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William R. Brugge, M.D. is the director of the Gastrointestinal Endoscopy Unit at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School. He is the co-author of the recent New England Journal of Medicine reviews of Upper Gastrointestinal Endoscopy and Pancreatic-biliary Endoscopy.
Dr Brugge has pioneered the use of endoscopic ultrasound (EUS), particularly in pancreatic diseases. In addition to his work on the staging and diagnosis of pancreatic cancer, he is directing a large multicenter investigation on the use of EUS for the diagnosis of pancreatic cystic neoplasms.
Dr Brugge's interest in pancreatic disease dates back to his original work on pancreatic function testing in 1980. At the University of Colorado, as a fellow in gastroenterology, he described the pancreatic Schilling test (Gastroenterology 1980; 78: 937-49). Using the principle of R protein degradation by pancreatic proteases, the test provided a non-invasive method for measuring protease secretion in a variety of pancreatic disease states. Along the same lines, Dr Brugge also described multiple secretory abnormalities in patients with acute and chronic pancreatitis while on the faculty of the State University of New York at Stony Brook. He has authored 26 research articles.
His interest in ultrasound as an imaging modality in pancreatic biliary diseases originated in his work on biliary lithotripsy at the Hospital of the University of Pennsylvania where he was the clinical director of gastroenterology.
Using ultrasound, he described the effects of lithotripsy and gallstone dissolution on gall-bladder motility. With the demise of biliary lithotripsy in the United States, he sought training in endoscopic ultrasound by traveling to Europe and Japan. He quickly became enthralled with the ability of EUS to image the pancreas and direct biopsies.
When he is not in the Massachusetts General Hospital Endoscopy Unit, he enjoys playing tennis, running the Boston marathon and making instructional EUS videotapes. In the coming two years, he will be seeking additional training in clinical investigation and interventional EUS, supported by a two-year American Digestive Health Foundation career development award.
- What made you decide to become a gastroenterologist?
- My original attraction to gastroenterology was the intricate system of neuro-hormonal control of pancreatic secretion. I was fascinated by the dual and overlapping systems for the pancreas and the stomach. The introduction of powerful agents for the control of gastric secretion was a confirmation in my mind that a thorough understanding of physiology would help us design specific drugs for the control of secretions. Later, I would learn to enjoy caring for patients with "simple" diseases, such as peptic ulcer disease, gallstones, and inflammatory bowel disease. As endoscopy became the primary tool for investigating patients, I became fascinated with endoscopic imaging and therapy.
- Who was the teacher you admired the most?
- In my third year of medical school, I decided to become a gastroenterologist because of the lectures given by Raj Goyal. He made gastrointestinal physiology beautiful. Later, Gene DiMagno's lectures on pancreatic physiology and diseases were a major inspiration for me and I decided to focus on diseases of the pancreas and biliary system.
- What is the most important fact that you have discovered?
- I have discovered very little on my own. Much of my work followed the investigations of other clinicians in pancreatic diseases. I am particularly proud of my original work on the development of the pancreatic Schilling test. My mentor designed the test and I carried out the clinical testing of it with other tests of pancreatic function. Although the test was never developed commercially, it stands today as one of only few non-invasive tests of pancreatic exocrine secretion.
- What is the biggest mistake that you have made?
- The biggest mistake I ever made was not committing myself to an academic career during my GI fellowship and in my first job. Fortunately, as I spent a difficult year in a clinic, I quickly realized that my true passion was in academic work. Quickly, I secured a position at a university hospital and I have never looked back. It may have been a mistake, but it also helped me commit to academic medicine.
- What is your unfulfilled ambition?
- My unfulfilled ambition is to compile and write a definitive color atlas on endoscopy and EUS. Not enough time for this yet.
- What is your greatest regret?
- My greatest regret is letting my tennis game suffer because of the pressures of my academic career. Perhaps some day I will take up this great sport again.
- How do you relax?
- I relax with my lovely wife by exercising (biking, tennis, swimming), playing musical instruments (piano, clarinet, recorder), and making instructional video tapes for EUS.
- What is your favorite sport?
- My favorite sport is playing tennis, particularly with my son or brother. For watching, I enjoy watching the New England Patriot football team lose every week.
- What is your best place in the world?
- The best place in the world is my home in Brookline, MA, with my wife. Other than Brookline, we enjoy Bermuda very much, particularly for scuba diving.
- What is your favorite film?
- My favorite film is "2001". I enjoy tension-filled films with a high-tech connection. Along the same lines, I enjoyed "Hunt for Red October".
- What car do you drive?
- I drive a BMW Z3 convertible coupe. Very nice.
- What is your best electronic 'toy'?
- I have many, many, many electronic toys. My favorite is the MAC computer with a video-editing module. Other than that, I enjoy electronic cameras, including video.
- What book are you reading at the moment?
- I currently reading a book called "The Informant", a story of the uncovering of corporate sabotage at ADM, a large multi-national corporation.
- Why did you get in involved in GastroHep.com?
- I enjoy using the Internet for teaching, communicating among colleagues, and improving the visibility of GI clinical research. I think GastroHep.com is a great opportunity for the GI community. I look forward to working the editors.