rodin. The newlyweds moved into a house in Framingham, Massachusetts, where they eventually brought up their family of three sons. Fuller’s family life enlarged his horizons. In addition to his longtime passion for rebinding tattered books in leather covers, he took up portrait photography as a hobby. He also developed a beautiful garden that became a point of friendly rivalry with an equally garden-minded colleague. No matter how absorbing these outside interests became, they could not keep Fuller from his work. In 1911, two years after Alzheimer’s disease had been recognized in print, he wrote his first paper on the subject, “Alzheimer’s Disease (Senium Praecox): The Report of a Case and Review of Published Cases” for the Journal of Nervous and Mental Diseases. The paper was reprinted in a later collection edited by Fuller and in honor Dr. George Adams, the superintendent of the Westborough Hospital.

In 1919 Fuller left his post as pathologist at Westborough to devote more time to teaching at Boston University. Racism prevented him from receiving status as a full professor, but he still headed the school’s Department of Neurology for a time. The official job title never accompanied his name, though. When the university promoted a white assistant professor to full professor and made him the department’s head, Fuller retired. He maintained ties with hospital work, however, by occupying a succession of part-time posts. He worked as a visiting neurologist at Massachusetts Memorial Hospital and as a consultant neurologist for Massachusetts General Hospital. He also became a consultant at Framing-ham Marlboro Hospital but then moved to the Allen-town, Pennsylvania, State Hospital.

At the same time, having learned that mental disease involved more than just the breakdown of cells, he devoted more time to his growing psychiatric practice. This was a wise switch, since diabetes conspired with racism to convince him to retire from Boston University in 1933. Diabetes also caused Fuller’s sight to fail beginning in 1942. Fuller, however, gamely continued to accept psychiatric patients whose physical examinations were performed for him by a friend. Unfortunately Fuller had to discontinue the hobbies that had given him such pleasure away from work. Eventually, even gardening had to cease because he could not locate enough weeds to prevent them from destroying his plants. Fuller insisted on a positive attitude, however, and found that the radio and conversation with friends and colleagues provided a measure of entertainment for his last years.

Sources

Hayden, Robert C, and Jacqueline Harris, Nine Black American Doctors, Addison-Wesley, 1976.

Kenney, John A., MD, The Negro in Medicine, Tuske-gee Institute Press, 1912.

Sharpley, Robert H., “Solomon Carter Fuller,” in Psychoanalysis, Psychotherapy and the New England Medical Scene, 1894-1944, edited by George E. Gifford, Jr., Science History Publications, 1978.