By Vanessa Shami, MD
The Man who has touched the lives of many… AKA “The Big Kahuna”
To those who know Dr David Peura only superficially, he is a renowned gastroenterologist with numerous accomplishments at UVA and world-wide. For those who have the privilege of knowing him well, descriptors such as “Teddy Bear” and “The Big Kahuna” come to mind. How did this man, who has touched the lives of so many, and is revered as The Gentle Giant for his patient care, teaching, and research, come to lead the way for us?
The foundation was laid during his years as an undergraduate student at the University of Vermont, as two seminal events shaped the rest of his life: he met and married Kristin, his lovely and supporting wife, and he enrolled in ROTC. He became a medical student at Letterman Army Medical Center in San Francisco and then completed gastroenterology fellowship at Walter Reed Army Medical Center in Washington DC. There, he rose through the ranks quickly becoming Chief of Gastroenterology in 1986.
He held the rank of Colonel and was an Associate Professor of Medicine at the Uniformed Services University of the Health Sciences. While at Walter Reed he received several awards, including the Eddie Palmer Endoscopy Award for Excellence in Endoscopic Research and Training, and “A” Professional Designer Award for Excellence in Clinical and Professorial Work. Dr Peura is a pioneer in the field of gastroenterology and endoscopy. He was among the first in the United States to place esophageal stents, and was widely recognized as an expert in ERCP, laparoscopy, and complex stricture dilation. Before moving from Walter Reed to the University of Virginia, Dr Peura was awarded the highest recognition a departing physician can receive – the Legion of Merit – in recognition of his outstanding contributions to military Gastroenterology.
Then came the transition to civilian life . . .
Dr Peura easily moved into a civilian academic career at UVA. He came on board as both the Director of Clinical Services and the Medical Director of the Endoscopy Unit. He became the cornerstone of leadership in the Division and soon was recognized as a formidable academic “triple threat”: inquisitive clinical researcher, esteemed clinician, and gifted teacher. These assets, along with his substantial physique gave rise to a respectful title: “The Big Kahuna”
Dr Peura easily moved into a civilian academic career at UVA. He came on board as both the Director of Clinical Services and the Medical Director of the Endoscopy Unit. He became the cornerstone of leadership in the Division and soon was recognized as a formidable academic “triple threat”: inquisitive clinical researcher, esteemed clinician, and gifted teacher. These assets, along with his substantial physique gave rise to a respectful title: “The Big Kahuna”.
Anyone evaluating the scholarly contributions to gastroenterology is aware of his many publications and the breadth of his research endeavors. His clinical interests focused on acid-related disorders, NSAID-induced gastropathy, and Helicobacter pylori. He began a rich collaboration with Dr. Barry Marshall, and together with a host of GI Fellows, their research covered basic science and clinical issues related to H. pylori. When Dr Marshall was awarded the Nobel Prize for medicine in 2005, he invited David and Kristin to Oslo to participate in the week-long festivities.
Dr Peura’s clinical research endeavors have been an inspiration to many. His enthusiasm for novel ideas made him a favorite among students, residents, and GI fellows who regularly sought his advice about research projects. As a medical student, I clearly recall him giving Grand Rounds on H pylori. I was so intrigued by his presentation that I approached him after the talk and later we worked together on a research project evaluating gastric juice H. pylori colonization. Ultimately, Dr Peura is the reason I went into gastroenterology and stayed at the University of Virginia. Dr Andrew Wang recalls that Dr Peura mentored and sponsored him to go to Bogota to learn ESD, and which has brought this technology to UVA. Thanks to Dr Peura’s mentorship, Dr Wang is now one of the national leaders in this technology.
To further cultivate clinical research at the University of Virginia, Dr Peura served as chair of the investigational Review Board for Health Sciences Research from April 1997 to June 2003. During his tenure, the IRB grew from an administrative staff of one secretary to a thriving organization with many professional level positions. Members of the board remember Dr Peura as a powerful advocate for the rights of research subjects.
During his career, Dr Peura has been the recipient of numerous national awards which include the AGA’s Distinguished Educator Award and the Mentor Honoree Award from the Foundation for Digestive Health and Nutrition (FDHN). He served with distinction on many committees in the AGA, and in 2005 he was elected the 100th President of the AGA. In 2011 Dr Peura was awarded the Julius M. Friedenwald Medal, which is the highest honor bestowed by the American Gastroenterological Association Institute. It is awarded in recognition of lifetime service, achievements, and contributions to the AGA and the field of Gastroenterology.
Students and fellows who have had the privilege of training with Dr Peura will always think of him as our best clinical teacher and mentor. He taught us to be well-rounded gastroenterologists: to be skilled endoscopists, to be meticulous and to use common sense when working up a patient, and to have compassion when dealing with illness. Rounds were always a pleasure. The Colonel was always punctual and well organized. The fellows competed for his Tuesday Morning clinic or fellows Clinic. These are some of the “Peuraisms” that his past and current fellows and colleagues recall:
“I wish God made you with a zipper so I can open you up and see what is going on.”
“If I could hit you over the head with a magic wand to make your symptoms go away I would.”
“Our goal is that you have more good days than bad days.”
“Don’t poke a skunk.”
“When is the last time a manometry changed what you did?”
Outside of medicine, Dr Peura is a “foodie” and a great cook – he has even published his own cookbook. Many of us have had the fortune of being invited to Barboursville vineyard for Mother’s Day brunch or Easter dinner. And Dr Peura never wanted anyone to be alone for the holidays. He and Kristin would always invite fellows on GI service to his home to celebrate and enjoy a fantastic holiday meal. In addition to food, he often smiles when he talks about his lovely grandchildren and kids.
For so many of us whose lives and careers he has influenced, Dr Peura is, and will always be, the Exemplar Par Excellence of a brilliant clinician, dedicated teacher, accomplished researcher, mentor, devoted husband and father, a skilled cook and a modest teddy bear who cares about humanity. On behalf of those who have had the privilege of working with him directly, there are no words to explain how fortunate and thankful we are. Dr Peura, you are a true and great gift, and although you will be missed sorely, you are ingrained in every fiber of our careers.