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Journal of Pediatric Gastroenterology & Nutrition:
Special Features

Presentation of the 2003 NASPGHAN Harry Shwachman Award to Dr. Peter R. Durie

Hamilton, Richard

Free Access

I am proud to introduce Peter Roy Durie to you as the recipient of the 2003 Shwachman Award. A productive, influential researcher, a fine physician, a respected educator and leader, and a passionate advocate, Peter more than meets the criteria for this prestigious award. Time and space permit only a selected account of his many achievements.

In research, the importance and productivity of Peter's work are reflected in his more than 150 refereed papers, his 27 books and book chapters, his umpteen review articles, guest lectures, and visiting professorships, and his consistent success with major research funding agencies. Working at the interfaces between basic pathophysiological science, and both clinical studies and ultra specialized genetic explorations, Peter's achievements have had a major and far reaching impact.

In his 23 year career as an independent investigator at the Hospital for Sick Children in Toronto, his central scientific focus has been the exocrine pancreas. In patients with cystic fibrosis, he and his team have defined the pathophysiological basis for exocrine pancreatic insufficiency (1), demonstrated that patients with pancreatic insufficiency differ genetically from those with pancreatic sufficiency (2), defined the relationship between malnutrition and poor survival (3), demonstrated the relationship between genotype and phenotype which was a key asset in the identification of the principal genetic defect in CF (4), and recently collaborated in the identification of the first putative modifier gene for meconium ileus (5).

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FIGURE. Peter R. Dur...
FIGURE. Peter R. Dur...
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In a large group of Shwachman-Diamond patients, his studies have provided the key ingredient leading to the discovery of the genetic defect in that disorder. Successful identification of the Shwachman Diamond gene was announced this spring in their Nature Genetics paper (6).

These and other research achievements have given Peter a high profile internationally; he is Pediatrics' version of Mr. Exocrine Pancreas.

Throughout his career, involving several “full-time” responsibilities simultaneously, Peter has maintained a large commitment to patient care. He is an excellent physician—well informed, communicative and compassionate. With one foot in the clinical camp and the other in research, Peter's highly regarded teaching has succeeded in bringing an up-to-date, in-depth scientific perspective to the bedside—not an easy challenge these days. He has been a mentor for more than 24 fellows, pediatric residents and medical students. In addition to these medical teaching responsibilities, Peter has always had an added drive to share his knowledge with colleagues in other professions and with lay groups. His consistent and important service in various capacities with the Canadian Cystic Fibrosis Foundation and the various Shwachman Diamond support groups in Canada and throughout the world have gone well beyond what might be expected. He directed the Toronto GI training program for 9 years.

Chosen for several positions of leadership, Peter hasn't just filled these jobs, he has really served in them. He has held several posts in our society including the Presidency in 1990-1992. He and his colleagues were instrumental at that time in guiding a rapidly growing NASPGAN into the modern era. He was a key member of the group of editors who launched the text Pediatric Gastrointestinal Disease and he is leading national and international studies aimed at identifying modifier genes in cystic fibrosis. A full professor at the University of Toronto since 1991, Peter was named Head of the Division of Gastroenterology at the Hospital for Sick Children in 1993. He was instrumental in merging the Gastoenterology and Nutrition Divisions in Toronto and served as Director of the Combined Division until 1998. Since 1998, he has been Head of the Cystic Fibrosis Research Group of the Research Institute at the same hospital.

I'll deal briefly now with Peter's role as an advocate. Always an effective spokesman for his colleagues, his patients, his students and staff, Peter's courageous recent stand in support of academic freedom and integrity in research, when they were threatened in his own institutions, warrants our gratitude and respect. At great cost to himself, he has defended and supported a colleague who ran afoul of very powerful forces in the pharmaceutical industry and in her institution; this lengthy conflict has exposed him to a vicious, litigious confrontation which few in this room could have withstood (7). This matter has already generated some very positive outcomes including more stringent editorial policies for many of our major journals and more effective regulation of industry-sponsored research in our institutions. Without Peter's selfless, unflinching involvement, the issues which generated these changes would have been swept under the carpet long ago.

