Author: Peter Cotton

Time to retire the labels “Medicine” and “Surgery” after 400 years

When I was a young doctor, a long time ago, it was not difficult to distinguish medical physicians from surgeons. Physicians, at least in England, wore smart pin-striped suits and carried stethoscopes. They managed patients with sympathy and medicines. Surgeons wore pyjamas and gloves, and looked for things to connect, drain or remove. The distinctions…
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Do you have a two-bit pancreas? You well might…better read on.

About 8% of people, at least in Western countries, are born with the pancreas in two pieces, so called “pancreas divisum”. It is about as common as left-handedness, and ten times that of red hair. How come, and who cares? Some technical stuff to get started. The human pancreas is formed from two parts which…
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Do not miss Nagi Reddy this Wednesday

Nagi Reddy, superstar founder and chair of the Asian Institute of Gastroenterology in Hyderabad will zoom speak on ESWL of Biliary and Pancreatic stones at our weekly MUSC grand rounds this wednesday at 7 am EST. He has by far the greatest experience in the world. Not to be missed…. Access free at

My Favorite city (and International meeting)

I am fortunate that my career has taken me to more than 50 countries. I am often asked for my favorite city, which one I would most like to revisit. Leaving aside my home now in USA, and my roots in England, my choices are much influenced by where I have friends (especially those with…
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A Boxing day story with American sub-titles

Boxing day was cool (10 degrees), so I wore plus twos over my pants, added a jumper and topped it off with my mackintosh, wellies and balaclava. There was not enough snow for sledging, so I left my toboggan behind. The translation. Boxing day. The day after Christmas, when it was traditional in Britain for…
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Have I GOTTEN all American now?

One of my readers (I hope that there may be more than one) chastised me recently for using the American word “gotten” in my latest blog. It is not in common usage in my native England, although some do refer to “ill-gotten gains”. Maybe “forgotten” and even “woe-begotten” are also somehow connected? Who said “two…
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What happened to the British Endoscopy Society 40 years ago?

Many gastroenterologists practicing today may not know that there was once a British Society for Digestive Endoscopy (BSDE). It folded in 1980. What was it, why, and what happened to it? The flexible endoscopy revolution started in the late 60s and blossomed in the 70s. Before that happened, the British Society of Gastroenterology (BSG) had…
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EPISOD revisited …..and validated, thank you Zach

My gastroenterologist readers, if any, (thank you) may recall that I led the team that developed a research study called EPISOD (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). The results were published in 2014 (Cotton PB, Durkalski V, Romagnuolo J, et al. A multicenter, randomized trial of endoscopic sphincterotomy for suspected sphincter of…
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New book about Fred the friendly snake

Delighted to confirm that my 6th book about Fred and friends is now available at booksellers and Amazon in hardback, soft cover and ebook versions Signed and personalized copies are available here on this web site Enjoy their fun adventures, including a scary moment when white water rafting

A medicine called “worse than cats”

Some may remember that I posted a piece called “Thinking about placebos and healing”. I thought it was just a few months ago, but it was actually in November 2018. It was stimulated by my surprise and confusion about the fact that most patients undergoing sham procedures in my EPISOD research study did remarkably well,…
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