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BOOK REVIEWS The Tunnel at the End of the Light: My Endoscopic Journey in Six Decades. Peter B. Cotton. Seattle, WA: CreateSpace (An Amazon Company) (self-publication). 2011. ISBN: 1452820465. Although I have written Forewords and reviewed numerous medical texts for journals in my professional career, it has been more than 50 years since I have done a book report. It is my great pleasure to do just that: a book report on Peter Cotton’s The Tunnel at the End of the Light: My Endoscopic Journey in Six Decades. Remember, a book report revolves around 7 facets of a story: character, plot, setting, theme, point of view, style, and tone. So here, in no particular order, is my report. The point of view is uniquely first person, although there are enough anecdotes from such luminaries as Tony Axon, Rob Hawes, John Cunningham, and Lars Aabakken to make you realize that this is not an endoscopic Everyman’s journey and that Peter and his colleagues and trainees were living in the ether and creating, not simply living in, the endoscopic practice of the day. Theme? The theme (evolution of endoscopy)—from the gastrocamera in the 1960s to Dr. Cotton’s first endoscopic sphincterotomy in the mid-1970s. Those of you who believe in infallibility will be reassured when you read that his first sphincterot- omy was associated with a “zipper phenomenon,” and his third patient went to surgery with a stone basket impacted in the biliary tree. The text includes subsequent endo- scopic developments, particularly in ERCP, and concludes with 3 predictions: that endoscopes, if not endoscopists, will become increasingly intelligent; that procedures will increasingly be done by nonphysicians; and, finally, that “none of my predictions will come true . . . and that some other paradigm shift will deflect our profession in other unexpected directions.” The style and tone of the book are matter-of-fact, light- hearted, but reflectional, and much of this reflection is based on Peter’s last ERCP performed on Friday, May 13, 2011, as well as having achieved “his biblical span.” For- tunately, the latter is not yet true, and Peter Cotton and his trainees remain a dominant force in endoscopic practice throughout the world today. Joseph Leung, Rob Hawes, John Baillie, and Tony Speer are only a few of his trainees from the Middlesex, as was Todd Baron at Duke and Paul Tarnasky at MUSC, which brings me to setting, which not only encompasses the time in London, Duke, and MUSC, but his own worldwide forays, including the world’s first live endoscopy course. Hong Kong? Repeatedly. India? Gastroenteritis (his lament) notwithstanding. Europe? As a contemporary of Demling, Classen, and Cremer. Iran to treat a Shah. Malaysia to forego endoscopy but still go pig hunting with a prince. Saudi Arabia to remove a stone from a king. The plot is simple: the evolution of endoscopy at a time when diagnostic radiology and surgical therapy reigned supreme. The story is comprehensive, but is not complete. It evolves from a diagnostic specialty to one that has allowed us to treat bleeding, resect or ablate potentially malignant tissue, dilate luminal obstructions, and treat a variety of pancreaticobiliary diseases. It may evolve further into deeper forays into interventional practice “surgical trajectory”), and Peter gives credit to his surgical col- leagues throughout his career. He also reinforces a con- cept that I heartily support: multidisciplinary care for pa- tients with digestive disorders. What great fun to read this book. I have known Peter for almost 4 decades—“subscribing” to his multiple edi- tions of Practical Gastrointestinal Endoscopy with Chris- topher Williams and Annual of Gastrointestinal Endos- copy, edited with Guido Tytgat. However, it is the scope and geography in this book that makes it most readable. After all, having Nagi Reddy as your “endoscopic grand- son” and John Cunningham describe the unfathomable game of cricket helps put the last half-century of our endoscopic revolution into perspective, a perspective with a harmonizing face. Richard A. Kozarek, MD, FASGE Digestive Disease Institute Virginia Mason Medical Center Seattle, Washington, USA University of Washington School of Medicine Seattle, Washington, USA Inflammatory Bowel Disease: An Evidence-based Practical Guide. Alisa L. Hart and Siew C. Ng, editors. Shrewsbury, UK, TFM Publishing Ltd, 2012. ISBN: 978-1-903378-82-3 As the name of the book suggests, it is meant to be a practical guide to the management of inflammatory bowel disease (IBD) for day-to-day man- agement of patients with IBD and is aimed at internists, gastroenterolo- gists, and other providers including trainees and mid- levels. The book comprises 3 parts; the first 2 deal with ulcerative colitis and Crohn’s disease, respectively, and 860 GASTROINTESTINAL ENDOSCOPY Volume 76, No. 4 : 2012 www.giejournal.org
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BOOK REVIEWS
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The Tunnel at the End of theLight: My Endoscopic Journeyin Six Decades.Peter B. Cotton. Seattle, WA:CreateSpace (An AmazonCompany) (self-publication).2011. ISBN: 1452820465.
Although I have written Forewordsand reviewed numerous medical textsfor journals in my professional career,
it has been more than 50 years since I have done a bookreport. It is my great pleasure to do just that: a book reporton Peter Cotton’s The Tunnel at the End of the Light: MyEndoscopic Journey in Six Decades. Remember, a bookreport revolves around 7 facets of a story: character, plot,setting, theme, point of view, style, and tone.
