In this podcast episode, Peter B. Cotton, MD, FRCP, FRCS, professor of medicine at the Medical University of South Carolina, discusses the development and invention of the ERCP procedure, the innovation of digestive disease centers and more.

• Intro :02
• Welcome to this episode of Gut Talk :23
• About Cotton :23
• The interview :37
• Where did you grow up? :37
• How did you get interested in gastroenterology? 1:38
• That [trainees wanting to come to the endoscopy lab and not go to the basic science lab] must have put you in a difficult situation at times. How did you navigate that? 6:12
• Could you tell us a little more about what that was like, from an operational perspective, of overseeing the endoscopy center, and perhaps how that role of operating in an endoscopy center as a trainee impacted you innovation in ER cepheid advanced endoscopy? 7:03
• How flexible is the shaft of those initial endoscopes, and did you use sedation? 8:49
• Is it a correct characterization that the building and innovation and inventions at this early stage in your career was really just to get the job done as opposed to you seeking out a role that was focused on inventing? 9:56
• You were the only gastroenterologist at Middlesex for many years, correct? 10:52
• How did that transition to Duke occur? … Did that [clinical load] drive a lot of your decision-making or was it more than that? 11:50
• Where did the ERCP start? 15:11
• How were you able to collaborate with other gastroenterologists and radiologists and surgeons? …What was that collaboration between these investigators that were really trying to drive this procedure forward like back in the Sixties and Seventies? 20:23
• Were you able to pass endoscopic videos back and forth, or was that not really the way cases were shared? 21:36
• About the Digestive Disorder Center at NUSC and Digestive Diseases Centers 24:43
• Has it worked out the way you had envisioned? … What are the potential downfalls as people think about that type of Digestive Health Center model? 27:43
• Summary of Cotton’s memoir, The Tunnel at the End of the Light: My Endoscopic Journey in Six Decades 31:34
• You also have written books for young children as well. What prompted you to writing and teaching one of the most complicated procedures to your book about “Fred the Snake”? 32:10
• What are you most excited about with regards to opportunities facing younger gastroenterologists moving forward, and what advice would you give them to seize those opportunities? 34:54
• Thank you Peter 36:42
• Thanks for listening 36:58

Peter B. Cotton, MD, FRCP, FRCS, is professor of medicine at the Medical University of South Carolina.

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Disclosures: Berry and Chey report no relevant financial disclosures. Cotton reports no relevant financial disclosures.