Before concluding, I shall try, in a few words, to explain to you how this fellow arrived where he is today. It's a story of some nurture and some nature, some good management and some good luck. Peter was born in Kenya and grew up there on his family's farm looking over the Rift Valley, the natural beauty of which was featured in the film, “Out of Africa ”. The Durie family, obviously, was a very enlightened one. With the dangerous turmoil leading up to Kenyan independence, they returned to England, turning over their farm and home to local people. Peter enrolled in the University of Wales, graduating with an honours degree in Zoology in 1966 after which he immigrated to Canada where he first worked as a teacher. A year or so later—here is where good luck enters the story—he persuaded Judy to join him from England and they married. A kindergarten teacher, Judy is a special person—caring, kind, compassionate and forthright. She has kept Peter grounded through the turmoil that enveloped his professional life in recent years and she gets my 2003 heroine award. Peter and Judy have 2 sons, Damian and Tristan; it won't surprise you to learn that they are a talented, bright and independent-minded pair.

Continuing with Peter's early life, he then enrolled in the new, exciting McMaster Medical School which was doing what new institutions should but rarely do – innovating. For example, their new curriculum departed dramatically from the conventional model of the day, emphasizing logical thought rather than memory, and they welcomed aging school teachers like Peter Durie, and others who previously would have had little access to medical school. McMaster has produced a generation of freethinking trouble-makers who have had a major and generally positive impact on Canadian Medicine. Toronto was lucky to latch on to a constructive member of that group when Peter joined the Pediatric residency program at the Hospital for Sick Children in Toronto in 1974.

A final example of both good fortune and good management occurred after Peter accepted a fellowship position in the Toronto GI Program and came under the influence of Gordon Forstner. Gordon and Janet's lab was a highly stimulating research environment and he was an inspiring mentor for Peter. A formidable team evolved with Gord, Peter, Kevin Gaskin, Mary Corey and many others and Peter never looked back. This summer, Peter, Judy, their boys and Peter's mother returned to their former home in Kenya for the first time and to an enthusiastic, emotional welcome. The Durie home is now a small hospital/clinic and the school Peter's mother founded now has 1000 students.

In closing, I want you to know that beneath Peter's serious demeanor, there lurks a bit of a rascal; some evidence follows. In the early days in Toronto, we had a lot of fun and plenty of lively parties. One evening in Toronto, with wet snow falling, we were all invited to Marc and Delia Rhoads' home for an Hawaiian evening. Never one to go half-way, Peter showed up in a grass skirt, with various island accoutrements. Everyone had a great time, with plenty of good food and drink after which, as was the custom in those times, we piled into our cars to drive home. The Toronto Police had just launched a program aimed at curtailing drinking and driving, which included spot checks and guess who was stopped? The image of Peter walking a straight line in bare feet and grass skirt in the snow on a major Toronto thoroughfare still gives us chuckles. By the way, he did pass that test as he has passed life's other tests.

I shall conclude by expressing a view that everyone who knows Peter Durie would share. This very accomplished, committed, quiet, compassionate, courageous colleague and friend is a huge credit to our Society. Harry Shwachman would be absolutely delighted with the choice of Peter Durie as this year's Shwachman Awardee.

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REFERENCES

1. Stormon MO, Durie PR. Pathophysiologic basis of exocrine pancreatic dysfunction in childhood. J Pediatr Gastroenterol Nutr 35:8–21, 2002.

2. Durno C, Corey M, Zielenski J, Tullis E, Tsui L-C, Durie P. Genotype and phenotype correlations in patients with cystic fibrosis and pancreatitis. Gastroenterology 123:1857–1864, 2002

3. Pencharz P, Durie PR. Pathogenesis of malnutrition in cystic fibrosis and its treatment. Clinical Nutrition 19:387–394, 2000.

4. Kerem E, Corey M, Kerem BS, Rommens J, Markiewicz D, Levison H, Tsui L-C, Durie PR. The relation between genotype and phenotype in cystic fibrosis: analysis of the most common mutation (ΔF508). New Engl J Med 323:1517–1522, 1990.

5. Zielenski J, Markiewicz D, Yuan X, Corey M, Patel M, Liu X, Kawasoe J, Durie P, Tsui L-C. Analysis of gene candidates for cystic fibrosis modifier 1 (CFM1) associated with meconium ileus in cystic fibrosis patients. Poster presentation. Sixteenth Annual North American Cystic Fibrosis Conference, New Orleans, Louisiana, October 3-6, 2002. Pediatric Pulmonology Supplement 24:226 (Abstract 137), 2002.

6. Boocock GRB, Morrison JA, Popovic M, Richards N, Ellis L, Durie PR, Rommens JM. Mutations in SBDS are associated with Shwachman-Diamond syndrome. Nature Genetics 33:97–101, 2003.

7. Somerville MA. A postmodern moral tale: the ethics of research relationships. Nature Reviews. Drug Discovery 1:316–320, April 2002.

© 2004 Lippincott Williams & Wilkins, Inc.

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