So here, in no particular order, is my report. The pointof view is uniquely first person, although there are enoughanecdotes from such luminaries as Tony Axon, RobHawes, John Cunningham, and Lars Aabakken to makeyou realize that this is not an endoscopic Everyman’sjourney and that Peter and his colleagues and traineeswere living in the ether and creating, not simply living in,the endoscopic practice of the day. Theme? The theme(evolution of endoscopy)—from the gastrocamera in the1960s to Dr. Cotton’s first endoscopic sphincterotomy inthe mid-1970s. Those of you who believe in infallibilitywill be reassured when you read that his first sphincterot-omy was associated with a “zipper phenomenon,” and histhird patient went to surgery with a stone basket impactedin the biliary tree. The text includes subsequent endo-scopic developments, particularly in ERCP, and concludeswith 3 predictions: that endoscopes, if not endoscopists,will become increasingly intelligent; that procedures willincreasingly be done by nonphysicians; and, finally, that“none of my predictions will come true . . . and that someother paradigm shift will deflect our profession in otherunexpected directions.”
The style and tone of the book are matter-of-fact, light-hearted, but reflectional, and much of this reflection isbased on Peter’s last ERCP performed on Friday, May 13,2011, as well as having achieved “his biblical span.” For-tunately, the latter is not yet true, and Peter Cotton and histrainees remain a dominant force in endoscopic practicethroughout the world today. Joseph Leung, Rob Hawes,John Baillie, and Tony Speer are only a few of his traineesfrom the Middlesex, as was Todd Baron at Duke and PaulTarnasky at MUSC, which brings me to setting, which notonly encompasses the time in London, Duke, and MUSC,but his own worldwide forays, including the world’s first
live endoscopy course. Hong Kong? Repeatedly. India? u860 GASTROINTESTINAL ENDOSCOPY Volume 76, No. 4 : 2012
astroenteritis (his lament) notwithstanding. Europe? As aontemporary of Demling, Classen, and Cremer. Iran toreat a Shah. Malaysia to forego endoscopy but still go pigunting with a prince. Saudi Arabia to remove a stonerom a king.
The plot is simple: the evolution of endoscopy at a timehen diagnostic radiology and surgical therapy reigned
upreme. The story is comprehensive, but is not complete.t evolves from a diagnostic specialty to one that hasllowed us to treat bleeding, resect or ablate potentiallyalignant tissue, dilate luminal obstructions, and treat a
ariety of pancreaticobiliary diseases. It may evolve furthernto deeper forays into interventional practice “surgicalrajectory”), and Peter gives credit to his surgical col-eagues throughout his career. He also reinforces a con-ept that I heartily support: multidisciplinary care for pa-ients with digestive disorders.
What great fun to read this book. I have known Peteror almost 4 decades—“subscribing” to his multiple edi-ions of Practical Gastrointestinal Endoscopy with Chris-opher Williams and Annual of Gastrointestinal Endos-opy, edited with Guido Tytgat. However, it is the scopend geography in this book that makes it most readable.fter all, having Nagi Reddy as your “endoscopic grand-on” and John Cunningham describe the unfathomableame of cricket helps put the last half-century of ourndoscopic revolution into perspective, a perspective withharmonizing face.
Richard A. Kozarek, MD, FASGEDigestive Disease Institute
Virginia Mason Medical CenterSeattle, Washington, USA
University of Washington School of MedicineSeattle, Washington, USA
Inflammatory Bowel Disease:An Evidence-based PracticalGuide.Alisa L. Hart and Siew C. Ng, editors.Shrewsbury, UK, TFM Publishing Ltd,2012. ISBN: 978-1-903378-82-3As the name of the book suggests, itis meant to be a practical guide to themanagement of inflammatory boweldisease (IBD) for day-to-day man-agement of patients with IBD and isaimed at internists, gastroenterolo-
ists, and other providers including trainees and mid-evels. The book comprises 3 parts; the first 2 deal with
lcerative colitis and Crohn’s disease, respectively, andwww.giejournal.org
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Book Reviews
the last part focuses on clinical issues related to IBD.This is not a textbook on IBD and purposefully providesonly limited information on the epidemiology, etio-pathogenesis, and clinical features of IBD. Instead, itsfocus is on the practical management and therapeuticsof common clinical presentations in these patients. Eachchapter is organized with algorithmic charts and keypoints. The information is very much evidence based,and the authors succinctly summarize the newer thera-peutic trials and put them in the proper perspective andrelevance for the clinicians. The colorful charts andfigures are very intuitive.
There are a few areas that could have been improved.Some chapters have too many references, which is notrequired in a practical guide. Some clinical situations arecommon enough to warrant more attention. Extraintestinalmanifestations of IBD, particularly the area of primarysclerosing cholangitis, needed more emphasis. In some
chapters, authors strayed away from an algorithmic ap-www.giejournal.org V
roach of management. A vast majority of the authors arerom the United Kingdom, and understandably they pres-nt a British view of this disease, which may be somewhatifferent from what is common practice in North America.Overall, as a nonexpert in IBD, I find that this book
ulfills a much needed quick reference guide to evidence-ased management of IBD. I do like its algorithmic ap-roach and am sure that providers particularly those withimited experience in IBD, will find this book very helpful.n many institutions and practices, at least in the Unitedtates, day-to-day management of patients with IBD isrovided by fellows, mid-levels, and physician extenders,nd I am confident that they will find this treatise anxcellent resource for providing the best and latest in theare of their patients with IBD.
Ananya Das, MDArizona Center for Digestive Health
Gilbert, Arizona
GIE on Twitter
GIE now has a Twitter account. Followers will learn when the new issues areposted and will receive up-to-the-minute news as well as links to author inter-views, podcasts, and articles. Search on Twitter for @GIE_Journal and follow allof GIE’s tweets.
olume 76, No. 4 : 2012 GASTROINTESTINAL ENDOSCOPY 861
