Tunnel Book review by Peter Down BSG Archivist, for GUT, May 2012

Home of Fred the Snake (and Dr. Peter)

Ask anyone attempting endoscopic retrograde cholangiopancreatography (ERCP) in the 1970s and you will be regaled with stories about Peter Cotton’s master classes at the Middlesex Hospital. He had brought ERCP to Britain after spending 2 weeks with Kazuei Ogoshi in Japan in 1971. His skill was legendary and people flocked to his unit to watch him. As his reputation grew he travelled widely lecturing and demonstrating, and was called to treat royalty and celebrities all over the world. In 1986, to the dismay of many, he moved to the Duke University, North Carolina, and later to Charleston, South Carolina, where in 2011 on the fortieth anniversary of his first ERCP he finally hung up his duodenoscope. This book is a delightful and humorous account of his adventures here and abroad. We hear of digestive challenges, strange hotels, hilarious misunderstandings, the importance of golf and especially the people and friends he made everywhere he went.

It takes more than mere technical skill to introduce a new technique and Peter with his commanding presence, hard work and great sense of fun made things happen. Yet, despite his success and fascinating career he is disarmingly modest and this is reflected in his autobiography. One of the most moving chapters relives his experience on his flight home to the States on 11 September 2001 when his plane was diverted to Newfoundland.

The book will be thoroughly enjoyed by those who know Peter Cotton and will intrigue those who do not. He was the son of a general practitioner and was expected to join the practice after qualifying at St Thomas’s Hospital. Fortunately for us he did not and was struggling with some basic research into small bowel metabolism when the first fully flexible endoscope arrived. He was good with his hands and took to the instrument like a ferret to a trouser pocket. Inevitably, endoscopy was self-taught at first and Cotton realized the dangers of this not just for the patient but for the reputation of the technique. He fought hard to get formal training and accreditation in endoscopy and played a pivotal role in the short but exciting life of the British Society for Digestive Endoscopy in the 1970s. Those who were lucky enough to be his trainees became friends for life and enjoyed highly successful careers in all corners of the world.

An endearing feature of Peter Cotton is his fund of stories and anecdotes. One of the best concerns a ‘seriously royal gall stone’ and there are no marks for guessing who it belonged to. Another amusing chapter recalls the ‘Perils of the Podium’. And did you know that a cause of dysphagia in Iran is leeches in the oesophagus? Now, we can share these tales in his entertaining and splendidly illustrated biography. I can recommend it unreservedly.