Remembering Peter

It is difficult to know where to begin when writing about Peter, because there is so much I would like to say about him, but the words cannot convey my deep respect and the incredible loss that I feel. I worked with Peter on a number of guidelines over the years, and I feel very privileged to have known him and worked with him.

What I will remember most about Peter is his extraordinary mind and the way that his thinking could take him in directions one could not expect. Peter seemed to have an ability to look at something that most of us would simply take for granted and turn it into “but we haven’t considered this…”. That critical thinking was one of the things I found so fascinating about him.

I remember the first occasion when Peter completely surprised me. I was working on COVID-19 guidelines, which were sent for a public consultation. Peter wasn’t a part of this working group. He was too busy setting up a temporary hospital for COVID-19 patients at the start of the pandemic. He did, however, respond to a consultation. We described two studies which discussed the same outbreak occurring in a seafood restaurant in China. One argued that this outbreak was the evidence of an airborne spread, another that it was droplet. Peter responded to this and came up with a perfectly plausible scenario that nobody else had thought of. “The elimination of “fomite” transmission in both these publications on the same incident is poorly described, essentially “no evidence was identified”. What they do not consider is the role of waiters’ hands, collecting used items and then distributing food, cutlery, and crockery. Some used items could be highly contaminated with saliva, particularly if shellfish or shell crab were eaten. It is reasonable that the same waiter(s) attended all three tables and attending to a group of tables in a line one after another is a reasonable thing to do. Contamination of waiters’ hands seems likely; hand hygiene between collecting used items and distributing new items seems unlikely”. I remember thinking “wow!”, it was a lightbulb moment. He not only knew a lot, but he could also see possibilities that other people hadn’t even considered.

Some of his research was weird and wonderful (his words). One paper from the 1980s especially caught my attention and Peter was telling me about it. He worked with his colleagues on an experiment investigating the dispersal of bacteria and skin particles from the human body after showering and after applying skin lotion. The study found that lotion dramatically reduced the amount of bacteria and skin scales released into the air. Peter mentioned that even though it worked well, the lotion was not well accepted by the surgeons. And he acknowledged that this was still one step removed from preventing infections. He was pragmatic like that. What makes the paper particularly memorable is the discussion of the various ways people had already tried to stop us shedding bacteria into the operating environment. These included tightly fitting neoprene sponge-rubber underpants and Gore-Tex clothing, among other approaches.

There is something very Peter-like about that research. The subject matter might initially make you smile, but underneath it was a genuine question about how microorganisms spread from people into the environment and how we can prevent it. That combination of curiosity and practicality made Peter such an interesting scientist.

Working with Peter was also special to me because there was a genuine mutual respect for our different areas of expertise. I trusted his judgement completely when it came to IPC, while Peter very much respected my judgement as a guideline methodologist. That meant a great deal to me. Only a few months ago, I came across a LinkedIn discussion about a study reporting fewer bacteria on disposable than reusable surgical caps. It sparked calls to move towards disposable caps, overlooking both the evidence that already existed and the work of people addressing sustainability in IPC. My immediate reaction was to think of Peter. A few years earlier, we had worked together on a guideline examining rituals and behaviours in operating theatres, which concluded that the type of surgical cap did not affect infection or theatre contamination. I also remembered Peter’s earlier work on bacterial shedding and skin lotion and wondered whether sebum on reusable caps might help retain bacteria on their surface. I emailed Peter, starting with “I think you will understand my frustration.” He did. More than that, he agreed with my reasoning, even though we both acknowledged that suggesting potential benefits of a dirty cap might not sit comfortably with IPC principles. He also pointed out that surgeons should be cautious about making microbiological interpretations in areas they do not fully understand. Having someone whose scientific judgement I respected so enormously engage seriously with my reasoning and tell me that I had got it right, made me incredibly proud of the work I was doing. What came from that conversation was the wonderful opportunity to write a blog. I am grateful that we had the chance to make something meaningful and memorable together. Unlike the many guidelines we worked on, this is something that feels uniquely ours, rather than another institutional piece of work.

There is another piece of work that has become particularly meaningful to me. After I left HIS, I continued working with on the nearly finished guideline. I had already been involved in the work, and I knew how much remained to be done to get it through to completion. I was very glad to be able to help the working party see it through. This guideline was Peter’s baby. He initiated the work back in 2012, when the guideline needed an update. He was its chair initially and contributed an enormous amount of work to it before he retired. The guideline was ultimately accepted for publication less than two months before Peter died. The last email I received from Peter was his response to the news: “Great news indeed, Can’t quite believe it’s actually happened.” It is difficult to read those words now without knowing that they would be the last email I received from him. At the time, it was just Peter being pleased that something he had worked on for so long had finally crossed the finish line. I am pleased that I was able to be part of getting this work there.

Peter was a brilliant scientist and an extraordinary mind, but I don’t think that this is all that made him special. He was also a genuinely wonderful human being. There will be plenty of moments in the future when I will read something and think that he would understand my frustration. I will desperately miss Peter. But I also feel very fortunate that our paths crossed, and I will cherish the time we had working together.